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  • 1
    In: Stroke, Ovid Technologies (Wolters Kluwer Health), Vol. 52, No. 4 ( 2021-04), p. 1234-1243
    Abstract: High blood pressure increases bleeding risk during treatment with antithrombotic medication. The association between blood pressure levels and the risk of recurrent stroke during long-term secondary stroke prevention with thienopyridines (particularly prasugrel) has not been well studied. Methods: This was a post hoc analysis of the randomized, double-blind, multicenter PRASTRO-I trial (Comparison of Prasugrel and Clopidogrel in Japanese Patients With Ischemic Stroke-I). Patients with noncardioembolic stroke were randomly assigned (1:1) to receive prasugrel 3.75 mg/day or clopidogrel 75 mg/day for 96 to 104 weeks. Risks of any ischemic or hemorrhagic stroke, combined ischemic events, and combined bleeding events were determined based on the mean level and visit-to-visit variability, including successive variation, of systolic blood pressure (SBP) throughout the observational period. These risks were also compared between quartiles of mean SBP level and successive variation of SBP. Results: A total of 3747 patients (age 62.1±8.5 years, 797 women), with a median average SBP level during the observational period of 132.5 mm Hg, were studied. All the risks of any stroke (146 events; hazard ratio, 1.318 [95% CI, 1.094–1.583] per 10-mm Hg increase), ischemic stroke (133 events, 1.219 [1.010–1.466] ), hemorrhagic stroke (13 events, 3.247 [1.660–6.296]), ischemic events (142 events, 1.219 [1.020–1.466] ), and bleeding events (47 events, 1.629 [1.172–2.261]) correlated with increasing mean SBP overall. Similarly, an increased risk of these events correlated with increasing successive variation of SBP (hazard ratio, 3.078 [95% CI, 2.220–4.225] per 10-mm Hg increase; 3.051 [2.179–4.262]; 3.276 [1.172–9.092] ; 2.865 [2.042–4.011]; 2.764 [1.524–5.016] , respectively). Event rates did not differ between the clopidogrel and prasugrel groups within each quartile of SBP or successive variation of SBP. Conclusions: Both high mean SBP level and high visit-to-visit variability in SBP were significantly associated with the risk of recurrent stroke during long-term medication with either prasugrel or clopidogrel after stroke. Control of hypertension would be important regardless of the type of antiplatelet drugs. Registration: URL: https://www.clinicaltrials.jp ; Unique identifier: JapicCTI-111582.
    Type of Medium: Online Resource
    ISSN: 0039-2499 , 1524-4628
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    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2021
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  • 2
    In: Journal of Experimental Medicine, Rockefeller University Press, Vol. 218, No. 1 ( 2021-01-04)
    Abstract: KRAS is the most frequently mutated human oncogene, and KRAS inhibition has been a longtime goal. Recently, inhibitors were developed that bind KRASG12C-GDP and react with Cys-12 (G12C-Is). Using new affinity reagents to monitor KRASG12C activation and inhibitor engagement, we found that an SHP2 inhibitor (SHP2-I) increases KRAS-GDP occupancy, enhancing G12C-I efficacy. The SHP2-I abrogated RTK feedback signaling and adaptive resistance to G12C-Is in vitro, in xenografts, and in syngeneic KRASG12C-mutant pancreatic ductal adenocarcinoma (PDAC) and non–small cell lung cancer (NSCLC). SHP2-I/G12C-I combination evoked favorable but tumor site–specific changes in the immune microenvironment, decreasing myeloid suppressor cells, increasing CD8+ T cells, and sensitizing tumors to PD-1 blockade. Experiments using cells expressing inhibitor-resistant SHP2 showed that SHP2 inhibition in PDAC cells is required for PDAC regression and remodeling of the immune microenvironment but revealed direct inhibitory effects on tumor angiogenesis and vascularity. Our results demonstrate that SHP2-I/G12C-I combinations confer a substantial survival benefit in PDAC and NSCLC and identify additional potential combination strategies.
