BACKGROUND: Immune checkpoint inhibitors (ICIs), including those targeting PD-1, are currently used in a wide range of tumors, but only 20-40% of patients achieve clinical benefit. The objective of our study was to find predictive peripheral blood-based biomarkers for ICI treatment. METHODS: In 41 patients with advanced malignant melanoma (MM) and NSCLC treated with PD-1 inhibitors, we analyzed peripheral blood-based immune subsets by flow cytometry before treatment initialization and the second therapy dose. Specifically, we assessed basic blood differential count, overall T cells and their subgroups, B cells, and myeloid-derived suppressor cells (MDSC). In detail, CD4 + and CD8 + T cells were assessed according to their subtypes, such as central memory T cells (TCM), effector memory T cells (TEM), and naïve T cells (TN). Furthermore, we also evaluated the predictive value of CD28 and ICOS/CD278 co-expression on T cells. RESULTS: Patients who achieved disease control on ICIs had a significantly lower baseline proportion of CD4 + TEM (p = 0.013) and tended to have a higher baseline proportion of CD4 + TCM (p = 0.059). ICI therapy-induced increase in Treg count (p = 0.012) and the proportion of CD4 + TN (p = 0.008) and CD28 + ICOS- T cells (p = 0.012) was associated with disease control. Patients with a high baseline proportion of CD4 + TCM and a low baseline proportion of CD4 + TEM showed significantly longer PFS (p = 0.011, HR 2.6 and p ˂ 0.001, HR 0.23, respectively) and longer OS (p = 0.002, HR 3.75 and p ˂ 0.001, HR 0.15, respectively). Before the second dose, the high proportion of CD28 + ICOS- T cells after ICI therapy initiation was significantly associated with prolonged PFS (p = 0.017, HR 2.51) and OS (p = 0.030, HR 2.69). Also, a high Treg count after 2 weeks of ICI treatment was associated with significantly prolonged PFS (p = 0.016, HR 2.33). CONCLUSION: In summary, our findings suggest that CD4 + TEM and TCM baselines and an early increase in the Treg count induced by PD-1 inhibitors and the proportion of CD28 + ICOS- T cells may be useful in predicting the response in NSCLC and MM patients.
- MeSH
- antigeny CD278 metabolismus MeSH
- antigeny CD279 antagonisté a inhibitory MeSH
- antigeny CD28 MeSH
- CD8-pozitivní T-lymfocyty imunologie účinky léků metabolismus MeSH
- dospělí MeSH
- inhibitory kontrolních bodů * terapeutické užití farmakologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- melanom * farmakoterapie imunologie krev patologie MeSH
- nádory plic * farmakoterapie imunologie krev patologie MeSH
- nemalobuněčný karcinom plic * farmakoterapie imunologie krev patologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Neoadjuvant chemotherapy (NAC) is the preferred treatment option in locally advanced breast cancer (BC). The administration of NAC is associated with a wide range of adverse effects. This pilot observational prospective study examined the effect of NAC using anthracycline + cyclophosphamide (AC) followed by paclitaxel (PTx) on a portfolio of 22 plasma and urinary amino acids, plasma proteins (albumin, prealbumin, transferrin), and products of nitrogen metabolism (urea, creatinine, uric acid) in plasma and urine. Plasma and 24-h urine samples were obtained from ten patients with early breast cancer (N1-3 N0-2 M0), at the following time points: before the start of NAC and during the AC/PTx treatment period (a total of 8 measurements at three-weekly intervals). Amino acids were analyzed using ion exchange chromatography. There were no significant differences in the measured parameters in plasma and urine between pre-NAC and during AC- and PTx-treatment. No trend was detected. A significant difference in the portfolio of plasma and urinary amino acids was found only in the pre-treatment period compared to the control group. Levels of eight plasma amino acids (8/22) were significantly reduced and those of nine urine amino acids were increased (9/22). Nitrogenous catabolites in plasma and urine were not indicative of increased protein catabolism during the anthracycline and taxane treatment periods. A slightly positive nitrogen balance was accompanied by an average weight gain of 3.3 kg (range 0-6 kg). The AC/PTx treatment regimen did not cause significant changes in the monitored laboratory parameters.
