bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dynamic monitoring of ctDNA to predict response to immunotherapy plus chemotherapy in BTC.
Authors: Liu Chen , Xiao Mingzhe , Wu Yingjun , Ao Jianyang 
Published: June 2023

e14550 Background: The survival of advanced BTC patients, especially those who received palliative surgery was unfavorable and the treatment options for these patients were limited. Immune checkpoint inhibitors （ICIs） were approved for the treatment for patients with BTC. However, only a subset of patients benefits from this treatment and the clinical performance was not well evaluated. Therefore, there is a need for a method that can promptly and dynamically evaluate the efficacy of patients receiving immunotherapy. Previous studies have shown that ctDNA can detect relapse and monitor therapeutic efficacy in diverse cancer. We performed a retrospective observational study examining whether ctDNA could serve as a biomarker to track treatment responses in BTC. Methods: Patients diagnosed with advanced BTC and who received ICI were screened and enrolled between January 2020 and October 2022 at Shanghai Eastern Hepatobiliary Surgery Hospital. The key inclusion criteria for patients were as follows: a recent diagnosis of gallbladder/intrahepatic cholangiocarcinoma; received immunotherapy (or plus target therapy); received ctDNA NGS monitoring. Patients were excluded based on the following criteria: patients with multiple primary cancers, or had history of allogeneic organ transplantation or allogeneic hematopoietic stem cell transplantation, or HIV infected person, or severe infections with poor clinical control. Blood samples were collected for ctDNA analysis at the beginning, after 3 and 6 months of ICI treatment. Results: The median age was 66 (42-79), and 12 (44.4%) were male. The ECOG score was mostly 1 (23 cases, 85.2%). Most of the patients were stage IV (21, 77.8%), and there were 5 (18.5%) stage III patients, 1 (3.7%) stage II and 0 (0%) stage I patients. The BTC patients were mostly histologically diagnosed with gallbladder cancer (GBC, 11, 40.7%) and intrahepatic cholangiocarcinoma (8 cases, 29.63%). There were 55% patients received palliative surgery. Among all mutations detected in ctDNA, the mutation status of KRSA at baseline was detected to be related to patient survival, and the KRAS-mut group had a significantly lower probability of overall survival compared to the KRAS-WT group (p=0.014). Patients with more than 3 new mutations during treatment presented a significantly unfavorable OS (p=0.025) and a trend of unfavorable PFS (p=0.062). Besides, patients with increasing amounts of total ctDNA during dynamic monitoring showed significantly worse overall survival probability (p=0.023). Conclusions: Mutation of KRAS in tissues at baseline might be a predictive marker of response to immunotherapy and survival prognosis. ctDNA as a compose biomarker can monitor treatment responses and predict overall survival. Considering the small size and the relatively short follow-up time of our cohort, further prospective and randomized controlled studies are indispensable.
Correlation between MSI, TMB, and TGFBR2 gene mutation in solid tumors.
Authors: Fan Xinglong , Hu Huimin , Cao Yufeng , Xuan Tiantian , Xin Jianjun , Gao Qiangfang , Ma Juan , Wang Chenxi , Ding Ran , Bu Fanfeng 
Published: June 2023

e14558 Background: TGFBR2 encodes a receptor kinase which signals to downstream effectors in the TGF-ß signaling pathway. Recent research has shown that truncation mutations of TGFBR2 in gastric cancer with high tumor mutational burden. However, the relationship remains unclear in other solid tumors. Methods: We retrospectively analyzed the TGFBR2 mutations of 19370 Chinese patients with pan-cancer during 2019-2022 (Simcere Diagnosis, Nanjing, China) Next-generation sequencing (NGS) assessed somatic mutations in tumor tissue. We figured out TGFBR2 mutation frequency, TMB and MSI in TGFBR2-mutant, TGFBR2 wild-type. Results: We have detected TGFBR2 mutants in 536 (2.8%) samples. The top 5 frequent cancers were colorectal cancer (132, 24.7%), lung cancer (118, 22%), gastric cancer (78, 14.5%), biliary tract tumors(52, 9.7%) liver cancer (33, 6.2%).TGFBR2 variants included missense/indel/insert (238, 44.4%), truncation (219, 40.9%), splicing site variant (23, 4.3%), and CNV (33, 6.2%).The inactive variants include missense, which occurs