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Leal AS, Hung PY, Chowdhury AS, Liby KT. Retinoid X Receptor agonists as selective modulators of the immune system for the treatment of cancer. Pharmacol Ther 2023; 252:108561. [PMID: 37952906 DOI: 10.1016/j.pharmthera.2023.108561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 09/28/2023] [Accepted: 11/06/2023] [Indexed: 11/14/2023]
Abstract
Upon heterodimerizing with other nuclear receptors, retinoid X receptors (RXR) act as ligand-dependent transcription factors, regulating transcription of critical signaling pathways that impact numerous hallmarks of cancer. By controlling both inflammation and immune responses, ligands that activate RXR can modulate the tumor microenvironment. Several small molecule agonists of these essential receptors have been synthesized. Historically, RXR agonists were tested for inhibition of growth in cancer cells, but more recent drug discovery programs screen new molecules for inhibition of inflammation or activation of immune cells. Bexarotene is the first successful example of an effective therapeutic that molecularly targets RXR; this drug was approved to treat cutaneous T cell lymphoma and is still used as a standard of care treatment for this disease. No additional RXR agonists have yet achieved FDA approval, but several promising novel compounds are being developed. In this review, we provide an overview of the multiple mechanisms by which RXR signaling regulates inflammation and tumor immunity. We also discuss the potential of RXR-dependent immune cell modulation for the treatment or prevention of cancer and concomitant challenges and opportunities.
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Affiliation(s)
- Ana S Leal
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States of America; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Pei-Yu Hung
- Department of Physiology, Michigan State University, East Lansing, MI, United States of America
| | - Afrin Sultana Chowdhury
- Department of Pharmacology and Toxicology, Indiana University School of Medicine, Indianapolis, IN, United States of America
| | - Karen T Liby
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, United States of America; Department of Medicine, Indiana University School of Medicine, Indianapolis, IN, United States of America.
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Leal AS, Moerland JA, Zhang D, Carapellucci S, Lockwood B, Krieger-Burke T, Aleiwi B, Ellsworth E, Liby KT. The RXR Agonist MSU42011 Is Effective for the Treatment of Preclinical HER2+ Breast Cancer and Kras-Driven Lung Cancer. Cancers (Basel) 2021; 13:5004. [PMID: 34638488 PMCID: PMC8508021 DOI: 10.3390/cancers13195004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 10/02/2021] [Accepted: 10/02/2021] [Indexed: 12/22/2022] Open
Abstract
(1) Background: Notwithstanding numerous therapeutic advances, 176,000 deaths from breast and lung cancers will occur in the United States in 2021 alone. The tumor microenvironment and its modulation by drugs have gained increasing attention and relevance, especially with the introduction of immunotherapy as a standard of care in clinical practice. Retinoid X receptors (RXRs) are members of the nuclear receptor superfamily and upon ligand binding, function as transcription factors to modulate multiple cell functions. Bexarotene, the only FDA-approved RXR agonist, is still used to treat cutaneous T-cell lymphoma. (2) Methods: To test the immunomodulatory and anti-tumor effects of MSU42011, a new RXR agonist, we used two different immunocompetent murine models (MMTV-Neu mice, a HER2 positive model of breast cancer and the A/J mouse model, in which vinyl carbamate is used to initiate lung tumorigenesis) and an immunodeficient xenograft lung cancer model. (3) Results: Treatment of established tumors in immunocompetent models of HER2-positive breast cancer and Kras-driven lung cancer with MSU42011 significantly decreased the tumor burden and increased the ratio of CD8/CD4, CD25 T cells, which correlates with enhanced anti-tumor efficacy. Moreover, the combination of MSU42011 and immunotherapy (anti-PDL1 and anti-PD1 antibodies) significantly (p < 0.05) reduced tumor size vs. individual treatments. However, MSU42011 was ineffective in an athymic human A549 lung cancer xenograft model, supporting an immunomodulatory mechanism of action. (4) Conclusions: Collectively, these data suggest that the RXR agonist MSU42011 can be used to modulate the tumor microenvironment in breast and lung cancer.
