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Hirshman BR, Compton J, Carroll KT, Ali MA, Wang SG, Chen CC. Cumulative Intracranial Tumor Volume as a Prognostic Factor in Patients with Brain Metastases Undergoing Stereotactic Radiosurgery. ACTA NEUROCHIRURGICA. SUPPLEMENT 2021; 128:57-69. [PMID: 34191062 DOI: 10.1007/978-3-030-69217-9_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Approximately 25-35% of all cancer patients suffer from brain metastases (BM), and many of them-in particular, those with a limited number of intracranial tumors-are treated with stereotactic radiosurgery (SRS). Accurate prediction of survival remains a key clinical challenge in this population. Several prognostic scales have been developed to facilitate this prognostication, including the Recursive Partitioning Analysis (RPA) classification, the modified Recursive Partitioning Analysis (mRPA) subclassifications, the Basic Score for Brain Metastases (BS-BM), the Score Index for Radiosurgery (SIR), the Graded Prognostic Assessment (GPA), and the diagnosis-specific Graded Prognostic Assessment (dsGPA). However, none of these scales include consideration of the cumulative intracranial tumor volume (CITV), which is defined as the sum of all intracranial tumor volumes. Since there is mounting evidence that the CITV carries significant prognostic value in SRS-treated patients with BM, this variable should be considered during survival prognostication, along with other pertinent clinical, pathological, and molecular characteristics.
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Affiliation(s)
- Brian R Hirshman
- Department of Neurosurgery, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Jason Compton
- School of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Kate T Carroll
- School of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Mir Amaan Ali
- School of Medicine, University of California San Diego (UCSD), La Jolla, CA, USA
| | - Sonya G Wang
- Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Clark C Chen
- Department of Neurosurgery, University of Minnesota Medical School, Minneapolis, MN, USA.
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Nicoletti NF, Erig TC, Zanin RF, Roxo MR, Ferreira NP, Gomez MV, Morrone FB, Campos MM. Pre-clinical evaluation of voltage-gated calcium channel blockers derived from the spider P. nigriventer in glioma progression. Toxicon 2017; 129:58-67. [PMID: 28202361 DOI: 10.1016/j.toxicon.2017.02.001] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 02/01/2017] [Accepted: 02/02/2017] [Indexed: 01/30/2023]
Abstract
This study investigated the effects of P/Q- and N-type voltage-gated calcium channel (VGCC) blockers derived from P. nigriventer in glioma progression, by means of in vitro and in vivo experiments. Glioma cells M059J, U-138MG and U-251MG were used to evaluate the antiproliferative effects of P/Q- and N-type VGCC inhibitors PhTx3-3 and Phα1β from P. nigriventer (0.3-100 pM), in comparison to MVIIC and MVIIA from C. magus (0.3-100 pM), respectively. The toxins were also analyzed in a glioma model induced by implantation of GL261 mouse cells. PhTx3-3, Phα1β and MVIIA displayed significant inhibitory effects on the proliferation and viability of all tested glioma cell lines, and evoked cell death mainly with apoptosis characteristics, as indicated by Annexin V/propidium iodide (PI) positivity. The antiproliferative effects of toxins were confirmed by flow cytometry using Ki67 staining. None of the tested toxins altered the proliferation rates of the N9 non-tumor glial cell line. Noteworthy, the administration of the preferential N-type VGCC inhibitors, Phα1β (50 pmol/site; i.c.v.), its recombinant form CTK 01512-2 (50 pmol/site; i.c.v. and i.t.), or MVIIA (10 pmol/site; i.c.v.) caused significant reductions of tumor areas in vivo. N-type VGCC inhibition by Phα1β, CTK 01512-2, and MVIIA led to a marked increase of GFAP-activated astrocytes, and Iba-1-positive microglia, in the peritumoral region, which might explain, at least in part, the inhibitory effects of the toxins in tumor development. This study provides novel evidence on the potential effects of P. nigriventer-derived P/Q-, and mainly, N-type VGCC inhibitors, in glioma progression.
