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Pustular Lichenoid Eruptions Induced by Immune Checkpoint Inhibitors: Two Case Reports and a Review of the Literature. 免疫检查点抑制剂引起的脓疱性地衣样疹:两例报告和文献综述。
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-02-01 DOI: 10.1097/CJI.0000000000000449
Charlotte Emonet, Florence Tétart, Olivia Bauvin, Lucie Cellier, Philippe Courville, Claire Mignard, Raphaël Janela-Lapert, Alexis Lefebvre, Samy Lachkar, Diane Lechevalier, Laurence Lagarce, Priscille Carvalho, Billal Tedbirt

Immune checkpoint inhibitors (ICIs) have become the standard treatment for many types of cancer. After several years of using these therapies, many adverse events related to ICIs have been observed. Dermatologic toxicities such as nonspecific morbilliform rash, vitiligo, Stevens-Johnson syndrome/toxic epidermal necrolysis, and more rarely, lichenoid eruptions have been described in the literature. We report 2 cases of pustular lichenoid eruptions, 1 in a patient with nonsmall cell lung carcinoma and 1 in a patient with metastatic melanoma, induced by pembrolizumab and nivolumab, respectively. The 2 patients were treated with topical corticosteroids, and complete healing of lesions was slowly obtained. Due to the severity of the cutaneous eruptions, pembrolizumab and nivolumab were discontinued. We identified 6 cases of pustular lichenoid eruptions induced by ICIs in the published literature and in the French Pharmacovigilance Database and reviewed their main clinical features and courses.

免疫检查点抑制剂(ICIs)已成为许多类型癌症的标准治疗方法。在使用这些疗法数年后,已经观察到许多与ici相关的不良事件。皮肤毒性,如非特异性麻疹样皮疹,白癜风,史蒂文斯-约翰逊综合征/中毒性表皮坏死松解,以及更罕见的地衣样疹,在文献中已有描述。我们报告2例脓疱性地衣样疹,1例为非小细胞肺癌患者,1例为转移性黑色素瘤患者,分别由派姆单抗和纳武单抗诱导。2例患者局部应用皮质类固醇治疗,病灶完全愈合缓慢。由于皮肤皮疹的严重程度,派姆单抗和纳武单抗被停药。我们在已发表的文献和法国药物警戒数据库中发现了6例由ICIs引起的地衣样脓疱性爆发,并回顾了他们的主要临床特征和病程。
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引用次数: 0
Haploidentical γδ T Cells Induce Complete Remission in Chemorefractory B-cell Non-Hodgkin Lymphoma. 单倍体γδ T细胞诱导化疗难治性b细胞非霍奇金淋巴瘤完全缓解
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-02-01 DOI: 10.1097/CJI.0000000000000450
Anna Bold, Johannes Gaertner, Alexander Bott, Volker Mordstein, Kerstin Schaefer-Eckart, Martin Wilhelm

The transformation of chronic lymphocytic leukemia to an aggressive lymphoma, called Richter transformation, is often accompanied by resistance to chemotherapy and high mortality. Thus, novel therapeutic strategies are required for the successful treatment of these patients. One possibility is cellular immunotherapy with chimeric antigen receptor T cells. However, the time delay until cells are available and the limited number of effector cells due to the impaired immune system of these patients potentially compromises the efficacy of this approach. Another promising attempt might be the therapy with γδ T cells. Once activated, they exhibit various antitumor effects against several types of malignancies. Furthermore, they can be safely used in an allogeneic setting and can be multiplied in vivo as already demonstrated in clinical studies. In vitro data, in addition, show that the cytotoxicity of γδ T cells can be significantly enhanced by monoclonal antibodies. Here we present a patient, who suffered from Richter transformation and did not respond to several lines of immunochemotherapy. Due to the lack of further therapy options, we conducted an individual therapy with adoptive transfer of haploidentical γδ T cells combined with the application of the monoclonal antibody obinutuzumab. A histologically confirmed complete remission was achieved through this therapy approach, whereby relevant side effects were not seen. This case highlights the potential of γδ T cells and the feasibility of this therapeutic approach for further clinical trials.

