Direct Antiproliferative Effects Research Articles

Hyperbaric Oxygen Therapy as a Novel Approach to Modulating Macrophage Polarization for the Treatment of Glioblastoma.

Glioblastoma multiforme (GBM) is a highly aggressive brain cancer with a poor prognosis despite current treatments. This is partially attributed to the immunosuppressive environment facilitated by tumor-associated macrophages, which predominantly underlie the tumor-promoting M2 phenotype. This study investigated the potential of hyperbaric oxygen (HBO) therapy, traditionally used to treat conditions such as decompression sickness, in modulating the macrophage phenotype toward the tumoricidal M1 state and disrupting the supportive tumor microenvironment. HBO has direct antiproliferative effects on tumor cells and reduces hypoxia, which may impair angiogenesis and tumor growth. This offers a novel approach to GBM treatment by targeting the role of the immune system within the tumor microenvironment. The effects of HBO on macrophage polarization and GBM cell viability and apoptosis were evaluated in this study. We detected that HBO promoted M1 macrophage cytokine expression while decreasing GBM cell viability and increasing apoptosis using GBM cell lines and THP-1-derived macrophage-conditioned media. These findings suggest that HBO therapy can shift macrophage polarization toward a tumoricidal M1 state. This can improve GBM cell survival and offers a potential therapeutic strategy. In conclusion, HBO can shift macrophages from a tumor-promoting M2 phenotype to a tumoricidal M1 phenotype in GBM. This can facilitate apoptosis and, in turn, improve treatment outcomes.

A case of successful treatment for pancreatic cancer (observation from practice)

Objective: In recent years, researchers are increasingly considering the possibility of using immunotherapeutic drugs as part of the antitumor treatment of such patients, which can potentiate the effectiveness of cytostatic therapy. Particular attention is drawn to the combination of interferon- and recombinant tumor necrosis factor-thymosin--1, which can activate an antitumor immune response, stimulate apoptosis of tumor cells, have a direct antiproliferative effect, cause destruction of neoplasm vessels, and stimulate tumor tissue necrosis.Methods: This paper presents the results of a follow-up of 24 patients with histologically confirmed pancreatic carcinoma. Some patients received combined immunotherapy as the only method of treatment, when the possibilities of standard therapy were exhausted, there were serious complications of anticancer treatment, severe concomitant pathology that did not allow the planned treatment to be carried out in full, or when the patient refused to use cytostatics. In other cases, the introduction of immunotherapeutic drugs was carried out against the background of other antitumor treatment of the 1st or 2nd line, prescribed in connection with the progression of the disease.Results: As a result of the use of a combination of interferon- and recombinant tumor necrosis factor-thymosin--1, patients noted an improvement in the tolerability of the main antitumor treatment, additional manifestations of toxicity from the use of immunodrugs were not observed. The existence of an average positive correlation (r=0.57, p=0.0004) between the level of TNF and the value of the Karnofsky index was revealed, indicating that an increase in the content of TNF is accompanied by an increase in the functional activity of patients. According to computed tomography data, in accordance with the RECIST 1.1 criteria, one patient had a partial response of the tumor to the treatment, in 9 - stabilization of the tumor process, in other cases, observation continues.Conclusions: The data presented are of a pilot nature. One of the available observations is presented in this paper as a clinical case.

Low glucose availability potentiates the effects of metformin on model T cell activation and exhaustion markers in vitro.

Modulation of immune cell metabolism is one of promising strategies to improve cancer immunotherapies. Metformin is an anti-diabetic drug with potential anti-cancer effects, ranging from normalization of blood glucose and insulin levels, direct anti-proliferative effects on cancer cells to emerging immunomodulatory effects on anti-tumor immunity. Metformin can reduce tumor hypoxia and PD-L1 expression, as well as normalize or improve T cell function and potentiate the effect of immune checkpoint inhibitors, making it a promising adjuvant to immunotherapy of tumors with poor response such as triple negative breast cancer (TNBC). However, although the effects of metformin on cancer cells are glucose-dependent, the role of glucose in modulating its effect on T cells has not been systematically studied. We thus investigated the effect of metformin as a function of glucose level on Jurkat cell and PBMC T cell models in vitro. While low metformin concentrations had little effect on T cell function, high concentration reduced proliferation and IFN-γ secretion in both models and induced a shift in T cell populations from memory to effector subsets. The PD-1/CD69 ratio was improved by high metformin in T cells from PBMC. Low glucose and metformin synergistically reduced PD-1 and CD69 expression and IFN-γ secretion in T cells from PBMC. Low glucose level itself suppressed Jurkat cell function due to their limited metabolic plasticity, but had limited effects on T cells from PBMC apart from reduced proliferation. Conversely, high glucose did not strongly affect either T cell model. Metformin in combination with glycolysis inhibitor 2-deoxy-D-glucose (2DG) reduced PD-1 in Jurkat cells, but also strongly suppressed their function. However, low, physiologically achievable 2DG concentration itself reduced PD-1 while mostly maintaining IL-2 secretion and, interestingly, even strongly increased IFN-γ secretion regardless of glucose level. Overall, glucose metabolism can importantly influence some of the effects of metformin on T cell functionality in the tumor microenvironment. Additionally, we show that 2DG could potentially improve the anti-tumor T cell response.

