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Mansur A, Song PN, Lu Y, Burns AC, Sligh L, Yang ES, Sorace AG. Combination Therapy with Trastuzumab and Niraparib: Quantifying Early Proliferative Alterations in HER2+ Breast Cancer Models. Biomedicines 2023; 11:2090. [PMID: 37626587 PMCID: PMC10452700 DOI: 10.3390/biomedicines11082090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 07/13/2023] [Accepted: 07/20/2023] [Indexed: 08/27/2023] Open
Abstract
HER2-targeted treatments have improved survival rates in HER2+ breast cancer patients, yet poor responsiveness remains a major clinical obstacle. Recently, HER2+ breast cancer cells, both resistant and responsive to HER2-targeted therapies, have demonstrated sensitivity to poly-(ADP-ribose) polymerase (PARP) inhibition, independent of DNA repair deficiencies. This study seeks to describe biological factors that precede cell viability changes in response to the combination of trastuzumab and PARP inhibition. Treatment response was evaluated in HER2+ and HER2- breast cancer cells. Further, we evaluated the utility of 3'-Deoxy-3'-[18F]-fluorothymidine positron emission tomography ([18F]FLT-PET) imaging for early response assessment in a HER2+ patient derived xenograft (PDX) model of breast cancer. In vitro, we observed decreased cell viability. In vivo, we observed decreased inhibition in tumor growth in combination therapies, compared to vehicle and monotherapy-treated cohorts. Early assessment of cellular proliferation corresponds to endpoint cell viability. Standard summary statistics of [18F]FLT uptake from PET were insensitive to early proliferative changes. Meanwhile, histogram analysis of [18F]FLT uptake indicated the potential translatability of imaging proliferation biomarkers. This study highlights the potential of combined trastuzumab and PARP inhibition in HER2+ breast cancer, while demonstrating a need for optimization of [18F]FLT-PET quantification in heterogeneous models of HER2+ breast cancer.
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Affiliation(s)
- Ameer Mansur
- Department of Biomedical Engineering, The University of Alabama, Birmingham, AL 35233, USA
| | - Patrick N. Song
- Department of Radiology, The University of Alabama, Birmingham, AL 35233, USA
- Graduate Biomedical Sciences, The University of Alabama, Birmingham, AL 35233, USA
| | - Yun Lu
- Department of Radiology, The University of Alabama, Birmingham, AL 35233, USA
- Graduate Biomedical Sciences, The University of Alabama, Birmingham, AL 35233, USA
| | - Andrew C. Burns
- Department of Biomedical Engineering, The University of Alabama, Birmingham, AL 35233, USA
| | - Luke Sligh
- Department of Radiology, The University of Alabama, Birmingham, AL 35233, USA
| | - Eddy S. Yang
- Department of Radiation Oncology, University of Kentucky, Lexington, KY 40506, USA
| | - Anna G. Sorace
- Department of Biomedical Engineering, The University of Alabama, Birmingham, AL 35233, USA
- Department of Radiology, The University of Alabama, Birmingham, AL 35233, USA
- O’Neal Comprehensive Cancer Center, The University of Alabama, Birmingham 35233, AL, USA
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Davenport AA, Lu Y, Gallegos CA, Massicano AVF, Heinzman KA, Song PN, Sorace AG, Cogan NG. Mathematical Model of Triple-Negative Breast Cancer in Response to Combination Chemotherapies. Bull Math Biol 2022; 85:7. [PMID: 36542180 DOI: 10.1007/s11538-022-01108-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 11/14/2022] [Indexed: 12/24/2022]
Abstract
Triple-negative breast cancer (TNBC) is a heterogenous disease that is defined by its lack of targetable receptors, thus limiting treatment options and resulting in higher rates of metastasis and recurrence. Combination chemotherapy treatments, which inhibit tumor cell proliferation and regeneration, are a major component of standard-of-care treatment of TNBC. In this manuscript, we build a coupled ordinary differential equation model of TNBC with compartments that represent tumor proliferation, necrosis, apoptosis, and immune response to computationally describe the biological tumor affect to a combination of chemotherapies, doxorubicin (DRB) and paclitaxel (PTX). This model is parameterized using longitudinal [18F]-fluorothymidine positron emission tomography (FLT-PET) imaging data which allows for a noninvasive molecular imaging approach to quantify the tumor proliferation and tumor volume measurements for two murine models of TNBC. Animal models include a human cell line xenograft model, MDA-MB-231, and a syngeneic 4T1 mammary carcinoma model. The mathematical models are parameterized and the percent necrosis at the end time point is predicted and validated using histological hematoxylin and eosin (H&E) data. Global Sobol' sensitivity analysis is conducted to further understand the role each parameter plays in the model's goodness of fit to the data. In both the MDA-MB-231 and the 4T1 tumor models, the designed mathematical model can accurately describe both tumor volume changes and final necrosis volume. This can give insight into the ordering, dosing, and timing of DRB and PTX treatment. More importantly, this model can also give insight into future novel combinations of therapies and how the immune system plays a role in therapeutic response to TNBC, due to its calibration to two types of TNBC murine models.