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Affiliation(s)
- Ana S. Leal
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
| | - Jessica A. Moerland
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
| | - Di Zhang
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
| | - Sarah Carapellucci
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
| | - Beth Lockwood
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
| | - Teresa Krieger-Burke
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
- In Vivo Facility, Michigan State University, East Lansing, MI 48824, USA
| | - Bilal Aleiwi
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
- Medicinal Chemistry Facility, Michigan State University, East Lansing, MI 48824, USA
| | - Edmund Ellsworth
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
- Medicinal Chemistry Facility, Michigan State University, East Lansing, MI 48824, USA
| | - Karen T. Liby
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI 48824, USA; (A.S.L.); (J.A.M.); (D.Z.); (S.C.); (B.L.); (T.K.-B.); (B.A.); (E.E.)
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Leal AS, Zydeck K, Carapellucci S, Reich LA, Zhang D, Moerland JA, Sporn MB, Liby KT. Retinoid X receptor agonist LG100268 modulates the immune microenvironment in preclinical breast cancer models. NPJ Breast Cancer 2019; 5:39. [PMID: 31700995 PMCID: PMC6825145 DOI: 10.1038/s41523-019-0135-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 10/10/2019] [Indexed: 02/08/2023] Open
Abstract
Despite numerous therapeutic advances in the past decade, breast cancer is expected to cause over 42,000 deaths in the United States in 2019. Breast cancer had been considered an immunologically silent tumor; however recent findings suggest that immune cells play important roles in tumor growth even in the breast. Retinoid X receptors (RXRs) are a subclass of nuclear receptors that act as ligand-dependent transcription factors that regulate a variety of cellular processes including proliferation and differentiation; in addition, they are essential for macrophage biology. Rexinoids are synthetic molecules that bind and activate RXRs. Bexarotene is the only rexinoid approved by the FDA for the treatment of refractory cutaneous T-cell lymphoma. Other more-potent rexinoids have been synthesized, such as LG100268 (LG268). Here, we report that treatment with LG 268, but not bexarotene, decreased infiltration of myeloid-derived suppressor cells and CD206-expressing macrophages, increased the expression of PD-L1 by 50%, and increased the ratio of CD8/CD4, CD25 T cells, which correlates with increased cytotoxic activity of CD8 T cells in tumors of MMTV-Neu mice (a model of HER2-positive breast cancer). In the MMTV-PyMT murine model of triple negative breast cancer, LG268 treatment of established tumors prolonged survival, and in combination with anti-PD-L1 antibodies, significantly (p = 0.05) increased the infiltration of cytotoxic CD8 T cells and apoptosis. Collectively, these data suggest that the use of LG268, a RXR agonist, can improve response to immune checkpoint blockade in HER2+ or triple-negative breast cancer.
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Affiliation(s)
- Ana S. Leal
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
| | - Kayla Zydeck
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
| | - Sarah Carapellucci
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
| | - Lyndsey A. Reich
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
| | - Di Zhang
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
| | - Jessica A. Moerland
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
| | - Michael B. Sporn
- Department of Molecular and Systems Biology, Dartmouth/Geisel School of Medicine at Dartmouth, Hanover, NH USA
| | - Karen T. Liby
- Department of Pharmacology & Toxicology, Michigan State University, East Lansing, MI USA
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Shen D, Wang H, Zheng Q, Cheng S, Xu L, Wang M, Li GH, Xia LQ. Synergistic effect of a retinoid X receptor-selective ligand bexarotene and docetaxel in prostate cancer. Onco Targets Ther 2019; 12:7877-7886. [PMID: 31576145 PMCID: PMC6768013 DOI: 10.2147/ott.s209307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 08/16/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore if bexarotene (BEX) synergistically enhances docetaxel (DTX) cytotoxicity in castration-resistant prostate cancer cell lines. Materials and methods MTT assay was used to measure the cytotoxic effect of DTX and BEX on castration-resistant prostate cancer (CRPC) cell proliferation and the combination index (CI) values calculated to analyze the interaction between DTX and BEX. Flow cytometry and Western blot analysis identified the underlying mechanism for the synergistic effect of BEX and DTX. Results When mitotic slippage happens, BEX can synergistically strengthen the anti-proliferation of DTX in a way of significantly down-regulating cyclinB1 and CDK1 expression, and then arresting cells in G2 phase. Conclusion Results from this study showed that BEX-induced G2 arrest and DTX-induced mitotic arrest probably contributed to the synergistic effect of BEX and DTX.