慢性淋巴细胞白血病向侵袭性淋巴瘤的转化,称为Richter转化,通常伴随着对化疗的抵抗和高死亡率。因此,需要新的治疗策略来成功治疗这些患者。一种可能性是使用嵌合抗原受体T细胞进行细胞免疫治疗。然而,细胞可用的时间延迟和由于这些患者免疫系统受损而导致的效应细胞数量有限,可能会损害这种方法的有效性。另一个有希望的尝试可能是用γδ T细胞治疗。一旦激活,它们对几种类型的恶性肿瘤表现出不同的抗肿瘤作用。此外,它们可以安全地用于异体环境,并且可以在体内繁殖,这已经在临床研究中得到证实。此外,体外实验数据表明,单克隆抗体可显著增强γδ T细胞的细胞毒性。在这里,我们提出了一个病人,谁遭受了里希特转化和没有响应的几线免疫化疗。由于缺乏进一步的治疗选择,我们采用了单克隆抗体obinutuzumab结合单克隆抗体的单克隆转移单倍体γδ T细胞的个体化治疗。组织学证实,通过这种治疗方法完全缓解,因此没有看到相关的副作用。这个病例强调了γδ T细胞的潜力和这种治疗方法在进一步临床试验中的可行性。
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引用次数: 2
Risk Factors for Refractory Immune Checkpoint Inhibitor-related Pneumonitis in Patients With Lung Cancer. 肺癌患者出现难治性免疫检查点抑制剂相关肺炎的风险因素
IF 3.2 4区 医学 Q3 IMMUNOLOGY Pub Date : 2023-02-01 Epub Date: 2023-01-16 DOI: 10.1097/CJI.0000000000000451
Peixin Tan, Wei Huang, Xinyan He, Fengquan Lv, Yanhai Cui, Shasha Du

Checkpoint inhibitor-related pneumonitis (CIP) is one of the most important immune checkpoint inhibitors side effects, and it is rare but fatal. Identifying patients at risk of refractory CIP before the start of CIP therapy is important for controlling CIP. We retrospectively analyzed the clinical data of 60 patients with lung cancer who developed CIP. Refractory CIP was defined as CIP with poor response to corticosteroid treatment, including CIP not relieved with corticosteroid administration or CIP recurrence during the corticosteroid tapering period. We analyzed clinical characteristics, peripheral blood biomarkers, treatment, and outcomes in nonrefractory and refractory CIP. Risk factors associated with refractory CIP were assessed. Among 60 patients with CIP, 16 (26.7%) had refractory CIP. The median onset time for patients with nonrefractory and those with refractory CIP was 16.57 (interquartile range [IQR], 6.82-28.14) weeks and 7.43 (IQR, 2.71-19.1) weeks, respectively. The level of lactate dehydrogenase (LDH) was significantly higher in the refractory CIP group at baseline (255 [222, 418] vs. 216 [183, 252], P =0.031) and at CIP onset (321.5 [216.75, 487.5] vs. 219 [198. 241], P =0.019). An LDH level >320 U/L at CIP onset was an independent risk factor of refractory CIP (odds ratio [OR], 8.889; 95% confidence interval [CI]: 1.294-61.058; P =0.026). The incidence of refractory CIP is high among patients with CIP. An increased LDH level at CIP onset is independently associated with refractory CIP. Monitoring LDH levels during immune checkpoint inhibitors treatment is recommended.

检查点抑制剂相关肺炎(CIP)是免疫检查点抑制剂最重要的副作用之一,虽然罕见但却是致命的。在CIP治疗开始前识别出有难治性CIP风险的患者对于控制CIP非常重要。我们回顾性分析了60例发生CIP的肺癌患者的临床数据。难治性CIP的定义是对皮质类固醇治疗反应差的CIP,包括使用皮质类固醇后CIP仍未缓解或在皮质类固醇减量期间CIP复发。我们分析了非难治性和难治性CIP的临床特征、外周血生物标志物、治疗和预后。我们还评估了与难治性 CIP 相关的风险因素。在60名CIP患者中,16人(26.7%)患有难治性CIP。非难治性和难治性CIP患者的中位发病时间分别为16.57周(四分位距[IQR]为6.82-28.14)和7.43周(四分位距[IQR]为2.71-19.1)。难治性CIP组的乳酸脱氢酶(LDH)水平在基线时(255 [222, 418] vs. 216 [183, 252],P =0.031)和CIP发病时(321.5 [216.75, 487.5] vs. 219 [198. 241],P =0.019)显著高于难治性CIP组。CIP发病时LDH水平>320 U/L是难治性CIP的独立危险因素(几率比[OR],8.889;95%置信区间[CI],1.294-61.058):1.294-61.058; P =0.026).难治性 CIP 在 CIP 患者中的发病率很高。CIP发病时LDH水平升高与难治性CIP独立相关。建议在免疫检查点抑制剂治疗期间监测LDH水平。
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引用次数: 0
Efficacy and Safety of Immune Checkpoint Inhibitors in Triple-negative Breast Cancer: A Study Based on 41 Cohorts Incorporating 6558 Participants. 免疫检查点抑制剂在三阴性乳腺癌中的疗效和安全性:一项基于41个队列纳入6558名参与者的研究
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-02-01 DOI: 10.1097/CJI.0000000000000447
Qing Wu, Chunlan Wu, Xianhe Xie