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Affiliation(s)
- Angelica A Davenport
- Department of Mathematics, Florida State University, 1017 Academic Way, Tallahassee, FL, 32304, USA.
| | - Yun Lu
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Carlos A Gallegos
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Katherine A Heinzman
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patrick N Song
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - N G Cogan
- Department of Mathematics, Florida State University, 1017 Academic Way, Tallahassee, FL, 32304, USA
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Song PN, Mansur A, Lu Y, Della Manna D, Burns A, Samuel S, Heinzman K, Lapi SE, Yang ES, Sorace AG. Modulation of the Tumor Microenvironment with Trastuzumab Enables Radiosensitization in HER2+ Breast Cancer. Cancers (Basel) 2022; 14:cancers14041015. [PMID: 35205763 PMCID: PMC8869800 DOI: 10.3390/cancers14041015] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/04/2022] [Accepted: 02/09/2022] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Trastuzumab and radiation are used clinically to treat HER2-overexpressing breast cancers; however, the mechanistic synergy of anti-HER2 and radiation therapy has not been investigated. In this study, we identify that a subtherapeutic dose of trastuzumab sensitizes the tumor microenvironment to fractionated radiation. This results in longitudinal sustained response by triggering a state of innate immune activation through reduced DNA damage repair and increased tumor oxygenation. As positron emission tomography imaging can be used to longitudinally evaluate changes in tumor hypoxia, synergy of combination therapies is the result of both cellular and molecular changes in the tumor microenvironment. Abstract DNA damage repair and tumor hypoxia contribute to intratumoral cellular and molecular heterogeneity and affect radiation response. The goal of this study is to investigate anti-HER2-induced radiosensitization of the tumor microenvironment to enhance fractionated radiotherapy in models of HER2+ breast cancer. This is monitored through in vitro and in vivo studies of phosphorylated γ-H2AX, [18F]-fluoromisonidazole (FMISO)-PET, and transcriptomic analysis. In vitro, HER2+ breast cancer cell lines were treated with trastuzumab prior to radiation and DNA double-strand breaks (DSB) were quantified. In vivo, HER2+ human cell line or patient-derived xenograft models were treated with trastuzumab, fractionated radiation, or a combination and monitored longitudinally with [18F]-FMISO-PET. In vitro DSB analysis revealed that trastuzumab administered prior to fractionated radiation increased DSB. In vivo, trastuzumab prior to fractionated radiation significantly reduced hypoxia, as detected through decreased [18F]-FMISO SUV, synergistically improving long-term tumor response. Significant changes in IL-2, IFN-gamma, and THBS-4 were observed in combination-treated tumors. Trastuzumab prior to fractionated radiation synergistically increases radiotherapy in vitro and in vivo in HER2+ breast cancer which is independent of anti-HER2 response alone. Modulation of the tumor microenvironment, through increased tumor oxygenation and decreased DNA damage response, can be translated to other cancers with first-line radiation therapy.
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Affiliation(s)
- Patrick N. Song
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (P.N.S.); (Y.L.); (S.S.); (S.E.L.)
- Graduate Biomedical Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Ameer Mansur
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.M.); (A.B.); (K.H.)
| | - Yun Lu
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (P.N.S.); (Y.L.); (S.S.); (S.E.L.)
- Graduate Biomedical Sciences, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Deborah Della Manna
- Department of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (D.D.M.); (E.S.Y.)
| | - Andrew Burns
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.M.); (A.B.); (K.H.)
| | - Sharon Samuel
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (P.N.S.); (Y.L.); (S.S.); (S.E.L.)
| | - Katherine Heinzman
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.M.); (A.B.); (K.H.)
| | - Suzanne E. Lapi
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (P.N.S.); (Y.L.); (S.S.); (S.E.L.)
