Abstract B100: Subtype specific expression of HRH1 contributes to increased chemoresistance of breast cancer cells

Background: Histamine is a monoamine produced by α-decarboxylation of histidine by the enzyme histidine decarboxylase (HDC). Histamine acts as an autocrine regulator of cell proliferation through its binding to HRH1-4 receptors. In breast cancer (BC), there are controversial results about the therapeutic efficacy of HRH1 or HRH2 inhibitors and the role of histamine receptors in tumor progression.

Given the phenotypic heterogeneity of BC and the presence of different molecular subtypes with different clinical outcome, we aimed to investigate the contribution of histamine receptors in the proliferation, migration and cell survival of BC cells of different molecular subtypes.

Methods: The expression of histamine receptors HRH1-4 and HDC in human breast tumors of different subtypes, and their correlation with clinical variables were gathered through informatics analysis using the “Gene expression based Outcome for Breast cancer Online” (GOBO) web-based tool. The measurement of the mRNA levels of HRH1-4 and HDC in a panel of breast cancer cell lines was used to confirm the subtype specific expression of each protein. Using specific HRH inhibitors in luminal and basal-like breast cancer cell lines we assessed the functional role of histamine receptors in cell proliferation, migration and survival.

Results: HRH1 was highly expressed in ER+ tumors while HDC was highly expressed in the ER- tumors. In any case, the high expression of HRH1 or HDC was significantly correlated with lower overall survival only in ER+ tumors. The same pattern of expression was observed in BC cell lines, where HRH1 was highly expressed in basal-like BC cells compared to the luminal ones. HRH2 and HRH3 were highly expressed in the estrogen-dependent MCF7 cell line, while HRH4 was not detected in any breast cancer cell line. Only the antagonism of HRH1 induced apoptosis, and decreased proliferation and migration, while HRH2 or HRH3 inhibition had no effect on cell survival. Interestingly, the luminal cell lines were more sensitive than the basal-like cell lines to HRH1 antagonism, even though the low expression of HRH1 in these cells.

Conclusion: Taken together, these findings suggest a complex role of the autocrine histamine signaling system in the progression of BC tumors of different subtype through the activation of HRH1.

Citation Format: Mario Mancino, Patricia Fernandez-Nogueira, Estel Enreig, Elisabet Ametller, Pedro Gascón, Vanessa Almendro. Subtype specific expression of HRH1 contributes to increased chemoresistance of breast cancer cells. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Breast Cancer Research: Genetics, Biology, and Clinical Applications; Oct 3-6, 2013; San Diego, CA. Philadelphia (PA): AACR; Mol Cancer Res 2013;11(10 Suppl):Abstract nr B100.

Abstract P3-05-04: Intra-tumor heterogeneity as a predictor of therapy response in HER2 positive breast cancer

Background: Breast cancer is known to be a heterogeneous disease both at the clinical and molecular level. In addition, heterogeneity can also exist within a given tumor, and subpopulations can have distinct phenotypic and genomic features. Little is known about the relationship between intra-tumor heterogeneity and prediction of response to treatment. This study aimed at using a combination of immunofluorescence and fluorescence in situ (FISH) technique (“double immunoFISH”) to identify intra-tumor heterogeneity in tumors from neo-adjuvant treated patients prior to and after therapy, searching for features predicting the response to neo adjuvant treatment.

Material and methods: Twentytwo patients diagnosed with HER2 positive, neo-adjuvant treated breast cancer ((3–4 FEC100 followed by 4 docetaxel plus trastuzumab, 3qw) were selected. Half of the patients had complete response and the others had partial response. By double immunoFISH both phenotypic (ER and HER2 protein) and genomic changes (copy number of HER2 gene and centromere 17) were assessed in the same cells simultaneously on biopsies before and after treatment. The samples were photographed in a Zeiss Axio Imager M1 with 5 fluorescence channels and analyzed with axiovision software. The intensity and localization of HER2 and ER immunofluorescence were semi-quantitatively estimated while the HER2 and centromere 17 FISH signals were counted in 100 cells.

