bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of transcription factor WT1 on triple-negative breast cancer metastasis through PFKFB4-mediated glycolysis.
Authors: Zhao Tingting , Zhou Yuqin , Wu Xiujuan , Peng Zaihui , Gao Pingping , Sun Na , Zhang Yi , Qi Xiaowei
Published: June 2024

e13145

Background: Triple-negative breast cancer (TNBC) is the most aggressive subtype of breast cancer with a high probability of metastasis as well as a lack of specific targets and targeted therapeutics. Preliminary study suggested that Wilms' tumor gene 1 (WT1) is highly expressed in breast cancer patients with poor prognosis and may promote TNBC metastasis, but the underlying mechanism remains poorly defined. Methods: WT1 expression was evaluated by immunohistochemistry (IHC) in breast cancer patients. Kaplan–Meier survival analysis was performed to assess the prognostic significance of WT1 expression. WT1 was silenced in MDA-MB-231 and BT549 cells or overexpressed in HCC1806 cells. qRT-PCR and Western blot were used to detect the WT1 expression in tissues and cells. Wound healing assays, transwell assays and 3D spheroid assays were used to examine the migration and invasion abilities in TNBC cells. The lung metastasis model of mice was used to evaluate metastasis of TNBC in vivo. Chromatin immunoprecipitation followed by next-generation sequencing (ChIP-seq) and transcriptome sequencing (RNA-seq) were performed to find PFKFB4, a downstream target gene for WT1. ChIP-PCR and dual-luciferase reporter assays were used to explore the transcriptional regulation of PFKFB4 by WT1. Seahorse XF glycolysis stress assay, glucose uptake assay, and lactate production assay were used to investigate the role of WT1 in regulating glycolysis metabolites. Results: WT1 was highly expressed in TNBC and correlated to poor prognosis in TNBC patients. Functional assays revealed that WT1 promoted TNBC cell metastasis in vitro and in vivo. Our mechanistic investigations demonstrated that WT1 promoted TNBC cells migration and invasion by transcriptionally activating the expression of PFKFB4.This action leaded to increased glycolytic capacity, glucose uptake, and lactate production in cancer cells, therefore promoting metastasis of TNBC. Clinically, the combined expression of WT1 and PFKFB4 provides a reliable predictive biomarker for the prognosis of TNBC patients. Conclusions: Our findings reveal a molecular mechanism of WT1 promoting TNBC metastasis, which provides new targets for the precision treatment of TNBC and new perspectives for the development of targeted metabolic anticancer drugs.
Activation of dendritic cells by a synthesized small molecule for breast cancer vaccination.
Authors: Wu Yuxuan , Yeh Yu-wen , Xiang Zou
Published: June 2024

e13149

Background: Dendritic cell-based vaccination is a promising immunotherapy for treating various types of cancer. However, tumor-loaded dendritic cells alone have limited treatment efficacy. We have designed a small molecule mimicking the action of damage-associated molecular pattern molecules as an adjuvant for activating dendritic cells in vitro, which demonstrated augmented treatment efficacy. Methods: We aimed at exploring the roles of the synthesized small molecule in augmenting the efficacy of dendritic cell-based cancer vaccination to target triple negative breast cancer. Breast cancer mouse model is constructed using a 4T1 tumor cell line. Data were analyzed using a two-tailed unpaired t-test. Results: Mouse dendritic cells could be activated in vitro by the small molecule as an adjuvant evidenced by increased expression of MHC-I, MHC-II and CD40. Augmented motility of dendritic cells was also observed after treatment with the adjuvant. The signaling of NFkB is remarkably activated in dendritic cells by the adjuvant, which facilitates the maturation of dendritic cells. Engraftment of adjuvant-primed dendritic cells loaded with 4T1 tumor antigen into 4T1 tumor-bearing mice efficiently reduced the tumor size and improved survival, compared with the group treated with dendritic cells only. After injection of adjuvant-activated dendritic cells, both CD4 T cell and CD8 T cell populations were expanded in the spleen and lymph nodes draining the tumor sites. Furthermore, the adjuvant could promote the production of IFN-γ and IL-2, cytokines required for T cell activation and expansion. Next, splenocytes were obtained from individual mice after dendritic cell-based treatment. Upon re-encounter with the tumor antigen in vitro, remarkable expansion of T cell populations with a memory cell feature was confirmed in splenocytes derived from mice that received adjuvant-treated dendritic cells. Consistently, production of TNF-α, IFN-γ and granzyme B, was profoundly increased in these T cells associated with the adjuvant treatment. Conclusions: Our work suggests a novel dendritic cell-based cancer immunotherapy by using a small molecule mimicking the action of damage-associated molecular pattern molecules, which have documented immune potentiation activities.
Addition of IL-6 and phosphate to the m-EASIX score and detection of ICANS and CRS progression.
Authors: Barker Kenneth , Marco Tom , Husnain Muhammad , Katsanis Emmanuel
Published: June 2024