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Affiliation(s)
- Natália Fontana Nicoletti
- PUCRS, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil; PUCRS, Instituto de Toxicologia e Farmacologia, Porto Alegre, RS, Brazil
| | | | - Rafael Fernandes Zanin
- PUCRS, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil
| | - Marcelo Ricardo Roxo
- Serviço de Neurocirurgia, Hospital São José, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil; UCS, Faculdade de Medicina, Departamento de Neurocirurgia, Caxias do Sul, RS, Brazil
| | - Nelson Pires Ferreira
- Serviço de Neurocirurgia, Hospital São José, Irmandade da Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brazil
| | - Marcus Vinicius Gomez
- UFMG, Faculdade de Medicina, Laboratório de Neurociências, Belo Horizonte, MG, Brazil
| | - Fernanda Bueno Morrone
- PUCRS, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil; PUCRS, Instituto de Toxicologia e Farmacologia, Porto Alegre, RS, Brazil; PUCRS, Faculdade de Farmácia, Porto Alegre, RS, Brazil
| | - Maria Martha Campos
- PUCRS, Programa de Pós-Graduação em Biologia Celular e Molecular, Porto Alegre, RS, Brazil; PUCRS, Instituto de Toxicologia e Farmacologia, Porto Alegre, RS, Brazil; PUCRS, Faculdade de Odontologia, Laboratório de Patologia, Porto Alegre, RS, Brazil.
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3
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Wu H, Shang LQ, Chen RL, Yang SM, Wang SL, Wang J, Sun G. Significance of Trask protein interactions in brain metastatic cohorts of lung cancers. Tumour Biol 2015; 36:4181-7. [PMID: 25775948 DOI: 10.1007/s13277-015-3053-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2014] [Accepted: 01/02/2015] [Indexed: 12/19/2022] Open
Abstract
A class of adhesion protein that occurs in the membrane with both extracellular and intracellular domain and play vital role in maintaining multicellularity is TRASK, also called CUB-domain containing protein1, CD318 (CDCP1). Specifically, in the current study, documented aggressive grades of lung cancers and distant metastatic tissues were examined for protein interactions of Trask and compared with lung cancer variants in situ. The intracellular domain of Trask has the ability to undergo tyrosine phosphorylation and thereafter undergo increased genomic expression, as well as interact with cytoskeletal proteins in the cell periphery and other local signal transduction machinery to induce invadopodia formation and distant metastasis. We incorporated proximity ligation assay to examine protein interactions of Trask in metastatic lung cancer tissues and compare with advanced and low-grade lung cancers restricted to the primary site of origins. Here, we provide direct evidence that activated Trask, which is a phosphorylated form, binds with cytoskeletal proteins actin and spectrin. These interactions were not seen in locally growing lung cancer and cancer in situ. These interactions may be responsible for invadopodia formation and breaking free from a multicellular environment. Functional studies demonstrated interaction between Trask and the STOCs Orai1 and Stim1. Calcium release from internal stores was highest in metastatic lung cancers, suggesting this mechanism as an initial stimulus for the cells to respond chaotically to external growth factor stimulation, especially in aggressive metastatic variants of lung cancers. Recently, inhibitors of STOCs have been identified, and preclinical evidence may be obtained whether these drugs may be of benefit in preventing the deadly consequences of lung cancer.
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Affiliation(s)
- Hua Wu
- Department of Respiratory Medicine, Shaanxi Provincial People's Hospital, No. 256, Youyi West Road, Beilin District, Xi'an, 710068, Shaanxi, China,
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Shabtay-Orbach A, Amit M, Binenbaum Y, Na'ara S, Gil Z. Paracrine regulation of glioma cells invasion by astrocytes is mediated by glial-derived neurotrophic factor. Int J Cancer 2014; 137:1012-20. [PMID: 25487790 DOI: 10.1002/ijc.29380] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 11/19/2014] [Indexed: 12/12/2022]
Abstract
It was suggested that the brain microenvironment plays a role in glioma progression. Here we investigate the mechanism by which astrocytes which are abundant in glioma tumors, promote cancer cell invasion. In this study, we evaluated the effects of astrocytes on glioma biology both in vitro and in vivo and determined the downstream paracrine effect of glial-derived neurotrophic factor (GDNF) on tumor invasion. Astrocytes-conditioned media (ACM) significantly increased human and murine glioma cells migration compared to controls. This effect was inhibited when the activity of GDNF on glioma cells was blocked by RET-Fc chimera or anti-GDNF Ab and by small interfering RNA directed against GDNF expression by astrocytes. Glioma cells incubated with ACM led to time dependent phosphorylation of the GDNF receptor, RET and downstream activation of AKT. Tumor migration and GDNF-RET-AKT activation was inhibited by the RET small-molecule inhibitor pyrazolopyrimidine-1 (PP1) and by the AKT inhibitor LY294002. Finally, blocking of RET by PP1 or knockout of the RET coreceptor GFRα1 in glioma cells reduced the size of brain tumors in immunocompetent mice. We suggest a mechanism by which astrocytes attracted to the glioma tumors facilitate brain invasion by secretion of GDNF and activation of RET/GFRα1 receptors expressed by the cancer cells.