- MeSH
- aminokyseliny * moč krev MeSH
- antracykliny terapeutické užití aplikace a dávkování MeSH
- cyklofosfamid * terapeutické užití MeSH
- dospělí MeSH
- dusík * moč MeSH
- kreatinin moč krev MeSH
- krevní proteiny * metabolismus analýza MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory prsu * farmakoterapie krev moč MeSH
- neoadjuvantní terapie * MeSH
- paclitaxel * terapeutické užití aplikace a dávkování MeSH
- pilotní projekty MeSH
- prospektivní studie MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- senioři MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- pozorovací studie MeSH
Plasma specimens from coronavirus disease 2019 patients were double-tested for anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies by two different batches of MAGLUMI 2019-nCov immunoglobulin M/immunoglobulin G (IgM/IgG) assays to evaluate IgM/IgG levels, qualitative interpretation, antibody kinetics, and linearity of diluted specimen. Here we show that (i) high-level IgM specimens need to be diluted with negative human plasma but not kit diluents and (ii) measured anti-SARS-CoV-2 IgM/IgG concentrations are substantially higher with later marketed immunoassay batch leading to (iii) the change of qualitative interpretation (positive vs. negative) in 12.3% of specimens measured for IgM, (iv) the informative time-course pattern of antibody production only when data from different immunoassay batches are not combined.
- MeSH
- COVID-19 krev imunologie MeSH
- imunoanalýza metody MeSH
- imunoglobulin G krev imunologie MeSH
- imunoglobulin M krev imunologie MeSH
- lidé MeSH
- luminiscence MeSH
- luminiscenční měření metody MeSH
- protilátky virové imunologie MeSH
- SARS-CoV-2 imunologie MeSH
- senzitivita a specificita MeSH
- testování na COVID-19 metody MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUND: In a prospective study with long-term follow-up, we analyzed circulating T cell subsets in patients with metastatic colorectal cancer (mCRC) in the context of primary tumor sidedness, KRAS status, and clinical outcome. Our primary goal was to investigate whether baseline levels of circulating T cell subsets serve as a potential biomarker of clinical outcome of mCRC patients treated with an anti-VEGF-based regimen. METHODS: The study group consisted of 36 patients with colorectal adenocarcinoma who started first-line chemotherapy with bevacizumab for metastatic disease. We quantified T cell subsets including Tregs and CD8+ T cells in the peripheral blood prior to therapy initiation. Clinical outcome was evaluated as progression-free survival (PFS), overall survival (OS), and objective response rate (ORR). RESULTS: 1) mCRC patients with KRAS wt tumors had higher proportions of circulating CD8+ cytotoxic T cells among all T cells but also higher measures of T regulatory (Treg) cells such as absolute count and a higher proportion of Tregs in the CD4+ subset. 2) A low proportion of circulating Tregs among CD4+ cells, and a high CD8:Treg ratio at initiation of VEGF-targeting therapy, were associated with favorable clinical outcome. 3) In a subset of patients with primarily right-sided mCRC, superior PFS and OS were observed when the CD8:Treg ratio was high. CONCLUSIONS: The baseline level of circulating immune cells predicts clinical outcome of 1st-line treatment with the anti-VEGF angio/immunomodulatory agent bevacizumab. Circulating immune biomarkers, namely the CD8:Treg ratio, identified patients in the right-sided mCRC subgroup with favorable outcome following treatment with 1st-line anti-VEGF treatment.