e14511

Background: Cytokine release syndrome (CRS) and immune cell associated neurotoxicity syndrome (ICANS) can be severe complications of CAR-T infusion. Both syndromes have been associated with endothelial dysfunction which prompted prior use of a modified version of the Endothelial Activation and Stress Index (m-EASIX) to predict the occurrence of severe grades of ICANS and CRS. Recent studies have linked low phosphorous (P) levels to both syndromes, and IL-6 is a known mediator of both. Our study aimed to enhance early prediction of CRS and ICANS by integrating both P and IL-6 into the m-EASIX score. Methods: This retrospective study included 44 patients (26 male and 18 female) ranging from 42 to 86 years old with non-Hodgkin's lymphoma presenting to the University of Arizona Cancer Center for CAR-T treatment. P, CRP, IL-6, and LDH were recorded up to 7 days before and 14 days after CAR-T infusion. All platelet levels were recorded the day of infusion. Variations of the m-EASIX score as outlined in table 1 were then calculated. The values of P were cubed to ensure relative differences in P had proportional consistency to differences in other values. The scores were then used to generate ROC curves for the occurrence of CRS, ICANS, and the progression of CRS to grade ≥2 with CI generated through the Wilson/Brown method. Results: Of the 44 patients, 21 developed CRS alone, 12 developed ICANS+CRS, and 11 developed neither. 18 patients had progression of CRS to grade ≥2. The median day of onset for CRS, ICANS, and progression of CRS to grade ≥2 was 2, 5, and 4 days respectively. Day 3 post infusion yielded the highest values of area under the curve (AUC) with each variation of the m-EASIX score statistically significant with a p<0.001 as represented in table 1. The addition of P and IL-6 to the m-EASIX score increased AUC, sensitivity, and specificity for the occurrence of CRS, ICANS, and progression of CRS to grade ≥2. Conclusions: The inclusion of P and IL-6 in the m-EASIX score improved the sensitivity and specificity of detecting CRS, CRS progression, and the development of ICANS on the 3rd day post infusion. Larger scale studies investigating the efficacy of inclusion of P and IL-6 in the m-EASIX score in guiding early interventions to mitigate complications associated with CAR-T therapy are necessary. [Table: see text]
Open-label, phase 1, multicenter study to evaluate the safety and preliminary anti-tumor activity of NT-175 in human leukocyte antigen-a*02:01-positive adult subjects with unresectable, advanced and/or metastatic solid tumors that are positive for the TP53 R175H mutation.
Authors: Becerra Carlos Roberto , Awad Mark M. , Hecht J. Randolph , Paulson Andrew Scott , Lee Jennifer , Palluconi Gabi , Dalton Jaquelin , Patel Anuradha , Yan Ying , Perez Arianne , Xie Sunny , Cohen Sarah , Fakih Marwan
Published: June 2024

e14514

Background: The TP53 tumor suppressor gene is the most commonly mutated gene across all cancer types, and TP53 R175H is the most common recurrent mutation across indications, identified in 6.7% of patients with breast cancer, 6% of patients withs colorectal cancer, and 4.2% of patients with pancreatic cancer. No therapy is approved for treatment directly targeting TP53 R175H. NT-175 is an armored autologous T-cell product expressing an HLA-A*02:01-restricted TCR recognizing TP53 R175H with disruption of the endogenous TCR and the transforming growth factor beta receptor type 2 (TGFBR2) genes. Methods: This first-in-human phase I, open label study will assess the safety and preliminary anti-tumor activity, identify the maximum tolerated dose (MTD), and evaluate the persistence, and functional capacity of NT-175 in subjects with advanced, recurrent unresectable/metastatic solid tumors refractory to treatment options. The study will enroll approximately 24 subjects harboring TP53 R175H and HLA-A*02:01. Enrolled patients will undergo leukapheresis from which CD4 and CD8 T cells will be enriched and activated ex vivo. The endogenous TCR α and β chain gene are knocked out utilizing clustered Regularly Interspaced Short Palindromic repeats (CRISPR-Cas9) and the TCR encoding an HLA-A*02:01-restricted TCR specific to the TP53 R175H mutation is inserted in the TCR α locus. Additionally, the T cells are edited to disrupt the gene encoding the TGFBR2 to reduce the immunosuppressive effect of TGF-β in the tumor microenvironment. Subjects will undergo lymphodepletion chemotherapy with fludarabine and cyclophosphamide followed by a single infusion of NT-175 and subcutaneous recombinant IL-2 administration for up to 8 days. Dose escalation will occur across 3 ascending dose levels following the BOIN design. Subjects will be monitored for dose-limiting toxicities for 28 days after NT-175 infusion. Tumor response will be assessed by RECISTv1.1 criteria. All subjects will be followed for up to 15 years. Primary endpoints include safety, dose limited toxicities, MTD determination, and recommended Phase II dose. Secondary endpoints include preliminary efficacy measures. Translational analysis will evaluate potential biomarkers for insights into mechanism of action, response prediction, or resistance mechanisms. The study was activated in March 2023 and is open to accrual; 5 patients have been enrolled as of 4 Jan 2024.
Next generation CD44v6-specific CAR-NK cells for the treatment of solid tumors.
Authors: Pecher Gabriele , Franzén Alexander Sebastian , Boulifa Abdelhadi , Radecke Clarissa , Stintzing Sebastian , Raftery Martin
Published: June 2024

e14518

Background: There is a medical need to develop new and effective therapies against solid tumors. CD44v6, an adhesion molecule that is implicated in tumorigenesis and metastases, was identified as a suitable target in solid tumors such as triple negative breast cancer (TNBC) or glioblastoma. Methods: We have developed a next-generation CAR targeting CD44v6 that incorporates IL-15 superagonist and checkpoint inhibitor molecules to overcome the immunosuppressive microenvironment (TME). NK cells were used due to their potential for allogeneic usage. Results: CD44v6 CAR-NK cells demonstrated effective cytotoxicity against TNBC and glioblastoma in 3D spheroid models. The IL-15 superagonist was specifically released upon recognition of CD44v6 on TNBC and contributed to the cytotoxic attack. Competitive inhibition of PD1 neutralized inhibition by PD1 ligands. We have validated iPSC-derived CD44v6 CAR-NK cells. Conclusions: Next generation CD44v6 CAR-NK cells are resistant to TME immunosuppression and offer a new therapeutic option for the treatment of solid tumors.
The promising feeder-free allogenic NK cell therapy: Clinical outcomes of GIC-102 monotherapy (GIC-102101) and synergistic potential with GI-101 (CD80-IgG4 Fc-IL2v) in advanced solid tumors and hematologic malignancies.
Authors: Lee Soohyeon , Hong Junshik , Cho Hyungwoo , Lee Woo Yul , Jang Do Soo , Lee YooJoon , Jang Myoung Ho , Yoon Dok Hyun
Published: June 2024