Results: The patients with partial response displayed a high grade of cell-to-cell diversity regarding HER2 copy number, nuclear shape and size and the expression of the membrane protein HER2. This was in contrast to the results from the complete responders who showed a reduced diversity and were more frequently ER negative. In the patients with partial response, a higher diversity was seen after treatment.

Conclusion: The genomic variability prior to therapy was higher in the partial-responders vs. the complete responders, and the remaining tumor was even more heterogeneous after treatment than prior to treatment. Double immunoFISH is a valuable tool for visualization of both phenotypic and genomic alterations in the same cell in FFPE sections. The cohort will be expanded to explore the diversity further, and the results will be presented.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-05-04.

Cellular heterogeneity and molecular evolution in cancer

Intratumor heterogeneity represents a major obstacle to effective cancer treatment and personalized medicine. However, investigators are now elucidating intratumor heterogeneity at the single-cell level due to improvements in technologies. Better understanding of the composition of tumors, and monitoring changes in cell populations during disease progression and treatment, will improve cancer diagnosis and therapeutic design. Measurements of intratumor heterogeneity may also be used as biomarkers to predict the risk of progression and therapeutic resistance. We summarize important considerations related to intratumor heterogeneity during tumor evolution. We also discuss experimental approaches that are commonly used to infer intratumor heterogeneity and describe how these methodologies can be translated into clinical practice.

Amplified loci on chromosomes 8 and 17 predict early relapse in ER-positive breast cancers

Adjuvant hormonal therapy is administered to all early stage ER+ breast cancers, and has led to significantly improved survival. Unfortunately, a subset of ER+ breast cancers suffer early relapse despite hormonal therapy. To identify molecular markers associated with early relapse in ER+ breast cancer, an outlier analysis method was applied to a published gene expression dataset of 268 ER+ early-stage breast cancers treated with tamoxifen alone. Increased expression of sets of genes that clustered in chromosomal locations consistent with the presence of amplicons at 8q24.3, 8p11.2, 17q12 (HER2 locus) and 17q21.33-q25.1 were each found to be independent markers for early disease recurrence. Distant metastasis free survival (DMFS) after 10 years for cases with any amplicon (DMFS  = 56.1%, 95% CI  = 48.3–63.9%) was significantly lower (P  = 0.0016) than cases without any of the amplicons (DMFS  = 87%, 95% CI  = 76.3% –97.7%). The association between presence of chromosomal amplifications in these regions and poor outcome in ER+ breast cancers was independent of histologic grade and was confirmed in independent clinical datasets. A separate validation using a FISH-based assay to detect the amplicons at 8q24.3, 8p11.2, and 17q21.33-q25.1 in a set of 36 early stage ER+/HER2- breast cancers treated with tamoxifen suggests that the presence of these amplicons are indeed predictive of early recurrence. We conclude that these amplicons may serve as prognostic markers of early relapse in ER+ breast cancer, and may identify novel therapeutic targets for poor prognosis ER+ breast cancers.

Intra-tumour heterogeneity: a looking glass for cancer?

Populations of tumour cells display remarkable variability in almost every discernable phenotypic trait, including clinically important phenotypes such as ability to seed metastases and to survive therapy. This phenotypic diversity results from the integration of both genetic and non-genetic influences. Recent technological advances have improved the molecular understanding of cancers and the identification of targets for therapeutic interventions. However, it has become exceedingly apparent that the utility of profiles based on the analysis of tumours en masse is limited by intra-tumour genetic and epigenetic heterogeneity, as characteristics of the most abundant cell type might not necessarily predict the properties of mixed populations. In this Review, we discuss both genetic and non-genetic causes of phenotypic heterogeneity of tumour cells, with an emphasis on heritable phenotypes that serve as a substrate for clonal selection. We discuss the implications of intra-tumour heterogeneity in diagnostics and the development of therapeutic resistance.

