Improved efficacy of pembrolizumab combined with soluble EphB4-albumin in HPV-negative EphrinB2 positive head neck squamous cell carcinoma

ObjectivePatients with relapsed or metastatic head and neck squamous cell carcinoma (HNSCC) after primary local therapy have low response rates with cetuximab, systemic chemotherapy or check point inhibitor therapy. Novel combination therapies with the potential to improve outcomes for patients with HNSCC is an area of high unmet need.MethodsThis is a phase II single-arm clinical trial of locally advanced or metastatic HNSCC patients treated with a combination of soluble EphB4-human serum albumin (sEphB4-HSA) fusion protein and pembrolizumab after platinum-based chemotherapy with up to 2 prior lines of treatment. The primary endpoints were safety and tolerability and the primary efficacy endpoint was overall response rate (ORR). Secondary endpoints included progression free survival (PFS) and overall survival (OS). HPV status and EphrinB2 expression were evaluated for outcome.ResultsTwenty-five patients were enrolled. Median follow up was 40.4 months (range 9.8 - 40.4). There were 6 responders (ORR 24%). There were 5 responders in the 11 HPV-negative and EphrinB2 positive patients, (ORR 45%) with 2 of these patients achieving a complete response (CR). The median PFS in HPV-negative/EphrinB2 positive patients was 3.2 months (95% CI 1.1, 7.3). Median OS in HPV-negative/EphrinB2 positive patients was 10.9 months (95% CI 2.0, 13.7). Hypertension, transaminitis and fatigue were the most common toxicities.DiscussionThe combination of sEphB4-HSA and pembrolizumab has a favorable toxicity profile and favorable activity particularly among HPV-negative EphrinB2 positive patients with HNSCC

LEA.135 expression: An independent and favorable prognostic biomarker for patients with primary invasive breast cancer

The prognostic significance of LEA.135 expression, detected by immunohistochemistry in formalin-fixed and paraffin-embedded tissue sections, was evaluated and compared with the widely utilized clinicopathological parameters for patients with primary invasive breast carcinomas. Pathological parameters such as tumor size, histological tumor type, histological grade, nuclear grade, lymph node (LN) status, bone marrow (BM) status, as well as age of patient at initial diagnosis together with follow-up in years were available for this group of patients (n = 178). Among these parameters, tumor size, histological tumor type, histological grade, LN status, and BM status were individually and significantly associated with increased probability of recurrence by univariate analysis. By multivariate analysis, however, only tumor size, LN status, and BM status remained statistically significant. LEA.135-positive patients showed a statistically significant probability of not recurring (77 +/- 5% at 5 years after surgery) compared with patients who were LEA. 135-negative (49 +/- 6% at 5 years after surgery) (log-rank p < 0. 001). Furthermore, the association remained statistically significant by multivariate analysis (log-rank p = 0.019), demonstrating that LEA.135 expression independently and significantly identified breast cancer patients with favorable clinical outcome. In addition, there was a statistically significant association between loss of LEA.135 expression and poor prognosis when patients were stratified by pathological parameters. Furthermore, a subgroup of patients who were LEA. 135-positive/LN-negative experienced a decreased rate of recurrence compared with those who were LEA.135-negative/LN-negative (16% vs. 27%, respectively). A similar result was also obtained when BM-negative patients were stratified on the basis of LEA. 135-positive or LEA.135-negative subgroups for recurrence (18% vs. 43%, respectively). Most interestingly, the patients whose cancer cells were LEA.135-positive/LN-positive experienced a much lower rate of recurrence than those whose cells were LEA. 135-negative/LN-positive (29% vs. 57%, respectively). The results clearly demonstrate that LEA.135 expression was a significantly independent and favorable prognostic marker for patients with primary invasive breast carcinoma by both univariate and multivariate analyses

LEA.135 expression: An independent and favorable prognostic biomarker for patients with primary invasive breast cancer

The prognostic significance of LEA.135 expression, detected by immunohistochemistry in formalin-fixed and paraffin-embedded tissue sections, was evaluated and compared with the widely utilized clinicopathological parameters for patients with primary invasive breast carcinomas. Pathological parameters such as tumor size, histological tumor type, histological grade, nuclear grade, lymph node (LN) status, bone marrow (BM) status, as well as age of patient at initial diagnosis together with follow-up in years were available for this group of patients (n = 178). Among these parameters, tumor size, histological tumor type, histological grade, LN status, and BM status were individually and significantly associated with increased probability of recurrence by univariate analysis. By multivariate analysis, however, only tumor size, LN status, and BM status remained statistically significant. LEA.135-positive patients showed a statistically significant probability of not recurring (77 +/- 5% at 5 years after surgery) compared with patients who were LEA. 135-negative (49 +/- 6% at 5 years after surgery) (log-rank p < 0. 001). Furthermore, the association remained statistically significant by multivariate analysis (log-rank p = 0.019), demonstrating that LEA.135 expression independently and significantly identified breast cancer patients with favorable clinical outcome. In addition, there was a statistically significant association between loss of LEA.135 expression and poor prognosis when patients were stratified by pathological parameters. Furthermore, a subgroup of patients who were LEA. 135-positive/LN-negative experienced a decreased rate of recurrence compared with those who were LEA.135-negative/LN-negative (16% vs. 27%, respectively). A similar result was also obtained when BM-negative patients were stratified on the basis of LEA. 135-positive or LEA.135-negative subgroups for recurrence (18% vs. 43%, respectively). Most interestingly, the patients whose cancer cells were LEA.135-positive/LN-positive experienced a much lower rate of recurrence than those whose cells were LEA. 135-negative/LN-positive (29% vs. 57%, respectively). The results clearly demonstrate that LEA.135 expression was a significantly independent and favorable prognostic marker for patients with primary invasive breast carcinoma by both univariate and multivariate analyses

Association between monocyte Fcγ subclass expression and acute coronary syndrome

Abstract Background Atherosclerosis lesions contain abundant immunoglobulins complexed with oxidized LDL (OxLDL) that are endocytosed by macrophages to form foam cells. While recent evidence supports a role for the macrophage scavenger receptor pathway in 75–90% of OxLDL uptake, in vitro evidence suggests another potential uptake pathway could involve autoantibody binding to IgG subclass-specific Fc receptors. Objective and Methods To address this mechanism from an in vivo standpoint, the objective of this study was to utilize flow cytometry to prospectively determine monocyte Fcγ (FcR) I, II, and III receptor expression levels in patients with acute coronary syndrome (ACS, n = 48), diabetes mellitus (DM, n = 59), or neither (C, n = 88). Results Increased FcR I expression was found in the ACS versus DM groups [geometric mean, (95% CI) = 2.26 (2.07, 2.47) versus 1.83 (1.69, 1.98) (p Conclusions This in vivo data supports a possible second OxLDL-autoantibody macrophage uptake mechanism through an Fc receptor-mediated pathway and a potential relationship between atherosclerotic plaque macrophage FcR levels and ACS.</p