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International Journal of Cancer 11/2012; · 5.44 Impact Factor
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Sergio Rutella,
Paola Iudicone,
Giuseppina Bonanno,
Daniela Fioravanti,
Annabella Procoli,
Claudio Lavorino,
Maria Laura Foddai,
Domenica Lorusso,
Enrica Martinelli,
Michele Vacca,
Francesco Ipsevich, Marianna Nuti,
Giovanni Scambia,
Luca Pierelli
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ABSTRACT: We have recently shown that thymoglobulin (TG) efficiently expands cytokine-induced killer (CIK) cells in combination with interferon (IFN)-γ and interleukin (IL)-2 (ITG2 protocol). It is presently unknown whether the infusion of autologous immune effector cells generated by TG, IFN-γ and IL-2 is feasible and safe.
Five patients with advanced and/or refractory solid tumors were enrolled in the present phase I/II study. Peripheral blood mononuclear cells (PBMC) collected by leukapheresis were stimulated under good manufacturing practice (GMP)-conditions with IFN-γ, followed by TG and IL-2. After 2-3 weeks in culture, a median of 4.65 × 10(6) immune effector cells per kilogram of recipient's body weight was obtained and infused intravenously. The median time from enrollment into the study to infusion of the expanded CIK cells was 30 days.
ITG2 efficiently expanded immune effector cells that comprised both conventional natural killer (NK) cells and CD3(+) CD16(+) CD56(+) CIK cells. One patient with advanced melanoma died because of disease progression before the infusion of CIK cells. The target dose of at least 2.5 × 10(6) CIK cells/kg of recipient's body weight was reached in four out of five evaluable patients. CIK cells were administered intravenously without any measurable toxicity. In vitro, CIK cells exerted lytic activity against cervical cancer cells. The median survival was 4.5 months (range 1-13) from the first infusion of CIK cells.
This study has highlighted the feasibility and safety of the administration of CIK cells generated with the ITG2 protocol. Whether CIK cells can help control disease burden in patients with advanced malignancies will be determined in future clinical trials.
Cytotherapy 05/2012; 14(7):841-50. · 3.63 Impact Factor
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Chiara Napoletano,
Ilaria G Zizzari,
Aurelia Rughetti,
Hassan Rahimi,
Tatsuro Irimura,
Henrik Clausen,
Hans H Wandall,
Francesca Belleudi,
Filippo Bellati,
Luca Pierelli,
Luigi Frati, Marianna Nuti
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ABSTRACT: Dendritic cells (DCs) sense the microenvironment through several types of receptors recognizing pathogen-associated molecular patterns. In particular, C-type lectins, expressed by distinct subsets of DCs, recognize and internalize specific carbohydrate antigen in a Ca(2+) -dependent manner. Targeting of these receptors is becoming an efficient strategy of delivering antigens in DC-based anticancer immunotherapy. Here we investigated the role of the macrophage galactose type C-lectin receptor (MGL), expressed by immature DCs (iDCs), as a molecular target for α-N-acetylgalactosamine (GalNAc or Tn)-carrying tumor-associated antigens to improve DC performance. MGL expressed by ex vivo-generated iDCs from healthy donors was engaged by a 60-mer MUC1(9Tn) -glycopeptide as a Tn-carrying tumor-associated antigen, and an anti-MGL antibody, as a specific MGL binder. We demonstrated that MGL engagement induced homotrimers and homodimers, triggering the phosphorylation of extracellular signal-regulated kinase 1,2 (ERK1,2) and nuclear factor-κB activation. Analysis of DC phenotype and function demonstrated that MGL engagement improved DC performance as antigen-presenting cells, promoting the upregulation of maturation markers, a decrease in phagocytosis, an enhancement of motility, and most importantly an increase in antigen-specific CD8(+) T-cell activation. These results demonstrate that the targeting of MGL receptor on human DCs has an adjuvant effect and that this strategy can be used to design novel anticancer vaccines.