Evolutionary pathways in BRCA1-associated breast tumors

BRCA1-associated breast tumors display loss of BRCA1 and frequent somatic mutations of PTEN and TP53. Here we describe the analysis of BRCA1, PTEN, and p53 at the single cell level in 55 BRCA1-associated breast tumors and computational methods to predict the relative temporal order of somatic events, on the basis of the frequency of cells with single or combined alterations. Although there is no obligatory order of events, we found that loss of PTEN is the most common first event and is associated with basal-like subtype, whereas in the majority of luminal tumors, mutation of TP53 occurs first and mutant PIK3CA is rarely detected. We also observed intratumor heterogeneity for the loss of wild-type BRCA1 and increased cell proliferation and centrosome amplification in the normal breast epithelium of BRCA1 mutation carriers. Our results have important implications for the design of chemopreventive and therapeutic interventions in this high-risk patient population.

The JAK2/STAT3 signaling pathway is required for growth of CD44⁺CD24⁻ stem cell-like breast cancer cells in human tumors

Intratumor heterogeneity is a major clinical problem because tumor cell subtypes display variable sensitivity to therapeutics and may play different roles in progression. We previously characterized 2 cell populations in human breast tumors with distinct properties: CD44+CD24- cells that have stem cell-like characteristics, and CD44-CD24+ cells that resemble more differentiated breast cancer cells. Here we identified 15 genes required for cell growth or proliferation in CD44+CD24- human breast cancer cells in a large-scale loss-of-function screen and found that inhibition of several of these (IL6, PTGIS, HAS1, CXCL3, and PFKFB3) reduced Stat3 activation. We found that the IL-6/JAK2/Stat3 pathway was preferentially active in CD44+CD24- breast cancer cells compared with other tumor cell types, and inhibition of JAK2 decreased their number and blocked growth of xenografts. Our results highlight the differences between distinct breast cancer cell types and identify targets such as JAK2 and Stat3 that may lead to more specific and effective breast cancer therapies.

Characterization of human pancreatic orthotopic tumor xenografts suitable for drug screening

BACKGROUND

Efforts to identify novel therapeutic options for human pancreatic ductal adenocarcinoma (PDAC) have failed to result in a clear improvement in patient survival to date. Pancreatic cancer requires efficient therapies that must be designed and assayed in preclinical models with improved predictor ability. Among the available preclinical models, the orthotopic approach fits with this expectation, but its use is still occasional.

METHODS

An in vivo platform of 11 orthotopic tumor xenografts has been generated by direct implantation of fresh surgical material. In addition, a frozen tumorgraft bank has been created, ensuring future model recovery and tumor tissue availability.

RESULTS

Tissue microarray studies allow showing a high degree of original histology preservation and maintenance of protein expression patterns through passages. The models display stable growth kinetics and characteristic metastatic behavior. Moreover, the molecular diversity may facilitate the identification of tumor subtypes and comparison of drug responses that complement or confirm information obtained with other preclinical models.

CONCLUSIONS

This panel represents a useful preclinical tool for testing new agents and treatment protocols and for further exploration of the biological basis of drug responses.

The neuronal influence on tumor progression

Nerve fibers accompany blood and lymphatic vessels all over the body. An extensive amount of knowledge has been obtained with regard to tumor angiogenesis and tumor lymphangiogenesis, yet little is known about the potential biological effects of "neoneurogenesis". Cancer cells can exploit the advantage of the factors released by the nerve fibers to generate a positive microenvironment for cell survival and proliferation. At the same time, they can stimulate the formation of neurites by secreting neurotrophic factors and axon guidance molecules. The neuronal influence on the biology of a neoplasm was initially described several decades ago. Since then, an increasing amount of experimental evidence strongly suggests the existence of reciprocal interactions between cancer cells and nerves in humans. Moreover, researchers have been able to demonstrate a crosstalk between cancer cells and nerve fibers as a strategy for survival. Despite all these evidence, a lot remains to be done in order to clarify the role of neurotransmitters, neuropeptides, and their associated receptor-initiated signaling pathways in the development and progression of cancer, and response to therapy. A global-wide characterization of the neurotransmitters or neuropeptides present in the tumor microenvironment would provide insights into the real biological influences of the neuronal tissue on tumor progression. This review is intended to discuss our current understanding of neurosignaling in cancer and its potential implications on cancer prevention and therapy. The review will focus on the soluble factors released by cancer cells and nerve endings, their biological effects and their potential relevance in the treatment of cancer.

