Serum levels of soluble E-selectin in women with breast cancer

E-selectin in vascular pathophysiology

Selectins are a group of Ca2+-dependent, transmembrane type I glycoproteins which attract cell adhesion and migration. E-selectin is exclusively expressed in endothelial cells, and its expression is strongly enhanced upon activation by pro-inflammatory cytokines. The interaction of E-selectin with its ligands on circulating leukocytes captures and slows them down, further facilitating integrin activation, firm adhesion to endothelial cells and transmigration to tissues. Oxidative stress induces endothelial cell injury, leading to aberrant expression of E-selectin. In addition, the elevated level of E-selectin is positively related to high risk of inflammation. Dysregulation of E-selectin has been found in several pathological conditions including acute kidney injury (AKI), pulmonary diseases, hepatic pathology, Venous thromboembolism (VTE). Deletion of the E-selectin gene in mice somewhat ameliorates these complications. In this review, we describe the mechanisms regulating E-selectin expression, the interaction of E-selectin with its ligands, the E-selectin physiological and pathophysiological roles, and the therapeutical potential of targeting E-selectin.

Selectins in Biology and Human Disease: Opportunity in E-selectin Antagonism

Selectins are cell adhesion proteins discovered in the 1980s. As C-type lectins, selectins contain an essential calcium ion in the ligand-binding pocket and recognize the isomeric tetrasaccharides sialyl Lewisx (sLex) and sialyl Lewisa (sLea). Three selectins, E-selectin, P-selectin, and L-selectin, play distinct, complementary roles in inflammation, hematopoiesis, and tumor biology. They have been implicated in the pathology of diverse inflammatory disorders, and several selectin antagonists have been tested clinically. E-selectin plays a unique role in leukocyte activation, making it an attractive target for intervention, for example, in sickle cell disease (SCD). This review summarizes selectin biology and pathology, structure and ligand binding, and selectin antagonists that have reached clinical testing with an emphasis on E-selectin.

Predictive Role of Soluble IL-6R, TNF-R1/2, and Cell Adhesion Molecules Serum Levels in the Preoperative and Adjuvant Therapy in Women with Nonmetastatic Breast Cancer: A Preliminary Study

Soluble cell adhesion molecules (sCAMs) are involved in the development of neoplastic diseases. sCAMs can block lymphocytes and promote angiogenesis and migration of breast cancer (BC) cells. Interleukin 6 (IL-6) and tumor necrosis factor α (TNF-α) enhance metastatic potential via upregulation of CAMs. We assessed soluble interleukin-6 receptor subunit alpha (IL-6Ra), TNF-R1, TNF-R2, E-selectin, P-selectin, VCAM-1, ICAM-1, and EpCAM in 89 women with stage I-III BC and 28 healthy women. Blood samples were obtained at the beginning of neoadjuvant/induction (N = 49) or adjuvant treatment (N = 40), and after 2 months. Surgery revealed complete response in 29.4% of patients, partial response in 67%, and stable disease in 5.9%. Achieving a pathological response was 4 times greater for baseline levels of sIL-6Ra >5.63 ng/mL [odds ratio (OR) = 4.1, 95% confidence interval (CI): 0.8-20.4, P = 0.08] and more than 6 times for soluble tumor necrosis factor receptor 1 (sTNF-R1) ≥ 0.97 ng/mL (OR = 6.2, 95% CI: 1.2-32.3, P < 0.05). Compared with the control group, serum sP-selectin, soluble epithelial cell adhesion molecule (sEpCAM), and sTNF-R2 concentrations were significantly higher in patients who started adjuvant therapy (P < 0.05) and preoperative therapy (P < 0.01). Baseline serum sIL-6Ra concentrations were significantly higher in patients before surgery than in patients after tumor resection (P < 0.05), independent of the follow-up time. The baseline serum soluble receptors of IL-6 (sIL-6R) and TNF-α (sTNF-R1) concentrations have a predictive value for preoperative therapy in patients with BC.

