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Pancreatic cancer and immune checkpoint

Tsutomu Takeda, Nobuaki Hattori, Takashi Takeda, Takehiro Noda, Hiroko Takeda
We treated 19 cancer patients with cancer types other than melanoma and lung cancer with immune checkpoint inhibitors, between June 2015 and April 2016. We administered nivolumab at 2-3mg/kg bw every 2-3 weeks. One patient received 14 doses, 5 received 6 doses, 3 received 5 doses, 3 received 4 doses, and 3 received 3 doses. Three remarkably effective responses were seen in cases of pancreatic cancer, esophageal cancer, and brain malignant lymphoma. In every effective case, dendritic cell therapy was administered prior to nivolumab...
October 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Rebecca A Evans, Mark S Diamond, Andrew J Rech, Timothy Chao, Max W Richardson, Jeffrey H Lin, David L Bajor, Katelyn T Byrne, Ben Z Stanger, James L Riley, Nune Markosyan, Rafael Winograd, Robert H Vonderheide
In carcinogen-driven cancers, a high mutational burden results in neoepitopes that can be recognized immunologically. Such carcinogen-induced tumors may evade this immune response through "immunoediting," whereby tumors adapt to immune pressure and escape T cell-mediated killing. Many tumors lack a high neoepitope burden, and it remains unclear whether immunoediting occurs in such cases. Here, we evaluated T cell immunity in an autochthonous mouse model of pancreatic cancer and found a low mutational burden, absence of predicted neoepitopes derived from tumor mutations, and resistance to checkpoint immunotherapy...
September 8, 2016: JCI Insight
Donnele Daley, Constantinos Pantelis Zambirinis, Lena Seifert, Neha Akkad, Navyatha Mohan, Gregor Werba, Rocky Barilla, Alejandro Torres-Hernandez, Mautin Hundeyin, Vishnu Raj Kumar Mani, Antonina Avanzi, Daniel Tippens, Rajkishen Narayanan, Jung-Eun Jang, Elliot Newman, Venu Gopal Pillarisetty, Michael Loran Dustin, Dafna Bar-Sagi, Cristina Hajdu, George Miller
Inflammation is paramount in pancreatic oncogenesis. We identified a uniquely activated γδT cell population, which constituted ∼40% of tumor-infiltrating T cells in human pancreatic ductal adenocarcinoma (PDA). Recruitment and activation of γδT cells was contingent on diverse chemokine signals. Deletion, depletion, or blockade of γδT cell recruitment was protective against PDA and resulted in increased infiltration, activation, and Th1 polarization of αβT cells. Although αβT cells were dispensable to outcome in PDA, they became indispensable mediators of tumor protection upon γδT cell ablation...
September 8, 2016: Cell
Kazuhiko Ikeuchi, Yusuke Okuma, Taku Tabata
Immune checkpoint inhibitor is a verified standard of care as a second-line chemotherapy for non-small cell lung cancer. Management of immune-related adverse effects (irAEs) is crucial for ensuring patient safety. However, less frequent irAEs may result in complications. Here, we report a patient with recurrent lung adenocarcinoma who was treated with nivolumab and developed immune-related pancreatitis. A 66-year-old Japanese female with recurrent lung adenocarcinoma and metastatic lymph nodes presented with anorexia, vomiting, and back pain on day 18 of two cycles of nivolumab...
September 2016: Lung Cancer: Journal of the International Association for the Study of Lung Cancer
Jianda Yuan
Immune checkpoint blockade therapies are revolutionizing standard cancer treatments. Immune checkpoint inhibitors likely function to enhance the tumor specific antigen response in order to achieve favorable clinical outcomes. Thus, continuous efforts to identify the common tumor-specific antigens are essential for the broad clinical application of these therapies. Several immunoproteomics approaches have been used in order to screen for this specificity. In a recent article from Jhaveri and colleagues published in the February issue of Cancer Immunology Research, antibody biomarkers were screened in pancreatic cancer patients who received allogeneic, granulocyte-macrophage colony stimulating factor-secreting pancreatic cancer vaccine (GVAX) by using a serum antibody-based SILAC immunoprecipitation (SASI) approach...