Tyrosine kinase receptor transactivation associated to G protein-coupled receptors

G protein-coupled receptors (GPCRs) comprise a large family of membrane receptors involved in signal transduction. These receptors are linked to a variety of physiological and biological processes such as regulation of neurotransmission, growth, cell differentiation and oncogenesis among others. Some of the effects of GPCRs are known to be mediated by the activation of MAPK pathways. Several GPCRs are also able to transactivate receptors with tyrosine kinase activity (TKR) such as EGFR and HER2 and thus to control DNA synthesis and cell proliferation. The interaction between these receptors not only plays an important physiological role but its disregulation can induce pathological states such as cancer. For this reason, the crosstalk between these two types of receptors can be considered a possible mechanism for cell transformation, tumor progression, reactivation of the metastatic disease, and the acquisition of resistance to therapies targeting TKR receptors. The transactivation of some TKRs by GPCRs is related to the lost of response of TKRs to inhibitors of TK activity, mainly by the activation of the c-Src protein which can directly phosphorylate and activate the cytoplasmic domain of a TKR. For these reason, the dual inhibition of GPCRs and TKRs in some types of cancer has been proposed as a better strategy to kill tumor cells. Increased understanding of the mechanisms that interconnect the two pathways regulated by GPCRs and TKRs may facilitate the design of new therapeutic strategies.

Tumor promoting effects of CD95 signaling in chemoresistant cells

Background

CD95 is a death receptor controlling not only apoptotic pathways but also activating mechanisms promoting tumor growth. During the acquisition of chemoresistance to oxaliplatin there is a progressive loss of CD95 expression in colon cancer cells and a decreased ability of this receptor to induce cell death. The aim of this study was to characterize some key cellular responses controlled by CD95 signaling in oxaliplatin-resistant colon cancer cells.

Results

We show that CD95 triggering results in an increased metastatic ability in resistant cells. Moreover, oxaliplatin treatment itself stimulates cell migration and decreases cell adhesion through CD95 activation, since CD95 expression inhibition by siRNA blocks the promigratory effects of oxaliplatin. These promigratory effects are related to the epithelia-to-mesenchymal transition (EMT) phenomenon, as evidenced by the up-regulation of some transcription factors and mesenchymal markers both in vitro and in vivo.

Conclusions

We conclude that oxaliplatin treatment in cells that have acquired resistance to oxaliplatin-induced apoptosis results in tumor-promoting effects through the activation of CD95 signaling and by inducing EMT, all these events jointly contributing to a metastatic phenotype.

Interleukin-15 increases calcineurin expression in 3T3-L1 cells: possible involvement on in vivo adipocyte differentiation

Different studies have revealed that the Ca2+-dependent serine/threonine phosphatase calcineurin is involved in the regulation of adipocyte differentiation. Calcineurin acts as a Ca2+-dependent molecular switch that negatively regulates the ability of 3T3-L1 cells to undergo adipocyte differentiation by preventing the expression of critical proadipogenic transcription factors. In this study we investigated the role of interleukin-15 (IL-15), a cytokine previously known to be involved in the control of fat accretion by adipose cells, in the differentiation of the 3T3-L1 preadipose cell line. We found that IL-15 is able to increase alpha-calcineurin mRNA content in white adipose tissue of rats chronically treated with the cytokine and also in the 3T3-L1 preadipose cell line. Moreover, IL-15 promoted a decrease in both leptin mRNA expression and lipid accumulation, as estimated by Red Oil O staining. Cotreatment with IL-15 and FK506 (a calcineurin inhibitor) resulted in no changes in lipid content compared with the non-treated group. These data suggest that IL-15 directly inhibits adipogenesis, possibly by upregulating alpha-calcineurin and preventing the induction of adipocyte differentiation.