The Predictive Role of Serum Levels of Soluble Cell Adhesion Molecules (sCAMs) in the Therapy of Advanced Breast Cancer—A Single-Centre Study

Background and Objectives: Soluble cell adhesion molecules (sCAMs) play a significant role in the metastatic potential of breast cancer (BC). They might block lymphocytes and promote angiogenesis and migration of cancer cells. We assessed the usefulness of sCAMs in the prognosis and monitoring of the progression of advanced BC. Materials and Methods: We assessed soluble E-selectin, P-selectin, VCAM-1, ICAM-1, EpCAM, IL-6Ra, TNF-R1, and TNF-R2 in 39 women with aBC. Blood samples were obtained at the beginning of the treatment and after 2 months. Results: The median progression-free survival (PFS) was 9 months, and overall survival (OS) was 27 months. The higher levels of sICAM-1 (HR = 2.60, p = 0.06) and lower levels of sEpCAM (HR = 2.72, p < 0.05) were associated with faster progression of aBC. High levels of sEpCAM through the follow-up period were significantly associated with a lower risk of progression (HR = 0.40, p < 0.01). We found the independent predictive value of higher than median sICAM-1 levels for PFS (HR = 2.07, p = 0.08) and of sVCAM-1 levels for OS (HR = 2.59, p < 0.05). Conclusions: Our data support the predictive value of sICAM-1 and sVCAM-1 and suggest that they could become markers for tailoring new therapies in aBC. sEpCAM level could be used as an early indicator of response to the therapy.

Lung-Derived Selectins Enhance Metastatic Behavior of Triple Negative Breast Cancer Cells

The lung is one of the deadliest sites of breast cancer metastasis, particularly for triple negative breast cancer (TNBC). We have previously shown that the lung produces several soluble factors that may enhance the metastatic behavior of TNBC, including E-, L-, and P-selectin. In this paper, we hypothesize that lung-derived selectins promote TNBC metastatic behavior and may serve as a potential therapeutic target. Lungs were isolated from mice and used to generate lung-conditioned media (CM). Lung-derived selectins were immunodepleted and TNBC migration and proliferation were assessed in response to native or selectin-depleted lung-CM. A 3D ex vivo pulmonary metastasis assay (PuMA) was used to assess the metastatic progression of TNBC in the lungs of wild-type versus triple-selectin (ELP^-/-) knockout mice. We observed that individual lung-derived selectins enhance in vitro migration (p ≤ 0.05), but not the proliferation of TNBC cells, and that ex vivo metastatic progression is reduced in the lungs of ELP^-/- mice compared to wild-type mice (p ≤ 0.05). Treatment with the pan-selectin inhibitor bimosiamose reduced in vitro lung-specific TNBC migration and proliferation (p ≤ 0.05). Taken together, these results suggest that lung-derived selectins may present a potential therapeutic target against TNBC metastasis. Future studies are aimed at elucidating the pro-metastatic mechanisms of lung-derived selectins and developing a lung-directed therapeutic approach.

High-pressure artificial pneumothorax promotes invasion and metastasis of oesophageal cancer cells

OBJECTIVES

This study aimed to investigate the viability, apoptosis, invasion and metastasis of oesophageal cancer cells in a simulated artificial pneumothorax model and to explore its potential mechanism of action.

METHODS

Oesophageal cancer cells were subjected to a simulated thoracoscopic CO2 pneumothorax environment with different pressures and exposure times (low-pressure group: 8 mmHg 1 h or 8 mmHg 4 h; high-pressure group: 12 mmHg 1 h). Cell viability, apoptosis, invasive capacity and mRNA expression of adhesion- and metastasis-related molecules in each group were detected. To explore in greater detail the potential reasons for the changes in biological behaviour under the high-pressure CO2 environment, we designed 3 additional experimental groups: (i) high-pressure group, (ii) hypoxia group and (iii) pH decrease group. An miRNA microarray analysis was performed by comparing 2 paired samples of cells from the high-pressure group and the control group.