The project was designed to investigate the efficacy and safety of immune checkpoint inhibitors (ICIs) in triple-negative breast cancer (TNBC). Electronic databases were screened to identify relevant trials. The primary endpoints were prognostic parameters and adverse events (AEs) through pooled rate, odds ratio, and hazard ratio (HR) with 95% CI. Totally, 6558 TNBC patients from 41 cohorts were included. The pooled pathologic complete response rate (odds ratio=2.03, 95% CI: 1.35-3.06, P =0.0007) and event-free survival (HR=0.84, 95% CI: 0.73-0.96, P =0.0100) of ICIs plus chemotherapy was higher than that of chemotherapy-alone in early-stage TNBC. For metastatic TNBC, compared with chemotherapy-alone, the addition of ICIs prolonged the progression-free survival (PFS) (HR=0.92, 95% CI: 0.88-0.96, P <0.0001); the improvement also existed in the following 3 subgroups: programmed cell death-ligand 1 positive, race of White and Asian, and patients without previous neoadjuvant or adjuvant chemotherapy; however, the benefit of the combined regimen was not observed in overall survival (OS) (HR=0.95; 95% CI: 0.89-1.03, P =0.2127). In addition, the pooled rates of OS, PFS, and objective response rate of ICIs plus chemotherapy were better than those of ICIs plus targeted therapy or ICIs-alone. In the safety analysis, compared with chemotherapy-alone, ICIs plus chemotherapy increased immune-related AEs and several serious AE. The regimen of ICIs plus chemotherapy is promising in both early-stage and metastatic TNBC, while the increased serious AE should not be neglected. Furthermore, the pooled rates of OS, PFS, and objective response rate of ICIs plus chemotherapy were better than those of ICIs plus targeted therapy or ICIs-alone.

该项目旨在研究免疫检查点抑制剂(ICIs)在三阴性乳腺癌(TNBC)中的疗效和安全性。筛选电子数据库以确定相关试验。主要终点是预后参数和不良事件(ae),通过合并率、优势比和95% CI的危险比(HR)来衡量。共纳入41个队列的6558名TNBC患者。在早期TNBC中,ICIs加化疗的总病理完全缓解率(优势比=2.03,95% CI: 1.35 ~ 3.06, P =0.0007)和无事件生存率(HR=0.84, 95% CI: 0.73 ~ 0.96, P =0.0100)高于单纯化疗。对于转移性TNBC,与单独化疗相比,添加ICIs延长了无进展生存期(PFS) (HR=0.92, 95% CI: 0.88-0.96, P
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引用次数: 1
Effect of Antacid Use on Immune Checkpoint Inhibitors in Advanced Solid Cancer Patients: A Systematic Review and Meta-analysis. 抗酸剂对晚期实体癌患者免疫检查点抑制剂的影响:一项系统综述和荟萃分析。
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-02-01 DOI: 10.1097/CJI.0000000000000442
Ruiyi Deng, Hua Zhang, Yuan Li, Yanyan Shi