e14526

Background: The allogeneic Natural Killer (NK) cell therapy derived from healthy donors may overcome the short lifespan and dysfunctional anti-tumor activity of current autologous approach. This limitation often restricts treatment efficacy and necessitating high dosages and frequent infusions. GIC-102, non-engineered / feeder-free, highly potent allogeneic NK cell derived from healthy donors, is a promising alternative. Here, we present the clinical outcomes from the Phase 1 study of GIC-102, along with nonclinical evidence demonstrating outstanding pharmacokinetics (PK) and pharmacodynamics (PD) when used in combination with a novel bi-specific Fc fusion protein, GI-101 (CD80-IgG4 Fc-IL2v/NCT04977453/KEYNOTE-B59). Methods: GIC-102101, a first-in-human study, evaluated GIC-102 monotherapy at doses of 1x109 QW and 3x109 QW in patients with advanced solid tumors or hematologic malignancies. A lympho-conditioning strategy using cyclophosphamide (300 mg/m2) and fludarabine (30 mg/m2) was implemented every two cycles before GIC-102 treatment. The study employed a conventional 3+3 dose escalation scheme. The primary endpoint was to determine the safety and tolerability of GIC-102, with tumor response assessed as secondary endpoints. Additionally, the PK/PD profile of GIC-102 in combination with GI-101 was evaluated in a mouse model. Results: As of December 31, 2023, six patients have been treated with GIC-102 monotherapy including two patients with Non-Hodgkin lymphoma (NHL), and four patients with metastatic colorectal cancer (CRC). The median number of prior treatments for patients with CRC and NHL was 4 and 6, respectively. No dose limiting toxicities (DLTs) were observed and maximum tolerated dose was not reached. Treatment-related adverse events (TRAEs) occurred in 5 patients (83%), with the majority being associated with the lympho-conditioning procedure; hyponatremia, neutropenia, lymphopenia and anemia. The best overall response was complete response (CR) in 1/6 patient (NHL) and stable disease (SD) in 4/6 patients (3 CRC, 1 NHL). Treatment for 1 CR (NHL) and 2 SD (CRC) is ongoing (for NHL, 215+ days/for CRC, 160+ days and 153+ days). The in-vivo study of GIC-102 in combination with GI-101 showed significantly enhanced anti-tumor activity and in-vivo NK cell proliferation lasting up to 4 weeks. Conclusions: The GIC-102, feeder-free allogeneic NK cell, was well tolerated without DLTs and demonstrated early promise in efficacy in patients for advanced solid tumors and hematologic malignancy. Further clinical investigation of GIC-102 in combination with GI-101, bi-specific Fc fusion protein, is currently ongoing. Clinical trial information: NCT05880043 .
Cardiotoxicity of immune checkpoint inhibitors: A retrospective cohort study of 93,362 patients.
Authors: Barzkar Hasti , Miles Brittany , Mehta Ankit
Published: June 2024

e14529

Background: The advent of immune checkpoint inhibitors (ICI) as therapy for a wide array of cancer types has extended patient survival and propelled the field of oncology into a new era. However, notable immune-related adverse events have been observed that transgress self-tolerance. Among these adverse events, myocarditis is emerging as a serious and often lethal toxicity. This study aims to assess whether a significant association exists between immune checkpoint inhibitors and myocarditis and/or pericarditis. Methods: The TriNetX research network was used for this study. Two patient cohorts were created by using International Classification of Disease 10 (ICD-10) codes and HCPCS codes. Both patient cohorts consisted of patients with malignancy (C00-D49) and no history of myocarditis. One cohort was treated with immunotherapy while the other was excluded from such exposure (HCPCS codes were used for ipilimumab, nivolumab, pembrolizumab, and durvalumab). The cohorts were balanced for age, race, gender, and ethnicity by propensity score matching and the greedy nearest neighbor algorithm, resulting in 46,681 patients in each arm. They were then evaluated for the development of myocarditis or pericarditis (I51.4, I31, I30) over the subsequent 5 years. Results: Cancer patients treated with immunotherapy were significantly more likely to experience myocarditis or pericarditis than those who did not receive those agents (7% vs 1.2%, RR 5.8, 95% CI (5.33,6.36), P value <0.0001). Conclusions: This study suggests a significant association between the use of immunotherapy agents and the development of myocarditis and pericarditis. Further studies are necessary to better delineate the mechanism by which these cardiac toxicities occur, establish guidelines for surveillance of its onset, and discover how to suppress the immune-toxicities while retaining anti-tumor effect.
Retrospective analysis on association of body mass index and immune checkpoint inhibitor response.
Authors: Batra Akshee , Vyas Abhinav , Khosla Atulya Aman , Chitkara Akshit , Alejos David , Xu Xiaocao , Jatwani Karan , Rehman Hibba Tul , Ahmed Shahid Sattar , Singh Rohit
Published: June 2024