RESULTS

Treatment with high-pressure CO2 pneumothorax significantly increased the cell viability (P < 0.001) and the cell invasion (P < 0.001). Significantly higher expression of adhesive- and metastasis-related molecules was also observed. Further experiments indicated that the high-pressure CO2 pneumothorax might increase cell invasion and metastasis through the high pressure and decreased pH. The miRNA microarray analysis results suggested that several potential pathways related to cancer development: the RhoA pathway, the PI3K-Akt signalling pathway and the MAPK signalling pathway.

CONCLUSIONS

The application of high-pressure CO2 pneumothorax promoted the invasion and metastasis of oesophageal cancer cells through high pressure and decreased pH. This process might be related to several signalling pathways.

Gene Expression of E-Selectin in Tissue and its Protein Level in Serum of Breast Cancer Patients

Aims and background

This study aims to detect the expression of E-selectin in tissue and the serum level of its soluble form in patients with primary breast cancer and benign breast tumors and to correlate the results with the clinicopathological data of the subjects.

Methods

Fifty participants were included in the study and stratified into 3 subgroups. Group A comprised 30 patients with primary breast cancer, group B 9 patients with benign breast tumors, and group C 11 healthy control women undergoing reduction mammoplasty. E-selectin gene expression was investigated in breast tissues by PCR techniques and soluble E-selectin was measured in sera by ELISA.

Results

The E-selectin gene was expressed in 73.3% of group A, 44.4% of group B and 9.1% of group C. It was expressed in 61.5% of patients with grade 2 breast cancer and in 82.4% of patients with grade 3 breast cancer. E-selectin gene expression was detected in 60%, 73.3% and 100% of patients with stage II, III and IV tumors, respectively. It was detected in 81.8% of patients with node-positive primary breast cancer and in 50% of patients with node-negative cancer. PCR in situ hybridization was done to locate the site of E-selectin expression. E-selectin was found on the membranes of peritumoral endothelial cells while it was not found on breast epithelial cells. Serum levels of soluble E-selectin were significantly elevated in group A compared to groups B and C ( P <0.001). They increased significantly with increasing breast cancer stage ( P <0.001) and were significantly higher in patients with lymph node involvement than in patients without node involvement ( P <0.001).

Conclusions

The studied marker showed associations with established prognostic parameters such as lymph node involvement and histological tumor grade. Further studies are needed to evaluate E-selectin as a possible target for antimetastat-ic therapy through modulation of the expression of the cell adhesion molecule. E-selectin can be regarded as a promising strategy in improving tumor therapy.

Identification of endothelial selectin as a potential prognostic marker in breast cancer

Endothelial selectin (ELAM1 or CD62E) has been previously reported as being associated with the prognosis of multiple types of cancer. However, its prognostic value in breast cancer (BC) remains unclear. The aim of the present study was to investigate the prognostic value of ELAM1 mRNA expression in BC tissue. The prognostic value of ELAM1 mRNA was assessed in patients with BC using the Kaplan-Meier plotter (KM-plot) database. The KM-plot generated updated ELAM1 mRNA expression data and survival analysis from a total of 3,951 patients with BC, gathered from 35 datasets. Low expression of ELAM1 mRNA was correlated with a poorer overall survival in 1,402 patients with BC followed for 20 years [hazard ratio (HR), 0.71; 95% confidence interval (CI), 0.57–0.88; log-rank P=0.0016]. Low expression of ELAM1 was also correlated with poorer relapse-free survival (HR, 0.69; 95% CI, 0.62–0.77; log-rank P=2.2e-11) in 3,951 patients and poorer distant metastasis-free survival (HR, 0.79; 95% CI, 0.65–0.96; log-rank P=0.02) in 1,746 patients with BC followed for 20 years. Results from the Metabolic gEne RApid visualizer database indicated that ELAM1 mRNA expression was elevated in normal tissue. The results of the present study suggest that ELAM1 mRNA is a potential prognostic and metastatic marker in patients with BC.