Identifying Tumor-Specific Immune Response and Biomarkers of High-Risk Hodgkin Lymphoma Patients Treated with and without Brentuximab on Children's Oncology Group Trial AHOD1331

Introduction: There is an unmet need to examine anti-tumor immune responses and predictive biomarkers in the peripheral blood to guide effective combination immunotherapies in classic Hodgkin Lymphoma (cHL). We hypothesized that treatment with the anti-CD30 antibody drug conjugate brentuximab vedotin (Bv) in combination with chemotherapy will have dual therapeutic effects in HL, with direct antiproliferative effects and a restoration of favorable tumor specific cytotoxic T cell immune response. We evaluated tumor-specific cytotoxic T cell response, cytokine and chemokine milieu in the peripheral blood of pediatric patients with HL before and after treatment with either standard chemotherapy or chemotherapy + Bv. Methods: Children's Oncology Group clinical trial AHOD1331 was a randomized phase III trial for newly diagnosed high risk cHL ages ≥2 to 22 years which compared standard chemotherapy with doxorubicin, bleomycin, etoposide, prednisone and cyclophosphamide (ABVE-PC) to Bv + AVE-PC with response adapted radiation. Peripheral blood samples were collected at diagnosis (pre) and following completion of treatment (post). Peripheral blood mononuclear cells and plasma were isolated using Ficoll Density gradient. Plasma was cryopreserved for batch testing of Th1/Th2 cytokines, sCD30, sCD163 and TARC by Luminex assay. Cytotoxic T cell responses to non-EBV HL specific tumor associated antigens (TAAs) MAGEA4, PRAME, and survivin pre and post treatment were tested using the interferon-γ ELISPOT assay after ex vivo expansion. TAA-T cell specificity was reported as spot forming count (SFC per 10 5 T cells). Changes in cytokine levels and T cell responses pre versus post treatment were compared using paired t-tests and blinded to treatment arm.Levels of sCD30, sCD163 and TARC were compared both pre and post treatment. Thecox model was used to evaluate association between levels and event free survival (EFS) across both arms. Results There was no difference in patient or disease characteristics between the entire study cohort (n=587) and patients analyzed (n=216). There were 184 patients with pre and post cytokine data, 71 patients with pre and post ELISPOT-T cell data, 147 patients with pre and post sCD30/sCD163 data, and 146 with pre and post TARC data. Compared to pre-treatment levels, there was a significant reduction in the immunosuppressive cytokines IL-13 (p=0.004) and increase in pro-inflammatory cytokines IL17a (p=0.03), Interferon-γ (p=0.0008), GCSF(p=0.0012) and MCP1(p=0.02). This change in cytokine levels from baseline to post-treatment was similar for both treatment arms except a higher increase in IL17a(p=0.015) was noted in the standard chemotherapy arm compared to the Bv arm (Table 1). Among 147 paired samples evaluated, sCD30, sCD163 and TARC all were significantly lower post treatment (Figure 1), but did not differ across arms. Pre treatment sCD163 and TARC values were significantly associated with EFS (p = 0.005 and 0.045), as was the degree of change in sCD163 post-treatment levels as compared to pre-treatment levels (p = 0.0156). Among 71 patients with pre and post ELISPOT-T cell data, there was a significant increase in the T cell responses specific to PRAME(p=0.04) post treatment and a trend for increased MAGEA4, but no association with EFS. Conclusions Treatment results in an increased T cell response to HL-specific antigen PRAME post therapy in both treatment arms suggesting that recovery post anti-HL treatment can promote tumor antigen specific T cell immunity in vivo. Further, reduction in immunosuppressive cytokines IL-13 and changes in proinflammatory cytokines Interferon-γ following treatment suggest a favorable milieu for T cell expansion. Pre-treatment levels of soluble CD163 and TARC are associated with EFS and may present a potential predictive biomarker, as well as degree of change of CD163 post treatment, irrespective of addition of immunotherapy. Our results have implications for identifying immune markers of response to guide future immunotherapies and cytotoxic T cell therapy in cHL. (NCT02166463)

Anti-melanoma Effects of Resiquimod (RSQ) In Vitro and in Combination with Immune Checkpoint Blockade In Vivo.

Melanoma is the deadliest form of skin cancer and surgery is currently the most effective treatment. However, there are situations where surgery fails or is not an option to treat melanoma patients. Immunotherapy such as immune checkpoint blockade (e.g., anti-PD-1) can be effective as an alternative treatment for melanoma patients; however, the percentage of melanoma patients that exhibit complete responses from anti-PD-1 monotherapy is low, and a hostile immunosuppressive tumor microenvironment may be at least partly responsible. Resiquimod (RSQ) is an imidazoquinolinamine derivative and TLR-7/8 agonist that could enhance the antitumor activity of immune checkpoint blockade when these agents are combined as a treatment for melanoma. Here, the effect of combining systemic anti-PD-1 and locally administered RSQ on the survival of melanoma-challenged mice was tested. Our results demonstrated that anti-PD-1 in combination with RSQ can significantly prolong the survival of melanoma-challenged mice, compared to untreated mice and mice treated with anti-PD-1 alone. In addition, the in vitro studies showed that RSQ can mediate a direct anti-proliferative effect on melanoma cells. In conclusion, the combination of RSQ and anti-PD-1 may be a promising treatment for melanoma patients, especially as both treatments have already been used independently to safely treat melanoma patients.

Physicochemical and Biopharmaceutical Controllability of New Self-Assembled Fatty Acid Conjugated Leuprolide for the Enhanced Anticancer Activity.

