Publications by authors named "Svane I"

Introduction: Advances in modern therapies have improved outcomes for patients with melanoma brain metastases (MBM), though prognosis remains poor. The optimal treatment strategy for patients who do not meet clinical trial inclusion criteria is unclear.

Methods: This study included all patients with MBM diagnosed in Denmark between 2015 and 2022, identified through the Danish Metastatic Melanoma Database (DAMMED) and local surgical and radiotherapy records.

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Groundbreaking studies have reshaped the treatment landscape for patients with resectable stage ≥IIIB melanoma by demonstrating the benefits of neoadjuvant therapy. Data from the NADINA and SWOG S1801 trials reveal substantial improvements in event-free survival compared to adjuvant therapy alone. These studies employed distinct neoadjuvant immunotherapy approaches - ipilimumab plus nivolumab in NADINA and anti-PD-1 monotherapy in SWOG S1801 - highlighting potential differences in efficacy and toxicity.

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Background: Despite significant advancements in the treatment of malignant melanoma, metastatic mucosal melanoma remains a therapeutic challenge due to its complex pathogenesis, distinct pathological characteristics, and limited response to immunotherapy. Combining different immunotherapeutic approaches offers a potential strategy to address these challenges. Tumor-infiltrating lymphocyte (TIL) therapy and oncolytic virus therapy represent promising treatment modalities that may synergize with each other.

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Although interleukin (IL)-6 is considered immunosuppressive and tumor-promoting, emerging evidence suggests that it may support antitumor immunity. While combining immune checkpoint inhibitors (ICIs) and radiotherapy in patients with pancreatic cancer (PC) has yielded promising clinical results, the addition of an anti-IL-6 receptor (IL-6R) antibody has failed to elicit clinical benefits. Notably, a robust TGFβ-specific immune response at baseline in PC patients treated solely with ICIs and radiotherapy correlated with improved survival.

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Purpose: There is an unmet need for new treatment options and biomarkers for patients with glioblastoma (GBM). Here we investigated three non-invasive biomarkers: type VI collagen degraded by granzyme B (C4G) and matrix metalloproteases (C4M), respectively, and ADAM10-degraded Tau (Tau-A).

Methods: Biomarker levels in pre- and on-treatment serum samples from patients with recurrent GBM (n = 39) treated with nivolumab and bevacizumab (NCT03890952) were compared to healthy levels (n = 22) and associated with overall survival (OS) outcome (median cutpoint).

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Article Synopsis
  • Metastatic posterior uveal melanoma (PUM) has a short median survival, but some patients live longer, prompting this study to explore if the location of metastases affects survival rates.
  • The study analyzed 178 patients divided into three groups: those with only liver metastases (hepatic), those with both liver and other metastases (hepatic-extrahepatic), and those with only non-liver metastases (extrahepatic).
  • Results showed that patients with extrahepatic metastases had a significantly longer median survival (17 months) compared to those with liver-only (11 months) or combined liver and other (7 months) metastases, highlighting the importance of anatomical location in prognosis.
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Introduction: Immune checkpoint inhibitors (ICIs) carry the risk of immune-related adverse events (irAEs), a significant concern as therapy has transitioned to the adjuvant setting. Balancing therapeutic benefits against potential risks is crucial, necessitating real-world data from an unselected patient population in addition to clinical trial data to ensure optimal clinical decision-making.

Methods: This nationwide real-world study assessed irAEs in patients receiving adjuvant anti-PD1 therapy, primarily nivolumab, for resected stage III-IV melanoma between 2018-2022.

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Article Synopsis
  • Modern therapies for advanced melanoma targeting the BRAF gene, like encorafenib and binimetinib, have improved patient outcomes but can lead to heart issues.
  • A study of 108 melanoma patients in Eastern Denmark (2019-2022) found that 18% had minor cardiotoxicity, while 6% experienced major cardiotoxicity, mostly without symptoms.
  • Results suggest that if no early signs of heart problems appear, monitoring heart function could be less frequent after 6-9 months into treatment.
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Immunotherapy can lead to long-term survival for some cancer patients, yet generalized success has been hampered by insufficient antigen presentation and exclusion of immunogenic cells from the tumor microenvironment. Here, we developed an approach to reprogram tumor cells in vivo by adenoviral delivery of the transcription factors PU.1, IRF8, and BATF3, which enabled them to present antigens as type 1 conventional dendritic cells.

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Over the past decade, treatment with immune checkpoint inhibitors (ICI) has been implemented in cancer treatment. It has led to a significant improvement in the prognosis for many types of cancer. ICIs work by inducing the body's immune response against cancer cells.

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Article Synopsis
  • * Data from the Danish Metastatic Melanoma Database (DAMMED) involved 79 treatment-naive patients, showing a complete response rate of 16.5% and an overall response rate of 46.9%.
  • * The 6-month progression-free survival rate was 53.5%, and the median overall survival was not reached, indicating that the real-world results align closely with those from previous phase II trials.
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Background: Adoptive cell therapy with tumor-infiltrating lymphocytes (TIL-ACT) has consistently shown efficacy in advanced melanoma. New results in the field provide now the opportunity to assess overall survival (OS) after TIL-ACT and to examine the effect of prior anti-programmed cell death protein 1/programmed death-ligand 1 [anti-PD-(L)1] therapy on its efficacy.