European Journal of Immunology 04/2012; 42(4):936-45. · 5.10 Impact Factor
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ABSTRACT: In the last fifty years the combining of different drugs has progressively improved response and survival rates in gynaecological malignancies. Results are, however, far from being satisfactory. Treatments used in cases of advanced or recurrent disease offer limited results in terms of long-term responses and the urgent need for new drugs has prompted researchers to investigate and propose new therapeutic modalities. One of the most important avenues that are being explored is represented by monoclonal antibodies (MoAb) directed against Vascular Endothelial Growth Factor (VEGF). Several antibodies against this target are now available and Bevacizumab appears to be one of the most promising agents. VEGF has been confirmed as an important therapeutic target in several clinical trials and in multiple disease settings, including gynaecological cancers, for its biological and clinical significance in tumour angiogenesis. The binding and blocking of VEGF growth factor is the basis of tumour growth inhibition, since angiogenesis is essential in the process of tumour growth and progression. Several clinical trials have utilized this agent successfully, either alone or in combination with other drugs. Despite initial concerns, adverse reactions have not been significant with side effects being more tolerable than those associated to conventional chemotherapy. Furthermore, the limited toxicity profile of this, as well as other target therapies, allows it to be combined with cytotoxic drugs without the requirement for a significant dose reduction of the latter. This review outlines the rationale for studying this anti-angiogenetic compound, summarizing the existing and emerging clinical evidence related to the use of Bevacizumab in the treatment of gynaecological malignancies, focusing on its potential benefits and adverse effects.
Critical reviews in oncology/hematology 11/2011; 83(1):35-46. · 5.27 Impact Factor
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ABSTRACT: We present two cases of advanced ovarian cancer treated with neoadjuvant chemotherapy with standard tri-weekly carboplatin and paclitaxel. Therapy was converted to weekly regimens because of disease progression, resulting in disease response. Weekly regimens could overcome drug resistance and this strategy should be attempted before abandoning first-line chemotherapy in favor of palliation.
International Journal of Clinical Oncology 09/2011; 17(4):385-9. · 1.41 Impact Factor
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Ilaria Grazia Zizzari,
Filippo Veglia,
Federica Taurino,
Hassan Rahimi,
Elena Quaglino,
Francesca Belleudi,
Federica Riccardo,
Morena Antonilli,
Chiara Napoletano,
Filippo Bellati,
Pierluigi Benedetti-Panici,
Maria Rosaria Torrisi,
Luigi Frati, Marianna Nuti,
Aurelia Rughetti
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ABSTRACT: Dendritic cell (DC)-based immunotherapy is an attractive approach to induce long lasting antitumor effector cells aiming to control cancer progression. DC targeting is a critical step in the design of DC vaccines in order to optimize delivery and processing of the antigen, and several receptors have been characterized for this purpose. In this study, we employed the FcγRs to target DCs both in vitro and in vivo. We designed a recombinant molecule (HER2-Fc) composed of the immunogenic sequence of the human tumor-associated antigen HER2 (aa 364-391) and the Fc domain of a human IgG(1). In a mouse model, HER2-Fc cDNA vaccination activated significant T cell-mediated immune responses towards HER2 peptide epitopes as detected by IFN-γ ELIspot and induced longer tumor latency as compared to Ctrl-Fc-vaccinated control mice. Human in vitro studies indicated that the recombinant HER2-Fc immunogen efficiently targeted human DCs through the FcγRs resulting in protein cross-processing and in the activation of autologous HER2-specific CD8(+) T cells from breast cancer patients.
Journal of Molecular Medicine 08/2011; 89(12):1231-40. · 4.67 Impact Factor
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Marianna Nuti,
Filippo Bellati,
Valeria Visconti,
Chiara Napoletano,
Lavinia Domenici,
Jlenia Caccetta,
Ilaria Grazia Zizzari,
Ilary Ruscito,
Hassan Rahimi,
Pierluigi Benedetti-Panici,
Aurelia Rughetti
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ABSTRACT: Trastuzumab's targeted therapy has become a stronghold for human epidermal growth factor receptor 2 positive breast cancer patients. This humanized monoclonal antibody binds to the extracellular juxta-membrane domain of HER2 and inhibits the proliferation and survival of HER2 dependent cancer cells. The ways by which this molecule exerts its action have been partially elucidated but several new mechanisms are being constantly identified. Several new agents are being introduced that interfere with HER2. Several new immunotherapy strategies are being introduced in order to direct the immune system against cells and tissues that aberrantly overexpressed HER2. We review the strategies currently adopted and those suggested against HER2 expressing tumors.