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Affiliation(s)
- Ayelet Shabtay-Orbach
- The Laboratory for Applied Cancer Research, The Clinical Research Center at Rambam, Haifa, Israel
| | - Moran Amit
- The Laboratory for Applied Cancer Research, The Clinical Research Center at Rambam, Haifa, Israel.,Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Rapaport School of Medicine, The Technion Israel Institute of Technology, Haifa, Israel
| | - Yoav Binenbaum
- The Laboratory for Applied Cancer Research, The Clinical Research Center at Rambam, Haifa, Israel
| | - Shorook Na'ara
- The Laboratory for Applied Cancer Research, The Clinical Research Center at Rambam, Haifa, Israel.,Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Rapaport School of Medicine, The Technion Israel Institute of Technology, Haifa, Israel
| | - Ziv Gil
- The Laboratory for Applied Cancer Research, The Clinical Research Center at Rambam, Haifa, Israel.,Department of Otolaryngology Head and Neck Surgery, Rambam Medical Center, Rapaport School of Medicine, The Technion Israel Institute of Technology, Haifa, Israel
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Martínez-Aranda A, Hernández V, Picón C, Modolell I, Sierra A. Development of a preclinical therapeutic model of human brain metastasis with chemoradiotherapy. Int J Mol Sci 2013; 14:8306-27. [PMID: 23591844 PMCID: PMC3645744 DOI: 10.3390/ijms14048306] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2012] [Revised: 03/16/2013] [Accepted: 03/26/2013] [Indexed: 01/22/2023] Open
Abstract
Currently, survival of breast cancer patients with brain metastasis ranges from 2 to 16 months. In experimental brain metastasis studies, only 10% of lesions with the highest permeability exhibited cytotoxic responses to paclitaxel or doxorubicin. Therefore, radiation is the most frequently used treatment, and sensitizing agents, which synergize with radiation, can improve the efficacy of the therapy. In this study we used 435-Br1 cells containing the fluorescent protein (eGFP) gene and the photinus luciferase (PLuc) gene to develop a new brain metastatic cell model in mice through five in vivo/in vitro rounds. BR-eGFP-CMV/Luc-V5 brain metastatic cells induce parenchymal brain metastasis within 60.8 ± 13.8 days of intracarotid injection in all mice. We used this model to standardize a preclinical chemoradiotherapy protocol comprising three 5.5 Gy fractions delivered on consecutive days (overall dose of 16.5 Gy) which improved survival with regard to controls (60.29 ± 8.65 vs. 47.20 ± 11.14). Moreover, the combination of radiotherapy with temozolomide, 60 mg/Kg/day orally for five consecutive days doubled survival time of the mice 121.56 ± 52.53 days (Kaplan-Meier Curve, p < 0.001). This new preclinical chemoradiotherapy protocol proved useful for the study of radiation response/resistance in brain metastasis, either alone or in combination with new sensitizing agents.
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Affiliation(s)
- Antonio Martínez-Aranda
- Biological Clues of the Invasive and Metastatic Phenotype Group, Bellvitge Biomedical Research Institute (IDIBELL), L’ Hospitalet de Llobregat, Barcelona 08907, Spain; E-Mails: (A.M.-A.); (V.H.)
- Autonoma University of Barcelona (UAB), Faculty of Biosciences, Campus Bellaterra, Building C, Cerdanyola del Vallés, Barcelona 08193, Spain
| | - Vanessa Hernández
- Biological Clues of the Invasive and Metastatic Phenotype Group, Bellvitge Biomedical Research Institute (IDIBELL), L’ Hospitalet de Llobregat, Barcelona 08907, Spain; E-Mails: (A.M.-A.); (V.H.)
| | - Cristina Picón
- Medical Physics Service, Oncology Catalan Institut, Duran I Reynals Hospital, L’Hospitalet de Llobregat, Barcelona 08907, Spain; E-Mails: (C.P.); (I.M.)
| | - Ignasi Modolell
- Medical Physics Service, Oncology Catalan Institut, Duran I Reynals Hospital, L’Hospitalet de Llobregat, Barcelona 08907, Spain; E-Mails: (C.P.); (I.M.)
| | - Angels Sierra
- Biological Clues of the Invasive and Metastatic Phenotype Group, Bellvitge Biomedical Research Institute (IDIBELL), L’ Hospitalet de Llobregat, Barcelona 08907, Spain; E-Mails: (A.M.-A.); (V.H.)
