Oncology
Abstract
Most prostate cancers depend on androgens for growth and therefore the mainstay treatment for advanced, recurrent or metastatic prostate cancer is androgen deprivation therapy (ADT). A prominent side effect in patients receiving ADT is an obese frailty syndrome that includes fat gain and sarcopenia, defined as the loss of muscle function accompanied by reduced muscle mass or quality. Mice bearing Pten deficient prostate cancers were examined to gain mechanistic insight into ADT-induced sarcopenic obesity. Castration induced fat gain as well as skeletal muscle mass and strength loss. Catabolic TGFß-family myokine protein levels were increased immediately prior to strength loss and pan-myokine blockade using a soluble receptor (ActRIIB-Fc) completely reversed the castration-induced sarcopenia. The onset of castration-induced strength and muscle mass loss, as well as the increase in catabolic TGFß-family myokine protein levels, were coordinately accelerated in tumor-bearing mice relative to tumor-free mice. Notably, GDF11 increased in muscle after castration only in tumor-bearing mice, but not in tumor free mice. An early surge of GDF11 in prostate tumor tissue and in the circulation suggests that endocrine GDF11 signaling from tumor to muscle is a major driver of the accelerated ADT-induced sarcopenic phenotype. In tumor-bearing mice, GDF11 blockade largely prevented castration-induced strength loss but did not preserve muscle mass, which confirms a primary role for GDF11 in muscle function and suggests an additional role for the other catabolic myokines.
Authors
Chunliu Pan, Neha Jaiswal Agrawal, Yanni Zulia, Shalini Singh, Kai Sha, James L. Mohler, Kevin H. Eng, Joe Chakkalakal, John J. Krolewski, Kent L. Nastiuk
Abstract
Small primary breast cancers can show surprisingly high potential for metastasis. Clinical decision making for tumor aggressiveness, including molecular profiling, relies primarily on analysis of the cancer cells. Here we show that this is insufficient; that the stromal microenvironment of the primary tumor plays a key role in tumor-cell dissemination and implantation at distant sites. We previously described two cancer-associated fibroblasts (CAFs) that either express (CD146pos) or lack (CD146neg) CD146 (official symbol MCAM; alias MUC18). We now find that when mixed with human breast cancer cells, each fibroblast subtype determines the fate of cancer-cells: CD146neg fibroblasts promote increased metastasis compared to CD146pos fibroblasts. Novel quantitative and qualitative proteomic analyses show that CD146pos CAFs produce an environment rich in basement membrane proteins, while CD146neg CAFs exhibit increases in FN1, LOX, and TNC; all over-expressed in aggressive disease. We also show clinically, that CD146neg CAFs predict for likelihood of lymph node involvement even in small primary tumors (<5 cm). Clearly small tumors enriched for CD146neg CAFs require aggressive treatments.
Authors
Heather M. Brechbuhl, Alexander S. Barrett, Etana Kopin, Jaime C. Hagen, Amy L. Han, Austin E. Gillen, Jessica Finlay-Schultz, Diana M. Cittelly, Philip Owens, Kathryn B. Horwitz, Carol A. Sartorius, Kirk C. Hansen, Peter Kabos
Abstract
In recent years, CAR-T cell therapy has proven to be a promising approach against cancer. Nonetheless, this approach still faces multiple challenges in eliminating solid tumors, one of which being the immunosuppressive tumor microenvironment (TME). Here we demonstrated that knocking out the endogenous TGFβ receptor II (TGFBR2) in CAR-T cells with CRISPR/Cas9 technology could reduce the induced regulatory T-cell (iTreg) conversion and prevent the exhaustion of CAR-T cells. Meanwhile, TGFBR2 edited CAR-T cells had better in vivo tumor elimination efficacy, both in cell line derived xenograft (CDX) and patient derived xenograft (PDX) solid tumor models, whether administered locally or systemically. In addition, the TGFBR2 edited CAR-T cells could eliminate contralaterally re-inoculated xenografts in mice effectively with an increased proportion of central memory and effector memory subsets. In conclusion, we greatly improved the in vitro and in vivo function of CAR-T cells in TGFβ-rich tumor environments by knocking out endogenous TGFBR2, proposing a new method to improve the efficacy of CAR-T cell therapy for treating solid tumors.
