Publications by authors named "Sana Karam"

Background: Treatment with immunotherapy can elicit varying responses across cancer types, and the mechanistic underpinnings that contribute to response vrsus progression remain poorly understood. However, to date there are few preclinical models that accurately represent these disparate disease scenarios.

Methods: Using combinatorial radio-immunotherapy consisting of PD-1 blockade, IL2Rβγ biased signaling, and OX40 agonism we were able to generate preclinical tumor models with conflicting responses, where head and neck squamous cell carcinoma (HNSCC) models respond and pancreatic ductal adenocarcinoma (PDAC) progresses.

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Over the last decade, the annual Immunorad Conference, held under the joint auspicies of Gustave Roussy (Villejuif, France) and the Weill Cornell Medical College (New-York, USA) has aimed at exploring the latest advancements in the fields of tumor immunology and radiotherapy-immunotherapy combinations for the treatment of cancer. Gathering medical oncologists, radiation oncologists, physicians and researchers with esteemed expertise in these fields, the Immunorad Conference bridges the gap between preclinical outcomes and clinical opportunities. Thus, it paves a promising way toward optimizing radiotherapy-immunotherapy combinations and, from a broader perspective, improving therapeutic strategies for patients with cancer.

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Radiation therapy (RT), a mainstay treatment for head and neck squamous cell carcinoma (HNSCC), kills cancer cells and modulates the tumor immune microenvironment. We sought to assess the effect of RT in combination with PD-L1/TGF-β dual blockade in squamous cell carcinomas (SCC) and analyze the underlying mechanisms. We transplanted mouse SCC cells derived from keratin-15 (K15) stem cells harboring Kras/Smad4 mutations into syngeneic recipients and irradiated tumors followed by PD-L1/TGF-β dual blockade.

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The EphB4-ephrinB2 signaling axis has been heavily implicated in metastasis across numerous cancer types. Our emerging understanding of the dichotomous roles that EphB4 and ephrinB2 play in head and neck squamous cell carcinoma (HNSCC) poses a significant challenge to rational drug design. We find that EphB4 knockdown in cancer cells enhances metastasis in preclinical HNSCC models by augmenting immunosuppressive cells like T regulatory cells (Tregs) within the tumor microenvironment.

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Recently developed ultrasound contrast agents are a promising tool for imaging and drug delivery in tumors. To better understand their unusual kinetics, we implemented a novel pixel clustering analysis, which provides unique information by accounting for spatial heterogeneity. By combining ultrasound results with proteomics of the imaged tumors, we show that this analysis is highly predictive of protein expression and that specific types of nanobubble time-intensity curve are associated with upregulation of different metabolic pathways.

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Background: This work seeks to understand whether IL15-incorporating treatments improve response to radiotherapy and uncover mechanistic rationale for overcoming resistance to IL15 agonism using novel therapeutic combinations.

Experimental Design: Orthotopic tumor models of PDAC were used to determine response to treatment. IL15-/- and Rag1-/- mouse models were employed to determine dependence on IL15 and CTLs, respectively.

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Purpose: Despite the agreed-on efficacy and benefits of palliative radiation therapy (PRT) to alleviate end-of-life complications related to cancer progression, PRT remains an underused treatment in the hospice-care setting. Common barriers for hospice patient use of PRT include educational and economic limitations. This paper discussed these barriers and ways to eliminate them based on previously published interventions.

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Background: Bone metastasis is the most common cause of cancer-related pain. Radiation therapy (RT) can provide successful palliation but there is currently no consensus for surveillance after palliative radiation. This study aimed to assess the feasibility of surveillance after RT for painful bone metastases.

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Unlabelled: Head and Neck Squamous Cell Carcinoma (HNSCC) is a deadly cancer with poor response to targeted therapy, largely driven by an immunosuppressive tumor microenvironment (TME). Here we examine the immune-modulatory role of the receptor tyrosine kinase EphA4 in HNSCC progression. Within the TME, EphA4 is primarily expressed on regulatory T cells (Tregs) and macrophages.

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Article Synopsis
  • The EphB4-ephrinB2 system is important in cancer spreading (metastasis) for many types of cancer, including head and neck cancer.
  • Reducing EphB4 in cancer cells can actually help them spread more because it increases certain immune cells that protect the tumor.
  • Blocking ephrinB2 in blood vessels while treating with radiation can help boost the immune response against the tumor and reduce spreading, suggesting that targeting this system could help in fighting the cancer.
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  • Gene expression helps cells adapt to stress, and a specific protein called P-TEFb plays a big role in how cells respond to heat and other stressors.
  • Researchers found that when pediatric brain cancer cells are treated with radiation, P-TEFb helps the cells quickly reorganize their DNA to repair damage and keep living.
  • Blocking P-TEFb while giving radiation treatment weakened the cells’ ability to adapt, making them more likely to die and improving survival time in experiments.
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Background: Adjuvant therapy is associated with improved pancreatic cancer survival after neoadjuvant chemotherapy and surgery. However, whether adjuvant treatment should include radiotherapy is unclear in this setting.