2016: Journal for Immunotherapy of Cancer
Volker Ellenrieder, Alexander König, Thomas Seufferlein
BACKGROUND: Pancreatic ductal adenocarcinoma (PDAC) is a highly aggressive malignancy with a median 5-year survival of <8%. At the time of diagnosis, a vast majority of pancreatic cancer patients were found to be with either metastatic spread of the disease or locally advanced tumors. Despite relatively low efficacy, gemcitabine administration was the first choice chemotherapeutic strategy in advanced PDAC for many years. In the last 5 years, however, our understanding of pancreatic carcinogenesis has improved dramatically and with this our therapeutic options have expanded significantly...
2016: Digestion
Yaqing Zhang, Ashley Velez-Delgado, Esha Mathew, Dongjun Li, Flor M Mendez, Kevin Flannagan, Andrew D Rhim, Diane M Simeone, Gregory L Beatty, Marina Pasca di Magliano
BACKGROUND: Pancreatic cancer is characterised by the accumulation of a fibro-inflammatory stroma. Within this stromal reaction, myeloid cells are a predominant population. Distinct myeloid subsets have been correlated with tumour promotion and unmasking of anti-tumour immunity. OBJECTIVE: The goal of this study was to determine the effect of myeloid cell depletion on the onset and progression of pancreatic cancer and to understand the relationship between myeloid cells and T cell-mediated immunity within the pancreatic cancer microenvironment...
July 8, 2016: Gut
Hong Jiang, Samarth Hegde, Brett L Knolhoff, Yu Zhu, John M Herndon, Melissa A Meyer, Timothy M Nywening, William G Hawkins, Irina M Shapiro, David T Weaver, Jonathan A Pachter, Andrea Wang-Gillam, David G DeNardo
Single-agent immunotherapy has achieved limited clinical benefit to date in patients with pancreatic ductal adenocarcinoma (PDAC). This may be a result of the presence of a uniquely immunosuppressive tumor microenvironment (TME). Critical obstacles to immunotherapy in PDAC tumors include a high number of tumor-associated immunosuppressive cells and a uniquely desmoplastic stroma that functions as a barrier to T cell infiltration. We identified hyperactivated focal adhesion kinase (FAK) activity in neoplastic PDAC cells as an important regulator of the fibrotic and immunosuppressive TME...
August 2016: Nature Medicine
Wenxin Zheng, Kinga B Skowron, Jukes P Namm, Byron Burnette, Christian Fernandez, Ainhoa Arina, Hua Liang, Michael T Spiotto, Mitchell C Posner, Yang-Xin Fu, Ralph R Weichselbaum
The majority of cancer patients respond poorly to either vaccine or checkpoint blockade, and even to the combination of both. They are often resistant to high doses of radiation therapy as well. We examined prognostic markers of immune cell infiltration in pancreatic cancer. Patients with low CD8+ T cell infiltration and high PD-L1 expression (CD8+ TloPD-L1hi) experienced poor outcomes. We developed a mouse tumor fragment model with a trackable model antigen (SIYRYYGL or SIY) to mimic CD8+ TloPD-L1hi cancers...
June 13, 2016: Oncotarget
Katelyn T Byrne, Nathan H Leisenring, David L Bajor, Robert H Vonderheide
Cancer immunotherapies are increasingly effective in the clinic, especially immune checkpoint blockade delivered to patients who have T cell-infiltrated tumors. Agonistic CD40 mAb promotes stromal degradation and, in combination with chemotherapy, drives T cell infiltration and de novo responses against tumors, rendering resistant tumors susceptible to current immunotherapies. Partnering anti-CD40 with different treatments is an attractive approach for the next phase of cancer immunotherapies, with a number of clinical trials using anti-CD40 combinations ongoing, but the optimal therapeutic regimens with anti-CD40 are not well understood...