The role of MMP7 and its cross-talk with the FAS/FASL system during the acquisition of chemoresistance to oxaliplatin

Background

The efficacy of oxaliplatin in cancer chemotherapy is limited by the development of drug resistance. MMP7 has been related to the loss of tumor cell response to cytotoxic agents although the exact mechanism is not fully understood. Moreover, MMP7 is an independent prognosis factor for survival in patients with colorectal cancer. The aim of the present study was to analyze the role of MMP7 and its cross-talk with the Fas/FasL system during the acquisition of oxaliplatin resistance in colon cancer cells.

Principal Findings

For this purpose we have developed three different oxaliplatin-resistant cell lines (RHT29, RHCT116 p53^+/+, RHCT116 p53^−/−) from the parental HT29, HCT116 p53^+/+ and HCT116 p53^−/− colon cancer cells. MMP7 basal expression was higher in the resistant compared to the parental cell lines. MMP7 was also upregulated by oxaliplatin in both HT29 (p53 mutant) and RHCT116 p53^−/− but not in the RHCT116 p53^+/+. Inhibition of MMP by 1,10-phenantroline monohydrate or siRNA of MMP7 restores cell sensitivity to oxaliplatin-induced apoptosis in both HT29 and RHCT116 p53^−/− but not in the RHCT116 p53^+/+. Some of these effects are caused by alterations in Fas receptor. Fas is upregulated by oxaliplatin in colon cancer cells, however the RHT29 cells treated with oxaliplatin showed a 3.8-fold lower Fas expression at the cell surface than the HT29 cells. Decrease of Fas at the plasma membrane seems to be caused by MMP7 since its inhibition restores Fas levels. Moreover, functional analysis of Fas demonstrates that this receptor was less potent in inducing apoptosis in RHT29 cells and that its activation induces MAPK signaling in resistant cells.

Conclusions

Taking together, these results suggest that MMP7 is related to the acquisition of oxaliplatin-resistance and that its inhibition restores drug sensitivity by increasing Fas receptor. Furthermore, Fas undergoes a change in its functionality in oxaliplatin-resistant cells inducing survival pathways instead of apoptotic signals.

Effects of IL-15 on rat brown adipose tissue: uncoupling proteins and PPARs

OBJECTIVES

Interleukin-15 (IL-15) plays an important role in lipid metabolism as its administration to rats causes a marked depletion of white adipose tissue (WAT). This reduction in fat mass seems to be caused by and related to hipotriglyceridemia as a result of a lower hepatic lipogenesis and an increased fatty acid oxidation. We have previously observed that IL-15 treatment induces the expression of uncoupling proteins (UCPs) in muscle. The aim of this study was to investigate the effects of IL-15 on brown adipose tissue (BAT), and in particular on genes related to lipid metabolism in this tissue.

METHODS AND PROCEDURES

Male Wistar rats were treated daily with IL-15 for 7 days. Adipose tissues were collected and the mRNA content of UCPs, peroxisome proliferator-activated receptors (PPARs) and several genes implicated in fatty acid transport and oxidation were evaluated on BAT.

RESULTS

IL-15 treatment in rats causes a decrease in the mass of both WAT and BAT (35 and 24%, respectively). In BAT, an important upregulation of the mRNA content of thermogenic proteins (UCP1 and UCP3), lipid-related transcription factors (PPARdelta and PPARalpha) and other proteins implicated in membrane transport (fatty acid translocase (FAT) and fatty acid transport protein (FATP)), mitochondrial transport (carnitine palmitoyl transferase-I (CPT-I) and CPT-II) and consumption (acyl-CoA synthetase 4 (ACS4)) of fatty acids was observed as a consequence of the treatment.