e14536

Background: The relationship between Body Mass Index (BMI) and cancer is a complex. We aim to study the impact of BMI on the response to immunotherapy in cancer patients. Methods: We did a retrospective observational study to investigate the influence of different BMI groups on patients receiving Immune Checkpoint Inhibitors (ICIs) at the University of Vermont Cancer Centre. We examined the medical records of people who received ICIs between January 2017 and June 2022 and collected demographic data, including age, sex, ethnicity, cancer stage, BMI, type and metastasis. We looked at Hazard Ratio (HR) in BMI subcategories compared to normal. The occurrence of immune-related adverse events (irAEs), metastasis and receipt of chemotherapy in different BMI subgroups was evaluated with relative risks (RRs). Results: A total of 288 cases were identified, out of which 269 had documented BMI, including 58% males, 94.8% whites with 64.17 years mean age. Lung cancer was most common at 41.3%, 46.5% were and 63.2% were stage 4. Total 71.4% of people received Pembrolizumab and 42.8% had concomitant chemotherapy. The median ECOG was 1 and the Charlson comorbidity index was 6. irAEs observed in 33% of cases, whereas mortality in 36%. The BMI distribution had 36.1% normal, 27.1% overweight, 16.5% obese, 14.5% extremely obese and 5.6% underweight. The HR in underweight subgroup was significant at 5.223 (p <0.001; 95CI: 2.2 to 12.4) compared to normal. The HR of overweight, obese and extremely obese decreased with HR of 1.15, 0.77 and 0.18 respectively but wasn’t significant as seen in Table 1. Table also shows that relative risk of irAEs, cancer stage, metastasis and concomitant chemotherapy were not significant. Conclusions: Clinically significant association was found between being underweight and mortality in cancer patients receiving immunotherapy. [Table: see text]
First-line immunochemotherapy modulates peripheral immune landscape in advanced gastric cancer and gastroesophageal junction cancer (GC/GEJC): Prediction of response to combination therapy.
Authors: Wu Hao , Meng Enqing , Li Ping , Jiang Rongqi , Cheng Xu , Zhu Chan , Zhang Xing , Chen Dongsheng
Published: June 2024

e14540

Background: The use of immunochemotherapy has brought about a change in the treatment of advanced or metastatic GC/GEJC, but only a subset of patients could benefit substantially. Therefore, seeking efficacious biomarkers to identify favorable populations for the regimen is imperative. This study aims to explore predictive markers and potential mechanism of combination therapy for GC/GEJC in real-world settings based on blood proteomic biopsy. Methods: This is a prospective, single-center trial in which all patients are adults with advanced or metastatic GC/GEJC confirmed by pathology or imaging. 30 eligible patients will receive PD-1 mab (sintilimab/nivolumab (NIVO) Q3W) and chemotherapy (SOX/XELOX Q3W) regardless of programmed death ligand-1 status. Blood samples were collected before treatment and after every two treatment cycles for Olink Target 96 IO analysis. CT scans were performed after every two cycles and will be categorized as responding (complete response plus primary response) or non-responding (progress disease plus stable disease) according to RECIST 1.1. Results: As of January 17, 2024, a total of 21 patients were enrolled. Eight of these patients received 16 samples before and after treatment, with 4 each of the 8 patients responding and non-responding. By analyzing the baseline samples comparing the responding and non-responding groups, it was found that patients in the responding group had lower expression of serum PD-L1 (sPD-L1) ( p=0.015). In the post-treatment samples, angiopoietin 1 was found to be poorly expressed in the responding patients ( p<0.001). In contrast, high expression of angiopoietin 2 in post-treatment blood samples was more pronounced in non-responders compared to pre-treatment ( p=0.020). Additionally, we observed that immunotherapy can modify the immune microenvironment by up-regulating the T cell receptor signaling and NK cell-mediated toxic effects pathways. These pathways may be potential targets for treatment. Conclusions: In summary, low sPD-L1 level before treatment may be a predictive biomarker for better efficacy of immuno-combination chemotherapy in advanced GC/GEJC; whereas elevation of angiopoietin after treatment predicts poor efficacy and suggests that antiangiogenic therapy may subsequently be added in non-responding patients. We are further recruiting more patients to obtain more accurate conclusions. Clinical trial information: ChiCTR2300078000 .
Development of a novel cell-free DNA fragmentomics assay for monitoring disease progression in real-time for stage IV cancer patients.
Authors: Sinha Sudhir , Brown Hiromi , Knopf Kevin B. , Hall Patrick , Shannon William G. , Haack William
Published: June 2024