July 1, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
Christian Bauer, Benjamin Kühnemuth, Peter Duewell, Steffen Ormanns, Thomas Gress, Max Schnurr
Pancreatic cancer is one of the most aggressive malignancies and has been considered poorly immunogenic for decades. However, this characterization might be over-simplistic. A more sophisticated approach is needed in order to develop new treatment strategies. In this review, we will focus on T cell exhaustion as a phenomenon of immune failure that is a useful paradigm to characterize immunosuppressive effects. Cancer creates an environment of constant antigen exposure and inflammation. In this setting, T cells transform into a differentiation state that has been termed T cell exhaustion, which is characterized by upregulation of inhibitory receptors, resulting in loss of effector function...
October 10, 2016: Cancer Letters
Nadia M Luheshi, Jane Coates-Ulrichsen, James Harper, Stefanie Mullins, Michal G Sulikowski, Philip Martin, Lee Brown, Arthur Lewis, Gareth Davies, Michelle Morrow, Robert W Wilkinson
Despite the availability of recently developed chemotherapy regimens, survival times for pancreatic cancer patients remain poor. These patients also respond poorly to immune checkpoint blockade therapies (anti-CTLA-4, anti-PD-L1, anti-PD-1), which suggests the presence of additional immunosuppressive mechanisms in the pancreatic tumour microenvironment (TME). CD40 agonist antibodies (αCD40) promote antigen presenting cell (APC) maturation and enhance macrophage tumouricidal activity, and may therefore alter the pancreatic TME to increase sensitivity to immune checkpoint blockade...
April 5, 2016: Oncotarget
Andrea Marie Ibrahim, Yao-He Wang
Pancreatic ductal adenocarcinoma (PDAC) is an almost uniformly lethal disease with less than 5% survival at five years. This is largely due to metastatic disease, which is already present in the majority of patients when diagnosed. Even when the primary cancer can be removed by radical surgery, local recurrence occurs within one year in 50%-80% of cases. Therefore, it is imperative to develop new approaches for the treatment of advanced cancer and the prevention of recurrence after surgery. Tumour-targeted oncolytic viruses (TOVs) have become an attractive therapeutic agent as TOVs can kill cancer cells through multiple mechanisms of action, especially via virus-induced engagement of the immune response specifically against tumour cells...
January 14, 2016: World Journal of Gastroenterology: WJG
Kelly Foley, Victoria Kim, Elizabeth Jaffee, Lei Zheng
Pancreatic cancer remains one of the most lethal cancers with few treatment options. Immune-based strategies to treat pancreatic cancer, such as immune checkpoint inhibitors, therapeutic vaccines, and combination immunotherapies, are showing promise where other approaches have failed. Immune checkpoint inhibitors, including anti-CTLA4, anti-PD-1, and anti-PD-L1 antibodies, are effective as single agents in immune sensitive cancers like melanoma, but lack efficacy in immune insensitive cancers including pancreatic cancer...
October 10, 2016: Cancer Letters
Frederick J Kohlhapp, Howard L Kaufman
Oncolytic viruses are native or engineered viruses that preferentially replicate in and lyse cancer cells. Selective tumor cell replication is thought to depend on infection of neoplastic cells, which harbor low levels of protein kinase R (PKR) and dysfunctional type I IFN signaling elements. These changes allow more efficient viral replication, and with selected deletion of specific viral genes, replication in normal cells with activated PKR may not be possible. Direct tumor cell lysis, release of soluble tumor antigens, and danger-associated molecular factors are all thought to help prime and promote tumor-specific immunity...