    Type of Medium: Online Resource
    ISSN: 0022-1007 , 1540-9538
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    Language: English
    Publisher: Rockefeller University Press
    Publication Date: 2021
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  • 3
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 81, No. 13_Supplement ( 2021-07-01), p. 1827-1827
    Abstract: Background: Targeting and engineering γδ T cells has emerged as an orthogonal therapeutic approach in oncology with capacity to modulate both innate and adaptive immunity. Solid tumors (e.g. pancreatic ductal adenocarcinoma (PDAC), melanoma, glioblastoma, ovarian-, breast- cancer etc.), can be enriched for γδ1T cells, where they mediate a robust, multi-faceted immunosuppression. We verified the phenotypic and functional features, and the immunosuppressive potential of cancer patient γδ1T cells and have developed a therapeutic antibody (mAb), LYT-210, for selective depletion of these immune evasion culprits. LYT-210 is highly specific, fully human, species cross-reactive IgG1 antibody, aimed for IND enabling studies and clinical development. Methods: γδ1T cells were profiled and studied from blood of healthy and cancer donors, and from surgically excised primary or metastatic tumors. A proprietary, synthetic Fab-phage library was used to generate LYT-210, a fully human IgG1 mAb. Functional assays (ADCC/ADCP) confirmed an expected and desired, Fcγ-dependent LYT-210 mode of action. We used healthy and patient PBMCs to assess the dynamics, dose dependence and specificity of γδ1 T cell killing with LYT-210. Patient tumor organoids were used for ex vivo efficacy studies. Purified proteins and engineered cell lines served to determine specificity and affinity of LYT-210. Retrogenix protein array ( & gt;5500 cell surface and secreted proteins) was used to identify possible off-target binding of LYT-210. Results: Anti-δ1antibody was used to treat patient tumor organoids (n = 29) and showed potent intra-tumoral T cell activation across tumor types (e.g. colorectal and liver cancer). Additionally, LYT-210 exerted potent ADCP and ADCC on: i) stable cell lines expressing γδ1TCRs and ii) γδ1T cells from patient PBMCs and did so by sparing αβ T cells and γδ2 T cells. Furthermore, LYT-210 induced ADCP and ADCC were Fcγ receptor dependent, confirming LYT-210-specific and effector cell dependent mode of action. LYT-210 induced γδ1 T cell-specific death rapidly, i.e. within 30 minutes of treatment with an EC50 of 26 pM and with the effect sustained over 70 hours of culture. Cell surface proteomics microarray analysis showed very weak cross reaction of LYT-210 with CEACAM5 (a known human cancer cell surface antigen), but in confirmatory assays had minimal binding to CEACAM5 expressed onto HEK293 cells (~200 nM) and no binding at all to purified CEACAM5. The Retrogenix array and additional assays therefore confirm the profound specificity of LYT-210 to γδ1T cells. Conclusions: We have developed a novel, therapeutic immuno-oncology strategy specifically targeting imunosuppressive γδ1cells. Our data support that this therapeutic approach may have the potential to be transformative for the treatment of cancers where γδ1T cells drive a pro-tumorigenic, immunosuppressive environment. Citation Format: Tatyana Panchenko, Wei Wang, Eric Denbaum, Akiko Koide, Takamitsu Hattori, Aleksandra Filipovic, George Miller, Shohei Koide. Efficacy and characterization of a specific and potent monoclonal antibody, LYT-210, against immunosuppressive gd1 T cell in cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 1827.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2021
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  • 4
    In: Histopathology, Wiley, Vol. 64, No. 4 ( 2014-03), p. 484-493
    Abstract: To evaluate the pathological features of clear cell renal cell carcinoma ( CCRCC ) treated with tyrosine kinase inhibitors ( TKI s), and to elucidate the mechanism of action of TKI s. Methods and results Twenty cases of CCRCC treated with TKI s (sorafenib or sunitinib) were retrospectively analysed: 16 were patients who had undergone radical nephrectomy after neoadjuvant TKI therapy, and four were autopsy cases of patients who received TKI treatment. All tumours had two distinct regions: one characterized by necrosis and/or degeneration, indicating antitumour activity; and the other characterized by no or few pathological changes, indicating the absence of antitumour activity. Vasculopathy of tumour vessels was observed in or adjacent to the necrotic or degenerative areas; a decreased density of endothelial cells was noted in the tumour vessels. Few or no changes of vasculopathy were observed in tumour vessels in the other CCRCC areas, indicating the absence or low levels of antitumour activity. Conclusions This is the first pathological report of vasculopathy in TKI ‐treated CCRCC cases. Our data suggest that TKI s initially induce vasculopathy in tumour vessels, and consequently cause reduction or diminution of blood supply to the CCRCC s, resulting in antitumour activity characterized by necrosis and hyalinization.