e14544

Background: Advances in oncology have improved treatment response rates and overall survival. Many treatments, even targeted therapies, can fail to deliver an initial response to stage IV patients. We aimed to evaluate cfDNA as a biomarker of non-response to therapy in metastatic cancer. Methods: Blood samples were prospectively collected in Streck tubes at baseline and 12 - 21 days after initiating treatment, along with detailed clinical data, including imaging assessments captured in a cohort of metastatic non-small-cell lung (50), small-cell lung (8), breast (21), and colorectal (51) cancer study participants. To determine the fragmentation pattern of the DNA in the patient plasma, cfDNA was extracted using QIAamp Circulating Nucleic ACID Kit (Qiagen). cfDNA fragment concentrations were quantitated using two multiplexed qPCR assays on a QuantStudio 5. Primers and probes for the qPCR assay were designed using the high copy number retrotransposons Alu and SVA, represented across all 23 chromosomes. The two assays were performed on each specimen: an >80bp, >265bp and internal positive control (IPC) assay and an >105bp, >265bp with IPC assay. Following analytic validation of the assays, specimens from all participants were analyzed. The results from both assays were combined and merged with the clinical results and statistically analyzed. Results: 130 patients were included in the analysis. The qPCR assays work across all tumor and therapy types analyzed. A logit regression model was developed which calculates the likelihood that a patient’s cancer is progressing. The area under the ROC is 0.93 with a p-value of <0.001. Results clustered above the logit value of 0.65 (n=15) are all progressors by imaging (PPV=100.0%). All logit values below 0.045 (n=69) are non-progressors by imaging (NPV=0.0%). Bootstrap resampling (1,000 iterations) suggests a 99.3% PPV at the 0.9 logit cut point. Healthy subjects (9) and patients with a variety of conditions (33) known to create elevated fragmented levels of cfDNA were also analyzed to determine which patients are not appropriate patients for the assay. Results indicate patients with following conditions within 10 days of a blood draw should be excluded: stroke, myocardial infarction, severe acute autoimmune event, and severe acute COPD exacerbation; and patients treated with a chemotherapy agent (i.e., methotrexate) within 10 days of a blood draw. Conclusions: These data support the value of a blood-based biopsy test for evaluating cancer cfDNA. cfDNA fragment assay is applicable to lung, colorectal, and breast cancer, and is agnostic to any mutation status. The cfDNA fragment analysis is a promising biomarker to monitor patient treatment and save time and the expense of clinically ineffective therapies, allowing the medical oncologist to evaluate the response to therapy in real-time and provide the best care possible for the patient.
Analytical and clinical validation of a personalized, tumor-informed circulating tumor DNA assay for minimal residual disease detection.
Authors: Yang Zuoquan , Zhou Yanqing , Chen Yaru , Teng Jiaman , An Heng , Cheng Shaochen , Xu Mingyan , Chen Shifu
Published: June 2024

e14545

Background: The detection of minimal residual disease (MRD) through circulating tumor DNA (ctDNA) analysis provides an advanced molecular method for early identification of surgical patients at high risk of recurrence. In this study, we present the development of mClear, a personalized, tumor-informed next-generation sequencing (NGS) assay for MRD detection. Furthermore, we report the analytical and clinical validation processes conducted to evaluate the performance of the MRD assay. Methods: mClear is designed to assess MRD in patients with solid tumors. Whole exome sequencing (WES) was performed on tumor tissues and matched peripheral blood samples to detect somatic variants comprehensively. Personalized MRD assays were carefully designed by selecting up to 40 prioritized variants, including single nucleotide variants (SNVs), small insertions and deletions (InDels), and fusions while ensuring coverage of 21 additional key driver genes. For analytical validation, we utilized a pan-cancer MRD ctDNA quality control product (LDT-999, LDT Bioscience), characterized by known variant allele frequency (VAF) gradients of 0%, 0.005%, 0.05%, and 0.5%, confirmed through droplet digital PCR (ddPCR). We conducted 18 replicate tests at VAF gradients of 0.5% and 0.05%, 23 replicates at the 0.005% VAF gradient, and 16 replicates at the 0% VAF gradient. For clinical validation, preoperative and postoperative blood samples from a cohort of 264 pan-cancer patients were analyzed. ctDNA collected for MRD detection underwent ultra-deep next-generation sequencing (100,000× average depth of coverage). The library preparation process commenced with an input of 30ng DNA. Results: At VAF gradients of 0.5% and 0.05%, the assay achieved an excellent sensitivity of 100%, and at VAF gradients of 0.005% and 0%, it demonstrated a sensitivity of 95.7% and a specificity of 100%. Preoperative ctDNA was detected in 86.7% (72/83) of the pan-cancer patients with 71.4% (5/7), 90.9% (10/11), 85.5% (47/55), and 100.0% (10/10) in pathological stage (pStage)I, pStage II, pStage III, and pStage IV, respectively. In the pan-cancer cohort, the positive rate of longitudinal MRD was 35.7% (75/210) with 17.8% (21/118), 50.0% (13/26), 55.1% (27/49), and 82.4% (14/17) in pStage I, II, III, and IV, respectively. In four patients who relapsed, MRD detection during surveillance preceded radiological recurrence by a lead time of 1-8 months. Conclusions: Our personalized MRD assay demonstrated excellent analytical sensitivity and specificity with a limit of detection (LoD) of 0.005% VAF at the sample level. Furthermore, it displayed high clinical sensitivity for the detection of ctDNA in the pan-cancer cohort, highlighting its potential for monitoring of recurrence.
A novel co-receptor with mutated TIGIT to enhance PSCA CAR-T therapy for bladder cancer.
Authors: Shen Junjie , Dai Depeng , Zhao Wenxu , Liu Tongcan , Zhao Yongchun , Xu Yanmin , Qi Yanan , Hong Juan , Shi Xianxun , Yang Zhi , Huang Xia , Qin Lei , Chen Jun , Qian Cheng
Published: June 2024