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +34-93-260-7429, Fax: +34-93-260-7426
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Lewis KM, Harford-Wright E, Vink R, Ghabriel MN. Characterisation of Walker 256 breast carcinoma cells from two tumour cell banks as assessed using two models of secondary brain tumours. Cancer Cell Int 2013; 13:5. [PMID: 23374226 PMCID: PMC3576291 DOI: 10.1186/1475-2867-13-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2012] [Accepted: 01/29/2013] [Indexed: 11/10/2022] Open
Abstract
UNLABELLED BACKGROUND Metastatic brain tumours are a common end stage of breast cancer progression, with significant associated morbidity and high mortality. Walker 256 is a rat breast carcinoma cell line syngeneic to Wistar rats and commonly used to induce secondary brain tumours. Previously there has been the assumption that the same cancer cell line from different cell banks behave in a similar manner, although recent studies have suggested that cell lines may change their characteristics over time in vitro. METHODS In this study internal carotid artery injection and direct cerebral inoculation models of secondary brain tumours were used to determine the tumorigenicity of Walker 256 cells obtained from two cell banks, the American Type Culture Collection (ATCC), and the Cell Resource Centre for Medical Research at Tohoku University (CRCTU). RESULTS Tumour incidence and volume, plus immunoreactivity to albumin, IBA1 and GFAP, were used as indicators of tumorigenicity and tumour interaction with the host brain microenvironment. CRCTU Walker 256 cells showed greater incidence, larger tumour volume, pronounced blood-brain barrier disruption and prominent glial response when compared to ATCC cell line. CONCLUSIONS These findings indicate that immortalised cancer cell lines obtained from different cell banks may have diverse characteristics and behaviour in vivo.
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Affiliation(s)
- Kate M Lewis
- Adelaide Centre for Neuroscience Research, School of Medical Sciences, The University of Adelaide, Adelaide, South Australia, Australia.
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Neurotrophin-3 modulates breast cancer cells and the microenvironment to promote the growth of breast cancer brain metastasis. Oncogene 2012; 32:4064-77. [PMID: 23001042 DOI: 10.1038/onc.2012.417] [Citation(s) in RCA: 82] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2012] [Revised: 07/16/2012] [Accepted: 07/31/2012] [Indexed: 01/17/2023]
Abstract
Metastasis, which remains incompletely characterized at the molecular and biochemical levels, is a highly specific process. Despite the ability of disseminated cancer cells to intravasate into distant tissues, it has been long recognized that only a limited subset of target organs develop clinically overt metastases. Therefore, subsequent adaptation of disseminated cancer cells to foreign tissue microenvironment determines the metastatic latency and tissue tropism of these cells. As a result, studying interactions between the disseminated cancer cells and the adjacent stromal cells will provide a better understanding of what constitutes a favorable or unfavorable microenvironment for disseminated cancer cells in a tissue-specific manner. Previously, we reported a protein signature of brain metastasis showing increased ability of brain metastatic breast cancer cells to counteract oxidative stress. In this study, we showed that another protein from the brain metastatic protein signature, neurotrophin-3 (NT-3), has a dual function of regulating the metastatic growth of metastatic breast cancer cells and reducing the activation of immune response in the brain. More importantly, increased NT-3 secretion in metastatic breast cancer cells results in a reversion of mesenchymal-like (EMT) state to epithelial-like (MET) state and vice versa. Ectopic expression of NT-3 in EMT-like breast cancer cells reduces their migratory ability and increases the expression of HER2 (human epidermal growth factor receptor 2) and E-cadherin at the cell-cell junction. In addition, both endogenous and ectopic expression of NT-3 reduced the number of fully activated cytotoxic microglia. In summary, NT-3 appears to promote growth of metastatic breast cancer cells in the brain by facilitating the re-epithelialization of metastatic breast cancer cells and downmodulating the cytotoxic response of microglia. Most importantly, our results provide new insights into the latency and development of central nervous system macrometastases in patients with HER2-positive breast tumors and provide mechanistic rationale to target HER2 signaling for HER2-positive breast cancer brain metastasis.