in the TGFBR2 serine/threonine kinase domain, truncation and splicing site variant. However, truncation was the most common type, recurring in a few hot spots (p.K153Sfs*35, p.K153Afs*3, p.R520* ). And we found that the TMB and MSI in the TGFBR2 mutation group was significantly higher than that in the TGFBR2 wild-type group [TMB-H (TMB ≥10 musts/Mb): TGFBR2-MUT vs TGFBR2-WT, 41.2% vs 9.5%, p < 0.01; MSI-H: TGFBR2-MUT vsTGFBR2-WT, 27.4% vs1.7% p < 0.01]. In the TGFBR2 mutation group, It was also observed that TMB and MSI in the TGFBR2 truncation or splicing site mutant (INACT) group was significantly higher than that in the other mutant types (VUS) group [TMB-H (TMB ≥10 musts/Mb): TGFBR2-INACT vs TGFBR2-VUS, 51.0% vs 27.9%, p < 0.01; MSI-H: TGFBR2-INACT vs TGFBR2-VUS 39.4% vs 10.6% p < 0.01]. And then, we separately analyzed the correlation between MSI, TMB and TGFBR2 gene mutation in the top 5 frequent cancers. Over 60% of patients with TGFBR2 mutations in colorectal cancers have high TMB and MSI values [TMB-H (TMB ≥10 musts/Mb): TGFBR2-MUT vs TGFBR2-WT, 71.3% vs 12.8%, p < 0.01; MSI-H: TGFBR2-MUT vs TGFBR2-WT, 61.2% vs 3.0% p < 0.01]. Conclusions: We analyzed the distribution of TGFBR2 mutants in Chinese patients with solid tumors. Our data showed that TGFBR2 mutant was significantly associated with TMB-H and MSI-H, and this may be a potential molecular marker of immunotherapy. And studies have shown that the combination of TGF-β inhibitors and immune checkpoint inhibitors can increase the killing effect of T cells on tumors. In short, detection of TGFBR2 mutation has certain clinical significance.
Find: Immunomodulation after a fasting mimicking diet analyzed by Nanostring and multispectral flowcytometry in healthy volunteers: A pilot study.
Authors: de Gruil Nadia , Welters Marij JP , Kaart Sam , Pijl Hanno , van der Burg Sjoerd H. , Kroep Judith R. 
Published: June 2023

e14560 Background: An increasing number of clinical trials, including our randomized phase III trial (NCT05503108), are investigating the potential benefit of short-term fasting using a fasting mimicking diet (FMD) on the anti-tumor effect of chemotherapy. Preclinical research suggests that FMD promotes infiltration of CD8+ T-cells, while decreasing regulatory T-cells (Treg). Extensive immunoprofiling is needed to investigate the immunomodulatory effects of FMD alone and guide ongoing translational trials on FMD as an adjunct to chemotherapy in patients with cancer. Methods: FIND is a prospective pilot study, which included 9 healthy volunteers who followed a 4-day FMD every 3 weeks, 2 times (NCT04833439). Peripheral blood samples were collected in a fed state (baseline), after overnight fasting (overnight) and directly after the second cycle of FMD (final). Metabolic markers (IGF1, glucose, ketone bodies) to ensure ketosis were measured in the plasma. The RNA from white blood cells was isolated and transcriptomics was performed with the Nanostring IO360 human Pancancer panel, and analyzed by nSolver Advanced analysis, Graphpad Prism and String analysis. Statistical testing was done using Wilcoxon signed-rank tests in R-studio. In addition, 40-plex spectral AURORA flow cytometry for immune cell composition with FlowJo analysis was performed. This study was approved by the local Medical ethical committee (NL76033.058.21). Results: Paired analysis of the Nanostring data identified 56 differentially expressed genes (DEG) comparing baseline and final samples initially, of which 19 genes showed at least 1.2 log2 fold-change in at least half of the participants. String analysis indicated that the DEGs were associated with fatty-acid metabolism, T-cell and myeloid cell function and immune regulatory pathways. Cell typing showed an increase in cytotoxic NK CD56dim cells (p=0.031) and a decrease in Tregs decreased (p=0.063) after FMD. In-depth analysis of gene specific pathway enrichment and immune cell profiling by flow cytometry will be presented. Conclusions: The expression profile of 56 genes in circulating immune cells changed after 2 FMD cycles, next to fatty-acid metabolism affecting the composition and function of both T-cells and myeloid cells and their regulation. Altogether, FMD induced immunological changes that could support cancer treatment and guide immunomonitoring in future trials evaluating the effects of FMD in cancer treatment. Clinical trial information: NCT04833439 .