e14574

Background: TIGIT plays a crucial role in immune regulation, particularly in tumor environments, by acting as an inhibitory receptor. Leveraging its interaction with ligands like CD155 on tumor cells, we developed an innovative CAR-T cell therapy using a mutated TIGIT co-receptor to overcome inhibitory effect induced by CD155, together with targeting Prostate Stem Cell Antigen (PSCA) CAR, chosen for its high expression in bladder and other cancers versus its minimal presence in normal tissues. Methods: We initiated our approach by inducing strategic mutations in TIGIT, selecting a variant with heightened affinity for CD155. Bio-Layer Interferometry (BLI) analysis confirmed the variant's high binding affinity (KD = 1.635 nM). This mutated TIGIT, combined with CD28's signaling components, was integrated as a co-receptor in our CAR construct. For PSCA targeting, we isolated a high-affinity ScFv against PSCA from a fully human phage display library. The specificity of this ScFv for PSCA was rigorously validated using Cell Membrane Protein Targeting Catcher (CMPTC) technology, covering over 6000 human cell membrane proteins. Results: In our comparative analyses, CAR-T cells featuring a mutated TIGIT co-receptor (T-PSCA-CAR-T) matched the cytotoxicity of traditional second-generation BBz-structured CAR-T cells (PSCA-CAR-T) against PSCA-expressing HT-1376 bladder cancer cells. However, T-PSCA-CAR-T cells distinguished themselves by producing significantly higher IFN-γ levels (3805.683±65.506 vs 1271.712±39.768 pg/mL). Our in vivo tumor model, utilizing luciferase-expressing HT-1376 cells, demonstrated T-PSCA-CAR-T's enhanced anti-tumor efficacy, as evidenced by a more significant reduction in bioluminescence signal intensity (average decreasing ratio: 0.02 for T-PSCA-CAR-T vs 0.35 for PSCA-CAR-T; p < 0.05). These results underscore the efficacy of the mutated TIGIT co-receptor in improving CAR-T cell therapy. Conclusions: Our study signifies a transformative advancement in CAR-T cell therapy by incorporating a mutated TIGIT co-receptor, markedly improving therapeutic outcomes in bladder cancer treatment. Utilizing PSCA as a model target not only validates the efficacy of this novel approach but also paves the way for its application in a broader range of cancers, representing a significant leap in the field of immunotherapy.
Effect of UNO101 on tumor microenvironment in relapsed or refractory, unresectable, primary, or metastatic cutaneous and subcutaneous malignancies.
Authors: Meirovitz Amichay , Greenberg David , Pegram Mark D. , Monson Jedidiah
Published: June 2024

e14575

Background: Nitric oxide (NO) is a ubiquitous, endogenously generated gas implicated in the homeostatic regulation of physiological processes, and NO is implicated in numerous pathological conditions. Preclinical studies evaluating the effect of high concentration exogenously administered NO demonstrated anti-cancer properties and suggested that it may serve as a potent tumoricidal agent. We have previously shown that treating mouse colon carcinoma (CT26) tumor-bearing mice with ultra-high concentrations of nitric oxide (UNO) upregulates innate and adaptive immune cells locally and systemically. Methods: Upon a signed written ICF, a single UNO101 dose of 25,000 parts per million (ppm), administered intratumorally over 5 minutes, was evaluated in relapsed or refractory, unresectable, primary, or metastatic cutaneous and subcutaneous malignancies. Subjects with an ECOG PS of 0–3, at least 3 months of life expectancy and tumor size of 4.5 mm minimum and 30 mm maximum length were eligible for enrollment. RECIST v1.1 and clinical physical examination by PI assessment was utilized to assess the rate of malignant tumor response. Toxicity was graded per NCI CTCAE v5.0. Results: In this first-in-human Phase 1 clinical trial, six subjects, 4F/2M were enrolled with a median age of 61.5 years, (range, 34–81) and ECOG PS reported as 0 or 1. Tumor types enrolled included breast (n=3), melanoma (n=1), and squamous cell carcinoma (n=2) with a median of 4 prior lines of therapy (range, 2–11) and a median of 4.7 years (range, 1.4–9.5) since time of diagnosis to study entry. One related SAE (not dose limiting) of hypoxia, Grade 4, was reported, which resulted in cessation of UNO101 treatment after 1:55 minutes. The other five administrations were completed successfully, with no further SAEs. Other reported drug related AEs were primarily Grade 1 that resolved/recovered without sequelae. Clinical immune blood biomarkers post UNO101 treatment demonstrated modulation of the tumor microenvironment by upregulating of cytotoxic T-cells (11.1%), T-central memory cells (190.6%) as a percent of total T-cells, and dendritic cells (231.4%) as a percentage of WBCs, from baseline to Day 21. Further, T-regulatory cells (38.0%) were downregulated as a percentage of total T-cells from baseline to Day 21. Based on available physical examination and caliper measurements, clinical presentation on Day 7 on two subjects, significant clinical responses were observed. Conclusions: To date,a single dose of UNO101 at 25,000 ppm is well tolerated, with biomarkers suggesting immune action within the tumor microenvironment, trending in a favorable direction on Day 21 in a heavily pre-treated population. Additional UNO101 single dose of 50,000 ppm, and possibly 100,000 ppm, will be further evaluated for safety/tolerability, impact on immune biomarkers, and preliminary efficacy. Clinical trial information: NCT05351502 .
Antitumor mechanisms of OncoTherad (MRB-CFI-1) nanoimmunotherapy involving monoamine oxidases: Clinical implications in BCG-unresponsive non-muscle invasive bladder cancer.
Authors: Fávaro Wagner José , Camargo Gabriela Cardoso de Arruda , Oliveira Gabriela , Ávila Monaliza , Roberto Isadora Manzato , Alonso João Carlos Cardoso
Published: June 2024