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Antiangiogenic therapy in the management of brain tumors: a clinical overview. Cancer Chemother Pharmacol 2012; 70:353-63. [DOI: 10.1007/s00280-012-1926-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2012] [Accepted: 07/05/2012] [Indexed: 12/15/2022]
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Stark AM. Neurosurgical treatment of breast cancer metastases to the neurocranium. PATHOLOGY RESEARCH INTERNATIONAL 2010; 2011:549847. [PMID: 21209717 PMCID: PMC3010687 DOI: 10.4061/2011/549847] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 11/08/2010] [Indexed: 12/04/2022]
Abstract
Breast cancer metastases to the neurocranium might involve the bone, the dura, or the brain parenchyma. The latter location is the far most common. The annual incidence of brain metastases in patients with breast cancer is in the range of 4–11 per 100.000 persons per year. Symptoms and findings mainly result from the location of the lesion. The diagnostic method of choice is magnetic resonance imaging before and after administration of contrast material. Breast cancer brain metastases present as solid, cystic, or partially cystic lesions with marked contrast enhancement and perilesional edema. The therapeutic option of choice is microsurgical resection whenever possible. Adjuvant treatment includes radiotherapy, radiosurgery, and/or chemotherapy.
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Affiliation(s)
- Andreas M Stark
- Department of Neurosurgery, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Stra β e 3, 24105 Kiel, Germany
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Lorger M, Felding-Habermann B. Capturing changes in the brain microenvironment during initial steps of breast cancer brain metastasis. THE AMERICAN JOURNAL OF PATHOLOGY 2010; 176:2958-71. [PMID: 20382702 DOI: 10.2353/ajpath.2010.090838] [Citation(s) in RCA: 223] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Brain metastases are difficult to treat and mostly develop late during progressive metastatic disease. Patients at risk would benefit from the development of prevention and improved treatments. This requires knowledge of the initial events that lead to brain metastasis. The present study reveals cellular events during the initiation of brain metastasis by breast cancer cells and documents the earliest host responses to incoming cancer cells after carotid artery injection in immunodeficient and immunocompetent mouse models. Our findings capture and characterize heterogeneous astrocytic and microglial reactions to the arrest and extravasation of cancer cells in the brain, showing immediate and drastic changes in the brain microenvironment on arrival of individual cancer cells. We identified reactive astrocytes as the most active host cell population that immediately localizes to individual invading tumor cells and continuously associates with growing metastatic lesions. Up-regulation of matrix metalloproteinase-9 associated with astrocyte activation in the immediate vicinity of extravasating cancer cells might support their progression. Early involvement of different host cell types indicates environmental clues that might codetermine whether a single cancer cell progresses to macrometastasis or remains dormant. Thus, information on the initial interplay between brain homing tumor cells and reactive host cells may help develop strategies for prevention and treatment of symptomatic breast cancer brain metastases.
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Affiliation(s)
- Mihaela Lorger
- Department of Molecular and Experimental Medicine, The Scripps Research Institute, 10550 North Torrey Pines Road, MEM-150, La Jolla, CA 92037, USA.
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Chen L, Swartz KR, Toborek M. Vessel microport technique for applications in cerebrovascular research. J Neurosci Res 2009; 87:1718-27. [PMID: 19115415 DOI: 10.1002/jnr.21973] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Cerebrovascular research suffers from a lack of reliable methods with which to deliver exogenous substances effectively into the central nervous system (CNS) of small experimental animals. Here we describe a novel vessel microport surgical technique for a variety of cerebrovascular applications that is reproducible and well tolerated in mice. The procedure is based on the insertion of a vessel microport into the external carotid artery for substance delivery into the CNS via the internal carotid artery. The method results in selective substance delivery into the ipsilateral hemisphere. Other novel aspects of this surgical technique include the ability to perform multiple injections, study of conscious mice well removed from surgery, and lack of occlusion of the common or internal carotid artery that allows carotid flow to be maintained. The feasibility of this technique has been validated by infusion of HIV Tat protein to induce permeability of the blood-brain barrier and by implantation of tumor cells to establish a brain metastasis model. Thus, the described vessel microport technique can be employed in a variety of cerebrovascular research applications.