Leuprolide (LEU), a synthetic nonapeptide analog of naturally occurring gonadotropin-releasing hormone (GnRH), could exert a direct inhibitory activity on the proliferation of prostate cancer cells. However, the short half-life in blood and the biopharmaceutical problem of LEU limit this anticancer activity. To improve its druggability for improving anticancer activity, the amine-group targeted LEU was conjugated with different chain lengths of saturated fatty acids (FAs). LEU-fatty acid conjugates (LFCs) were synthesized by exploiting N-hydroxysuccinimidyl (NHS) conjugation chemistry. The physicochemical properties and the self-assembled behaviors of the conjugates were extensively investigated. The in vitro anticancer activity of three LFCs was extensively studied in both 2D monolayer and 3D spheroid culture models of a prostate cancer cell line, PC3. Three LFCs could be readily self-assembled into nanoparticles (LFNs) with a small size of around 100 nm, positive charges, and exhibited greater permeability rates compared to the same concentration of LEU, excluding LSN. The chain length of FA in conjugate was positively related to the selectivity index between cancer cells and non-cancerous cell lines. All LFCs showed a superior direct antiproliferative effect on cancer cells in the following order: LSC (98.9%) > LPC (86.7%) > LLC (75.0%) > LEU (8.9%) after repeat daily of the same dose strength of LEU for 4 days. In addition, the 3D spheroid model study indicates that all LFCs with a one-time treatment performed a long-acting inhibitory effect on tumor growth as compared to LEU after 7 days. The conjugation of LEU with different chain lengths of FAs could provide a novel strategy to improve peptide stability and exert an additional superior direct inhibitory effect for the treatment of several hormone-responsive tumor systems using therapeutic peptides.

Abstract P3-07-22: Presurgical Trial of Metformin plus Atorvastatin in Women with Operable Breast Cancer

Abstract Introduction: Metformin is an oral anti-diabetic agent that exhibits direct anti-proliferative effects on pre-clinical models through activation of the AMPK pathway. However, pre-surgical studies of metformin alone among women with operable breast cancer have not consistently shown reductions in tumor proliferation, and adjuvant metformin in women with high-risk operable breast cancer did not improve invasive disease-free survival compared with placebo. Dysregulation of the mevalonate pathway of cholesterol synthesis can also lead to cell proliferation, and inhibition of HMG-CoA reductase by statins can decrease tumor proliferation. There is close interaction between the AMPK and mevalonate pathways, and dual therapy with a statin and metformin might be synergistic to decrease cell proliferation. We evaluated the effect of combination therapy with metformin plus atorvastatin on markers of proliferation (i.e. Ki67 proliferation index) in women with operable breast cancer. Methods: We conducted an open-label, single-arm presurgical “window of opportunity” study of metformin plus atorvastatin in non-diabetic women age 21+ years with newly-diagnosed stage 0-III operable breast cancer at Columbia University Irving Medical Center (CUIMC). Enrolled patients received metformin 1500mg oral [p.o.] daily (500mg in the morning/1000mg in the afternoon) and atorvastatin 80mg p.o. nightly for up to 4 weeks before breast surgery. The primary endpoint was change in Ki67 proliferation index from baseline (diagnostic biopsy) to post-treatment (surgical specimen). Secondary endpoints included change in body mass index (BMI), waist and hip circumferences, tumor assessment of AMPK/mTOR signaling and apoptosis, and reduction of fasting markers of the insulin growth factor pathway. Paired t-tests were conducted to assess difference in ln(Ki67) pre- and post-therapy, as well as differences in absolute Ki67, BMI, and waist/hip circumferences pre- and post-therapy, at a level of significance of 0.05. Results: Between Nov. 2013 and Jan. 2018, 22 women were enrolled, and two withdrew consent prior to study treatment. Among evaluable participants (n=20), 45% were Hispanic with median age 56 years (range, 33-73) and median baseline BMI 28.4 kg/m2 (range, 22.5-45.8). All had hormone receptor-positive (HR+), HER2-negative breast cancer, and 16 (80%) had invasive cancer. Median time on study treatment was 11 days (range, 5-29). Changes in Ki67 and anthropomorphic measures are shown in Table 1. There was no significant change in BMI, waist or hip circumference with study treatment. Among women with available Ki67 measurements (n=11), there was no significant difference in pre- and post-treatment ln(Ki67) (p=0.25). There was a numeric decrease in absolute Ki67, though statistical significance was not reached (p=0.09). Discussion: There was a numeric reduction in absolute Ki-67 with presurgical metformin plus atorvastatin in patients with newly diagnosed HR+/HER2- breast cancer, although our analysis was limited by small sample size and statistical significance was not achieved. There was no difference in ln(Ki67) or anthropometric measurements. Analyses of additional tissue and serum biomarkers, including markers of insulin resistance, are ongoing to identify associations with absolute Ki67 Table 1 Citation Format: Julia E. McGuinness, Katherine D. Crew, Meghna S. Trivedi, Melissa K. Accordino, Shing M. Lee, Hua Guo, Hanina Hibshoosh, Dawn Hershman, Kevin Kalinsky. Presurgical Trial of Metformin plus Atorvastatin in Women with Operable Breast Cancer [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-07-22.

Melatonin modulates the Warburg effect and alters the morphology of hepatocellular carcinoma cell line resulting in reduced viability and migratory potential

AimsHepatocellular Carcinoma (HCC) is a primary neoplasm derived from hepatocytes with low responsiveness and recurrent chemoresistance. Melatonin is an alternative agent that may be helpful in treating HCC. We aimed to study in HuH 7.5 cells whether melatonin treatment exerts antitumor effects and, if so, what cellular responses are induced and involved. Main methodsWe evaluated the effects of melatonin on cell cytotoxicity and proliferation, colony formation, morphological and immunohistochemical aspects, and on glucose consumption and lactate release. Key findingsMelatonin reduced cell motility and caused lamellar breakdown, membrane damage, and reduction in microvillus. Immunofluorescence analysis revealed that melatonin reduced TGF and N-cadherin expression, which was further associated with inhibition of epithelial-mesenchymal transition process. In relation to the Warburg-type metabolism, melatonin reduced glucose uptake and lactate production by modulating intracellular lactate dehydrogenase activity. SignificanceOur results indicate that melatonin can act upon pyruvate/lactate metabolism, preventing the Warburg effect, which may reflect in the cell architecture. We demonstrated the direct cytotoxic and antiproliferative effect of melatonin on the HuH 7.5 cell line, and suggest that melatonin is a promising candidate to be further tested as an adjuvant to antitumor drugs for HCC treatment.