- O’Neal Comprehensive Cancer Center, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Eddy S. Yang
- Department of Radiation Oncology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (D.D.M.); (E.S.Y.)
- O’Neal Comprehensive Cancer Center, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Anna G. Sorace
- Department of Radiology, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (P.N.S.); (Y.L.); (S.S.); (S.E.L.)
- Department of Biomedical Engineering, The University of Alabama at Birmingham, Birmingham, AL 35294, USA; (A.M.); (A.B.); (K.H.)
- O’Neal Comprehensive Cancer Center, The University of Alabama at Birmingham, Birmingham, AL 35294, USA
- Correspondence:
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Focused ultrasound for opening blood-brain barrier and drug delivery monitored with positron emission tomography. J Control Release 2020; 324:303-316. [DOI: 10.1016/j.jconrel.2020.05.020] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/14/2022]
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Preclinical Molecular Imaging for Precision Medicine in Breast Cancer Mouse Models. CONTRAST MEDIA & MOLECULAR IMAGING 2019; 2019:8946729. [PMID: 31598114 PMCID: PMC6778915 DOI: 10.1155/2019/8946729] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/28/2019] [Accepted: 07/25/2019] [Indexed: 12/18/2022]
Abstract
Precision and personalized medicine is gaining importance in modern clinical medicine, as it aims to improve diagnostic precision and to reduce consequent therapeutic failures. In this regard, prior to use in human trials, animal models can help evaluate novel imaging approaches and therapeutic strategies and can help discover new biomarkers. Breast cancer is the most common malignancy in women worldwide, accounting for 25% of cases of all cancers and is responsible for approximately 500,000 deaths per year. Thus, it is important to identify accurate biomarkers for precise stratification of affected patients and for early detection of responsiveness to the selected therapeutic protocol. This review aims to summarize the latest advancements in preclinical molecular imaging in breast cancer mouse models. Positron emission tomography (PET) imaging remains one of the most common preclinical techniques used to evaluate biomarker expression in vivo, whereas magnetic resonance imaging (MRI), particularly diffusion-weighted (DW) sequences, has been demonstrated as capable of distinguishing responders from nonresponders for both conventional and innovative chemo- and immune-therapies with high sensitivity and in a noninvasive manner. The ability to customize therapies is desirable, as this will enable early detection of diseases and tailoring of treatments to individual patient profiles. Animal models remain irreplaceable in the effort to understand the molecular mechanisms and patterns of oncologic diseases.
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Elmi A, McDonald ES, Mankoff D. Imaging Tumor Proliferation in Breast Cancer: Current Update on Predictive Imaging Biomarkers. PET Clin 2018; 13:445-457. [PMID: 30100082 DOI: 10.1016/j.cpet.2018.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Uncontrolled growth is a hallmark of cancer; imaging cell proliferation can provides an early indicator of therapeutic response. This capability is especially well-matched to the emerging cell cycle-specific chemotherapeutics with the goal of identifying patients that benefit from these treatments early in the course of treatment to guide personalized therapy. This article focuses on investigational cell proliferation imaging PET radiotracers to evaluate tumor proliferation in the setting of cell cycle-targeted chemotherapy and endocrine therapy for metastatic breast cancer.
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Affiliation(s)
- Azadeh Elmi
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - Elizabeth S McDonald
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA
| | - David Mankoff
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.