- MeSH
- adenokarcinom krev farmakoterapie mortalita patologie MeSH
- bevacizumab aplikace a dávkování terapeutické užití MeSH
- cytotoxické T-lymfocyty metabolismus MeSH
- doba přežití bez progrese choroby MeSH
- dospělí MeSH
- inhibitory angiogeneze aplikace a dávkování terapeutické užití MeSH
- kolorektální nádory krev farmakoterapie mortalita patologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů farmakoterapie MeSH
- míra přežití MeSH
- nádorové biomarkery metabolismus MeSH
- následné studie MeSH
- počet lymfocytů MeSH
- prospektivní studie MeSH
- protoonkogenní proteiny p21(ras) analýza MeSH
- regulační T-lymfocyty metabolismus MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- vaskulární endoteliální růstový faktor A antagonisté a inhibitory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
BACKGROUND: Rechallenge with oxaliplatin is common in the treatment of colorectal cancer and increases the risk of a detrimental oxaliplatin-induced immune reaction. Allergic reactions to oxaliplatin may be partially avoided by desensitization protocols involving immune suppressive drugs, slow administration and gradually increasing chemotherapeutic doses. However, non-IgE-mediated immunopathologic reactions to oxaliplatin remain challenging and may be potentially life-threatening. CASE PRESENTATION: Here we report two potentially fatal cases of type II hypersensitivity to oxaliplatin in metastatic colorectal cancer patients. Both patients manifested with severe thrombocytopenia, intravascular haemolysis, and acute kidney injury 4-6 h after oxaliplatin administration in a rechallenge setting. Serology revealed that the reactive entity for immune haemolysis was an IgG oxaliplatin-induced antibody. The course of anti-cancer treatment and severe adverse event after oxaliplatin rechallenge including diagnostic dilemma and the results of detailed routine clinical chemistry and hematology testing are described. Extended immunohaematology/serology testing revealed that the oxaliplatin-induced IgG antibody was present in the circulation prior to the onset of hypersensitivity, persisted for months and elicited cross-reactivity with other platinum agents. CONCLUSION: Development of type II hypersensitivity reaction manifesting as a sudden onset of severe thrombocytopenia and immune haemolysis must be considered in patients treated with oxaliplatin, especially those on long-term therapy or when rechallenged. Step-wise diagnosis involves clinical presentation, detection of haemolysis in patient's blood and/or urine, evaluation of platelet count, and direct anti-globulin Coombs test.
- MeSH
- adenokarcinom komplikace diagnóza farmakoterapie MeSH
- akutní poškození ledvin MeSH
- desenzibilizace imunologická MeSH
- hemolýza MeSH
- hormony kůry nadledvin terapeutické užití MeSH
- léková alergie diagnóza farmakoterapie etiologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nádory rekta komplikace diagnóza farmakoterapie MeSH
- nežádoucí účinky léčiv diagnóza farmakoterapie etiologie MeSH
- oxaliplatin škodlivé účinky terapeutické užití MeSH
- protinádorové látky škodlivé účinky terapeutické užití MeSH
- senioři MeSH
- trombocytopenie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
PURPOSE: The goal of our analysis was to study pretherapeutic circulating 25-OHD plasma levels in patients with previously untreated advanced gastric cancer treated in the randomised controlled phase III Erbitux (cetuximab) in combination with Xeloda (capecitabine) and cisplatin in advanced esophago-gastric cancer (EXPAND) trial (NCT00678535) and to explore whether low 25-OHD plasma levels are associated with worse prognosis and may compromise the clinical efficacy of cetuximab. METHODS: Six hundred thirty patients with available pretherapeutic 25-OHD plasma levels and treated with chemotherapy based on capecitabine and cisplatin, or chemotherapy and cetuximab, were included. The Cox proportional hazard regression model was used to analyse the association between low 25-OHD and survival in both treatment arms. RESULTS: Majority of study patients were found to have severe vitamin D deficiency. No prognostic impact of 25-OHD plasma levels could be found in our patient cohort, and there was no indication of an interference of 25-OHD plasma levels and the efficacy of treatment with the anti-epidermal growth factor receptor monoclonal antibody cetuximab. CONCLUSIONS: Although majority of patients with advanced gastric cancer show hypovitaminosis D deficiency, there is no proof for a negative impact on survival or reduced treatment response. A prospective study is needed to investigate the potential benefit of vitamin D supplementation in this patient cohort during first-line chemotherapy.