The effect of soluble E-selectin on tumor progression and metastasis

Background

Distant metastasis resulting from vascular dissemination of cancer cells is the primary cause of mortality from breast cancer. We have previously reported that E-selectin expression on the endothelial cell surface mediates shear-resistant adhesion and migration of circulating cancer cells via interaction with CD44. As a result of shedding, soluble E-selectin (sE-selectin) from the activated endothelium is present in the serum. In this study, we aimed to understand the role of sE-selectin in tumor progression and metastasis.

Methods

We investigated the effect of sE-selectin on shear-resistant adhesion and migration of metastatic breast cancer cells and leukocytes in vitro and in vivo.

Results

We found that sE-selectin promoted migration and shear-resistant adhesion of CD44^+/high breast cancer cell lines (MDA-MB-231 and MDA-MB-468) to non-activated human microvessel endothelial cells (ES-HMVECs), but not of CD44^-/low breast cancer cell lines (MCF-7 and T-47D). This endothelial E-selectin independent, sE-selectin-mediated shear-resistant adhesion was also observed in a leukocyte cell line (HL-60) as well as human peripheral blood mononuclear cells (PBMCs). Additionally, the incubation of MDA-MB-231 cells with sE-selectin triggered FAK phosphorylation and shear-resistant adhesion of sE-selectin-treated cells resulted in increased endothelial permeabilization. However, CD44 knockdown in MDA-MB-231 and HL-60 cells resulted in a significant reduction of sE-selectin-mediated shear-resistant adhesion to non-activated HMVECs, suggesting the involvement of CD44/FAK. Moreover, functional blockade of ICAM-1 in non-activated HMVECs resulted in a marked reduction of sE-selectin-mediated shear-resistant adhesion. Finally, the pre-incubation of CD44⁺ 4 T1 murine breast cancer cells with sE-selectin augmented infiltration into the lung in E-selectin K/O mice and infusion of human PBMCs pre-incubated with sE-selectin stimulated MDA-MB-231 xenografted breast tumor growth in NSG mice.

Conclusions

Our data suggest that circulating sE-selectin stimulates a broad range of circulating cells via CD44 and mediates pleiotropic effects that promote migration and shear-resistant adhesion in an endothelial E-selectin independent fashion, in turn accelerating tissue infiltration of leukocytes and cancer cells.

Electronic supplementary material

The online version of this article (doi:10.1186/s12885-016-2366-2) contains supplementary material, which is available to authorized users.

In silico modeling of the molecular interactions of antacid medication with the endothelium: novel therapeutic implications in head and neck carcinomas

Pathological acid reflux is a common event in patients afflicted with head and neck squamous cell carcinomas (HNSCCs), known to play a role in HNSCC etiology and contribute to complications after surgery or during radiation and chemotherapy. Antacid medications are commonly prescribed in HNSCC patients as part of their cancer treatment, and consist of two classes: histamine 2 receptor antagonist class (H2RA, with cimetidine as its prototypical drug) and proton pump inhibitors class (PPI, with omeprazole as its prototypical drug). Clinical evidence revealed a significant survival benefit of antacid usage in a large cohort of HNSCC patients treated in our Otolaryngology Department, with a median follow-up of over 5 years. Therefore, we postulate that one mechanism by which antacid intake enhances patient survival could involve modulation of tumor cell adhesion to endothelium, critical in the initiation of the metastatic dissemination. This study investigates the potential physical interactions between cimetidine and omeprazole with the endothelial E-selection (E-sel) and its ligand sialyl Lewis X (sLe(x)) using a molecular visualization energy-based program (AutoDock). Docking results were further analyzed with the PyMOL program, which allowed for measurements of the distances between the drugs and the closest interacting atoms or residues on E-sel and sLe(x) molecules. Our model predicts that omeprazole displays a stronger interaction with E-sel than cimetidine, as extrapolated from the calculated overall binding energies. However, the shorter distances existing between interacting atoms in the proposed E-sel/cimetidine complex are suggestive of more stable interactions. Neither antacid/E-sel complex overcame the stronger Autodock-calculated sLe(x)/E-sel interaction, suggesting competitive inhibition was not involved. This study provides the first in silico evidence of omeprazole and cimetidine ability to bind to adhesion molecules involved in tumor dissemination, underlining their therapeutic potential in the HNSCC clinical management.