Authors
Na Tang, Chen Cheng, Xingying Zhang, Miaomiao Qiao, Na Li, Wei Mu, Xiao-Fei Wei, Weidong Han, Haoyi Wang
Abstract
Inherited bone marrow failure syndromes (IBMFSs) such as Fanconi Anemia (FA) and Shwachman-Diamond syndrome (SDS) feature progressive cytopenia and a risk of acute myeloid leukemia (AML). Using deep phenotypic analysis of early progenitors in FA/SDS bone marrow samples we revealed selective survival of progenitors that phenotypically resembled granulocyte-monocyte progenitors (GMP). Whole exome and targeted sequencing of GMP-like cells in leukemia-free patients revealed a higher mutation load than in healthy controls and molecular changes that are characteristic of AML: increased G>A/C>T variants, decreased A>G/T>C variants, increased trinucleotide mutations at Xp(C>T)pT and decreased mutation rates at Xp(C>T)pG sites compared to other Xp(C>T)pX sites and enrichment for Cancer signature 1 (X indicates any nucleotide). Potential pre-leukemic targets in the GMP-like cells from FA/SDS patients included SYNE1, DST, HUWE1, LRP2, NOTCH2 and TP53. Serial analysis of GMPs from a SDS patient, who progressed to leukemia revealed a gradual increase in mutational burden, enrichment of G>A/C>T signature and emergence of new clones. Interestingly, the molecular signature of marrow cells from two FA/SDS patients with leukemia was similar to that of FA/SDS patients without transformation. The predicted founding clones in SDS-AML harbored mutations in several genes including TP53, while in FA-AML the mutated genes included ARID1B and SFPQ. We described an architectural change in the hematopoietic hierarchy of FA/SDS with remarkable preservation of GMP-like populations harboring unique mutation signatures. GMP-like cells might represent a cellular reservoir for clonal evolution.
Authors
Stephanie Claudia Heidemann, Brian Bursic, Sasan Zandi, Hongbing Li, Sagi Abelson, Robert J. Klaassen, Sharon Abish, Meera S Rayar, Vicky R. Breakey, Houtan Moshiri, Santhosh Dhanraj, Richard de Borja, Adam Shlien, John E. Dick, Yigal Dror
Abstract
Myelofibrosis (MF) is a myeloproliferative neoplasm characterized by cytopenia and extramedullary hematopoiesis, resulting in splenomegaly. Multiple pathological mechanisms (e.g., circulating cytokines and genetic alterations, such as JAKV617F mutation) have been implicated in the etiology of MF, but the molecular mechanism causing resistance to JAK2V617F inhibitor therapy remains unknown. Among MF patients who were treated with the JAK inhibitor ruxolitinib, we compared noncoding RNA profiles of ruxolitinib therapy responders versus nonresponders and found miR-543 was significantly upregulated in nonresponders. We validated these findings by reverse transcription–quantitative PCR. in this same cohort, in 2 additional independent MF patient cohorts from the United States and Romania, and in a JAK2V617F mouse model of MF. Both in vitro and in vivo models were used to determine the underlying molecular mechanism of miR-543 in MF. Here, we demonstrate that miR-543 targets the dioxygenases ten-eleven translocation 1 (TET1) and 2 (TET2) in patients and in vitro, causing increased levels of global 5-methylcytosine, while decreasing the acetylation of histone 3, STAT3, and tumor protein p53. Mechanistically, we found that activation of STAT3 by JAKs epigenetically controls miR-543 expression via binding the promoter region of miR-543. Furthermore, miR-543 upregulation promotes the expression of genes related to drug metabolism, including CYP3A4, which is involved in ruxolitinib metabolism. Our findings suggest miR-543 as a potentially novel biomarker for the prognosis of MF patients with a high risk of treatment resistance and as a potentially new target for the development of new treatment options.