Prognostic value of systemic inflammatory response in early-stage triple-negative breast cancer.
Authors: Ovcaricek Tanja , Matos Erika , Auprih Masa , Borstnar Simona 
Published: June 2023

e14562 Background: Among breast cancer (BC) triple-negative (TN) subtype is the most immunogenic. Host and systemic immune response characterised by tumor-infiltrating lymphocytes (TILs) and immune cells in peripheral blood shape the net anti-tumor immune status. The systemic immune-inflammation index (SII) represents an effective indicator of the peripheral immune status. To date, TILs and SII have been largely examined separately. Therefore, in the present study, we investigated the prognostic value and relationship between pretreatment TILs and SII in a large number of unselected patients (pts) with early (e) stage TNBC. Methods: A total of 301 consecutive eTNBC pts treated with curative intent at Oncology Institute Ljubljana from January 2000 till August 2007 were investigated. Histopathological and clinical data were obtained retrospectively from the medical records. TILs were scored as intensive vs others. SII was determined by platelet × neutrophil/lymphocyte. Univariate and multivariate analyses were performed using the Cox proportional hazard model. The optimal cut-off value of SII was 675 and was evaluated using the receiver operating characteristic (ROC) curve. Results: The median follow-up period was 17,6 years (16.9-18.3), and the entire cohort`s 10-year DFS was 67.5% and 10-year OS 72.1%. The median age was 54 (53-57) years. Most pts were diagnosed node negative (40.7%), with larger tumors (≥ 2 cm, 57.1%), grade 3 (83.5%) and underwent perioperative chemotherapy (cht) (81%). Patients with positive lymph nodes (LN) had higher SII (r=0.21, p=0.003), no correlation between LN and TILs was found. Patients with higher TILs had significantly better OS (HR: 0.40, 95% CI 0.37-0.97, p=00.004), and lower SII predicted significantly better DFS and OS (HR for DFS: 1.65 95% CI 1,03-2.67, p=0.038, HR for OS: 1.72, 95% CI 1.11-2.65, p=0,015). In multivariate analysis, positive LN status retained its independent prognostic value for worse DFS and positive LN and higher SII for worse OS. Conclusions: Our data confirms important role of systemic immune response in the prognosis of eTNBC. The survival of these pts is significantly influenced by the pretreatment SII and TILs, the prognostic value of SII seems to be stronger in our cohort. However, positive lymph node status remains the strongest predictor for worse survival in eTNBC. [Table: see text]
Efficacy and safety study of a novel alpha-fetoprotein (AFP)-maytansine conjugate in an ovarian xenograft model.
Authors: Sherman Igor A. , Hill Wendy , Griffin Patricia , Andrews David , Boohaker Rebecca J , Stinson Karr , Gien Lilian Tran , Buzina Alla , Schormann Wiebke 
Published: June 2023

e14570 Background: AFP receptor is an oncofetal antigen and a novel target for cancer therapeutics. It is highly expressed on the surfaces of many cancers and Myeloid Derived Suppressor Cells (MDSCs) but absent on normal tissues. By conjugating maytansine toxin to a recombinant human AFP, we selectively deliver toxin to cancer cells and MDSCs while sparing normal cells, enabling a combination of targeted and immune activating approaches. We previously reported high efficacy of AFP-maytansine conjugate in a xenograft model of colorectal cancer. Here we report the effect of this conjugate in an ovarian xenograft model and in 2 independent patient-derived 3D ovarian organoids, supporting the wider utility of this approach. Methods: Four dose regimens of AFP-maytansine conjugate were compared to control in a mouse A2780 ovarian xenograft model. The conjugate was administered IV 10 days after implantation, when tumor volumes reached ≈150 mm3. Mice were randomized into 4 treatment and 1 control group (10 mice/group, table below). Tumor growth, survival and clinical observations were assessed for 62 days post implantation. In addition, organoids were cultured from primary reprogrammed tumor cells from 2 separate patients with high-grade serous ovarian carcinoma. Conjugate, staurosporine, thapsigargin or DMSO (control) were added to the media. Cytotoxicity was assessed by staining for AnnexinV and TMRE. Results: A statistically significant dose-dependent reduction in tumor volume (p<0.001) and increase in survival (p<0.002) were seen in all treatment groups relative to control. All animals in Groups 1,3 and 4 survived to the end of the study and 6 of 10 mice survived in the lowest dose group. 100% of mice in Group 1, highest dose group had complete tumor regression with no regrowth seen by day 62. In the other treatment groups majority of animals had complete tumor regression with no regrowth. All control animals were dead by day 38 due to excessive tumor burden. No signs of toxicity, such as ocular toxicity or vascular scarring of the tail were seen. All mice gained weight during the study. Gross pathology at the time of sacrifice was unremarkable. In addition, in the 2 ovarian organoids the AFP-maytansine conjugate demonstrated a cytotoxic effect over 72 hours exposure similar to that of thapsigargin and staurosporine given at known effective concentrations. Conclusions: This ovarian xenograft study confirms high activity without obvious toxicity of the novel AFP-maytansine conjugate in a 2nd tumor type. The targeted cytotoxic activity is further confirmed by the effect of the conjugate in 2 different ovarian cancer organoids. These results support advancing this novel conjugate toward clinical use with a dose-dense regimen. [Table: see text]
Evaluation of THEO-260 as a novel oncolytic virus therapy for treating stromal rich tumours.