Systemic inflammation promotes lung metastasis via E-selectin upregulation in mouse breast cancer model

Systemic inflammation might modulate the microenvironment in the lungs and promotes metastasis. E-selectin, an inflammation inducible endothelial cell adhesion molecule, has been reported to play an important role in homing metastatic cancer cells. To study the effects of E-selectin expression induced by systemic inflammation on breast cancer metastasis, we first treated BALB/c mice with lipopolysaccharide (LPS) to induce systemic inflammation. Pulmonary tissues were analyzed by wet/dry ratio, hematoxylin and eosin (H&E) staining and immunohistochemistry. Then 4T1 cells were injected via tail vein. Lung surface metastasis was counted and detected by histological analysis. LPS-induced E-selectin expression and tumor cells adhesion were assessed by western blotting and immunofluorescence. The circulating levels of proinflammatory cytokines in sera were evaluated by ELISA. Our results showed that a significant increase in breast cancer metastasis to lungs was observed in LPS-treated mice vs. the PBS-treated mice, accompanying with an increased E-selectin expression in pulmonary tissue of LPS-treated mice. In vitro studies showed a significant elevation of E-selectin production in MPVECs which enhanced the adhesion activity of 4T1 cells. Treatment with anti-E-selectin antibody significantly reduced the development of metastasis in vivo, and significantly reduced the adhesion of 4T1 cells to MPVECs in vitro. Our results suggest that systemic inflammation may increase the expression of E-selectin which mediated the lung metastasis of breast cancer in mouse model.

Prognostic molecular markers in head and neck squamous cell carcinoma in a New Zealand population: matrix metalloproteinase-2 and sialyl Lewis x antigen

OBJECTIVE

The survival rate for head and neck squamous cell carcinoma (HNSCC) is among the lowest of the major cancers and has not substantially improved in the past two decades. Tumours with similar histological features may have widely differing clinical outcomes and thus identification of prognostic and predictive biomarkers may be valuable for determining appropriate clinical management strategies. The objective of this study was to establish the prognostic significance of six molecular markers in HNSCC in a New Zealand population: matrix metalloproteinases 2 and 9 (MMP-2, MMP-9), tissue inhibitor of matrix metalloproteinase-1, sialyl Lewis antigens a and x (sLe(a) , sLe(x) ) and alpha B-crystallin.

METHODS

Retrospective review of 145 sequential HNSCC patients from a tertiary centre with minimum 3 years surveillance. Sections from formalin-fixed paraffin-embedded tumour blocks were immunostained for the molecular markers and scored. Cox regression modelling was used to adjust for potential confounding variables impacting on cancer survival.

RESULTS

Multivariate analysis for individual biomarkers, controlling for age, sex, tumour grade, N-stage, T-stage, tumour site, smoking history and alcohol use, revealed poorer survival with tumour expression of MMP-2 (hazard ratio = 1.98, 95% confidence interval: 1.11-3.52, P = 0.021) and sLe(x) (hazard ratio = 3.22, 95% confidence interval: 1.33-7.80, P = 0.010). A stepwise analysis showed that MMP-2 and sLe(x) were independently prognostic after covariate adjustment.

CONCLUSIONS

MMP-2 and sLe(x) were negative prognostic markers for survival in these HNSCC patients. This offers opportunities for clinical trials to reduce the risk of nodal and distant metastases through blocking tumour cell adhesion to endothelium.

Polymorphic variant Ser128Arg of E-Selectin is associated with breast cancer risk and high grade tumors

BACKGROUND

The present study aimed to evaluate the association between the E-Selectin Ser128Arg polymorphism and breast cancer risk and clinicopathological characteristics of the patients.

MATERIALS AND METHODS

The genotypes of 387 breast cancer patients and 252 healthy women who had no history of any malignancy were detected using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in a hospital-based Malaysian population.