DISCUSSION

The changes observed in BAT suggest that IL-15 could be implicated in lipid consumption in this tissue by regulating lipid oxidation and probably thermogenesis, processes mediated by UCPs and PPARs.

Antiproteolytic effects of plasma from hibernating bears: A new approach for muscle wasting therapy?

BACKGROUND & AIMS

In rodents and humans, inactivity or starvation leads to atrophy of skeletal muscle including a decrease in the number and size of muscle cells and in the myofibrillar protein content. It has previously been described that in overwintering bears the inactivity does not provoke any loss of skeletal muscle cell number or size. Taking all these into account, the aim of this study is to test if hibernating bear plasma has any antiproteolytic effect on incubated rat skeletal muscle.

METHODS

Rat skeletal extensor digitorum longus (EDL) muscles were incubated in the presence of hibernating, non-hibernating and control bear plasma. After that, proteolytic rate was evaluated as levels of tyrosine released to the medium and muscle mRNA content for different proteolytic systems were measured by Northern blot.

RESULTS

Rat skeletal EDL muscles incubation in the presence of hibernating bear plasma resulted in a 40% decrease of the net proteolytic rate. This inhibition of proteolysis was accompanied by decreases in the expression of both lysosomal (cathepsin B) and ubiquitin-dependent (ubiquitin) proteolytic systems.

CONCLUSIONS

The results suggest that during hibernation the bear is able to produce a powerful proteolytic inhibitor which is released to the circulation and blocks muscle wasting associated with immobilization.

Are Peroxisome Proliferator-Activated Receptors Involved in Skeletal Muscle Wasting during Experimental Cancer Cachexia? Role of β2-Adrenergic Agonists

Implantation of the Yoshida AH-130 ascites hepatoma to rats resulted in a decrease in muscle weight 7 days after the inoculation of the tumor. These changes were associated with increases in the mRNA content for both peroxisome proliferator-activated receptor (PPAR) gamma and PPAR delta in skeletal muscle. The increase in gene expression for these transcription factors was related to increases in the expression of several genes involved in fatty acid transport, activation, and oxidation. Tumor burden also resulted in increases in PPAR gamma coactivator-1 alpha gene expression and pyruvate dehydrogenase kinase 4. All these changes in lipid metabolism genes suggest that a metabolic shift occurs in skeletal muscle of tumor-bearing rats toward a more oxidative phenotype. Formoterol treatment to tumor-bearing rats resulted in an amelioration of all the changes observed as a result of tumor burden. Administration of this beta(2)-adrenergic agonist also resulted in a decrease in mRNA content of muscle PPAR alpha, PPAR delta, and PPAR gamma, as well as in mRNA levels of many of the genes involved in both lipid and mitochondrial metabolism. All these results suggest an involvement of the different PPARs as transcription factors related with muscle wasting and also indicate that a possible mode of action of the anticachectic compound formoterol may involve a normalization of the levels of these transcription factors.

Optimized preclinical models for human pancreatic adenocarcinoma therapy research

15019

Background: Efforts to find new therapies for human pancreatic ductal adenocarcinoma (PDAC) have not resulted in clear improvements on patient survival. Better knowledge of resistance mechanisms and redefiniton of molecular targets is essential to design more efficient therapies. The multifactorial origin of PDAC points to combined strategies as the therapy of choice, though the effective development of such strategies is hampered by the lack of optimal preclinical models. We have generated and validated optimized human PDAC models by direct implantation of fresh tumoral tissue into the pancreas of athymic mice. Methods: Thirteen pancreatic adenocarcinoma specimens from PDAC patients were obtained by surgical resection. From each specimen, several 10 mg-fragments were used to generate the corresponding intrapancreatic xenografted tumours. Eleven human PDAC orthotopic models have been successfully generated and perpetuated by succesive passages (up to 4). Histological and molecular analyses of both primary and xenografted tumors have been performed by tissue- array, western-blot and DNA sequentiation. Results: Initial engraftment rate ranged from 20 to 100% (mean 59%) and it improved with succesive passages (mean 76% at second and 90% at third generation). Ki67 expression and degree of differentiation in primary tumors correlated with xenograft growth kinetics. Furthermore, their spontaneous metastatic behaviour fairly reproduced the original patient dissemination patterns. Xenografted tumors kept the original architecture and expression patterns of common PDAC markers. Efficacy of several agents was tested on different xenografted tumors, validating this model and underlining its utility to define future therapeutic strategies for drug development and clinical trials. Conclusions: The orthotopic models described here are, probably, the closest resemblance to a patient clinical setting since they preserve human pancreatic structures, genotypic features and biological behaviour. From their use, biological relevant data could be drawn for future clinical trials and for testing new agents and new drug combinations since they represent, very likely, the most reliable animal models at present.