Journal of Cancer. 01/2011; 2:317-23.
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ABSTRACT: During the last decades, several improvements in treating gynecological malignancies have been achieved. In particular, target therapies, mostly monoclonal antibodies, have emerged as an attractive option for the treatment of these malignancies. In fact, various molecular-targeted agents have been developed for a variety of malignancies with the objective to interfere with a precise tumor associated receptor, essential for cancer cell survival or proliferation, blocking its function, of the cancer cells. Alternatively, monoclonal antibodies have been developed to block immune suppression or enhance functions of immune effector cells. So far, several monoclonal antibodies have been tested for clinical efficacy for the treatment of gynecological cancers. Antibodies against Vascular Endothelial Growth Factor (VEGF) and Epidermal Growth Factor Receptor (EGFR) have been used in different neoplasms such as ovarian and cervical cancer. Catumazumab, a bivalent antibody against CD3 and EpCAM, is effective in the treatment of neoplastic ascites. Other antibodies are peculiar for specific cancer-associated antigen such as Oregovomab against CA125 or Farletuzumab against the folate receptor. Here we describe the preclinical and clinical experience gained up to now with monoclonal antibodies in tumors of the female genital tract and trace future therapeutic and research venues.
Clinical and Developmental Immunology 01/2011; 2011:890758. · 1.84 Impact Factor
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Journal of Clinical Oncology 09/2010; 28(27):e471-2; author reply e473. · 18.37 Impact Factor
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Journal of Clinical Oncology 07/2010; 28(21):e369-70; author reply e371. · 18.37 Impact Factor
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ABSTRACT: Malignant ascites resistant to conventional drugs frequently affects ovarian cancer patients at the end of life. Here we report the case of a patient who benefited from complete resolution of ascites after low dose intraperitoneal administration of bevacizumab. Immunological analyses showed an initial increase in proportion and function of CD8(+) effector T cells and a reduction of circulating T(reg) cells. A review of the current literature regarding bevacizumab in ovarian cancer is reported. Bevacizumab has shown a high efficacy in the treatment of ovarian cancer. Intraperitoneal administration induces an immune activation and appears promising in the treatment of malignant ascites.
Investigational New Drugs 11/2009; 28(6):887-94. · 3.36 Impact Factor
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ABSTRACT: The incidence of multiple primary cancers has greatly increased in the last decade. We report the first case of a woman who suffered from 3 distinct HPV-induced neoplasms: cervical, vulvar, and head and neck carcinomas.
American journal of obstetrics and gynecology 09/2009; 201(2):e9-e12. · 3.28 Impact Factor
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Chiara Napoletano,
Filippo Bellati,
Rachele Landi,
Simona Pauselli,
Claudia Marchetti,
Valeria Visconti,
Patrizio Sale,
Marco Liberati,
Aurelia Rughetti,
Luigi Frati,
Pierluigi Benedetti Panici, Marianna Nuti
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ABSTRACT: Surgery is the primary therapeutic strategy for most solid tumours; however, modern oncology has established that neoplasms are frequently systemic diseases. Being however a local treatment, the mechanisms through which surgery plays its systemic role remain unknown. We have investigated the influence of cytoreduction on the immune system of primary and recurrent ovarian cancer. All ovarian cancer patients show an increase in CD4+ CD25+ FOXP3+ circulating cells (CD4 T(reg) ). CD4/CD8 ratio is increased in primary tumours, but not in recurrent neoplasms. Primary cytoreduction is able to increase circulating CD4 and CD8 effector cells and decrease CD4 naïve T cells. CD4+ T(reg) cells rapidly decreased after primary tumour debulking, while CD8+ CD25+ FOXP3+ (CD8 T(reg) ) cells are not detectable in peripheral blood. Similar results on CD4 T(reg) were observed with chemical debulking in women subjected to neoadjuvant chemotherapy. CD4 and CD8 T(reg) cells are both present in neoplastic tissue. Interleukin (IL)-10 serum levels decrease after surgery, while no changes are observed in transforming growth factor-β₁ and IL-6 levels. Surgically induced reduction of the immunosuppressive environment results in an increased capacity of CD8+ T cells to respond to the recall antigens. None of these changes was observed in patients previously subjected to chemotherapy or affected by recurrent disease. In conclusion, we demonstrate in ovarian cancer that primary debulking is associated with a reduction of circulating T(reg) and an increase in CD8 T-cell function. Debulking plays a beneficial systemic effect by reverting immunosuppression and restoring immunological fitness.