Authors: Krell Jonathan , Frost Sally , Negroni Caterina , Moriconi Chiara , Taverner William , Nicholls Brannon , Saunders Deanna , Cunnea Paula , Fotopoulou Christina , Lim Alfred , Bazan-Peregrino Miriam , Fisher Kerry , Duffy Margaret R 
Published: June 2023

e14573 Background: Stromal rich tumours pose a significant challenge to the effectiveness of systemic anticancer therapies, including immunotherapies and oncolytic viruses. This is due to the abundance of cancer associated fibroblasts (CAFs) that suppress immune cells and limit drug penetration. THEO-260 is a potent, mechanistically novel oncolytic virus therapy intrinsically capable of lysing both cancer cells and CAFs, and is currently in development for late stage relapsed refractory ovarian cancer. Methods: The efficacy and safety of THEO-260 was assessed in multicellular spheroids, in patient-derived ex vivo fresh ovarian samples and in mouse models of human stromal tumours. Results: Unpassaged ascites and tumour samples collected from cytoreductive surgeries for advanced ovarian cancer (n=24 independent patients) were treated with a clinically-relevant dose of THEO-260. THEO-260 effectively killed the cancer cell (EpCAM+ EGFR+PDL1+ CA125+) and CAF (FAP+) populations, being efficacious in treatment-naive and platinum-resistant patient samples. Importantly, the T cell population in these patients, in addition to primary normal fibroblasts (including intestinal, pulmonary, dermal, cardiac, uterine fibroblasts) from healthy donors, were not damaged. Ex vivo studies show THEO-260 stimulates effector T cell responses upon tumour lysis as indicated by IFNγ release. Demonstrating suitability as an IV delivered agent, THEO-260 was active in pooled human serum and whole human blood (n = 10 donors). THEO-260 excels in low nutrient, low proliferative environments, typical of human solid tumours and has been developed with a view to persist in the tumour microenvironment without the need for repeated cycles of delivery. THEO-260 is well tolerated in vivo following a clinically relevant intravenous dosing regimen. In PARP inhibitor and platinum resistant ovarian cancer murine models containing human CAFs and cancer cells, THEO-260 shows antitumor efficacy, with a complete reduction in tumour volume in subcutaneous and intraperitoneal systems, and superiority to SOC. Virus activity is not restricted to ovarian cancer, with cell line data demonstrating killing in additional solid tumour types, including pancreatic, colorectal, lung, and breast cancer. THEO-260 exhibits genetic and temperature based stability, and GMP manufacturing to high yields is underway. Conclusions: Taken together, we present a preclinical data package for THEO-260 supporting progression to Phase I clinical trials.
Preliminary safety, efficacy, and pharmacokinetics (PK) results of the EP4 antagonist INV-1120 from a phase I study in Chinese patients with advanced solid tumors.