- MeSH
- adenokarcinom krev farmakoterapie mortalita MeSH
- capecitabinum terapeutické užití MeSH
- cetuximab terapeutické užití MeSH
- cisplatina terapeutické užití MeSH
- erbB receptory antagonisté a inhibitory MeSH
- humanizované monoklonální protilátky terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- nádory žaludku krev farmakoterapie mortalita MeSH
- nedostatek vitaminu D epidemiologie MeSH
- prevalence MeSH
- prognóza MeSH
- protokoly protinádorové kombinované chemoterapie terapeutické užití MeSH
- senioři MeSH
- vitamin D krev MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky, fáze III MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
Východiska: Myeloidní supresorové buňky (MDSCs) přispívají k úniku nádoru imunitní kontrole a podporují nádorový růst produkcí růstových faktorů. Zaměřili jsme se na klinické a analytické otázky týkající se MDSCs jako potenciálních biomarkerů a imunitních regulátorů, které se podílejí na progresi nádoru. Soubor pacientů a metody: Analyzovali jsme skupinu 10 pacientů s pokročilým kolorektálním karcinomem (colorectal carcinoma - CRC) a přítomnými metastázami (podskupina M1), nebo bez metastáz (podskupina M0) v době diagnózy. Krev byla pacientům odebrána v době diagnózy před zahájením protinádorové léčby a dále 12 měsíců po zahájení léčby. Fluorescenční imunoanalýzou na průtokovém cytometru byly detekovány subpopulace MDSCs - monocytární MDSC (M-MDSCs) s imunofenotypem CD45+ CD11b+ CD33+ HLA-DRlow/-CD14+ CD15- a granulocytární MDSC (CD33hi PMN-MDSC) s imunofenotypem CD45+ CD11b+ CD33hi HLA-DRlow/- CD14- CD15+. V preanalytické a analytické části studie byly změřeny náhodně vybrané vzorky krve pacientů s onkologickou diagnózou. Výsledky: Hladina cirkulujících M-MDSCs není asociována s metastatickým CRC. Naopak cirkulující CD33hi PMN-MDSCs byly zvýšeny u pacientů se vzdálenými metastázami (M1) v porovnání s T3 M0 podskupinou. Cirkulující M-MDSCs byly zvýšeny po podání chemoterapeutické léčby u 9 z 10 pacientů. CD33hi PMN-MDSCs značně poklesly po zahájení léčby u 5 z 10 pacientů a byly zvýšeny u 2 z 10 pacientů. Absolutní a relativní počty MDSCs spolu korelovaly a oba mohou být použity pro kvantifikaci MDSCs. Variační koeficient (CV) opakovatelnosti byl 6-11 % pro M-MDSCs a 25-44 % pro CD33hi PMN-MDSCs. CV mezilehlé preciznosti byl vyšší - 8-22 % u M-MDSCs a 35-79 % u CD33hi PMN-MDSCs, což ukazuje, že časová prodleva měření MDSCs ve vzorku plné krve ovlivňuje množství detekovaných MDSCs. Závěr: Kvantifikace subpopulací MDSC je závislá na typu zkoumaného vzorku a jeho preanalytickém zpracování. Explorativní analýza M-MDSCs a CD33hi PMN-MDSCs u pacientů s CRC ukázala, že dynamika cirkulujících MDSCs před a po podání protinádorové léčby je odlišná s ohledem na konkrétní subset myeloidních supresorových buněk.
Background: Myeloid-derived suppressor cells (MDSCs) contribute to tumor escape from host immune surveillance and to tumor progression by producing tumor-promoting factors. We focused on clinical and analytical MDSCs-related issues as potential biomarkers and immune regulators involved in tumor progression. Patients and Methods: We analyzed 10 patients with advanced colorectal carcinoma (CRC) with (M1 subgroup) or without (M0 subgroup) distant metastases at diagnosis. Peripheral blood was collected at diagnosis prior to treatment and subsequently 12 months after therapy initiation. Using multicolor flow cytometry MDSC subsets were evaluated. Monocytic MDSCs (M-MDSCs) were detected as CD45+ CD11b+ CD33+ HLA-DRlow/- CD14+ CD15- granulocytic MDSCs (CD33hi PMN-MDSC) were detected as CD45+ CD11b+ CD33hi HLA-DRlow/- CD14- CD15+. For analytical and preanalytical studies, random fresh blood specimens predominantly from cancer patients were analyzed. Results: Levels of circulating M-MDSCs were not associated with metastatic disease within advanced CRC patients. Levels of circulating CD33hi PMN-MDSCs were elevated in patients with distant metastases compared to T3 M0 subgroup. Circulating M-MDSCs increased upon treatment initiation in 9 out of 10 patients. CD33hi PMN-MDSCs substantially dropped upon treatment initiation in 5 out of 10 patients and substantially increased in 2 out of 10 patients. Analytical part showed that absolute and relative counts within each MDSC subset are correlated. Coefficient of variation (CV) for repeatability was 6-11% for M-MDSCs and 25-44% for CD33hi PMN-MDSCs. CV for reproducibility was higher with 8-22% for M-MDSCs and 35-79% for CD33hi PMN-MDSCs demonstrating that delay in measurement of MDSCs in whole blood specimen may distort quantification of circulating MDSC subsets. Conclusion: The quantification of MDSC subsets is substantially dependent on the type of specimen examined and its preanalytical processing. Exploratory analysis of M-MDSCs and CD33hi PMN-MDSCs in CRC patients revealed different dynamics of M-MDSC and CD33hi PMN-MDSC subsets in the context anti-cancer treatment.