Authors
Enrique Fuentes-Mattei, Recep Bayraktar, Taghi Manshouri, Andreia M. Silva, Cristina Ivan, Diana Gulei, Linda Fabris, Nayra Soares do Amaral, Pilar Mur, Cristina Perez, Elizabeth Torres-Claudio, Mihnea P. Dragomir, Adriana Badillo-Perez, Erik Knutsen, Pranav Narayanan, Leonard Golfman, Masayoshi Shimizu, Xinna Zhang, Wanke Zhao, Wanting Tina Ho, Marcos Roberto Estecio, Geoffrey Bartholomeusz, Ciprian Tomuleasa, Ioana Berindan-Neagoe, Patrick A. Zweidler-McKay, Zeev Estrov, Zhizhuang J. Zhao, Srdan Verstovsek, George A. Calin, Roxana S. Redis
Abstract
Anti-PD1 therapy has become an immunotherapeutic backbone for treating many cancer types. While many studies have aimed to characterize the immune response to anti-PD1 therapy in the tumor and in the peripheral blood, relatively less is known about the changes in the tumor draining lymph nodes (TDLNs). TDLNs are primary sites of tumor antigen exposure that are critical to both regulation and cross-priming of the antitumor immune response. We employed multi-panel mass cytometry to obtain a high-parameter proteomic (39 total unique markers) immune profile of the TDLN in a well-studied PD1-responsive immunocompetent mouse model. Based on combined hierarchal gating and unsupervised clustering analyses, we found that anti-PD1 therapy enhances remodeling of both B and T cell compartments toward memory phenotypes. Functionally, expression of checkpoint markers was increased in conjunction with production of IFNγ, TNFα, or IL2 in key cell types, including B and T cell subtypes and rarer subsets such as Tregs and NKT cells. A deeper profiling of the immunologic changes that occur in the TDLN milieu during effective anti-PD1 therapy may lead to the discovery of novel biomarkers for monitoring response and provide key insights toward developing combination immunotherapeutic strategies.
Authors
Won Jin Ho, Mark Yarchoan, Soren Charmsaz, Rebecca M. Munday, Ludmila Danilova, Marcelo B. Sztein, Elana J. Fertig, Elizabeth M. Jaffee
Abstract
Background. Current clinical biomarkers for the PD-1 blockade therapy are insufficient because they rely only on the tumor properties such as PD-L1 expression frequency and the amount of tumor mutation burden. Identifying reliable responsive biomarkers based on the host immunity is necessary to improve the predictive values. Methods. We investigated the levels of plasma metabolites and T cell properties including energy metabolism markers in the blood of patients with non-small cell lung cancer before and after treatment with nivolumab (n = 55). Predictive value of combination markers statistically selected were evaluated by cross validation and linear discriminant analysis on discovery and validation cohorts, respectively. Correlation between plasma metabolites and T cell markers were investigated. Results. The four metabolites derived from microbiome (hippuric acid), fatty acid oxidation (butyrylcarnitine) and redox (cystine and glutathione disulfide) provided high response probability (AUC = 0.91). Similarly, a combination of four T cell markers, those related to mitochondrial activation (PGC-1 expression and reactive oxygen species), and the frequencies of CD8+ PD-1high and CD4+ T cells demonstrated even higher prediction value (AUC = 0.96). Among the pool of all selected markers, the four T cell markers were exclusively selected as the highest predictive combination probably due to their linkage to the above mentioned metabolite markers. In a prospective validation set (n = 24) these four cellular markers showed a high accuracy rate for the clinical responses of the patients (AUC = 0.92). Conclusion. Combination of biomarkers reflecting host immune activity is quite valuable for the responder prediction.