Authors: Liu Chang , Zhang Miao , Yuan Jiajia , Liu Dan , Gong Jifang , Zhu Yi , Lin Lishan , Sun Yongkui , Nippgen Johannes , Shen Lin 
Published: June 2023

e14579 Background: INV-1120 is a highly selective, orally available inhibitor of PGE2-EP4, an immunosuppressive mediator in the TME. Objectives of this Phase I study in Chinese patients was to assess safety and pharmacokinetics and define a RP2D of INV-1120. Methods: Escalation was based on a 3+3 sequential design starting @ 60mg QD po as guided by the FIH trial in a Western population. DLT evaluation period was 4 weeks. Efficacy (RECIST 1.1) was evaluated every 8 weeks. Blood samples were collected for pharmacokinetics. Results: 9 patients were enrolled and treated with INV-1120 in 3 dose cohorts (60, 100, 150mg, n=3 each). All 9 patients had CRC. All 9 patients were evaluable for activity. Stable disease was observed in 3 of 9 (33.3%) patients. The median PFS (95% CI) was 55.0 days (range: 42.0-NE). The plasma exposure increased from 60 mg to 100 mg. Maximum concentrations were achieved approximately 2 hours post dose. The half-life was approximately 5-16 hours. No accumulation was noted after multiple doses. The PK profiles were similar to that in a Western population [NCT04443088, presented @ SITC 2022]. Conclusions: Single agent INV-1120 was generally well tolerated in the Chinese population and showed preliminary signs of antitumor activity in terms of stable disease. Data from this trial were in line with data in a Western population [NCT04443088, presented @ SITC 2022] and warrant further Global development. Due to the combined findings of this study and the above-mentioned sister study, the doses of 60, 100 and/or 150mg QD are proposed for further exploration in combination trials. Clinical trial information: ChiCTR20211872 . Clinical trial information: CTR20211872 . [Table: see text][Table: see text]
A phase I study of isunakinra, an IL-1 alfa/beta inhibitor, in combination with nivolumab for patients with solid tumors refractory to standard therapies.
Authors: Becerra Carlos Roberto , Paulson Andrew Scott , Kowalski Jan , Olivecrona Hans , de Chateau Maarten 
Published: June 2023

e14580 Background: Interleukin-1 is a master cytokine produced by macrophages (IL-1 β) and released upon cell death (IL-1 α). IL-1 upregulates other cytokines in the tumor microenvironment (i.e. IL-6 and IL-8), drives chronic non-resolving inflammation in the tumor, induces cancer cell invasion and metastasis (EMT), has profound effects on immune cells and cancer associated fibroblasts and can attract granulocytic myeloid suppressor cells to the tumor (PMN-MDSC), that in turn inhibit cytotoxic T cell responses. Isunakinra is a small recombinant protein resembling IL-1Ra, with an inhibitory potency 10-20 times higher, that binds to the IL1-R1 and blocks activation of the receptor by both IL-1α and IL-1β. We conducted a phase I dose escalation study with isunakinra as monotherapy and in combination with a PD-1 inhibitor in patients with locally advanced or metastatic solid tumors that had exhausted all treatment options. Methods: Enrolled patients with refractory metastatic solid tumor, ECOG 0-2, on a 3 + 3 dose-escalation trial at three dose levels of isunakinra (15, 25 or 50 mg). Isunakinra was self-administered once daily SC for three weeks followed by 4 additional weeks in combination with nivolumab Q4W at 480 mg, flat dose to complete the DLT period of 7 weeks. Thereafter, isunakinra/nivolumab was continued until week 28. Primary endpoints: DLTs, safety, and pharmacokinetics. Secondary endpoints: tumor and immune monitoring. Results: Enrolled fifteen patients with metastatic or unresectable locally advanced solid tumors (colorectal, pancreatic, triple-negative BC, anal, prostatic, CCA, and appendix) that had received 2-5 prior lines of therapy. Seven SAE occurred in three rapidly deteriorating subjects, all disease related hospitalizations, leading to study withdrawal during the DLT period. No DLTs, irAE or predefined laboratory deviations occurred in any subject. The highest dose, 50 mg, was selected as RP2D. Twelve subjects completed visit week 8, six of them week 12, and four completed the trial. One patient with metastatic colon cancer (MSS, KRAS mut, high TMB) was granted extended treatment for PR and continued response at end of study. Isunakinra exposure totaled 1575 daily doses, 81% during combination with nivolumab, t 1/2 5 hours with no accumulation over time. At 50mg of isunakinra, plasma levels where well above 100 ng/mL, a target for complete IL-1 inhibition. Conclusions: Isunakinra is safe and well-tolerated in combination with standard dose nivolumab. Ongoing expansion cohorts and future studies will explore the safety and efficacy of isunakinra in specific tumors and with other immunotherapy combinations. Clinical trial information: NCT04121442 .