The influence of antacids use on immune checkpoint inhibitor (ICI) efficacy remains unclear. A systematic review and meta-analysis was performed to evaluate the effect of proton pump inhibitors (PPIs) and histamine-2-receptor antagonists (H2RAs) on ICI efficacy in advanced solid cancer patients. A systematic literature search in PubMed, EMBASE, and Web of Science was performed to retrieve studies investigating the effect of antacid use on ICI efficacy. Overall survival (OS), progression-free survival (PFS), objective response rate (ORR), and immune-related adverse events were measured using hazard ratios (HRs) or odds ratios (ORs). Thirty studies enrolling 16,147 advanced cancer patients receiving ICI treatment were included. The pooled analysis indicated that PPI use was associated with shorter OS (HR=1.40, 95% CI, 1.25-1.57) and PFS (HR=1.34, 95% CI, 1.19-1.52) in advanced cancer patients treated with ICIs. PPI use did not show effect on ORR or immune-related adverse event of advanced cancer patients receiving ICI treatment. OS, PFS, and ORR did not differ between H2RA users and non-H2RA users. In subgroup analyses, PPI use was associated with shorter OS and PFS in NSCLC and urothelial carcinoma patients and in patients treated with anti-programmed cell death 1 or anti-programmed cell death ligand 1 monotherapy. In addition, ICI efficacy was different in the antacid exposure time frame subgroups. In conclusion, PPI use has a negative effect on OS and PFS among advanced cancer patients receiving ICI treatment. PPIs should be cautiously administered among advanced cancer patients treated with ICI. The safety of H2RAs and the influence of H2RAs on ICI efficacy need further investigation.

抗酸剂对免疫检查点抑制剂(ICI)疗效的影响尚不清楚。通过系统回顾和荟萃分析来评估质子泵抑制剂(PPIs)和组胺-2受体拮抗剂(H2RAs)对晚期实体癌患者ICI疗效的影响。在PubMed、EMBASE和Web of Science中进行了系统的文献检索,以检索有关抗酸剂使用对ICI疗效影响的研究。总生存期(OS)、无进展生存期(PFS)、客观缓解率(ORR)和免疫相关不良事件采用风险比(hr)或优势比(ORs)进行测量。30项研究纳入了16147名接受ICI治疗的晚期癌症患者。合并分析表明,使用PPI与接受ICIs治疗的晚期癌症患者较短的OS (HR=1.40, 95% CI, 1.25-1.57)和PFS (HR=1.34, 95% CI, 1.19-1.52)相关。使用PPI对接受ICI治疗的晚期癌症患者的ORR或免疫相关不良事件没有影响。OS、PFS和ORR在H2RA用户和非H2RA用户之间没有差异。在亚组分析中,在非小细胞肺癌和尿路上皮癌患者以及接受抗程序性细胞死亡1或抗程序性细胞死亡配体1单药治疗的患者中,PPI的使用与更短的OS和PFS相关。此外,抗酸剂暴露时间亚组的ICI疗效也不同。综上所述,在接受ICI治疗的晚期癌症患者中,PPI的使用对OS和PFS有负面影响。接受ICI治疗的晚期癌症患者应谨慎使用PPIs。H2RAs的安全性及对ICI疗效的影响有待进一步研究。
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引用次数: 5
Successful Pregnancy and Cancer Outcomes With Ipilimumab and Nivolumab for Metastatic Renal Cell Carcinoma: Case Report and Review of the Literature. Ipilimumab和Nivolumab治疗转移性肾细胞癌的成功妊娠和癌症结局:病例报告和文献回顾。
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-01-01 DOI: 10.1097/CJI.0000000000000448
Francisco Zambrana, Carmen Barbancho, Miriam Huelves, Belén García de Santiago, Yolanda Martín, Marta Muñoz de Lengaria, Guillermo de Velasco

Pregnancy and cancer share CTLA-4 and PD-1/PD-L1 as some of the immunomodulatory pathways that reshape the immune system from a destructive response to a state of tolerance to the fetus and the tumor, respectively. Ipilimumab (anti-CTLA-4 inhibitor) and nivolumab (anti-PD-1 inhibitor) are used in combination for the treatment of metastatic renal cell carcinoma, and their use could theoretically result in an immune response against the fetus. Furthermore, these immune checkpoint inhibitors are immunoglobulin G antibodies that transfer from the mother to the fetus and may cause a direct toxicity. We present the first report of a metastatic renal cell carcinoma patient in which ipilimumab and nivolumab were successfully used starting in her first trimester of pregnancy, with sufficient follow-up to show favorable outcomes for both the mother and the child. We describe our management of this challenging case and we review the available evidence, coming from Developmental and Reproductive Toxicology Studies and case reports of metastatic melanoma patients.