Type I and II interferon signaling in colorectal cancer liver metastasis.

Metastatic colorectal cancer is one of the leading causes of cancer-related deaths worldwide. Traditional chemotherapy extended the lifespan of cancer patients by only a few months, but targeted therapies and immunotherapy prolonged survival and led to long-term remissions in some cases. Type I and II interferons have direct pro-apoptotic and anti-proliferative effects on cancer cells and stimulate anti-cancer immunity. As a result, interferon production by cells in the tumor microenvironment is in the spotlight of immunotherapies as it affects the responses of anti-cancer immune cells. However, promoting effects of interferons on colorectal cancer metastasis have also been reported. Here we summarize our knowledge about pro- and anti-metastatic effects of type I and II interferons in colorectal cancer liver metastasis and discuss possible therapeutic implications.

Vitamin D in liver cancer: novel insights and future perspectives

Vitamin D has been a focus of attention in liver cancer due to its direct and indirect antineoplastic effects. This review critically evaluates data from recently published basic and clinical studies investigating the role of vitamin D in liver cancer. Basic studies indicate that vitamin D plays an important role in liver cancer development by suppressing the activity of hepatic stellate cells and Kupffer cells. Furthermore, vitamin D has a direct anti-proliferative, anti-angiogenic, proapoptotic, and prodifferentiative effect on liver cancer cells. Recent investigation suggested several interesting mechanisms of these actions, such as inactivation of Notch signaling, p27 accumulation, and tyrosine-protein kinase Met/extracellular signal-regulated kinases inhibition. On the other hand, data from clinical observational studies, although promising, are still inconclusive. Unfortunately, studies on the effect of vitamin D supplementation were generally focused on short-term outcomes of chronic liver diseases (liver enzyme levels or elastographic finding); therefore, there are still no reliable data on the effect of vitamin D supplementation on liver cancer occurrence or survival.

Sulfonamide metformin derivatives induce mitochondrial-associated apoptosis and cell cycle arrest in breast cancer cells

Metformin, an oral anti-diabetic drug, has attracted scientific attention due to its anti-cancer effects. This biguanide exerts preventive effects against cancer, and interferes with cancer-promoting signaling pathways at the cellular level. However, the direct cytotoxic or anti-proliferative effect of the drug is observed at very high concentrations, often exceeding 5–10 mM. This paper presents the synthesis of eight novel sulfonamide-based biguanides with improved cellular uptake in two breast cancer cell lines (MCF-7 and MDA-MB-231), and evaluates their effects on cancer cell growth.The synthesized sulfonamide-based analogues of metformin (1–5) were efficiently taken up in MCF-7 and MDA-MB-231 cells, and were characterized by stronger cytotoxic properties than those of metformin. Generally, compounds were more effective in MCF-7 than in MDA-MB-231. Compound 2, with an n-octyl chain, was the most active molecule with IC50 = 114.0 μmol/L in MCF-7 cells. The cytotoxicity of compound 2 partially results from its ability to induce early and late apoptosis. Increased intracellular reactive oxygen species (ROS) production and reduced mitochondrial membrane potential suggest that compound 2 promotes mitochondrial dysfunction and activates the mitochondrial-associated apoptosis-signaling pathway. In addition, compound 2 was also found to arrest cell cycle in the G0/G1 and G2/M phase and significantly inhibit cancer cell migration.In conclusion, this study supports the hypothesis that improved transporter-mediated cellular uptake of potential drug molecule is accompanied by its increased cytotoxicity. Therefore, compound 2 is a very good example of how chemical modification of a biguanide scaffold can affect its biological properties and improve anti-neoplastic potential.

Functional Multi-Omics Reveals Genetic and Pharmacologic Regulation of Surface CD38 in Multiple Myeloma