    Type of Medium: Online Resource
    ISSN: 0309-0167 , 1365-2559
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2014
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  • 5
    In: Journal of Immunological Methods, Elsevier BV, Vol. 490 ( 2021-03), p. 112952-
    Type of Medium: Online Resource
    ISSN: 0022-1759
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    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
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  • 6
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 79, No. 13_Supplement ( 2019-07-01), p. 2382-2382
    Abstract: Background: Targeting and engineering γδ T cells has recently emerged as an orthogonal therapeutic approach in oncology with capacity to effectively modulate both innate and adaptive immune properties. We and others have shown that in solid tumors such as pancreatic ductal adenocarcinoma (PDA), melanoma, glioblastoma, breast cancer etc., γδ1 T cells express immunosuppression-related molecules and possess a pro-tumorigenic capacity. Previously, we have shown that intra-tumoral γδ T cells from patients bearing PDA, colorectal cancer (CRC) and hepatocellular carcinoma (HCC) potently inhibit patients’ αβ T cells, rendering them immunosuppressed. We hypothesized that anti-δ1 monoclonal antibody would be a potent and effective, novel therapeutic. In order to harness the therapeutic potential of γδ1 T cell blockade we have developed a set of highly specific, fully human anti-δ1 T cell receptor (TCR) antibodies. Methods: We have sequenced δ chains from 19 cancer patients with primary PDA, primary CRC and gastric cancer (GC) to identify tumor-specific δ1. A proprietary synthetic, human antibody library was screened via phage display to identify high-affinity antibodies. Surface plasmon resonance and bead-based assays were used to measure binding affinity. We used a panel of ex-vivo experiments to assess the immunosuppressive features of γδ T cells. Antibody efficacy was assayed using patient-derived organotypic tumor spheroids (PDOTS) which recapitulate complex tumor architecture. PDOTS of n = 20 patients (PDA, CRC and liver metastases, HCC) were treated with the antibodies and resulting immune profiles analyzed by flow cytometry. Results: Because the δ1 chains in patients showed diverse CDR3 sequences, we used a selection strategy to identify antibodies that bind diverse δ1 TCRs. Our first-in-class anti-δ1 antibodies have low nanomolar affinity to human δ1 TCRs and show no binding to δ2 TCRs. Furthermore, we chose the lead clinical candidate that showed no preference for the γ chains of the TCR, as patients may harbor a diverse set of γδ heterodimers. Importantly, we show that our lead anti-δ1 antibody achieves reproducible and robust efficacy in the PDOTS system as shown by the up-regulation of pro-inflammatory T cell markers (IFNγ, TNF-α, CD44). Ongoing experiments in γδ knockout mice will investigate the efficacy of combination of γδ1 T cell targeting and existing checkpoint inhibitors (anti- PD1, PDL1, and CTLA4). Conclusion: We have defined a novel therapeutic immuno-oncology strategy and translated it to develop and characterize a lead clinical candidate anti-δ1 monoclonal antibody. Overall, our results demonstrate that we have an efficacious, novel immunotherapy that has the potential to be transformative for the treatment of cancers where γδ1 T cells drive a pro-tumorigenic, immunosuppressive environment. Citation Format: Tatyana Panchenko, Wei Wang, Eric Denbaum, Takamitsu Hattori, Akiko Koide, Aleksandra Filipovic, George Miller, Shohei Koide. Development and testing of the first in class immunotherapy targeting immuno-suppressive δ1 containing γδ T cells for the treatment of pancreatic ductal adenocarcinoma and other solid tumors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 2382.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2019
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