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Noninvasive Evaluation of Cellular Proliferative Activity in Brain Neurogenic Regions in Rats under Depression and Treatment by Enhanced [18F]FLT-PET Imaging. J Neurosci 2017; 36:8123-31. [PMID: 27488633 DOI: 10.1523/jneurosci.0220-16.2016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2016] [Accepted: 06/21/2016] [Indexed: 12/31/2022] Open
Abstract
UNLABELLED Neural stem cells in two neurogenic regions, the subventricular zone and the subgranular zone (SGZ) of the hippocampal dentate gyrus, can divide and produce new neurons throughout life. Hippocampal neurogenesis is related to emotions, including depression/anxiety, and the therapeutic effects of antidepressants, as well as learning and memory. The establishment of in vivo imaging for proliferative activity of neural stem cells in the SGZ might be used to diagnose depression and to monitor the therapeutic efficacy of antidepressants. Positron emission tomography (PET) imaging with 3'-deoxy-3'-[(18)F]fluoro-l-thymidine ([(18)F]FLT) has been studied to allow visualization of proliferative activity in two neurogenic regions of adult mammals; however, the PET imaging has not been widely used because of lower accumulation of [(18)F]FLT, which does not allow quantitative assessment of the decline in cellular proliferative activity in the SGZ under the condition of depression. We report the establishment of an enhanced PET imaging method with [(18)F]FLT combined with probenecid, an inhibitor of drug transporters at the blood-brain barrier, which can allow the quantitative visualization of neurogenic activity in rats. Enhanced PET imaging allowed us to evaluate reduced cell proliferation in the SGZ of rats with corticosterone-induced depression, and further the recovery of proliferative activity in rats under treatment with antidepressants. This enhanced [(18)F]FLT-PET imaging technique with probenecid can be used to assess the dynamic alteration of neurogenic activity in the adult mammalian brain and may also provide a means for objective diagnosis of depression and monitoring of the therapeutic effect of antidepressant treatment. SIGNIFICANCE STATEMENT Adult hippocampal neurogenesis may play a role in major depression and antidepressant therapy. Establishment of in vivo imaging for hippocampal neurogenic activity may be useful to diagnose depression and monitor the therapeutic efficacy of antidepressants. Positron emission tomography (PET) imaging has been studied to allow visualization of neurogenic activity; however, PET imaging has not been widely used due to the lower accumulation of the PET tracer in the neurogenic regions. Here, we succeeded in establishing highly quantitative PET imaging for neurogenic activity in adult brain with an inhibitor for drug transporter. This enhanced PET imaging allowed evaluation of the decline of neurogenic activity in the hippocampus of rats with depression and the recovery of neurogenic activity by antidepressant treatment.
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Manning HC, Buck JR, Cook RS. Mouse Models of Breast Cancer: Platforms for Discovering Precision Imaging Diagnostics and Future Cancer Medicine. J Nucl Med 2016; 57 Suppl 1:60S-8S. [PMID: 26834104 DOI: 10.2967/jnumed.115.157917] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Representing an enormous health care and socioeconomic challenge, breast cancer is the second most common cancer in the world and the second most common cause of cancer-related death. Although many of the challenges associated with preventing, treating, and ultimately curing breast cancer are addressable in the laboratory, successful translation of groundbreaking research to clinical populations remains an important barrier. Particularly when compared with research on other types of solid tumors, breast cancer research is hampered by a lack of tractable in vivo model systems that accurately recapitulate the relevant clinical features of the disease. A primary objective of this article was to provide a generalizable overview of the types of in vivo model systems, with an emphasis primarily on murine models, that are widely deployed in preclinical breast cancer research. Major opportunities to advance precision cancer medicine facilitated by molecular imaging of preclinical breast cancer models are discussed.
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Affiliation(s)
- H Charles Manning
- Vanderbilt University Medical Center, Nashville, Tennessee Vanderbilt-Ingram Cancer Center, Nashville, Tennessee Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; and Vanderbilt Center for Molecular Probes, Nashville, Tennessee
| | - Jason R Buck
- Vanderbilt University Medical Center, Nashville, Tennessee Vanderbilt University Institute of Imaging Science, Nashville, Tennessee; and Vanderbilt Center for Molecular Probes, Nashville, Tennessee
| | - Rebecca S Cook
- Vanderbilt University Medical Center, Nashville, Tennessee Vanderbilt-Ingram Cancer Center, Nashville, Tennessee
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Cieslak JA, Sibenaller ZA, Walsh SA, Boles Ponto LL, Du J, Sunderland JJ, Cullen JJ. Fluorine-18-Labeled Thymidine Positron Emission Tomography (FLT-PET) as an Index of Cell Proliferation after Pharmacological Ascorbate-Based Therapy. Radiat Res 2016; 185:31-8. [PMID: 26720803 PMCID: PMC4720529 DOI: 10.1667/rr14203.1] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Pharmacological ascorbate (AscH(-)) induces cytotoxicity and oxidative stress selectively in pancreatic cancer cells compared with normal cells. Positron emission tomography (PET) with the thymidine analog 3'-deoxy-3'-((18)F) fluorothymidine (FLT) enables noninvasive imaging and quantification of the proliferation fraction of tumors. We hypothesized that the rate of tumor proliferation determined by FLT-PET imaging, would be inversely proportional to tumor susceptibility to pharmacological AscH(-)-based treatments. Indeed, there was decreased FLT uptake in human pancreatic cancer cells treated with AscH(-) in vitro, and this effect was abrogated by co-treatment with catalase. In separate experiments, cells were treated with AscH(-), ionizing radiation or a combination of both. These studies demonstrated that combined AscH(-) and radiation treatment resulted in a significant decrease in FLT uptake that directly correlated with decreased clonogenic survival. MicroPET (18)F-FLT scans of mice with pre-established tumors demonstrated that AscH(-) treatment induced radiosensitization compared to radiation treatment alone. These data support testing of pharmacological ascorbate as a radiosensitizer in pancreatic cancer as well as the use of FLT-PET to monitor response to therapy.