Journal of Cellular and Molecular Medicine 09/2009; 14(12):2748-59. · 4.13 Impact Factor
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Sergio Rutella,
Giuseppina Bonanno,
Annabella Procoli,
Andrea Mariotti,
Maria Corallo,
Maria Grazia Prisco,
Adriana Eramo,
Chiara Napoletano,
Daniela Gallo,
Alessandro Perillo, Marianna Nuti,
Luca Pierelli,
Ugo Testa,
Giovanni Scambia,
Gabriella Ferrandina
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ABSTRACT: Cancer stem cells represent an attractive therapeutic target for tumor eradication. The present study aimed to determine whether CD133 expression may identify cells with characteristics of cancer stem/progenitor cells in human endometrial tumors.
We analyzed 113 tumor samples for CD133/1 expression by flow cytometry, immunohistochemistry, and semiquantitative reverse transcription-PCR. CD133(+) cells were isolated and used to assess phenotypic characteristics, self-renewal capacity, ability to maintain CD133 expression and form sphere-like structures in long-term cultures, sensitivity to chemotherapeutic agents, gene expression profile, and ability to initiate tumors in NOD/SCID mice.
Primary tumor samples exhibited a variable degree of immunoreactivity for CD133/1, ranging from 1.3% to 62.6%, but stained negatively for other endothelial and stem cell-associated markers. Isolated CD133(+) cells expanded up to 4.6-fold in serum-replenished cultures and coexpressed the GalNAcalpha1-O-Ser/Thr MUC-1 glycoform, a well-characterized tumor-associated antigen. Dissociated bulk tumors formed sphere-like structures; cells grown as tumor spheres maintained CD133 expression and could be propagated for up to 12 weeks. CD133(+) cells purified from endometrioid adenocarcinomas were resistant to cisplatin-induced and paclitaxel-induced cytotoxicity and expressed a peculiar gene signature consisting of high levels of matrix metalloproteases, interleukin-8, CD44, and CXCR4. When serially transplanted into NOD/SCID mice, CD133(+) cells were capable of initiating tumor formation and recapitulating the phenotype of the original tumor.
CD133 is expressed by human endometrial cancers and might represent a valuable tool to identify cells with cancer stem cell characteristics.
Clinical Cancer Research 07/2009; 15(13):4299-311. · 7.74 Impact Factor
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ABSTRACT: The aim of this study was to evaluate the prevalence of cancer testis tumor-associated antigens MAGE-A and NY-ESO-1 in cervical cancer and correlate expression patterns with clinicopathologic parameters and prognosis.
One hundred sixty-two cervical cancer samples from 109 patients who were treated with radical hysterectomy, neoadjuvant chemotherapy, or pelvic disease recurrence were analyzed by immunohistochemistry.
MAGE-A was expressed by 32/94 (34%) and 7/15 (47%) previously untreated and recurrent tumors, respectively. NY-ESO-1 was expressed by 46/94 (49%) and 6/15 (40%) previously untreated and recurrent tumors, respectively. MAGE-A in early stage tumors was correlated to tumor size and lymph node metastases (P = .024 and P = .046, respectively) whereas NY-ESO-1 to tumor grading (P = .039).
Cervical cancer frequently expresses cancer testis tumor-associated antigens. MAGE-A and NY-ESO-1 expression rates are not influenced by systemic therapies. Cancer testis tumor-associated antigens are correlated to common prognostic factors.
