Monitoring the immune competence of cancer patients to predict outcome

Chang, Serena; Kohrt, Holbrook E.; Maecker, Holden T.

doi:10.1007/s00262-014-1521-3

Cited by 42 publications

(25 citation statements)

References 39 publications

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“…We have suggested that the TEX immunosuppressive profile could serve as a measure of tumor-induced immune dysfunction and tumor progression. This rationale is based on recent data indicating that the extent of immune dysfunction in cancer reflects tumor progression and correlates with outcome [5,128]. If so, then TEX could serve as surrogate markers of immune dysfunction in cancer and, by extension, of unfavorable prognosis.…”

Section: Tex As Markers Of Anti-tumor Immune Responsesmentioning

confidence: 99%

The potential of tumor-derived exosomes for noninvasive cancer monitoring

Whiteside

2015

Expert Review of Molecular Diagnostics

123

108

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Tumor-derived exosomes (TEXs) are emerging as a new type of cancer biomarker. TEXs are membrane-bound, virus-size vesicles of endocytic origin present in all body fluids of cancer patients. Based on the expanding albeit incomplete knowledge of their biogenesis, secretion by tumor cells and cancer cell-specific molecular and genetic contents, TEXs are viewed as promising, clinically-relevant surrogates of cancer progression and response to therapy. Preliminary proteomic, genetic and functional profiling of tumor cell-derived or cancer plasma-derived exosomes confirms their unique characteristics. Alterations in protein or nucleic acid profiles of exosomes in plasma of cancer patients responding to therapies appear to correlate with clinical endpoints. However, methods for TEX isolation and separation from the bulk of human plasma-derived exosomes are not yet established and their role as biomarkers remains to be confirmed. Further development and validation of TEXs as noninvasive, liquid equivalents of tumor biopsies are necessary to move this effort forward.

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Section: Tex As Markers Of Anti-tumor Immune Responsesmentioning

confidence: 99%

The potential of tumor-derived exosomes for noninvasive cancer monitoring

Whiteside

2015

Expert Review of Molecular Diagnostics

123

108

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“…Th erefore, the loss of immune competence may be an important risk factor 16 . Unfortunately, there are no standardized tests for immune competence, nor is there agreement on what to measure and what is predictive of the outcome 17 . Daily VAP prevention strategies are performed in the ICU, such as mechanical ventilation protocols, sedation and weaning protocols, head of bed elevation above 30 degrees and oral care with chlorhexidine 18 .…”

Section: Discussionmentioning

confidence: 99%

Ventilator-Associated Pneumonia: Comparing Cadaveric Liver Transplant and Non-Transplant Surgical Patients

Brusich

2016

acc

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SUMMARY -Ventilator-associated pneumonia is a frequent complication in intensive care surgical patients, particularly those with high severity scores on admission. We studied the incidence and clinical outcome of ventilator-associated pneumonia among patients undergoing major general surgery procedures and those undergoing cadaveric liver transplantation in our hospital. Patients with the intensive care unit stay longer than four days having undergone surgery or transplantation and mechanically ventilated for more than 48 hours were included in the study. Ventilator-associated pneumonia diagnosis was based on a combination of radiological signs (progressive infi ltrate on chest radiograph), clinical signs (fever >38.3 °C, leukocytes >12×10 9 /mL) and microbiological data (positive culture from tracheal aspiration >10 5 or bronchoalveolar lavage >10 4 colonies/mL). Medical records of 1037 patients were reviewed and 157 patients were found to have been mechanically ventilated for more than 48 hours: 62 transplanted and 95 non-transplanted. Only 39 (24.84%) patients matched the criteria for ventilator-associated pneumonia. Th ere were no diff erences in sex, age, duration of mechanical ventilation, length of stay or outcome between the two groups. However, the main diff erence was the mean severity score on admission (Simplifi ed Acute Physiology Score II) which was higher among non-transplant patients (42±16 vs. 31±9; p=0.03). Gram-negative bacteria were the leading causative agents (82.03%) and were multidrug-resistant. In the intensive care surgical population, transplantation per se does not seem to increase patient risk for either ventilator-associated pneumonia acquisition or worse outcomes.

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“…Immune monitoring (23), especially in early phase clinical trials, has the major goal of establishing proof-of-principle for the proposed immunologic effect and showing immunogenicity of the administered antigens. Monitoring of the immune response to a vaccine can be useful to assess variations in patient immunocompetency that may affect the study results (24). Responses against known immunogens (e.g.…”

Section: Review Of the Recommendations And Discussionmentioning

confidence: 99%

The FDA Guidance on Therapeutic Cancer Vaccines: The Need for Revision to Include Preventive Cancer Vaccines or for a New Guidance Dedicated to Them

Finn

Khleif

Herberman³

2015

Cancer Prevention Research

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Cancer vaccines based on antigens derived from self molecules rather than pathogens, have been under basic and clinical investigations for many years. Up until very recently they had been tested primarily in the setting of metastatic disease with the goal to engage the immune system in slowing down disease progression. Many therapeutic vaccine trials, either investigator-initiated or led by pharmaceutical companies, have been completed and many are currently ongoing, following the FDA Guidance on therapeutic cancer vaccines published in 2011. In recent years the target of cancer vaccines is being shifted to early cancer and even premalignant disease with the goal of preventing cancer. While some issues addressed in the FDA Guidance on therapeutic vaccines apply to preventive vaccines, many do not. Here we discuss a set of recommendations for revising the current Guidance to also cover preventive vaccines, or to include in a new Guidance dedicated specifically to vaccines for cancer prevention.

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Monitoring the immune competence of cancer patients to predict outcome

Cited by 42 publications

References 39 publications

The potential of tumor-derived exosomes for noninvasive cancer monitoring

The potential of tumor-derived exosomes for noninvasive cancer monitoring

Ventilator-Associated Pneumonia: Comparing Cadaveric Liver Transplant and Non-Transplant Surgical Patients

The FDA Guidance on Therapeutic Cancer Vaccines: The Need for Revision to Include Preventive Cancer Vaccines or for a New Guidance Dedicated to Them

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