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Affiliation(s)
- Lei Chen
- Molecular Neuroscience and Vascular Biology Laboratory, Lexington, Kentucky 40536, USA
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Stark AM, Hugo HH, Tscheslog H, Mehdorn HM. p53, BCL-2 and BAX in non-small cell lung cancer brain metastases: a comparison of real-time RT-PCR, ELISA and immunohistochemical techniques. Neurol Res 2007; 29:435-40. [PMID: 17535549 DOI: 10.1179/016164107x165282] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVES Metastasis to the brain is a severe and common complication in non-small cell lung cancer (NSCLC). The examination of cell cycle associated genes in these lesions may contribute to the understanding of metastatic growths in the central nervous system. The aim of this study was to evaluate the p53, BCL-2 and BAX mRNA and protein expression in NSCLC brain metastases in comparison with matched primary tumors. METHODS For quantitative TaqMan real-time reverse transcription-polymerase chain reaction (RT-PCR) and enzyme-linked immunosorbent assay (ELISA), fresh frozen tumor specimens from 12 patients with NSCLC brain metastases were available. For immunohistochemical staining, 78 surgically removed NSCLC brain metastases were used. PCR results were analysed using the DeltaDeltaCT method. Staining was analysed using a modified immunoreactive score (IRS). RESULTS Overall, p53, BCL-2 and BAX expression values in brain metastases and primary tumors showed a wide variety. The comparison of different techniques revealed different findings on the mRNA and protein level. Herein, PCR and ELISA revealed no clear tendencies. In contrast, immunohistochemistry showed significant overexpression of BAX and underexpression of BCL-2 in brain metastases. CONCLUSION A high variability in the expression of p53, BCL-2 and BAX in NSCLC exists in brain metastases. Immunohistochemistry revealed overexpression of BAX and underexpression of BCL-2 in brain metastases, whereas there were no clear tendencies using PCR and ELISA techniques. More insights into the BAX/BCL-2 interaction are needed before reasonable conclusions can be drawn from the existing data.
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Affiliation(s)
- Andreas M Stark
- Department of Neurosurgery, University of Schleswig-Holstein Medical Center, Campus Kiel, Schittenhelmstr. 10, 24105 Kiel, Germany.
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Affiliation(s)
- Joohee Sul
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA
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Stark AM, Anuszkiewicz B, Mentlein R, Yoneda T, Mehdorn HM, Held-Feindt J. Differential expression of matrix metalloproteinases in brain- and bone-seeking clones of metastatic MDA-MB-231 breast cancer cells. J Neurooncol 2006; 81:39-48. [PMID: 16850107 DOI: 10.1007/s11060-006-9207-0] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2006] [Accepted: 05/31/2006] [Indexed: 10/24/2022]
Abstract
Matrix Metalloproteinases (MMPs) play a crucial role in breast cancer metastasis. We examined the mRNA and protein expression of several MMPs in brain- and bone-seeking clones of MDA-MB-231 breast cancer cells, their transcriptional regulation and their functional role in the metastatic process. MMP mRNA expression was examined using real-time reverse transcription polymerase chain reaction. Protein expression was examined using enzyme linked immunosorbent essay (ELISA). The inducibility of mRNA and protein expression was tested with TPA (phorbol 12-myristate 13-acetate; 50 microM); epidermal growth factor and transforming growth factor beta (20 ng/ml both). Migration and invasion assays were performed with the QCM 96-Well Migration/Invasion Assay (8 microm; Chemicon) over 24 h with or without specific MMPs inhibitors (MMP Inhibitor I Mix (5 microM); MMP-2/MMP-9 Inhibitor III (50 microM); EMD Biosciences). We found significantly higher mRNA expression of MMP-1 and -9 in brain-seeking 231-clones in comparison to -bone and -parental cells. In contrast, the mRNA expression of MMP-3 and -14 was comparable in all cells lines examined and MMP-13 expression was lower in both selective metastatic lines. MMP-2 and -8 were not expressed. ELISA revealed a higher amount of total as well as active MMP-1 and -9 in brain-seeking cells. TPA stimulation showed that MMP-1 and -9 transcription was inducible on the mRNA and protein level in 231-parental but not in 231-brain or -bone. 231-brain showed the highest migration and invasive capacity which could be decreased by the application of MMP-1 and/or MMP-9 inhibitor. Our results indicate functional importance of MMP-1 and -9 overexpression in brain metastasis in an in vitro model.
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Affiliation(s)
- Andreas M Stark
- Department of Neurosurgery, University of Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany
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Abstract
Metastases are the most common tumors of the central nervous system (CNS), but cancer databases are often incomplete leading to underestimation of the incidence of even symptomatic brain metastases. Brain imaging studies are not routinely performed on neurologically asymptomatic cancer patients and autopsy studies are outdated. Furthermore, while incidence rates for cancers are stable and mortality is decreasing due to earlier detection and better therapy, the incidence of brain metastases appears to be increasing. The pathophysiology of brain metastases is a complex multistage process, mediated by molecular mechanisms; from the primary organ, cancer cells must transform, grow and be transported to the CNS where they can lay dormant for various lengths of time before invading and growing further. Understanding the pathophysiology of brain metastases is of great importance, because it may lead to the development of more efficient therapies to combat brain tumor growth or to possibly make the CNS an undesirable environment for tumor progression.