American journal of obstetrics and gynecology 02/2008; 198(1):99.e1-7. · 3.28 Impact Factor
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ABSTRACT: Cancer testis tumour associated antigens (C/T-TAAs) were investigated in several gynaecologic and non-gynaecologic neoplasms as possible prognostic markers and targets for immunotherapy. The objective of the present study was to evaluate C/T-TAA expression patterns and prognostic significance in patients affected by vulvar cancer. Melanoma antigen E (MAGE)-A1, MAGE-A4 and NY-ESO-1 expression was determined by immunohistochemistry in paraffin-embedded tissue specimens from 45 primary and 14 recurrent vulvar carcinomas treated with surgery. MAGE-A1, MAGE-A4 and NY-ESO-1 were expressed in 25 (42%), 38 (64%) and 40 (68%) of the 59 samples, respectively. MAGE-A4 was significantly more frequently expressed in tumours with lymph node metastases (p<0.002) and in recurrent tumours (p<0.02). NY-ESO-1 was more highly expressed by moderately or poorly differentiated tumours (p<0.01). This study demonstrates that vulvar cancer frequently expresses C/T-TAAs. Antigen expression correlates with the presence of lymph node metastases and poor tumour differentiation.
European Journal of Cancer 11/2007; 43(17):2621-7. · 5.54 Impact Factor
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Chiara Napoletano,
Aurelia Rughetti,
Mads P Agervig Tarp,
Julia Coleman,
Eric P Bennett,
Gianfranco Picco,
Patrizio Sale,
Kaori Denda-Nagai,
Tatsuro Irimura,
Ulla Mandel,
Henrik Clausen,
Luigi Frati,
Joyce Taylor-Papadimitriou,
Joy Burchell, Marianna Nuti
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ABSTRACT: The type of interaction between tumor-associated antigens and specialized antigen-presenting cells such as dendritic cells (DCs) is critical for the type of immunity that will be generated. MUC1, a highly O-glycosylated mucin, is overexpressed and aberrantly glycosylated in several tumor histotypes. This results in the expression of tumor-associated glycoforms and in MUC1 carrying the tumor-specific glycan Tn (GalNAcalpha1-O-Ser/Thr). Glycopeptides corresponding to three tandem repeats of MUC1, enzymatically glycosylated with 9 or 15 mol of GalNAc, were shown to specifically bind and to be internalized by immature monocyte-derived DCs (iDCs). Binding required calcium and the GalNAc residue and was competed out by GalNAc polymer and Tn-MUC1 or Tn-MUC2 glycopeptides. The macrophage galactose-type C-type lectin (MGL) receptor expressed on iDCs was shown to be responsible for the binding. Confocal analysis and ELISA done on subcellular fractions of iDCs showed that the Tn-MUC1 glycopeptides colocalized with HLA class I and II compartments after internalization. Importantly, although Tn-MUC1 recombinant protein was bound and internalized by MGL, the glycoprotein entered the HLA class II compartment, but not the HLA class I pathway. These data indicate that MGL expressed on iDCs is an optimal receptor for the internalization of short GalNAcs carrying immunogens to be delivered into HLA class I and II compartments. Such glycopeptides therefore represent a new way of targeting the HLA class I and II pathways of DCs. These results have possible implications in designing cancer vaccines.
Cancer Research 10/2007; 67(17):8358-67. · 7.86 Impact Factor
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ABSTRACT: Dendritic cells (DCs) are the most potent antigen presenting cells and are therefore widely used in cancer immunotherapy. An optimal method for the generation of DCs for clinical use remains to be established. The aim of the study was to find a serum-free media (SFM) able to generate reproducible and functional cultures of DCs for clinical studies. We characterized immature and mature DCs cultured in SFM, CellGro DC and X-VIVO15, and serum media (SM), RPMI 1640+5% human serum or autologous serum. The expression of HLA-DR, CD86, CD83 was higher in SM-cultured DCs (SM-DCs) than SFM-derived DCs (SFM-DCs). Between SFM-DCs, CellGro-cultured DCs (CellGro-DCs) showed a higher expression and an improved up-regulation capacity of all molecules as compared with X-VIVO15-derived DCs (X-VIVO15-DCs). CellGro-DCs and SM-DCs showed a similar mannose receptor expression and related endocytic capacity tested by fluorescein isothiocyanate-dextran uptake. In contrast X-VIVO15-DCs expressed low levels of mannose receptor and were unable to endocyte fluorescein isothiocyanate-dextran. DCs cultured in all conditions stimulated a mix lymphocyte reaction, but CellGro-DCs and SM-DCs induced a more potent T-cell proliferation compared with X-VIVO15-DCs. Cytokine analysis showed that after maturation, all DC cultures produced IL-12p70 and IL-10 except for X-VIVO15-DCs which only produced the latter cytokine. SM-DCs and SFM-DCs induced a TH1 polarization in allogeneic naive T cells. In conclusion, a comparative analysis of DC performance generated in different conditions allows us to determine CellGro DC as the optimal medium for the generation of clinical grade DCs.