e14597

Background: Bacillus Calmette-Guérin (BCG) immunotherapy has been the gold standard treatment for non-muscle invasive bladder cancer (NMIBC) for nearly half a century. However, many high-risk patients experience recurrence, including those who progress and eventually become unresponsive to BCG. The emergence of new immunotherapeutic agents has revolutionized the treatment of various tumor types, including urothelial carcinoma. In this context, our research group has developed OncoTherad (MRB-CFI-1) immunotherapy, which has shown promising results in cancer treatment, particularly in NMIBC. Given the inherent complexity of the immune response, patient selection and the development of biomarkers to guide the identification of individuals who will derive the greatest benefit from a specific immunotherapy remain crucial. Over the past years, several studies have demonstrated the upregulation of monoamine oxidases (MAOs) in tumor progression and metastasis. Therefore, the objectives of this present study were to characterize the effects of OncoTherad (MRB-CFI-1) on the modulation of MAOs (MAO-A and MAO-B) in the bladder of patients with BCG-unresponsive NMIBC. Methods: A total of 40 bladder biopsies from patients with BCG-unresponsive NMIBC treated with OncoTherad (MRB-CFI-1) were collected and analyzed from Paulínia Municipal Hospital (HMP). These samples were then divided into two groups (n=20 per group): Group 1 (biopsy before OncoTherad treatment) and Group 2 (biopsy after OncoTherad treatment). Subsequently, the samples underwent immunohistochemical analyses for MAO-A and MAO-B. The retrospective anonymous study was approved by the local ethics committee (Clinical Trial: RBR-6swqd2). Results: Our results demonstrated high immunoreactivities for both MAO-A and MAO-B in the bladder tumor microenvironment prior to OncoTherad (MRB-CFI-1) treatment, confirming that the pattern reported in literature studies can also be observed in NMIBC. Total immunoreactivities for MAO-A did not differ statistically between bladder biopsies of Groups 1 and 2, indicating that this treatment does not interfere with the action of MAO-A in bladder tissue. In contrast, immunoreactivities for MAO-B were significantly lower (p<0.05) in the Group 2 when compared to Group 1 suggesting that this immunotherapy reversed the immunosuppressive state and tumor progression induced by MAO-B. Conclusions: Taken together, our results support the use of MAO-B as a biomarker for clinical response to OncoTherad (MRB-CFI-1) immunotherapy.
Efficacy and safety of immune checkpoint inhibitors in recurrent or metastatic nasopharyngeal carcinoma: A systematic review and meta-analysis.
Authors: Leite da Silva Luis Felipe , Siegloch Barros Maria Luísa , da Silva Raul Vinícius , Rodrigues Farley Reis , Vilbert Maysa
Published: June 2024

e14612

Background: Treatment options for recurrent or metastatic nasopharyngeal carcinoma (NPC) are limited. Recently, the introduction of Immune Checkpoint Inhibitors (ICIs), either as single agents or combined with other treatment options, has emerged as a potential treatment for NPC. Hence, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of ICIs compared to standard chemotherapy. Methods: We systematically searched PubMed, EMBASE, and Cochrane databases for randomized controlled trials (RCTs) comparing ICIs versus standard chemotherapy in patients with NPC. The main outcomes were progression-free survival (PFS), overall survival (OS) and adverse events rate. All analyses used a random-effects model, with 95% confidence intervals (CIs) and were conducted on Review Manager 5.4. Results: A total of 1,188 patients from 5 RCTs were included, of which 634 (53.3%) received PD-1 inhibitors. In a pooled analysis of all studies, treatment with ICIs demonstrated a statistically significant benefit in OS (HR 0.73; 95% CI 0.61-0.87; p<0.01). In trials evaluating ICI monotherapy versus chemotherapy (617 patients), PFS was not significantly different between groups (p=0.91). However, pooling two studies evaluating ICI combined with chemotherapy vs. chemotherapy (541 patients) demonstrated higher PFS for the ICI group (HR 0.53; 95% CI 0.42-0.67; p<0.01). Overall pooled PFS was non-significant (HR 0.75; 95% CI 0.49-1.16; p=0.20). In all subgroup analyses, patients treated with ICI achieved greater PFS than chemotherapy: low EBV DNA level (HR 0.61; 95% CI 0.42-0.87; p=0.007) or high EBV DNA level (HR 0.44; 95% CI 0.35-0.56; p<0.01), without liver metastasis (HR 0.68; 95% CI 0.47-0.98; p=0.04), and with liver metastasis (HR 0.56; 95% CI 0.38-0.83; p=0.04). Moreover, ICIs were well tolerated and not associated with an increased risk of serious adverse events (HR 0.96; 95% CI 0.82-1.11; p=0.56). The frequency of hypothyroidism increased in the ICI group (HR 2.07; 95% CI 1.63-2.63; p<0.01). Other adverse events had similar rates in both groups, such as AST and ALT levels, diarrhea, pruritus, rash, stomatitis, and vomiting. Conclusions: This meta-analysis demonstrated that immune checkpoint inhibitors significantly enhanced overall survival without substantially increasing serious adverse events in patients with M/R NPC. Further studies are needed to identify the patients who benefit the most from ICI monotherapy or combination therapies. [Table: see text]
Updated estimates of eligibility and response: Immune checkpoint inhibitors.
Authors: Prasad Vinay , Haslam Alyson , Olivier Timothee
Published: June 2024