Authors
Ryusuke Hatae, Kenji Chamoto, Young Hak Kim, Kazuhiro Sonomura, Kei Taneishi, Shuji Kawaguchi, Hironori Yoshida, Hiroaki Ozasa, Yuichi Sakamori, Maryam Akrami, Sidonia Fagarasan, Izuru Masuda, Yasushi Okuno, Fumihiko Matsuda, Toyohiro Hirai, Tasuku Honjo
Abstract
Immune checkpoint inhibitor (ICI) treatment has recently become a first-line therapy for many non–small cell lung cancer (NSCLC) patients. Unfortunately, most NSCLC patients are refractory to ICI monotherapy, and initial attempts to address this issue with secondary therapeutics have proven unsuccessful. To identify entities precluding CD8+ T cell accumulation in this process, we performed unbiased analyses on flow cytometry, gene expression, and multiplexed immunohistochemical data from a NSCLC patient cohort. The results revealed the presence of a myeloid-rich subgroup, which was devoid of CD4+ and CD8+ T cells. Of all myeloid cell types assessed, neutrophils were the most highly associated with the myeloid phenotype. Additionally, the ratio of CD8+ T cells to neutrophils (CD8/PMN) within the tumor mass optimally distinguished between active and myeloid cases. This ratio was also capable of showing the separation of patients responsive to ICI therapy from those with stable or progressive disease in 2 independent cohorts. Tumor-bearing mice treated with a combination of anti-PD1 and SX-682 (CXCR1/2 inhibitor) displayed relocation of lymphocytes from the tumor periphery into a malignant tumor, which was associated with induction of IFN-γ–responsive genes. These results suggest that neutrophil antagonism may represent a viable secondary therapeutic strategy to enhance ICI treatment outcomes.
Authors
Julia Kargl, Xiaodong Zhu, Huajia Zhang, Grace H. Y. Yang, Travis J. Friesen, Melissa Shipley, Dean Y. Maeda, John A. Zebala, Jill McKay-Fleisch, Gavin Meredith, Afshin Mashadi-Hossein, Christina Baik, Robert H. Pierce, Mary W. Redman, Jeffrey C. Thompson, Steven M. Albelda, Hamid Bolouri, A. McGarry Houghton
Abstract
Pancreatic ductal adenocarcinoma (PDAC) has dismal five-year survival (<9%). We hypothesize that exposure of tumors to conventional therapies may preferentially modulate immune biomarkers in the tumor microenvironment in PDAC. PDAC patients who underwent upfront surgical resection or who received neoadjuvant FOLFIRINOX with or without neoadjuvant radiotherapy followed by surgical resection were selected for study. Total expression of immunologically relevant transcripts and spatially resolved expression of immunologically relevant proteins was quantitated using multiplexed methods (Nanostring nCounter and GeoMX platforms). This analysis identified numerous differentially expressed transcripts associated with the type of neoadjuvant therapy received. Moreover, we identified significant alterations in the expression and/or spatial distribution of immunologically relevant proteins in different regions (tumor cell rich, immune cell rich, stromal cell rich) of the TME. These data provide insight into the immunological effects of clinically relevant neoadjuvant therapy for resectable/borderline-resectable PDAC, by describing significant differences in the expression of key immunologic biomarkers within the PDAC microenvironment that were associated with the type of treatment patients received prior to surgical resection. This represents a comprehensive analysis of numerous biomarkers conducted on the PDAC microenvironment. This work may guide strategic new combination therapies for pancreatic cancer.
Authors
Matthew R. Farren, Layal Sayegh, Michael Brandon Ware, Hsiao-Rong Chen, Jingjing Gong, Yan Liang, Alyssa Krasinskas, Shishir K. Maithel, Mohammad Zaidi, Juan M. Sarmiento, David Kooby, Pretesh Patel, Bassel El-Rayes, Walid Shaib, Gregory B. Lesinski
Abstract
NK cells contribute to protective antitumor immunity, but little is known about the functional states of NK cells in human solid tumors. To address this issue, we performed single-cell RNA-seq analysis of NK cells isolated from human melanoma metastases, including lesions from patients who had progressed following checkpoint blockade. This analysis identified major differences in the transcriptional programs of tumor-infiltrating compared with circulating NK cells. Tumor-infiltrating NK cells represented 7 clusters with distinct gene expression programs indicative of significant functional specialization, including cytotoxicity and chemokine synthesis programs. In particular, NK cells from 3 clusters expressed high levels of XCL1 and XCL2, which encode 2 chemokines known to recruit XCR1+ cross-presenting DCs into tumors. In contrast, NK cells from 2 other clusters showed a higher level of expression of cytotoxicity genes. These data reveal key features of NK cells in human tumors and identify NK cell populations with specialized gene expression programs.
Authors
Lucas Ferrari de Andrade, Yuheng Lu, Adrienne Luoma, Yoshinaga Ito, Deng Pan, Jason W. Pyrdol, Charles H. Yoon, Guo-Cheng Yuan, Kai W. Wucherpfennig
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