No significant financial relationships to disclose.

Targets in clinical oncology: the metabolic environment of the patient

Cancer cachexia is a syndrome characterized by a marked weight loss, anorexia, asthenia and anemia. The degree of cachexia is inversely correlated with the survival time of the patient and it always implies a poor prognosis. Lean body mass depletion is one of the main features of cachexia and it involves not only skeletal muscle but also affects cardiac protein. The cachectic state is invariably associated with the presence and growth of the tumour and leads to a malnutrition status due to the induction of anorexia or decreased food intake. In addition, the competition for nutrients between the tumour and the host leads to an accelerated starvation state which promotes severe metabolic disturbances in the host, including hypermetabolism which leads to an increased energetic inefficiency. Unfortunately, at the clinical level, cachexia is not treated until the patient suffers from a considerable weight loss and wasting. Therefore, it is of great interest to analyze possible early markers of the syndrome. In the present review both metabolic and hormonal markers are described. Although the search for the cachectic factor(s) started a long time ago, and although many scientific and economic efforts have been devoted to its discovery, we are still a long way from fully understanding the underlying basis for this syndrome. The suggested mediators (associated with both depletion of fat stores and muscular tissue) can be divided into two categories: of tumour origin (produced and released by the neoplasm) and humoural factors (mainly cytokines). One of the aims of the present review is to summarize and evaluate the different catabolic mediators (both humoural and tumoural) involved in cancer cachexia, since they may represent targets for clinical investigations. Additionally, an overview of the main therapeutic approaches for the treatment of the cachectic syndrome is presented.

The AP-1/NF-kappaB double inhibitor SP100030 can revert muscle wasting during experimental cancer cachexia

Daily treatment of rats bearing the cachectic Yoshida AH-130 ascites hepatoma with the double inhibitor of NF-kappaB and AP-1 SP100030 at a dose of 1 mg/kg of body weight resulted in a clear amelioration of the cachectic effect, especially at the level of skeletal muscle. Thus, tumour-bearing rats treated with SP100030 showed a significant recovery in the weights of gastrocnemius, EDL, tibialis and cardiac muscles. In addition, treatment with the inhibitor affected both liver and kidney weights. The amelioration in muscle weight was accompanied by an increase in MyoD gene expression, the main transcription factor of muscle tissue involved in muscle differentiation, in gastrocnemius muscle. At the dose used in this study, SP100030 was an effective inhibitor of AP-1; however, the NF-kappaB transcription factor was not affected. The effects of the inhibitor seem to be at the level of proteolysis since lower total proteolytic rates were found when incubating isolated rat muscles in the presence of SP100030. The inhibitor influenced the gene expression of the ubiquitin-conjugating enzyme E214K in skeletal muscle of tumour-bearing rats; this enzyme seems to be the main regulator of the activity of the main proteolytic system involved during cancer cachexia, the ubiquitin-proteasome system. In conclusion, treatment of cachectic tumour-bearing rats with SP100030 results in an amelioration of the muscle wasting effect, suggesting that the AP-1 signaling cascade plays an important role in the signaling of muscle wasting associated with disease.