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Affiliation(s)
- John A. Cieslak
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Zita A. Sibenaller
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
| | - Susan A. Walsh
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
- Department of Small Animal Imaging Core, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Laura L. Boles Ponto
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Department of Small Animal Imaging Core, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Juan Du
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
| | - John J. Sunderland
- Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Joseph J. Cullen
- Free Radical and Radiation Biology Program, Department of Radiation Oncology
- Department of Surgery, University of Iowa Carver College of Medicine, Iowa City, Iowa
- Holden Comprehensive Cancer Center, Iowa City, Iowa
- Iowa City Veterans Affairs Medical Center, Iowa City, Iowa
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Sorace AG, Quarles CC, Whisenant JG, Hanker AB, McIntyre JO, Sanchez VM, Yankeelov TE. Trastuzumab improves tumor perfusion and vascular delivery of cytotoxic therapy in a murine model of HER2+ breast cancer: preliminary results. Breast Cancer Res Treat 2016; 155:273-84. [PMID: 26791520 PMCID: PMC4833210 DOI: 10.1007/s10549-016-3680-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 01/04/2016] [Indexed: 01/17/2023]
Abstract
To employ in vivo imaging and histological techniques to identify and quantify vascular changes early in the course of treatment with trastuzumab in a murine model of HER2+ breast cancer. Dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) was used to quantitatively characterize vessel perfusion/permeability (via the parameter K (trans) ) and the extravascular extracellular volume fraction (v e ) in the BT474 mouse model of HER2+ breast cancer (N = 20) at baseline, day one, and day four following trastuzumab treatment (10 mg/kg). Additional cohorts of mice were used to quantify proliferation (Ki67), microvessel density (CD31), pericyte coverage (α-SMA) by immunohistochemistry (N = 44), and to quantify human VEGF-A expression (N = 29) throughout the course of therapy. Longitudinal assessment of combination doxorubicin ± trastuzumab (N = 42) tested the hypothesis that prior treatment with trastuzumab will increase the efficacy of subsequent doxorubicin therapy. Compared to control tumors, trastuzumab-treated tumors exhibited a significant increase in K (trans) (P = 0.035) on day four, indicating increased perfusion and/or vessel permeability and a simultaneous significant increase in v e (P = 0.01), indicating increased cell death. Immunohistochemical and ELISA analyses revealed that by day four the trastuzumab-treated tumors had a significant increase in vessel maturation index (i.e., the ratio of α-SMA to CD31 staining) compared to controls (P < 0.001) and a significant decrease in VEGF-A (P = 0.03). Additionally, trastuzumab dosing prior to doxorubicin improved the overall effectiveness of the therapies (P < 0.001). This study identifies and validates improved perfusion characteristics following trastuzumab therapy, resulting in an improvement in trastuzumab-doxorubicin combination therapy in a murine model of HER2+ breast cancer. This data suggests properties of vessel maturation. In particular, the use of DCE-MRI, a clinically available imaging method, following treatment with trastuzumab may provide an opportunity to optimize the scheduling and improve delivery of subsequent cytotoxic therapy.