- MeSH
- cholekalciferol terapeutické užití MeSH
- interpretace statistických dat MeSH
- kolorektální nádory * diagnóza terapie MeSH
- lidé MeSH
- metastázy nádorů MeSH
- nedostatek vitaminu D MeSH
- prognóza MeSH
- prospektivní studie MeSH
- vitamin D * krev MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- práce podpořená grantem MeSH
AIM: To develop and validate a biomarker-based index to optimize referral and diagnosis of patients with suspected ovarian cancer. Furthermore, to compare this new index with the Risk of Malignancy Index (RMI) and Risk of Ovarian Malignancy Algorithm (ROMA). PATIENTS AND METHODS: A training study, consisting of patients with benign ovarian disease (n=809) and ovarian cancer (n=246), was used to develop the Copenhagen Index (CPH-I) utilizing the variables serum HE4, serum CA125 and patient age. Eight international studies provided the validation population; comprising 1060 patients with benign ovarian masses and 550 patients with ovarian cancer. RESULTS: Overall, 2665 patients were included. CPH-I was highly significant in discriminating benign from malignant ovarian disease. At the defined cut-off of 0.070 for CPH-I the sensitivity and specificity were 95.0% and 78.4% respectively in the training cohort and 82.0% and 88.4% in the validation cohort. Comparison of CPH-I, ROMA and RMI demonstrated area-under-curve (AUC) at 0.960, 0.954 and 0.959 respectively in the training study and 0.951, 0.953 and 0.935 respectively in the validation study. Using a sensitivity of 95.0%, the specificities for CPH-I, ROMA and RMI in the training cohort were 78.4%, 71.7% and 81.5% respectively, and in the validation cohort 67.3%, 70.7% and 69.5% respectively. CONCLUSION: All three indices perform well at the clinically relevant sensitivity of 95%, but CPH-I, unlike RMI and ROMA, is independent of ultrasound and menopausal status, and may provide a simple index to optimize referral of women with suspected ovarian cancer.
- MeSH
- algoritmy MeSH
- antigen CA-125 krev MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- kohortové studie MeSH
- lidé středního věku MeSH
- lidé MeSH
- membránové proteiny krev MeSH
- mladiství MeSH
- mladý dospělý MeSH
- multivariační analýza MeSH
- nádorové biomarkery krev MeSH
- nádory vaječníků krev diagnóza patologie MeSH
- nemoci ovaria krev diagnóza patologie MeSH
- prospektivní studie MeSH
- proteiny metabolismus MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- statistické modely MeSH
- stupeň závažnosti nemoci MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
Cisplatin and doxorubicin are widely used anticancer drugs that cause DNA damage, which activates the ATM-Chk2-p53 pathway in cancer cells. This activation leads to cell cycle block or apoptosis, depending on the nature of the DNA damage. In an attempt to enhance the effects of these agents, we inhibited ATM/ATR and Chk2, which are known upstream regulators of p53. The cancer cell lines A2780 and ARN8, bearing the wild-type p53 protein, were used to study changes in p53 activation and trans-activation. Our results suggest that the G(1)-checkpoint, normally activated by DNA damage, is functionally overcome by the action of kinase inhibitors that sensitize cells to apoptosis. Both inhibitors show these effects, albeit with variable intensity in different cell lines, which is promising for other studies and theoretically for use in clinical practice.
- MeSH
- apoptóza MeSH
- cisplatina farmakologie MeSH
- DNA vazebné proteiny antagonisté a inhibitory metabolismus MeSH
- down regulace MeSH
- doxorubicin farmakologie MeSH
- G0 fáze MeSH
- inhibitory proteinkinas farmakologie MeSH
- lidé MeSH
- nádorové buněčné linie MeSH
- nádorové supresorové proteiny antagonisté a inhibitory metabolismus MeSH
- nádorový supresorový protein p53 metabolismus MeSH
- poškození DNA MeSH
- protein-serin-threoninkinasy antagonisté a inhibitory metabolismus MeSH
- proteiny buněčného cyklu antagonisté a inhibitory metabolismus MeSH
- protinádorové látky farmakologie MeSH
- průtoková cytometrie MeSH
- signální transdukce MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