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Affiliation(s)
- Igor T Gavrilovic
- Department of Neurology, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10021, USA
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Stark AM, Tongers K, Maass N, Mehdorn HM, Held-Feindt J. Reduced metastasis-suppressor gene mRNA-expression in breast cancer brain metastases. J Cancer Res Clin Oncol 2004; 131:191-8. [PMID: 15592684 DOI: 10.1007/s00432-004-0629-9] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Accepted: 08/18/2004] [Indexed: 01/27/2023]
Abstract
PURPOSE Brain metastases are an increasingly common complication in breast cancer patients. The Metastasis Suppressor Genes (MSG) Nm23, KISS1, KAI1, BRMS1, and Mkk4 have been associated with the metastatic potential of breast cancer in vitro and in vivo. METHODS The mRNA expression of Nm23, KISS1, KAI1, BRMS1, and Mkk4 in fresh frozen tissue samples of brain metastases from ductal invasive breast cancer specimens was examined in relation to primary tumors. In a first step, mRNA expression screening was carried out using a semi-quantitative RT-PCR approach, in a second step quantitative real-time RT-PCR was performed on selected specimens. By immunohistochemical staining, gene products were visualized on the protein level. RESULTS Semi-quantitative RT-PCR revealed reduced mRNA expression of Nm23, KISS1, KAI1, BRMS, and Mkk4 in brain metastases. Results for KISS1, KAI1, BRMS, and Mkk4 were confirmed by real-time RT-PCR. In detail, mRNA expression reduction in breast cancer brain metastases was tenfold. Expression of MSG could be confirmed by immunohistochemical staining on protein level. CONCLUSIONS Our investigations revealed significantly reduced mRNA expression of metastases suppressor genes KISS1, KAI1, BRMS1, and Mkk4 in breast cancer brain metastasis. Particularly, in the case of KISS1 and Mkk4, an important role for future treatment of patients with breast cancer brain metastatic lesions can be assumed.
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Affiliation(s)
- Andreas M Stark
- Department of Neurosurgery, University of Schleswig-Holstein Medical Center, Campus Kiel, Schittenhelmstrasse 10, 24105 Kiel, Germany
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Abstract
BACKGROUND Systemic cancer is the second most common cause of death for adults in the United States. Twenty percent of these patients develop neurologic symptoms sometime during their illness. An apparent increase in the incidence of both systemic cancers and resulting brain metastases are posing an increasing challenge to health care providers. Neurologic complications lead to significant morbidity and mortality in these patients. Therefore, it is important to understand the current concepts of diagnosis and treatment of patients with brain metastases. REVIEW SUMMARY This review summarizes the epidemiology, clinical features, pathophysiology, and diagnostic evaluation of brain metastases. The section on current treatments is presented from the perspective of the three most common primary tumor locations along with the treatment approach to other metastatic tumors. This review includes a thorough evaluation of the literature, highlights controversies over treatment options, and provides insight into novel approaches currently under investigation. Clinical studies needed for further study are also discussed. CONCLUSIONS A clearer understanding of the pathophysiology of metastatic tumors and advances in diagnostic technology have paved the road to a better approach to treatment of brain metastases. Although no curative treatments are available to date, significant improvement in a patient's quality of life and life expectancy can be achieved with the available therapy. A better understanding of different primary cancers leading to brain metastases leads to a more effective treatment. More studies are needed to critically analyze the clear benefit of these treatment options in selected patients.
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18
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Hunter KW. Allelic diversity in the host genetic background may be an important determinant in tumor metastatic dissemination. Cancer Lett 2003; 200:97-105. [PMID: 14568162 DOI: 10.1016/s0304-3835(03)00420-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Metastasis, the spread and growth of tumors at secondary sites, is an extremely important clinical event, since the majority of cancer mortality is associated with the metastatic tumors rather than the primary tumor. In spite of the importance of metastasis in the clinical setting, the actual process is extremely inefficient. Millions of tumor cells can be shed into the vasculature daily yet few secondary tumors are formed. To successfully colonize a distant site tumor cells must overcome a series of barriers. Failure to complete any single step in the metastatic cascade abrogates the ability to form a secondary lesion. A variety of theories have been proposed to explain the inefficiency of the metastatic process. The most commonly accepted, the progression theory, posits a series of random mutational occurs within a primary tumor to generate a small subpopulation that acquires full metastatic capability. While significant evidence supports this model, recent discoveries demonstrating the ability to predict metastatic propensity from gene expression profiles in bulk tumor tissue are not consistent with only a small subpopulation of cells in the primary tumor acquiring metastatic ability. A second theory of metastatic inefficiency, the transient compartment theory, is more consistent with the microarray data, but does not completely explain observations like metastasis associated loss-of-heterozygosity events. To reconcile the observed results additional variables need to be added to the model of metastatic inefficiency. One possible variable that might explain the discrepancies is genetic background effects. Studies have demonstrated that the genetic background a tumor arises on can have significant affects on the ability of the tumor to metastasize and on gene expression profiles. Thus the observations could be reconciled by combining the theories, with genetic background influencing both metastatic efficiency and predictive gene expression profiles, upon which subsequently occur metastasis-promoting mutational and epigenetic events. If the genetic background is an important determinant of metastatic efficiency it would have significant implications for the clinical prediction and treatment of metastatic disease, as well as for the design of potential prevention strategies.