e14613

Background: Immune checkpoint inhibitors (ICIs) have notably changed the landscape of systemic treatment of advanced and metastatic cancers in the last decade. We previously estimated the eligibility for and responses to ICIs, but since then, there have been multiple approvals for additional indications. As such, we have updated these estimates to include all approvals, as of December 2023. Methods: For eligibility, we used death data from the American Cancer Society’s Cancer Facts and Figures. Deaths was used as a stand-in for eligibility because these therapies are often given in later lines. Data from the peer-reviewed literature was used to further refine specific tumor type estimates (e.g., the percentage of lung cancers that are non-small cell and small cell lung cancer). For each tumor type, we multiplied the response rates reported in the FDA’s package insert by the number of deaths for each respective tumor type. When multiple drugs were approved for the same indication, we used the highest response rate. Results: Eleven ICI drugs were approved for 88 different indication approvals in the advanced/metastatic setting between 2015 and 2023. These approvals were for 20 general tumor types. The estimated eligibility for ICIs increased from 1.54% in 2011 to 55.47% in 2023. The tumor types with the highest eligibility in 2023 were non-small cell lung cancer with PDL1 status of 50% (13.28%) or less and PDL1 status >50% (4.42%), solid tumors TMB-h (6.81%), and hepatocellular (4.82%). The estimated response to ICIs increased from 0.14% in 2011 to 19.60% in 2023. The tumor types with the highest contribution to response estimates in 2023 were non-small cell lung cancer with PDL1 status of 50% (4.78%) or less and PDL1 status >50% (1.99%), solid tumors TMB-h (2.72%), and renal cell carcinoma (1.95%). Conclusions: We find that the estimated eligibility for and response to ICIs has increased since their introduction in 2011. Our estimates are an upper bound since many people are not eligible due to contraindications or healthcare coverage. Both the response and eligibility were driven by certain tumor types, including non-small cell lung cancer (either PDL1 high or PDL1 low). Patients with these types of tumors made up about one-third of the estimated response and eligibility. Solid tumors TMB-h, hepatocellular and renal cell carcinoma were other tumors with high eligibility and response, but other tumor types had low eligibility and response. While many patients have benefited from ICIs, half of patients with advanced or metastatic cancers are either not eligible or likely do not respond. [Table: see text]
Effect of GSDMD-mediated pyroptosis on the myocardial injury induced by PD-1 inhibitor combined with x-ray radiation.
Authors: Bibo Wu , Su Shengfa
Published: June 2024

e14631

Background: Radiation in combination with programmed cell death 1 (PD-1) antibodies greatly enhanced the anti-tumor activity by reactivating T lymphocytes. Whether it will produce the superposition of toxic side effects and the underlying mechanism remains elusive. Pyroptosis is a novel type of programmed cell death associated with the pathogenesis of many inflammatory diseases. We hypothesized that GSDMD plays a pathogenic role in PD-1 inhibitor combined with radiation-induced myocardial injury (RIMI) and that GSDMD gene knockout (KO) or blockade the caspase-1/GSDMD pathway will alleviate RIMI. Methods: GSDMD-KO mice and their wildtype (WT) C57BL/6J were used to investigate whether PD-1 inhibitor aggravated RIMI through pyroptosis pathway. Myocardial contractile functions, myocardial inflammation and fibrosis, and myocardial injury were assessed. Pyroptosis-related proteins and inflammatory cytokines were evaluated. Flow cytometry was used to detect the level of lymphocyte in myocardium. To further confirm the presence of pyroptosis in cardiomyocyte, double-immunostaining was performed. We verified the effect of radiotherapy combined with PD-1 inhibitor on pyroptosis in cell experiments. Results: Compared with irradiation or anti-PD-1 alone, PD-1 inhibitor could aggravate RIMI, increase the infiltration of CD8+T cells in the myocardium, and aggravate inflammatory reactions. The expressions of pyroptosis-related proteins and inflammatory cytokines were upregulated. Immunofluorescence also indicated that pyroptosis cells were increasing. While GSDMD-KO or caspase-1GSDMD inhibitor, myocardial injury and pyroptosis-related proteins were significantly reduced. Conclusions: We speculate that PD-1 inhibitors activate CD8+T cells and mediate cardiomyocyte pyroptosis. GSDMD-triggered immune-inflammatory response plays a key role in the aggravation of myocardial injury.
Integrative multimodality spatial biomarker analysis for tailoring checkpoint inhibitor therapies in non-small cell lung cancer.
Authors: Ramos Corinne , Ramos Corinne , Senechal Victor , Ruez Richard , Delebecq Sandra
Published: June 2024

e14664

Background: Checkpoint inhibitor therapy has become a cornerstone in the treatment of non-small cell lung cancer (NSCLC). However, the response to checkpoint inhibitors varies widely among patients, with some experiencing significant benefits and others facing adverse reactions without therapeutic gain. The ability to accurately predict which patients will benefit from checkpoint inhibitor therapies is essential for enhancing treatment efficacy and minimizing side effects. In this context, the identification and analysis of predictive biomarkers, including the expression of immune checkpoint proteins such as PD-L1 and TIGIT, and the comprehensive profiling of cytokines in the tumor microenvironment, are of paramount importance. Methods: A multimodal strategy was employed to identify predictive biomarkers for checkpoint inhibitor therapy in non-small cell lung cancer (NSCLC). This approach integrated metabolic, transcriptomic, and proteomic data to achieve a thorough insight into the biomarkers likely to influence patient responses. The diverse data sets were fused through advanced machine learning techniques, creating a holistic dataset. Analysis of this integrated dataset facilitated the discovery of multimodal biomarker signatures, offering the potential to predict which NSCLC patients would positively respond to checkpoint inhibitor treatments. Results: Initial observations revealed considerable variability in the expression of PD-L1 and TIGIT alongside other immune checkpoint molecules, across different regions of the tumor microenvironment in non-small cell lung cancer (NSCLC). Multimodal biomarker signatures, encompassing distinct expressions of immune checkpoint inhibitors, cytokine levels, and the presence of immune cells, showed a strong correlation with patient outcomes following treatment with immune checkpoint inhibitors. Conclusions: Our research highlights the significant promise of using a multimodal stratification method to unravel the complexities of non-small cell lung cancer (NSCLC) and to predict patient responses to immune checkpoint inhibitors. Through the integration of metabolomic, transcriptomic, and proteomic data, we discovered distinctive biomarker signatures that were highly predictive of responses to these immunotherapies.