妊娠和癌症共享CTLA-4和PD-1/PD-L1作为一些免疫调节途径,分别重塑免疫系统从对胎儿和肿瘤的破坏性反应到耐受状态。Ipilimumab(抗ctla -4抑制剂)和nivolumab(抗pd -1抑制剂)联合用于治疗转移性肾细胞癌,理论上它们的使用可能导致对胎儿的免疫反应。此外,这些免疫检查点抑制剂是免疫球蛋白G抗体,从母体转移到胎儿,可能导致直接毒性。我们首次报道了一例转移性肾细胞癌患者,在她怀孕的前三个月就成功地使用了易普利姆单抗和纳沃单抗,并进行了充分的随访,显示母亲和孩子都有良好的结果。我们描述了我们对这个具有挑战性的病例的处理,我们回顾了现有的证据,来自发育和生殖毒理学研究以及转移性黑色素瘤患者的病例报告。
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引用次数: 0
The Combination of TIM3-Based Checkpoint Blockade and Oncolytic Virotherapy Regresses Established Solid Tumors. 基于 TIM3 的检查点阻断疗法与溶瘤病毒疗法相结合可使已确诊的实体瘤消退。
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-01-01 Epub Date: 2022-11-01 DOI: 10.1097/CJI.0000000000000444
Cody C Gowan, Mee Y Bartee, Erica Flores, Bulent A Aksoy, Conor Templeton, Kati Baillie, Myroslawa Happe, Eric Bartee

T-cell immunoglobulin and mucin domain 3 (TIM3) is emerging as a potential target for antibody-based checkpoint blockade. However, the efficacy of TIM3 blockade in combination with other treatment modalities, has not been extensively studied. In the current work we combined TIM3 blockade with myxoma virus-based oncolytic virotherapy (OV). Our results demonstrate that myxoma virus's ability to initiate an immense antitumor immune response complements the ability of TIM3 blockade to shift the tumor microenvironment to a more proinflammatory state. As a result, the combination of TIM3 blockade and OV is able to completely eradicate established disease, while neither monotherapy is effective. These data represent the first demonstration that OV can enhance the efficacy of TIM3 blockade and suggest that this treatment may need to be incorporated into more aggressive, combinatorial regimens in order to fulfill its potential as an immunotherapeutic.

T细胞免疫球蛋白和粘蛋白结构域3(TIM3)正在成为基于抗体的检查点阻断疗法的潜在靶点。然而,TIM3阻断与其他治疗方式相结合的疗效尚未得到广泛研究。在目前的研究中,我们将 TIM3 阻断与基于肌瘤病毒的溶瘤病毒疗法(OV)相结合。我们的研究结果表明,肌瘤病毒启动巨大抗肿瘤免疫反应的能力与TIM3阻断将肿瘤微环境转变为更多促炎状态的能力相辅相成。因此,TIM3 阻断与 OV 的联合疗法能够彻底根除既定疾病,而单一疗法均无效。这些数据首次证明了 OV 可以增强 TIM3 阻断的疗效,并表明这种疗法可能需要被纳入更具侵略性的组合疗法中,以发挥其作为免疫疗法的潜力。
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引用次数: 0
The Association of Immunotherapy With the Overall Survival of Inoperable Stage III Non-small Cell Lung Cancer Patients Who Do Not Receive Chemoradiation. 免疫治疗与不能手术且未接受放化疗的III期非小细胞肺癌患者总生存率的关系
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-01-01 DOI: 10.1097/CJI.0000000000000443
Saber A Amin, Michael J Baine, Ibur Rahman, Chi Lin