Journla of Immunotherapy 06/2007; 30(5):567-76. · 3.27 Impact Factor
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Aurelia Rughetti,
Ilenia Pellicciotta,
Mauro Biffoni,
Malin Bäckström,
Thomas Link,
Eric P Bennet,
Henrik Clausen,
Thomas Noll,
Gunnar C Hansson,
Joy M Burchell,
Luigi Frati,
Joyce Taylor-Papadimitriou, Marianna Nuti
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ABSTRACT: Tumors exploit several strategies to evade immune recognition, including the production of a large number of immunosuppressive factors, which leads to reduced numbers and impaired functions of dendritic cells (DCs) in the vicinity of tumors. We have investigated whether a mucin released by tumor cells could be involved in causing these immunomodulating effects on DCs. We used a recombinant purified form of the MUC1 glycoprotein, an epithelial associated mucin that is overexpressed, aberrantly glycosylated, and shed during cancer transformation. The O-glycosylation profile of the recombinant MUC1 glycoprotein (ST-MUC1) resembled that expressed by epithelial tumors in vivo, consisting of large numbers of sialylated core 1 (sialyl-T, ST) oligosaccharides. When cultured in the presence of ST-MUC1, human monocyte-derived DCs displayed a modified phenotype with decreased expression of costimulatory molecules (CD86, CD40), Ag-presenting molecules (DR and CD1d), and differentiation markers (CD83). In contrast, markers associated with an immature phenotype, CD1a and CD206 (mannose receptor), were increased. This effect was already evident at day 4 of DC culture and was dose dependent. The modified phenotype of DCs corresponded to an altered balance in IL-12/IL-10 cytokine production, with DC expressing an IL-10(high)IL-12(low) phenotype after exposure to ST-MUC1. These DCs were defective in their ability to induce immune responses in both allogeneic and autologous settings, as detected in proliferation and ELISPOT assays. The altered DC differentiation and Ag presentation function induced by the soluble sialylated tumor-associated mucin may represent a mechanism by which epithelial tumors can escape immunosurveillance.
The Journal of Immunology 07/2005; 174(12):7764-72. · 5.79 Impact Factor
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Aurelia Rughetti,
Mauro Biffoni,
Luca Pierelli,
Hassan Rahimi,
Giuseppina Bonanno,
Serena Barachini,
Ilenia Pellicciotta,
Chiara Napoletano,
Edoardo Pescarmona,
Angelo Del Nero,
Patrizia Pignoloni,
Luigi Frati, Marianna Nuti
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ABSTRACT: MUC1 is a large surface glycoprotein expressed by epithelial cells, which is overexpressed and aberrantly glycosylated in carcinomas. MUC1 is involved in epithelial cell interactions and appears to function as a signal-transducing molecule. The finding that MUC1 can also be expressed in the haematopoietic lineages prompted us to further investigate the possible function(s) of this molecule in haematopoietic cells. In bone marrow differentiating cells, MUC1 was strongly and selectively expressed during erythropoiesis; it was also weakly expressed during megakaryocytopoiesis and granulomonocytopoiesis; however, no correlation between MUC1 and differentiation marker expression was observed in these lineages. In vitro CD34+ cells, induced towards erythroid differentiation, acquired MUC1 transiently, while expressing increasing levels of the lineage marker glycophorin A. MUC1 was absent in the circulating erythrocytes. During erythropoiesis, MUC1 expression was transcriptionally regulated and the molecule underwent phosphorylation. To investigate the possible role of MUC1 during erythropoiesis, we studied the ability of MUC1 to act as ligand for cell-cell interaction. The sialylated MUC1 glycoforms selectively expressed on erythroid cells were able to bind the macrophage-restricted molecule sialoadhesin. These results suggest that MUC1 can function as a cross-talk molecule between the erythroblasts and the surrounding cells during erythropoiesis.
British Journal of Haematology 02/2003; 120(2):344-52. · 4.94 Impact Factor