Background: CD38 is a surface ectoenzyme expressed at high levels on myeloma plasma cells and is the target for the monoclonal antibodies (mAbs) daratumumab and isatuximab. These antibodies have multiple mechanisms of action, primarily involving recruiting and modulating components of the immune system, but they may also carry direct anti-tumor effects. CD38 density on tumor cells is an important determinant of mAb efficacy while CD38 is lost after mAb treatment. Several small molecules have been found to increase tumor surface CD38, with the goal of boosting mAb efficacy in a co-treatment strategy. However, we do not yet have a broad global sense of the transcriptional or post-transcriptional networks that most strongly impact CD38 expression. There may be alternate strategies to even more potently increase CD38 expression that have not yet been identified. Furthermore, prior clinical studies showed that CD38 downregulation after daratumumab treatment was accompanied by increases in the complement inhibitors CD55 and CD59. Are there other features of myeloma surface remodeling driven by CD38 downregulation? Here we sought to extend our currently limited insight into CD38 surface expression by using a multi-omics approach.Methods: Genome-wide CRISPR interference screening was performed in RPMI-8226 cells stably expressing the dCas9-KRAB fusion protein. Cells were grown for 14 days after library transduction, flow-sorted on the top and bottom 25% of CD38 surface expression, and sgRNA's deep sequenced. Antibody-dependent cellular cytoxicity assays were performed with NK92-CD16 cells. Cell surface proteomics was performed using N-glycoprotein cell surface capture in triplicate. Phosphoproteomics was performed used immobilized metal affinity chromatography in triplicate. Murine studies were performed in NSG mice under approved IACUC-approved institutional protocols.Results: A genome-wide CRISPR-interference screen in RPMI-8226 cells demonstrated that transcriptional and epigenetic factors played the most prominent role in surface CD38 regulation (Fig. 1A). One of the genes that when knocked down led to greatest surface CD38 increase was RARA. This finding supports the promise of all-trans retinoic acid (ATRA), which leads to RARA degradation, as a potent agent to induce CD38 upregulation. Validation of additional screen hits TLE3 and HEXIM1 also illustrated that these negative regulatory transcription factors suppress CD38 expression at baseline (not shown). We found the transcription factor SPI1 to be a prominent positive regulator of CD38. SPI1 knockdown led to daratumumab resistance both in vitro and in vivo, similar to the resistance observed after CD38 knockdown (not shown). Analysis of myeloma patient ATAC-seq data, assessing transcription factor motifs present at the CD38 locus, combined with a predictive machine learning model, further identified XBP1 as one of the most potent transcriptional regulators of CD38 (Fig. 1B). We next used “antigen escape profiling” - knockdown of CD38 followed by unbiased cell surface proteomics - to mimic surface alterations in the context of CD38 loss. We found minimal changes in other cell surface proteins beyond CD38 (Fig. 1C), indicating the CD38 loss alone is not sufficient to remodel the myeloma surfaceome. This finding also supports the hypothesis that complement or other immune system interactions are necessary to lead to other myeloma surface protein alterations. In a parallel analysis of pharmacologic regulation, we also used cell surface proteomics integrated with RNA-seq to demonstrate that ATRA leads to few other surface protein changes beyond CD38 (not shown). In contrast, other molecules, such as azacytidine and panobinostat, led to broader changes across many more surface proteins, showing a lack of specificity when driving CD38 upregulation. Finally, unbiased phosphoproteomics revealed partial inhibition of the MAP kinase pathway after daratumumab binding (Fig. 1D). This result may comprise a direct anti-proliferative effect of anti-CD38 therapeutic antibody engagement in myeloma.Conclusions: Our work provides a resource to design strategies to enhance efficacy of CD38-targeting immunotherapies in myeloma. Our approach also outlines a broad multi-omic strategy to evaluate surface and transcriptional regulation of other key immunotherapeutic targets in hematologic malignancies. [Display omitted] DisclosuresChoudhry: Genentech: Current Employment, Current equity holder in publicly-traded company. Ramkumar: Senti Biosciences: Current Employment, Current holder of individual stocks in a privately-held company.

Modakafusp Alfa (TAK-573), an Immunocytokine, Shows Clinical Activity in Patients with Relapsed/Refractory Multiple Myeloma; Updated Results from a First-in-Human Phase 1 Study

Modakafusp Alfa (TAK-573), an Immunocytokine, Shows Clinical Activity in Patients with Relapsed/Refractory Multiple Myeloma; Updated Results from a First-in-Human Phase 1 Study

Characterization of receptor tyrosine kinase activation and biological activity of toceranib phosphate in canine urothelial carcinoma cell lines

BackgroundUrothelial carcinoma (UC) accounts for > 90% of canine tumors occurring in the urinary bladder. Toceranib phosphate (TOC) is a multi-target receptor tyrosine kinase (RTK) inhibitor that exhibits activity against members of the split kinase family of RTKs. The purpose of this study was to evaluate primary UC tumors and UC cell lines for the expression and activation of VEGFR2, PDGFRα, PDGFRβ, and KIT to assess whether dysregulation of these RTKs may contribute to the observed biological activity of TOC.ResultsTranscript for VEGFR2, PDGFRα, PDGFRβ, and KIT was detected in all UC tissue samples and UC cell lines. The Proteome Profiler™ Human Phospho-RTK Array Kit (R & D Systems) provided a platform to assess phosphorylation of 42 different RTKs in primary UC tumors and UC cell lines. Evidence of PDGFRα and PDGFRβ phosphorylation was present in only 11% or 33% of UC tumors, respectively, and 25% of UC cell lines. Treatment of UC cell lines with TOC had no significant impact on cell proliferation, including UC cell lines with evidence of PDGFRβ phosphorylation.ConclusionsPhosphorylation of several key RTKs targeted by TOC is present in a small subset of primary UC tumors and UC cell lines, suggesting that these RTKs do not exist in a state of continuous activation. These data suggest that activation of RTKs targeted by TOC is present in a small subset of UC tumors and UC cell lines and that treatment with TOC at physiologically relevant concentrations has no direct anti-proliferative effect on UC cells.

Anti-proliferative effects of indomethacin, acemetacin and their tromethamine salts in HCT116 human colon cancer cells

Background and Aims: Since 1980's, several preclinical studies have been published on the anti-colorectal cancer activity of the nonsteroidal anti-inflammatory drug indomethacin. The direct anti-proliferative effect of indomethacin seems to occur via a variety of reported COX-independent mechanisms. Acemetacin is a glycolic acid ester derivative of indomethacin and contrary to indomethacin, there is not much published research on anti-cancer effects of acemetacin. Herein, we compared the in vitro anti-proliferative properties of indomethacin, acemetacin, and their tromethamine salts in HCT116 colon cancer cells. Methods: The tromethamine salts of indomethacin and acemetacin were synthesized and the structures were established by microanalysis, IR, 1 H-NMR, 13C-NMR (APT) and 2D-NMR (HSQC and HMBC) spectrometry. Cell proliferation assays were performed using xCELLigence real-time cell analysis system. Results: Indomethacin exhibited profound inhibitory effects with IC50 values at low micromolar ranges. Acemetacin exhibited far lower cytotoxic activity as compared to that of indomethacin. Surprisingly, indomethacin-tromethamine salt was 2-fold and 4.4-fold more potent than indomethacin at 48 and 72 h, respectively, while maintaining its activity at 24 h. The tromethamine salt of acemetacin was more potent than acemetacin at 24 h and 48 h post-treatment. Conclusion: The anti-proliferative effect of indomethacin in HCT116 cells was found to be at low micro-molar levels. The esterification of indomethacin with glycolic acid caused a strong decrease in anti-proliferative effect. The salt formation caused a positive effect on the anti-proliferative activity of indomethacin and indomethacin-tromethamine salt may be a promising candidate for additional in vivo studies.