Immunotherapy has been approved for stage III non-small cell lung cancer (NSCLC) as consolidation therapy after chemoradiation in patients whose disease does not progress after chemoradiation. However, many patients do not receive chemoradiation due to either the drugs' side effects or poor performance status. This study's objective is to investigate the association of immunotherapy combined with chemotherapy or Radiotherapy (RT) with the overall survival (OS) of stage III NSCLC patients who do not receive chemoradiation. Patients with stage III NSCLC who received either chemotherapy or RT with or without immunotherapy were identified from NCDB. The Cox proportional hazard regression analysis was implied to assess the effect of immunotherapy on survival after adjusting the model for age at diagnosis, race, sex, education, treatment facility type, insurance status, comorbidity score, histology year of diagnosis, and treatment types, such as chemotherapy and radiation therapy. The final analysis included 32,328 patients, among whom 3,205 (9.9%) received immunotherapy. In the multivariable analysis adjusted for all the factors previously mentioned, immunotherapy was associated with significantly improved OS (HR: 0.76, CI: 0.71-0.81) compared with no immunotherapy. Treatment with chemotherapy plus immunotherapy was significantly associated with improved OS (HR: 0.83, CI: 0.77-0.90) compared with chemotherapy without immunotherapy. Further, RT plus immunotherapy was associated with significantly improved OS (HR: 0.62, CI: 0.54-0.70) compared with RT alone. In this comprehensive analysis, the addition of immunotherapy to chemotherapy or radiotherapy was associated with improved OS compared with chemotherapy or radiation therapy without immunotherapy in stage III NSCLC patients.

免疫疗法已被批准用于III期非小细胞肺癌(NSCLC)患者在放化疗后疾病没有进展的巩固治疗。然而,由于药物的副作用或表现不佳,许多患者没有接受放化疗。本研究的目的是探讨免疫治疗联合化疗或放疗(RT)与未接受放化疗的III期NSCLC患者总生存期(OS)的关系。接受化疗或放疗(伴或不伴免疫治疗)的III期NSCLC患者从NCDB中确定。在调整了诊断年龄、种族、性别、教育程度、治疗机构类型、保险状况、合并症评分、诊断组织学年份和治疗类型(如化疗和放疗)等因素后,采用Cox比例风险回归分析来评估免疫治疗对生存率的影响。最终分析包括32328例患者,其中3205例(9.9%)接受了免疫治疗。在对上述所有因素进行校正的多变量分析中,与未进行免疫治疗相比,免疫治疗与显著改善的OS相关(HR: 0.76, CI: 0.71-0.81)。与不进行免疫治疗的化疗相比,化疗加免疫治疗与改善OS显著相关(HR: 0.83, CI: 0.77-0.90)。此外,与单独放疗相比,放疗加免疫治疗与显著改善的OS相关(HR: 0.62, CI: 0.54-0.70)。在这项综合分析中,与不进行免疫治疗的化疗或放疗相比,在III期NSCLC患者中,在化疗或放疗中加入免疫治疗与改善OS相关。
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引用次数: 1
Large Scale Ex Vivo Expansion of γδ T cells Using Artificial Antigen-presenting Cells. 人工抗原提呈细胞大规模体外扩增γδ T细胞
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-01-01 DOI: 10.1097/CJI.0000000000000445
Justin C Boucher, Bin Yu, Gongbo Li, Bishwas Shrestha, David Sallman, Ana Marie Landin, Cheryl Cox, Kumar Karyampudi, Claudio Anasetti, Marco L Davila, Nelli Bejanyan

Higher γδ T cell counts in patients with malignancies are associated with better survival. However, γδ T cells are rare in the blood and functionally impaired in patients with malignancies. Promising results are reported on the treatment of various malignancies with in vivo expansion of autologous γδ T cells using zoledronic acid (zol) and interleukin-2 (IL-2). Here we demonstrated that zol and IL-2, in combination with a novel genetically engineered K-562 CD3scFv/CD137L/CD28scFv/IL15RA quadruplet artificial antigen-presenting cell (aAPC), efficiently expand allogeneic donor-derived γδ T cells using a Good Manufacturing Practice (GMP) compliant protocol sufficient to achieve cell doses for future clinical use. We achieved a 633-fold expansion of γδ T cells after day 10 of coculture with aAPC, which exhibited central (47%) and effector (43%) memory phenotypes. In addition, >90% of the expanded γδ T cells expressed NKG2D, although they have low cell surface expression of PD1 and LAG3 inhibitory checkpoint receptors. In vitro real-time cytotoxicity analysis showed that expanded γδ T cells were effective in killing target cells. Our results demonstrate that large-scale ex vivo expansion of donor-derived γδ T cells in a GMP-like setting can be achieved with the use of quadruplet aAPC and zol/IL-2 for clinical application.