March 1, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Matthew R Farren, Thomas A Mace, Susan Geyer, Sameh Mikhail, Christina Wu, Kristen Ciombor, Sanaa Tahiri, Daniel Ahn, Anne M Noonan, Miguel Villalona-Calero, Tanios Bekaii-Saab, Gregory B Lesinski
PURPOSE: Pancreatic ductal adenocarcinoma (PDAC) is an aggressive cancer with a 5-year survival rate <7% and is ultimately refractory to most treatments. To date, an assessment of immunologic factors relevant to disease has not been comprehensively performed for treatment-naïve patients. We hypothesized that systemic immunologic biomarkers could predict overall survival (OS) in treatment-naïve PDAC patients. EXPERIMENTAL DESIGN: Peripheral blood was collected from 73 patients presenting with previously untreated metastatic PDAC...
May 15, 2016: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Eriko Katsuta, Shinji Tanaka, Kaoru Mogushi, Shu Shimada, Yoshimitsu Akiyama, Arihiro Aihara, Satoshi Matsumura, Yusuke Mitsunori, Daisuke Ban, Takanori Ochiai, Atsushi Kudo, Hiroshi Fukamachi, Hiroshi Tanaka, Koh Nakayama, Shigeki Arii, Minoru Tanabe
Identification and purification of cancer stem cells (CSCs) lead to the discovery of novel therapeutic targets; however, there has been no study on isolation of the CSC population among pancreatic neuroendocrine tumors (pNETs). This study aimed to identify pNET CSCs and to characterize a therapeutic candidate for pNET CSCs. We identified CSCs by aldehyde dehydrogenase (ALDH) activity in pNET clinical specimens and cell lines. We verified whether or not these cells have the stemness property in vivo and in vitro...
February 2016: International Journal of Oncology
Kinsey A McCormick, Andrew L Coveler, Gabriela R Rossi, Nicholas N Vahanian, Charles Link, E Gabriela Chiorean
Pancreatic adenocarcinoma is notoriously lethal, and despite improvements in systemic chemotherapy approaches bringing survival rates for metastatic disease to almost 1 year, by 2030 it is expected to become the second leading cause of cancer death. Pancreatic cancer (PC) prognosis has been associated with both the presence of intratumoral helper and cytotoxic T lymphocytes, as well as humoral immune responses to tumor associated antigens like mesothelin. It is well described that the PC microenvironment is characterized by a fibroinflammatory and immunosuppressive stroma...
March 3, 2016: Human Vaccines & Immunotherapeutics
Lijie Zhai, Stefani Spranger, David C Binder, Galina Gritsina, Kristen L Lauing, Francis J Giles, Derek A Wainwright
Indoleamine 2, 3-dioxygenase 1 (IDO1), IDO2, and tryptophan 2, 3-dioxygenase (TDO) comprise a family of enzymes that catalyze the first- and rate-limiting step associated with the catabolic conversion of tryptophan (Trp) into kynurenine (Kyn). Through subsequent enzymatic and spontaneous reactions, Kyn is further converted into the energetic substrates, NAD(+) and ATP, to fuel cellular metabolic functions. Coincidently, the depletion of Trp and accumulation of Kyn has been demonstrated to induce effector T-cell apoptosis/dysfunction and immunosuppressive regulatory T-cell induction, respectively...
December 15, 2015: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Daniel Delitto, Chelsey Perez, Song Han, David H Gonzalo, Kien Pham, Andrea E Knowlton, Christina L Graves, Kevin E Behrns, Lyle L Moldawer, Ryan M Thomas, Chen Liu, Thomas J George, Jose G Trevino, Shannon M Wallet, Steven J Hughes
The cancer microenvironment allows tumor cells to evade immune surveillance through a variety of mechanisms. While interferon-γ (IFNγ) is central to effective antitumor immunity, its effects on the microenvironment are not as clear and have in some cancers been shown to induce immune checkpoint ligands. The heterogeneity of these responses to IFNγ remains poorly characterized in desmoplastic malignancies with minimal inflammatory cell infiltration, such as pancreatic cancer (PC). Thus, the IFNγ response within and on key cells of the PC microenvironment was evaluated...
December 2015: Cancer Immunology, Immunotherapy: CII
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