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Affiliation(s)
- Anna G. Sorace
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA,Vanderbilt Institute of Imaging Science, Vanderbilt University Medical Center, AA-1105 Medical Center North, 1161 21st Ave South, Nashville, TN 37232-2310, USA
| | - C. Chad Quarles
- Division of Neuroimaging Research, Barrow Neurological Institute, Dignity Health, St. Joseph’s Hospital and Medical Center, Phoenix, AZ 85013, USA
| | - Jennifer G. Whisenant
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA,Vanderbilt Institute of Imaging Science, Vanderbilt University Medical Center, AA-1105 Medical Center North, 1161 21st Ave South, Nashville, TN 37232-2310, USA
| | - Ariella B. Hanker
- Department of Cancer Biology, Vanderbilt University, Nashville, TN, USA
| | - J. Oliver McIntyre
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA,Vanderbilt Institute of Imaging Science, Vanderbilt University Medical Center, AA-1105 Medical Center North, 1161 21st Ave South, Nashville, TN 37232-2310, USA,Department of Cancer Biology, Vanderbilt University, Nashville, TN, USA
| | - Violeta M. Sanchez
- Department of Hematology Oncology, Vanderbilt University, Nashville, TN, USA
| | - Thomas E. Yankeelov
- Department of Radiology and Radiological Sciences, Vanderbilt University, Nashville, TN, USA,Vanderbilt Institute of Imaging Science, Vanderbilt University Medical Center, AA-1105 Medical Center North, 1161 21st Ave South, Nashville, TN 37232-2310, USA,Department of Cancer Biology, Vanderbilt University, Nashville, TN, USA,Department of Biomedical Engineering, Vanderbilt University, Nashville, TN, USA,Vanderbilt Ingram Cancer Center, Vanderbilt University, Nashville, TN, USA,Department of Physics and Astronomy, Vanderbilt University, Nashville, TN, USA
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11
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Whisenant JG, Sorace AG, McIntyre JO, Kang H, Sánchez V, Loveless ME, Yankeelov TE. Evaluating treatment response using DW-MRI and DCE-MRI in trastuzumab responsive and resistant HER2-overexpressing human breast cancer xenografts. Transl Oncol 2014; 7:768-79. [PMID: 25500087 PMCID: PMC4311041 DOI: 10.1016/j.tranon.2014.09.011] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 09/10/2014] [Accepted: 09/26/2014] [Indexed: 01/28/2023] Open
Abstract
We report longitudinal diffusion-weighted magnetic resonance imaging (DW-MRI) and dynamic contrast enhanced (DCE)-MRI (7 T) studies designed to identify functional changes, prior to volume changes, in trastuzumab-sensitive and resistant HER2 + breast cancer xenografts. Athymic mice (N = 33) were subcutaneously implanted with trastuzumab-sensitive (BT474) or trastuzumab-resistant (HR6) breast cancer cells. Tumor-bearing animals were distributed into four groups: BT474 treated and control, HR6 treated and control. DW- and DCE-MRI were conducted at baseline, day 1, and day 4; trastuzumab (10 mg/kg) or saline was administered at baseline and day 3. Animals were sacrificed on day 4 and tumors resected for histology. Voxel-based DW- and DCE-MRI analyses were performed to generate parametric maps of ADC, Ktrans, and ve. On day 1, no differences in tumor size were observed between any of the groups. On day 4, significant differences in tumor size were observed between treated vs. control BT474, treated BT474 vs. treated HR6, and treated vs. control HR6 (P < .0001). On day 1, ve was significantly higher in the BT474 treated group compared to BT474 control (P = .002) and HR6 treated (P = .004). On day 4, ve and Ktrans were significantly higher in the treated BT474 tumors compared to BT474 controls (P = .0007, P = .02, respectively). A significant decrease in Ki67 staining reinforced response in the BT474 treated group compared to BT474 controls (P = .02). This work demonstrated that quantitative MRI biomarkers have the sensitivity to differentiate treatment response in HER2 + tumors prior to changes in tumor size.
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Affiliation(s)
- Jennifer G Whisenant
- Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675
| | - Anna G Sorace
- Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675
| | - J Oliver McIntyre
- Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Cancer Biology, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675
| | - Hakmook Kang
- Departments of Biostatistics, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675
| | - Violeta Sánchez
- Departments of Breast Cancer Research Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University, 2220 Pierce Avenue, Nashville, TN 37232-2675
| | - Mary E Loveless
- Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675
| | - Thomas E Yankeelov
- Institute of Imaging Science, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Radiology and Radiological Sciences, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Cancer Biology, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Physics, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Biomedical Engineering, Vanderbilt University, 1161 21st Avenue South, Medical Center North, AA-1105, Nashville, TN 37232-2675; Departments of Breast Cancer Research Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University, 2220 Pierce Avenue, Nashville, TN 37232-2675.
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