恶性肿瘤患者较高的γδ T细胞计数与较好的生存率相关。然而,γδ T细胞在血液中很少见,在恶性肿瘤患者中功能受损。唑来膦酸(zol)和白细胞介素-2 (IL-2)在体内扩增自体γδ T细胞治疗多种恶性肿瘤的研究取得了可喜的结果。在这里,我们证明了zol和IL-2,结合一种新的基因工程K-562 CD3scFv/CD137L/CD28scFv/IL15RA四联体人工抗原呈递细胞(aAPC),使用符合良好生产规范(GMP)的方案,有效地扩增异体供体来源的γδ T细胞,足以达到将来临床使用的细胞剂量。在与aAPC共培养第10天后,我们获得了633倍的γδ T细胞扩增,表现出中心(47%)和效应(43%)记忆表型。此外,>90%的扩增的γδ T细胞表达NKG2D,尽管它们的细胞表面表达PD1和LAG3抑制检查点受体较低。体外实时细胞毒性分析表明,扩增的γδ T细胞能有效杀伤靶细胞。我们的研究结果表明,使用四联体aAPC和zol/IL-2可以在gmp样环境中实现供体来源的γδ T细胞的大规模体外扩增,用于临床应用。
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引用次数: 5
Concomitant Drugs Prognostic Score in Patients With Metastatic Renal Cell Carcinoma Receiving Ipilimumab and Nivolumab in the Compassionate Use Program in Italy: Brief Communication. 在意大利的同情使用计划中接受Ipilimumab和Nivolumab治疗的转移性肾癌患者的伴随药物预后评分:简短交流。
IF 3.9 4区 医学 Q1 Pharmacology, Toxicology and Pharmaceutics Pub Date : 2023-01-01 Epub Date: 2022-11-04 DOI: 10.1097/CJI.0000000000000446
Sebastiano Buti, Umberto Basso, Diana Giannarelli, Ugo De Giorgi, Marco Maruzzo, Roberto Iacovelli, Luca Galli, Camillo Porta, Francesco Carrozza, Giuseppe Procopio, Giuseppe Fonarini, Giovanni Lo Re, Matteo Santoni, Roberto Sabbatini, Antonio Cusmai, Paolo Andrea Zucali, Carlo Aschele, Editta Baldini, Elena Zafarana, Adolfo Favaretto, Silvana Leo, Alketa Hamzaj, Rosanna Mirabelli, Franco Nole', Silvia Zai, Claudio Chini, Cristina Masini, Sonia Fatigoni, Andrea Rocchi, Emiliano Tamburini, Alessio Cortellini, Melissa Bersanelli

A concomitant drug-based score was developed by our group and externally validated for prognostic and predictive purposes in patients with advanced cancer treated with immune checkpoint inhibitors (ICIs). The model considers the use of three classes of drugs within a month before initiating ICI, assigning score 1 for each between proton pump inhibitor and antibiotic administration until a month before immunotherapy initiation and score 2 in case of corticosteroid intake. In the present analysis, the drug score was validated in a prospective population of 305 patients with metastatic renal cell carcinoma treated with ipilimumab plus nivolumab in the first-line setting. The value of the model in predicting overall survival and progression-free survival was statistically significant and clinically meaningful, with an overall survival rate at 12 months of 73% vs. 44% (P<0.0001), and median progression-free survival of 11.6 (95% CI: 9.1-14.1) months versus 4.8 (95% CI: 2.7-7.0) months (P=0.002), respectively, for patients belonging to the favorable group (score 0-1) versus the unfavorable (score 2-4). Further development will be represented by the gut microbiome analysis according to the drug-based model classification and to the outcome of patients to ICI therapy to demonstrate the link between drug exposure and immune sensitivity.

我们的研究小组开发了一种基于药物的伴随评分,并对接受免疫检查点抑制剂(ICIs)治疗的晚期癌症患者的预后和预测目的进行了外部验证。该模型考虑了在开始ICI前一个月内使用三类药物,在质子泵抑制剂和抗生素给药之间各得1分,直到免疫治疗开始前一个月中,在皮质类固醇摄入的情况下得2分。在本分析中,药物评分在305名转移性肾细胞癌患者的前瞻性人群中进行了验证,这些患者在一线环境中接受了易普利木单抗联合尼沃单抗的治疗。该模型在预测总生存率和无进展生存率方面的价值具有统计学意义和临床意义,12个月时的总生存率为73%对44%(P
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Journal of Immunotherapy
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