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Affiliation(s)
- Danyang Shen
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Huan Wang
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Qiming Zheng
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Sheng Cheng
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Liwei Xu
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Mingchao Wang
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Gong H Li
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
| | - Li Q Xia
- Department of Urology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou 310016, People's Republic of China
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5
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Shen D, Yu X, Wu Y, Chen Y, Li G, Cheng F, Xia L. Emerging roles of bexarotene in the prevention, treatment and anti-drug resistance of cancers. Expert Rev Anticancer Ther 2018. [PMID: 29521139 DOI: 10.1080/14737140.2018.1449648] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Danyang Shen
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Xiaoming Yu
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yan Wu
- Department of Pharmacy, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yuanlei Chen
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Gonghui Li
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Feng Cheng
- College of Biotechnology and Bioengineering, Zhejiang University of Technology, Hangzhou, China
| | - Liqun Xia
- Department of Urology and Chawnshang Chang Liver Cancer Center, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Yenerall P, Kittler R. Minireview: Familiar Faces in Unfamiliar Places: The Emerging Role of Nuclear Receptors in Lung Cancer. Mol Endocrinol 2015; 29:1675-83. [PMID: 26484581 DOI: 10.1210/me.2015-1199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Nuclear hormone receptors (NRs) are a superfamily of 48 transcription factors that are frequently modulated by ligands and control various cancer-relevant cellular pathways, such as differentiation, proliferation, migration, and metabolism. These properties make them excellent therapeutic targets in cancers dependent upon their activity, and as such, 3 NRs, estrogen receptor-α, androgen receptor, and retinoic acid receptor-α (more specifically, the promyelocytic leukemia-retinoic acid receptor-α translocation), have been targeted clinically in breast cancer, prostate cancer, and acute promyelocytic leukemia, respectively. Recently, a number of studies have highlighted a putative role for NRs in nonsmall cell lung cancer (NSCLC), a highly lethal type of lung cancer with relatively few targeted agents. Here, we review the potential roles of selected NRs in NSCLC and offer insights on how NRs may be leveraged in NSCLC to improve patient outcomes.
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Affiliation(s)
- Paul Yenerall
- Eugene McDermott Center for Human Growth and Development (P.Y., R.K.), Hamon Center for Therapeutic Oncology Research (P.Y., R.K.), Simmons Comprehensive Cancer Center (R.K.), Department of Pharmacology (R.K.), and Green Center for Reproductive Biology Sciences (R.K.), The University of Texas Southwestern Medical Center, Dallas, Texas 75390
| | - Ralf Kittler
- Eugene McDermott Center for Human Growth and Development (P.Y., R.K.), Hamon Center for Therapeutic Oncology Research (P.Y., R.K.), Simmons Comprehensive Cancer Center (R.K.), Department of Pharmacology (R.K.), and Green Center for Reproductive Biology Sciences (R.K.), The University of Texas Southwestern Medical Center, Dallas, Texas 75390
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A carbazole alkaloid deactivates mTOR through the suppression of rictor and that induces apoptosis in lung cancer cells. Mol Cell Biochem 2015; 405:149-58. [PMID: 25893736 DOI: 10.1007/s11010-015-2406-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2014] [Accepted: 04/09/2015] [Indexed: 12/18/2022]
Abstract
Non-small cell lung cancer (NSCLC) is known to be a difficult cancer to treat because of its poor prognosis, limited option for surgery, and resistance to chemo or radiotherapy. In this study, we have demonstrated that suppression of rictor expression in A549 and H1299 NSCLC cells by mahanine, a carbazole alkaloid, disrupted constitutive activation of mTOR and Akt. Mahanine suppression of rictor gene expression and consequent attenuation of its protein expression affected the inhibition of mTOR (Ser-2481) and Akt (Ser-473) phosphorylation. Since mahanine treatment revealed this new insight of rictor-mTOR relationship, we examined an association between mTOR activation with rictor expression. Interestingly, in rictor knockdown (KD) NSCLC cells, mTOR activation was significantly impaired. Transfection of rictor over-expression vector into the NSCLC cells reversed this situation. In fact, both rictor KD and mahanine treated cells showed considerably depleted phospho-mTOR level. These results indicate that rictor is required to maintain constitutive activation of mTOR in lung cancer cells. When mTOR kinase activity in rictor KD cells was examined with Akt as substrate, a significant reduction of Akt phosphorylation indicated impairment of mTOR kinase potentiality. Disruption of mTOR and Akt activation caused drastic mortality of NSCLC cancer cells through apoptosis. Hence, our study reveals a new dimension in mTOR-rictor relationship, where rictor stands to be a suitable therapeutic target for lung cancer.