RESULTS

The frequency of the Arg allele was significantly (p = 0.030) higher in breast cancer patients than in healthy individuals. Women who were Ser/Arg heterozygotes (adjusted odds ratio (OR(adj)) = 1.607; 95% confidence interval (CI) = 1.008-2.564), and carriers of the Arg allele genotype (OR(adj) = 1.587; 95% CI = 1.037-2.430) or Arg allele (OR(adj) = 1.509; 95% CI = 1.040-2.189) showed a significantly increased risk of breast cancer. Patients who were carriers of the Arg allele genotype showed a significant association with poorly differentiated tumors (p = 0.002).

CONCLUSION

The Ser128Arg polymorphism might confer an increased susceptibility to breast cancer and contribute to aggressive phenotypic characteristics.

Highly sensitivity adhesion molecules detection in hereditary haemochromatosis patients reveals altered expression

Several abnormalities in the immune status of patients with hereditary haemochromatosis (HH) have been reported, suggesting an imbalance in their immune function. This may include persistent production of, or exposure to, altered immune signalling contributing to the pathogenesis of this disorder. Adhesion molecules L-, E- and P-Selectin, intercellular adhesion molecule-1 (ICAM-1), vascular cell adhesion molecule-1 (VCAM-1) are some of the major regulators of the immune processes and altered levels of these proteins have been found in pathological states including cardiovascular diseases, arthritis and liver cancer. The aim of this study was to assess L-, E- and P-Selectin, ICAM-1 and VCAM-1 expression in patients with HH and correlate these results with HFE mutation status and iron indexes. A total of 139 subjects were diagnosed with HH (C282Y homozygotes = 87, C282Y/H63D = 26 heterozygotes, H63D homozygotes = 26), 27 healthy control subjects with no HFE mutation (N/N), 18 normal subjects heterozygous for the H63D mutation served as age-sex-matched controls. We observed a significant decrease in L-selectin (P = 0.0002) and increased E-selectin and ICAM-1 (P = 0.0006 and P = 0.0059) expression in HH patients compared with healthy controls. This study observes for the first time that an altered adhesion molecules profile occurs in patients with HH that is associated with specific HFE genetic component for iron overload, suggesting that differential expression of adhesion molecules may play a role in the pathogenesis of HH.

Breast cancer screening and biomarkers

Annual screening mammograms have been shown to be cost-effective and are credited for the decline in mortality of breast cancer. New technologies including breast magnetic resonance imaging (MRI) may further improve early breast cancer detection in asymptomatic women. Serum tumor markers such as CA 15-3, carcinoembyonic antigen (CEA), and CA 27-29 are ordered in the clinic mainly for disease surveillance, and not useful for detection of localized cancer. This review will discuss blood-based markers and breast-based markers, such as nipple/ductal fluid, with an emphasis on biomarkers for early detection of breast cancer. In the future, it is likely that a combination approach to simultaneously measure multiple markers would be most successful in detecting early breast cancer. Ideally, such a biomarker panel should be able to detect breast cancer in asymptomatic patients, even in the setting of normal mammogram and physical examination results.

Role of S128R polymorphism of E-selectin in colon metastasis formation

The extravasation of cancer cells is a key step of the metastatic cascade. Polymorphisms in genes encoding adhesion molecules can facilitate metastasis by increasing the strength of interaction between tumor and endothelial cells as well as impacting other properties of cancer cells. We investigated the Ser128Arg (a561c at the nucleotide level) polymorphism in the E-selectin gene in patients with metastatic colon cancer and its functional significance. Genotyping for a561c polymorphism was performed on 172 cancer patients and on an age-matched control population. The colon cancer group was divided into groups with (M(+)) and without observable metastasis (M(-)). For in vitro functional assays, Huvec transfected cells expressing wild-type (WT) or the S128R variant of E-selectin were established to study in vitro binding ability and signal transduction processes of T84 colon cancer cell line. Our results demonstrated that the Arginine(128) allele was more prevalent in the M(+) group than in the M(-) group or normal controls (p < 0.005; odds ratio, 1.56; 95% confidence interval (CI) 1.16-1.92; p < 0.001, odds ratio = 1.65; CI = 1.24-1.99, respectively). In vitro, S128R E-selectin transfected Huvec cells, supported increased adhesion as well as increased cellular signaling of T84 cancer cells compared to WT E-selectin and mock-transfected Huvec cells. These findings suggest that the E-selectin S128R polymorphism can functionally affect tumor-endothelial interactions as well as motility and signaling properties of neoplastic cells that may modulate the metastatic phenotype.