Blocking HDAC3 in Bone Marrow Stromal Cells Has Direct Anti-Multiple Myeloma Effect and Modulates T Cell Function

IntroductionHistone deacetylases (HDAC) are therapeutic targets in Multiple Myeloma (MM) and the pan-HDAC inhibitor Panobinostat is FDA approved. However, clinical trials showed that non-selective HDAC inhibitors have a narrow therapeutic index, prompting the development of isoform-specific HDAC inhibitors such as the HDAC6 inhibitor Ricolinostat. Preclinical studies have shown that HDAC3 downregulation/inhibition exerts an anti-myeloma effect, suggesting that HDAC3 may be a novel molecular target in MM. However, the effect of targeting HDAC3 in the bone marrow (BM) microenvironment has not been investigated. The BM microenvironment, particularly stromal and immune cells, have been shown to be key in supporting MM growth, immune escape, and resistance to therapy. We sought to study whether targeting HDAC3 in BM stroma cells (BMSC) has direct cytotoxic effects against stromal cells and/or impacts MM cell and T cell function through secreted factors and/or cell-to-cell contact mechanisms.MethodsWe targeted HDAC3 in human BMSC line HS-5 and primary-derived BMSC from MM patients (MM-BMSC) via siRNA or via the HDAC3-selective inhibitor BG45. MTT assay and flow cytometry with annexin V/PI staining were used to assess viability and apoptosis post-HDAC3 KD/pharmacologic inhibition. Downregulation of HDAC3 was confirmed by immunoblotting. To assess the effect of HDAC3 silencing in MM-BMSC on MM cells, we performed siRNA-mediated HDAC3 KD in HS-5 and MM-BMSC, removed transfection media after 48 hours, and performed co-culture experiments with MM1S.Luc and H929.Luc MM cell lines. After 96 hours MM cell proliferation was measured using the Luciferase Assay. Scrambled siRNA transfected HS-5 and MM-BMSC were used as control. To assess the effect of HDAC3 silencing in BMSC on T cells, we isolated peripheral blood mononuclear cells from healthy donors by Ficoll density gradient separation. CD3+ T cells were isolated using EasySep™ Human T Cell Isolation Kit and activated using Dynabeads Human T-Activator CD3/CD28. Cytokine array profiling was performed on the cell-culture supernatant using the Raybiotech C-series Human Cytokine Array according to manufacturer's protocol.ResultsFirst, we showed that pharmacological inhibition of HDAC3 via BG45 does not have direct anti-proliferative or cytotoxic effect on the HS-5 stromal cell line at doses up to 5-fold higher than the EC50 of MM cell lines. Consistent with this data, siRNA-mediated HDAC3 KD does not have direct anti-proliferative and/or cytotoxic effects on HS-5 or MM-BMSC. However, when MM cell lines were co-cultured with HDAC3-silenced HS-5 or MM-BMSC, there was a statistically significant decrease in BMSC-induced MM proliferation compared to control (HS-5: 38% decrease in MM proliferation in HDAC3 KD, p < 0.05; MM-BMSC: 24.1-27.5% decrease in MM proliferation in HDAC3 KD, p < 0.05). To assess whether cell-to-cell contact is necessary to mediate this growth arrest, we cultured MM cell lines in conditioned media from HDAC3 or scrambled siRNA transfected BMSC and discovered that the former was sufficient to induce growth/proliferation arrest (HS-5: 31.5% decrease in MM proliferation in HDAC3 KD, p < 0.05; MM-BMSC: 24.3% decrease in MM proliferation in HDAC3 KD, p < 0.05), suggesting a paracrine effect.We next showed that conditioned supernatant from HDAC3-KD HS-5, cultured alone or in combination with MM cell lines, significantly inhibited the proliferation of activated T-cells (HS-5 supernatant: 47.8% decrease in MM proliferation in HDAC3 KD; HS-5 + MM co-culture supernatant: 32.6% decrease in MM proliferation in HDAC3 KD). To identify the soluble factors responsible for this paracrine effect, we subjected HDAC3-KD and scrambled-transfected HS-5 supernatant to cytokine profiling. We identified a number of cytokines modulated by HDAC3 KD, which we are currently analyzing. Among these, we identified a 1.37-fold increase in soluble PD-L1 when HDAC3 was silenced in HS-5 cells.ConclusionsOur results show that inhibiting HDAC3 in BMSC mediates anti-MM and anti-T cell effect via soluble factors. Gene expression profiling and proteomic studies are currently underway to define the molecular mechanisms supporting these effects. Our preliminary data suggest that targeting HDAC3 in BMSC may alter the checkpoint repertoire in the BM milieu, suggesting potential utility of therapeutic strategies combining HDAC3 and checkpoint inhibitors. DisclosuresHideshima:C4 Therapeutics: Equity Ownership; Acetylon: Consultancy. Mazitschek:Acetylon: Equity Ownership. Anderson:C4 Therapeutics: Other: scientific founder; Oncopep: Other: scientific founder; Bristol-Myers Squibb: Membership on an entity's Board of Directors or advisory committees; MedImmune: Membership on an entity's Board of Directors or advisory committees; Millenium Pharmaceuticals: Membership on an entity's Board of Directors or advisory committees; Gilead Sciences: Membership on an entity's Board of Directors or advisory committees.