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Affiliation(s)
- Kent W Hunter
- Laboratory of Population Genetics, Center for Cancer Research, National Cancer Institute, National Institutes of Health, Building 41, Room D702, 41 Library Drive, Bethesda, MD 20892-5060, USA.
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19
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Abstract
Neoplastic meningitis (NM) is a dreaded metastatic complication occurring in 5% to 10% of cancer patients. Survival is limited, usually ranging from 4 to 16 weeks. The pathogenesis of NM has not been extensively investigated but can be considered from the anatomic and molecular biologic standpoints. Malignant cells reach the cerebrospinal fluid (CSF) and meninges by direct invasion from tumors located near or within the central nervous system (CNS), or via the bloodstream or other pathways that contact the CNS. Symptoms of NM are caused by malignant cells invading and damaging nervous tissue, obstructing the vascular supply to nervous tissue, or obstructing CSF pathways. The molecular changes responsible for the development of NM are not well delineated, but it is likely that they involve changes in molecules responsible for tumor cell adhesion, migration, and proliferation. An understanding of the pathogenesis of NM will allow for its earliest possible diagnosis and ultimately lead to therapies targeted at the underlying molecular causes of this devastating condition.
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Affiliation(s)
- Morris D Groves
- Department of Neuro-Oncology, The University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 431, Houston, TX 77030, USA.
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20
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Gilbert MR. Neoplastic meningitis: a unique disease process or a 'test tube' for evaluating cancer treatments? Curr Oncol Rep 2003; 5:11-4. [PMID: 12493145 DOI: 10.1007/s11912-003-0081-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Improved treatment of systemic cancers has prolonged the lives of many patients but has also led to increased incidence of neoplastic meningitis. The prognosis for patients who develop neoplastic meningitis or leptomeningeal dissemination of cancer cells remains poor. This paper reviews the pathologic reasons for this poor prognosis, describes recent research in animal models that explores new therapies, and discusses the potential of these new treatment possibilities for clinical use in the context of the associated biology and pathology. The author provides an overview of the accompanying articles for the Neuro-Oncology section, which explore the mechanisms leading to neoplastic meningitis, the role of radiotherapy and chemotherapy in this disease process, and the toxicities of treatment.
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Affiliation(s)
- Mark R Gilbert
- Department of Clinical Neuro-Oncology, University of Texas M.D. Anderson Cancer Center, 1515 Holcombe Boulevard, Box 0100, Houston, TX 77030, USA.
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Weaver VM, Lelièvre S, Lakins JN, Chrenek MA, Jones JCR, Giancotti F, Werb Z, Bissell MJ. beta4 integrin-dependent formation of polarized three-dimensional architecture confers resistance to apoptosis in normal and malignant mammary epithelium. Cancer Cell 2002; 2:205-16. [PMID: 12242153 PMCID: PMC2788997 DOI: 10.1016/s1535-6108(02)00125-3] [Citation(s) in RCA: 592] [Impact Index Per Article: 26.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Tumor cells can evade chemotherapy by acquiring resistance to apoptosis. We investigated the molecular mechanism whereby malignant and nonmalignant mammary epithelial cells become insensitive to apoptosis. We show that regardless of growth status, formation of polarized, three-dimensional structures driven by basement membrane confers protection to apoptosis in both nonmalignant and malignant mammary epithelial cells. By contrast, irrespective of their malignant status, nonpolarized structures are sensitive to induction of apoptosis. Resistance to apoptosis requires ligation of beta4 integrins, which regulates tissue polarity, hemidesmosome formation, and NFkappaB activation. Expression of beta4 integrin that lacks the hemidesmosome targeting domain interferes with tissue polarity and NFkappaB activation and permits apoptosis. These results indicate that integrin-induced polarity may drive tumor cell resistance to apoptosis-inducing agents via effects on NFkappaB.
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Affiliation(s)
- Valerie M Weaver
- Department of Pathology and Institute for Medicine and Engineering, University of Pennsylvania, Philadelphia, PA 19104, USA.
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