Methods: A comprehensive search was conducted in PubMed up to 29 February 2024.

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Glioblastoma (GBM) is an aggressive brain tumor with poor prognosis. Although immunotherapy is being explored as a potential treatment option for patients with GBM, it is unclear whether systemic immunotherapy can reach and modify the tumor microenvironment in the brain. We evaluated immune characteristics in patients receiving the anti-PD-1 immune checkpoint inhibitor nivolumab 1 week prior to surgery, compared with control patients receiving salvage resection without prior nivolumab treatment.

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Purpose: The purpose of this study was to evaluate the clinical benefits of nivolumab with/without ipilimumab combined with stereotactic body radiotherapy (SBRT) in patients with pretreated metastatic biliary tract cancer (mBTC).

Patients And Methods: The study was a phase 2 randomized trial with Simon's optimal two-stage design requiring 36 evaluable patients per group after second stage. Sixty-one patients were included from September 2018 to January 2022 and randomized (1:1) to receive SBRT (15 Gy × 1 on day 1 to a primary or metastatic lesion) and nivolumab (3 mg/kg intravenously on day 1 and every 2 weeks) with/without ipilimumab (1 mg/kg intravenously on day 1 and every 6 weeks).

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Protein identification and quantification is an important tool for biomarker discovery. With the increased sensitivity and speed of modern mass spectrometers, sample preparation remains a bottleneck for studying large cohorts. To address this issue, we prepared and evaluated a simple and efficient workflow on the Opentrons OT-2 robot that combines sample digestion, cleanup, and loading on Evotips in a fully automated manner, allowing the processing of up to 192 samples in 6 h.

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The origins of cancer vaccines date back to the 1800s. Since then, there have been significant efforts to generate vaccines against solid and hematologic malignancies using a variety of platforms. To date, these efforts have generally been met with minimal success.

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Background: Mutation-derived neoantigens are critical targets for tumor rejection in cancer immunotherapy, and better tools for neoepitope identification and prediction are needed to improve neoepitope targeting strategies. Computational tools have enabled the identification of patient-specific neoantigen candidates from sequencing data, but limited data availability has hindered their capacity to predict which of the many neoepitopes will most likely give rise to T cell recognition.

Method: To address this, we make use of experimentally validated T cell recognition towards 17,500 neoepitope candidates, with 467 being T cell recognized, across 70 cancer patients undergoing immunotherapy.

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Article Synopsis
  • The study investigates immune-related thyroid adverse events (irTAEs) occurring in melanoma patients receiving immune checkpoint inhibitors, focusing on incidence, potential contributing factors, and treatment impact.
  • Out of 454 patients analyzed, 21.8% experienced irTAEs, with a notable split between transient (46.5%) and persistent (53.5%) conditions, typically developing within the first three months.
  • Female patients were significantly more likely to have irTAEs, but these events did not correlate with better recurrence-free or overall survival rates, suggesting no positive impact on clinical outcomes.
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Immune checkpoint blockade (ICB) has improved outcome for patients with metastatic melanoma but not all benefit from treatment. Several immune- and tumor intrinsic features are associated with clinical response at baseline. However, we need to further understand the molecular changes occurring during development of ICB resistance.

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Introduction: Although checkpoint inhibitors (CPIs) have improved outcomes for patients with metastatic melanoma, those progressing on CPIs have limited therapeutic options. To address this unmet need and overcome CPI resistance mechanisms, novel immunotherapies, such as T-cell engaging agents, are being developed. The use of these agents has sometimes been limited by the immune response mounted against them in the form of anti-drug antibodies (ADAs), which is challenging to predict preclinically and can lead to neutralization of the drug and loss of efficacy.

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Article Synopsis
  • Clinical trials indicate that adjuvant immunotherapy is effective for patients with resected melanoma, and real-life data can enhance treatment decisions and patient management.
  • A study analyzing the Danish Metastatic Melanoma Database found that out of 785 patients treated with anti-PD-1, a significant portion experienced strong survival rates, but many did not complete their planned therapy.
  • The findings suggest that survival outcomes for real-world melanoma patients receiving anti-PD-1 are consistent with trial results, and combining ipilimumab with nivolumab does not improve patient outcomes compared to using ipilimumab alone after anti-PD-1 treatment.
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The activity of immune checkpoint inhibitors (ICIs) in patients with metastatic melanoma is often monitored using fluorine-18-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) scans. However, distinguishing disease progression (PD) from pseudoprogression (PsPD), where increased FDG uptake might reflect immune cell activity rather than tumor growth, remains a challenge. This prospective study compared the efficacy of dual-time point (DTP) FDG-PET/CT with modified response criteria (PERCIMT) in differentiating PsPD from PD.

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