Metformin attenuates expression of angiogenic and inflammatory genes in human endometriotic stromal cells

Endometriosis is a benign gynecological disease that is manifested by the presence and growth of endometrial cells and glands outside the uterine. Active angiogenesis, migration, and invasion of endometrial tissue outside the uterine are critical for the development of endometriosis and lead to the survival and growth of endometriotic lesions. Metformin, as an anti-diabetic agent, represents anti-angiogenic property. Here, we performed a study using human normal endometrial stromal cells (N-ESCs) from healthy endometrial tissue and human eutopic endometrial stromal cells (EU-ESCs) and ectopic endometrial stromal cells (ECT-ESCs) from endometriosis patients. ESCs were cultured and treated with different concentrations of Metformin (0–20 mmol/l) for 72 h to evaluate Metformin effect on cell viability, proliferation, migration was measured by methyl thiazolyl tetrazolium (MTT) assay and scratch test respectively as well as expression of angiogenesis and migration markers. The Metformin reduced cell migration, and proliferation of endometriotic stromal cells in a time and concentration dependently manner. Furthermore, Metformin attenuated the expression of angiogenic and inflammatory genes in human endometriotic stromal cells. The direct anti-proliferative effect on ECT-ESCs combined with the effects of Metformin on inflammatory and angiogenesis-related genes expression supports its therapeutic potential for endometriosis. Metformin could be used as an effective adjuvant in endometriosis treatment.

VEGFR2 blockade augments the effects of tyrosine kinase inhibitors by inhibiting angiogenesis and oncogenic signaling in oncogene-driven non-small-cell lung cancers.

Molecular agents targeting the epidermal growth factor receptor (EGFR)‐, anaplastic lymphoma kinase (ALK)‐ or c‐ros oncogene 1 (ROS1) alterations have revolutionized the treatment of oncogene‐driven non‐small‐cell lung cancer (NSCLC). However, the emergence of acquired resistance remains a significant challenge, limiting the wider clinical success of these molecular targeted therapies. In this study, we investigated the efficacy of various molecular targeted agents, including erlotinib, alectinib, and crizotinib, combined with anti‐vascular endothelial growth factor receptor (VEGFR) 2 therapy. The combination of VEGFR2 blockade with molecular targeted agents enhanced the anti‐tumor effects of these agents in xenograft mouse models of EGFR‐, ALK‐, or ROS1‐altered NSCLC. The numbers of CD31‐positive blood vessels were significantly lower in the tumors of mice treated with an anti‐VEGFR2 antibody combined with molecular targeted agents compared with in those of mice treated with molecular targeted agents alone, implying the antiangiogenic effects of VEGFR2 blockade. Additionally, the combination therapies exerted more potent antiproliferative effects in vitro in EGFR‐, ALK‐, or ROS1‐altered NSCLC cells, implying that VEGFR2 inhibition also has direct anti‐tumor effects on cancer cells. Furthermore, VEGFR2 expression was induced following exposure to molecular targeted agents, implying the importance of VEGFR2 signaling in NSCLC patients undergoing molecular targeted therapy. In conclusion, VEGFR2 inhibition enhanced the anti‐tumor effects of molecular targeted agents in various oncogene‐driven NSCLC models, not only by inhibiting tumor angiogenesis but also by exerting direct antiproliferative effects on cancer cells. Hence, combination therapy with anti‐VEGFR2 antibodies and molecular targeted agents could serve as a promising treatment strategy for oncogene‐driven NSCLC.

Direct anti-proliferative effect of adipose-derived mesenchymal stem cells of ankylosing spondylitis patients on allogenic CD4+ cells.

ObjectivesT-cell-mediated adaptive immunity contributes to the development and persistence of ankylosing spondylitis (AS). Mesenchymal stromal/stem cells (MSCs) have immunomodulatory potential and are able to inhibit T-cell proliferation, but their functionality in AS patients is relatively unknown. The aim of the study was to assess the direct anti-proliferative effects of MSCs isolated from subcutaneous abdominal adipose tissue of AS patients (AS/ASCs) on allogeneic T lymphocytes, using commercially available ASC lines from healthy donors (HD/ASCs) as a control.Material and methodsCD3+CD4+ T-cells were isolated from peripheral blood of healthy blood donors, activated with anti-CD3/CD28 beads, and co-cultured for 5 days with untreated and TNF+IFN-γ pre-stimulated HD/ASCs (5 cell lines) and AS/ASCs, obtained from 11 patients (6F/5M). The proliferative response of T-cells was analysed by flow cytometry, while the concentrations of kynurenines, prostaglandin E2 (PGE-2), interleukin 10 (IL-10), and interleukin 1 receptor antagonist (IL-1Ra) were measured spectrophotometrically or using a specific enzyme-linked immunosorbent assay (ELISA).ResultsHD/ASCs and AS/ASCs similarly reduced the T-cell proliferation response, i.e. the percentage of proliferating cells, the proliferation, and replication indices, and these effects were dependent mostly on soluble factors. In the co-cultures of activated CD4+ T-cells with HD/ASCs and AS/ASCs significant increases of kynurenines, PGE-2, and IL-1Ra, but not IL-10, production were observed. The release of these factors was dependent either on cell-to-cell contact (IL-10, IL-1Ra) or soluble factors (kynurenines, PGE-2). There was a moderate to strong negative correlation between T-cell proliferative response, and the concentrations of kynurenines, PGE-2, and IL-10, but not IL-1Ra. This association was more evident in the case of TI-treated AS/ASCs than HD/ASCs.ConclusionsAS/ASCs, similar to HD/ASCs, exert a direct effective anti-proliferative impact on CD4+ T cells, acting via soluble factors that are released in cell contact-dependent (IL-10) and independent (kynurenines, PGE-2) pathways. Thus, our results suggest that AS/ASCs are potentially useful for therapeutic application.