Phase II trial of bevacizumab in combination with weekly docetaxel in metastatic breast cancer patients

PURPOSE

To evaluate the safety and efficacy of bevacizumab and weekly docetaxel as first- or second-line therapy in patients with metastatic breast cancer (MBC).

PATIENTS AND METHODS

Twenty-seven MBC patients received i.v. bevacizumab at 10 mg/kg on days 1 and 15 in combination with i.v. docetaxel 35 mg/m2 on days 1, 8, and 15 of a 28-day cycle. Primary end points were to assess toxicity, overall response rate, and progression-free survival. A secondary end point was to assess the relationship between plasma endothelial and cell adhesion markers and clinical outcomes.

RESULTS

One-hundred fifty-eight treatment cycles were administered with a median of six cycles (range 1-15 cycles) per patient. The most common grade 4 toxicities per patient were as follows: 2 (7%)-pulmonary embolus, 1 (4%)-febrile neutropenia, and 1 (4%)-infection; grade 3 toxicities were 4 (15%)-neutropenia, 4 (15%)-fatigue, 2 (7%)-neuropathy, 2 (7%)-athralgias, 2 (7%)-stomatitis, 1 (7%)-pleural effusion, and 1 (4%)-hypertension. The overall response rate was 52% [95% confidence interval (95% CI), 32-71%], median response duration was 6.0 months (95% CI, 4.6-6.5 months), and the median progression-free survival was 7.5 months (95% CI, 6.2-8.3 months). In hypothesis-generating univariate and limited multivariate analyses, E-selectin was statistically significantly associated with response to the combination.

CONCLUSION

Bevazicumab in combination with weekly docetaxel is active with acceptable toxicities in MBC. Additional studies evaluating E-selectin as a marker of response to bevacizumab-containing chemotherapy are warranted.

Targeted imaging of human endothelial-specific marker in a model of adoptive cell transfer

Imaging of endothelial-specific markers is critically important in non-invasive detection of early signs of vascular pathologies (eg inflammation, atherosclerosis and angiogenesis). A model of adoptive human endothelial cell (HUVEC) transfer was used to test-specific imaging probes for human vascular disease consisting of cross-linked iron oxide (CLIO) nanoparticles conjugated to anti-human E-selectin (CLIO-F(ab')(2)). To perform in vivo imaging of E-selectin expression in functional blood vessels, human vascular endothelium cells (HUVECs) were implanted in athymic mice in Matrigel solution, which served as a temporary neovascularization scaffold after the solidification. The formation of HUVEC-containing vessels was established by histology and microscopy. CLIO-F(ab')(2) probes were administered via an i.v. injection following the induction of E-selectin expression by IL-1beta. High-resolution MR images were obtained before and after the administration of CLIO-F(ab')(2), which showed specific hypointensity only if treated with IL-1beta. A three-times higher CLIO-induced MR signal decrease on T2(*) images was measured in HUVEC implants in response to IL-1beta treatment. Image signal intensity did not change in control animals that: (1) harbored Matrigel alone, (2) in the absence of IL-1beta treatment or (3) in animals injected with CLIO linked to the idiotype-matched control F(ab')(2). Experiments in an adoptive transfer model demonstrated that HUVEC-containing neovessels are perfused and that IL-1beta inducible E-selectin expression in these vessels is detectable with non-invasive imaging by using targeted nanoparticles.