Methods: This study queried the National Cancer Database for pancreatic adenocarcinoma patients who underwent curative resection after multiagent neoadjuvant chemotherapy between 2010 and 2019 and received adjuvant treatment.

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Article Synopsis
  • Current immunotherapies for head and neck squamous cell carcinoma (HNSCC) largely focus on immune checkpoint blockade but show limited effectiveness in early-stage disease.
  • Research indicates that combining interleukin-7 (IL7) with radiotherapy (RT) enhances CD8+ T-cell activation and significantly reduces tumor growth in both HPV-related and unrelated HNSCC models.
  • The IL7 and RT treatment not only improves CD8 T-cell infiltration into tumors but also boosts the proliferation of T-cell progenitors, suggesting a promising new immunotherapy approach beyond traditional methods.
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Background: The Phase 1 CLOVER study (NCT03509012) assessed durvalumab in combination with concurrent chemoradiotherapy (cCRT) in patients with advanced solid tumors; we report results from the head and neck squamous cell carcinoma (HNSCC) cohort.

Methods: Patients with histologically/cytologically confirmed locally advanced HNSCC, eligible for definitive cCRT and not considered for primary surgery, received durvalumab plus cisplatin and concurrent external beam radiation. Objectives were to assess safety/tolerability and preliminary efficacy.

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Introduction: For patients with unresectable, stage III non-small-cell lung cancer (NSCLC), current standard of care is concurrent chemoradiotherapy (cCRT) followed by consolidation durvalumab. However, earlier initiation of durvalumab simultaneously with cCRT may increase antitumor activity relative to initiation after cCRT. The phase 1 CLOVER study (NCT03509012) evaluated durvalumab combined with cCRT in patients with advanced solid tumors; we report findings from the NSCLC cohort.

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The oil and gas industries (OGI) are the primary global energy source, with pipelines as vital components for OGI transportation. However, pipeline leaks pose significant risks, including fires, injuries, environmental harm, and property damage. Therefore, maintaining an effective pipeline maintenance system is critical for ensuring a safe and sustainable energy supply.

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Background: Perineural invasion (PNI) and nerve density within the tumor microenvironment (TME) have long been associated with worse outcomes in head and neck squamous cell carcinoma (HNSCC). This prompted an investigation into how nerves within the tumor microenvironment affect the adaptive immune system and tumor growth.

Methods: We used RNA sequencing analysis of human tumor tissue from a recent HNSCC clinical trial, proteomics of human nerves from HNSCC patients, and syngeneic orthotopic murine models of HPV-unrelated HNSCC to investigate how sensory nerves modulate the adaptive immune system.

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Purpose: Complementary health approaches (CHAs) equip patients to self-manage radiation therapy (RT)-related symptoms and fulfill unmet needs, but few disclose CHA use to their radiation oncologist. An integrative medicine educational program (IMEP) was developed to assess its ability to improve patient self-efficacy for symptom management and CHA use disclosure.

Methods And Materials: The IMEP included 4 1-hour sessions covering topics of (1) meditation, (2) yoga, (3) massage therapy, and (4) nutrition.

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Purpose: Head and neck cancer (HNC) improvements are stagnant, even with advances in immunotherapy. Our previous clinical trial data show that altered fatty acid (FA) metabolism correlates with outcome. We hypothesized that pharmacologic and dietary modulation of FA catabolism will affect therapeutic efficacy.

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Article Synopsis
  • Pancreatic cancer is known for its poor survival rates, improving slowly compared to other types of cancer.
  • Treatment typically involves a combination of chemotherapy, surgery, and radiotherapy, with a focus on how the cancer spreads locally.
  • Recent advancements in treatment strategies prompt a need for further research to explore new ways to manage and improve outcomes for pancreatic cancer patients.
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Lymphatic transport facilitates the presentation of cancer antigens in tumor-draining lymph nodes (tdLNs), leading to T cell activation and the generation of systemic antitumor immune surveillance. Surgical removal of LNs to control cancer progression is routine in clinical practice. However, whether removing tdLNs impairs immune checkpoint blockade (ICB) is still controversial.

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Article Synopsis
  • - The study investigates how pancreatic ductal adenocarcinoma (PDAC) cells release CSF-1, leading to NLRP3 activation in immune cells, which contributes to an immune-tolerant microenvironment that facilitates tumor growth and drug resistance.
  • - Higher NLRP3 expression was observed in PDAC patients, correlating with increased inflammation driven by IL1β, which suppresses CD8+ T-cell activation and promotes tumor expansion.
  • - The study highlights the potential of using NLRP3 inhibitors in combination with gemcitabine chemotherapy to enhance immune response and reduce tumor growth, suggesting a new therapeutic target for PDAC treatment.
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