In Vivo Efficacy of Anti-CD20-Interferon-Gamma Fusion Protein Against Syngeneic B Cell Lymphoma Is Mediated By Natural Killer Cells

Background: The interferons, including IFNα/IFNβ (type I) and IFNγ (type II) are essential mediators of anti-cancer immunity. To achieve efficient targeting of IFNs to tumor sites, we have developed antibody (Ab)-IFN fusion protein technology. We previously reported the antigen-specific targeting of IFNα to CD20+ target cells with efficient inhibition of proliferation, induction of apoptosis, and in vivo tumor eradiation dependent upon IFNα receptors on the tumor cell surface (Xuan et al, Blood, 2010). A fusion protein targeting human CD20 (anti-CD20-IFNα) exhibited stronger direct anti-proliferative effects, complement-dependent cytotoxicity (CDC), Ab-dependent cell-mediated cytotoxicity (ADCC), and in vivo potency against B-cell lymphoma xenograft models compared to the parent Ab rituximab (Timmerman et al, Blood 2015). Based on these results, a phase I, first-in-human, dose-escalation trial of anti-CD20-IFNα for B cell non-Hodgkin lymphoma is now underway (NCT02519270). Given the distinct properties of IFNγ from type I IFNs, including upregulation of antigen presentation, control of immune cell trafficking, and activation of T cells, NK cells, and macrophages, we hypothesized that Ab-targeted IFNγ may have anti-tumor effects mechanistically-distinct from those of Ab-IFNα fusions. We now report on the construction and characterization of anti-CD20 fusions containing IFNγ. Methods: The VH and VL regions from antibody 2B8 recognizing human CD20 were engineered in recombinant form with mouse IgG2a constant regions, and fused at the C-terminus with mIFNγ, yielding anti-hCD20-mIFNγ. Tumor cell proliferation in vitro was measured by [3H]-thymidine incorporation, ADCC by LDH release using mouse splenocyte effectors, CDC by propidium iodide (PI) exclusion, and in vivo tumor growth assessed using the huCD20-expressing syngeneic mouse B cell lymphoma 38C13-huCD20. Tumor-infiltrating lymphocytes were measured by flow cytometry. Results: Anti-hCD20-mIFNγ displayed potent IFNγ bioactivity comparable to free recombinant mIFNγ, and suppressed the in vitro proliferation of 38C13-huCD20 lymphoma cells by up to 70% (at 1 nM), though not as potently as anti-hCD20-mIFNα, which inhibited proliferation by 98% (Figure 1). Anti-hCD20-mIFNγ showed enhanced ADCC against lymphoma cells compared with the unfused, parent antibody (16-20% at E:T ratio of 20:1, versus 9-12%, respectively, p=0.0024)(Figure 2), while CDC was identical to unfused antibody. In vivo efficacy was demonstrated in mice bearing established subcutaneous 38C13-huCD20 tumors, with systemic (i.v.) injection of 100 μg anti-hCD20-mIFNγ fusion protein on days 5, 6, 7, or 5, 6, 7, 9 after tumor inoculation resulting in cure of approximately 70-80% of mice in repeated experiments. In contrast, therapy with equimolar doses of unfused, native anti-hCD20 Ab resulted in no cures. Mechanistic studies in anti-hCD20-mIFNγ fusion protein-treated mice showed that depletion of natural killer (NK) cells (using anti-asialo-GM1) significantly abrogated tumor clearance (p=0.01), while depletion of macrophages (clodronate liposomes) had lesser, borderline effects (p= 0.05)(Figure 2), and depletion of complement (cobra venom factor) or T cells (CD4+ or CD8+) had no significant effects on tumor eradication. Subcutaneous mouse B cell lymphomas treated with intratumoral injections of anti-hCD20-mIFNγ displayed increased tumor-infiltrating CD8+ T cells (mean 20.6% versus 5% in PBS-treated controls, p=0.008), and CD4+ T cells (mean 15.3% versus 6.6%). Conclusions: Anti-hCD20-mIFNγ fusion protein has in vitro and in vivo efficacy in a syngeneic, immunocompetent model of B cell lymphoma, with NK cells and possibly macrophages implicated in the mechanism(s) of tumor eradication. Ab-targeted mIFNγ can also promote infiltration of immune cells into the tumor microenvironment. These findings may suggest a novel approach for the immunotherapy of B cell lymphomas and other cancers. Disclosures Vasuthasawat: Qwixel therapeutics LLC: Other: stake;which receives some funding through UCLA. Trinh:Qwixel therapeutics LLC: Other: stake;which receives some funding through UCLA. Morrison:Qwixel therapeutics LLC: Other: stake;which receives some funding through UCLA. Timmerman:ImmunGene: Research Funding; Bristol-Myers Squibb: Consultancy, Honoraria, Other: travel support, Research Funding; Merck: Research Funding; Kite, A Gilead Company: Consultancy, Honoraria, Other: travel support, Research Funding; Spectrum Pharmaceuticals: Research Funding.