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Seal S, Chatterjee P, Bhattacharya S, Pal D, Dasgupta S, Kundu R, Mukherjee S, Bhattacharya S, Bhuyan M, Bhattacharyya PR, Baishya G, Barua NC, Baruah PK, Rao PG, Bhattacharya S. Vapor of volatile oils from Litsea cubeba seed induces apoptosis and causes cell cycle arrest in lung cancer cells. PLoS One 2012; 7:e47014. [PMID: 23091605 PMCID: PMC3473030 DOI: 10.1371/journal.pone.0047014] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Accepted: 09/11/2012] [Indexed: 01/05/2023] Open
Abstract
Non-small cell lung carcinoma (NSCLC) is a major killer in cancer related human death. Its therapeutic intervention requires superior efficient molecule(s) as it often becomes resistant to present chemotherapy options. Here we report that vapor of volatile oil compounds obtained from Litsea cubeba seeds killed human NSCLC cells, A549, through the induction of apoptosis and cell cycle arrest. Vapor generated from the combined oils (VCO) deactivated Akt, a key player in cancer cell survival and proliferation. Interestingly VCO dephosphorylated Akt at both Ser(473) and Thr(308); through the suppression of mTOR and pPDK1 respectively. As a consequence of this, diminished phosphorylation of Bad occurred along with the decreased Bcl-xL expression. This subsequently enhanced Bax levels permitting the release of mitochondrial cytochrome c into the cytosol which concomitantly activated caspase 9 and caspase 3 resulting apoptotic cell death. Impairment of Akt activation by VCO also deactivated Mdm2 that effected overexpression of p53 which in turn upregulated p21 expression. This causes enhanced p21 binding to cyclin D1 that halted G1 to S phase progression. Taken together, VCO produces two prong effects on lung cancer cells, it induces apoptosis and blocked cancer cell proliferation, both occurred due to the deactivation of Akt. In addition, it has another crucial advantage: VCO could be directly delivered to lung cancer tissue through inhalation.
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Affiliation(s)
- Soma Seal
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Priyajit Chatterjee
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Sushmita Bhattacharya
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Durba Pal
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Suman Dasgupta
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
| | - Rakesh Kundu
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Sandip Mukherjee
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Shelley Bhattacharya
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
| | - Mantu Bhuyan
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
| | | | - Gakul Baishya
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
| | - Nabin C. Barua
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
| | - Pranab K. Baruah
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
| | - Paruchuri G. Rao
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
| | - Samir Bhattacharya
- Centre for Advanced Studies in Zoology, School of Life Science, Visva-Bharati University, Santiniketan, West Bengal, India
- CSIR-North East Institute of Science and Technology, Jorhat, Assam, India
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Fritz H, Kennedy D, Fergusson D, Fernandes R, Doucette S, Cooley K, Seely A, Sagar S, Wong R, Seely D. Vitamin A and retinoid derivatives for lung cancer: a systematic review and meta analysis. PLoS One 2011; 6:e21107. [PMID: 21738614 PMCID: PMC3124481 DOI: 10.1371/journal.pone.0021107] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 05/19/2011] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Despite reported antiproliferative activity of vitamin A and its common use for cancer, there is no comprehensive synthesis of its safety and efficacy in lung cancers. To address this issue we conducted a systematic review of the safety and efficacy of vitamin A for the treatment and prevention of lung cancers. METHODS AND FINDINGS Two independent reviewers searched six electronic databases from inception to July 2009 for clinical, observational, and preclinical evidence pertaining to the safety and efficacy of vitamin A and related retinoids for lung cancers. 248 studies were included for full review and analysis. Five RCTs assessed treatment of lung cancers, three assessed primary prevention, and three looked at secondary prevention of lung cancers. Five surrogate studies, 26 phase I/II, 32 observational, and 67 preclinical studies were also included. 107 studies were included for interactions between vitamin A and chemo- or radiation-therapy. Although some studies demonstrated benefits, there was insufficient evidence overall to support the use of vitamin A or related retinoids for the treatment or prevention of lung cancers. Retinyl palmitate combined with beta carotene increased risk of lung cancer in smokers in the large CARET trial. Pooling of three studies pertaining to treatment and three studies on secondary prevention revealed no significant effects on response rate, second primary tumor, recurrence, 5-year survival, and mortality. There was a small improvement in event free survival associated with vitamin A compared to controls, RR 1.24 (95% CI 1.13-1.35). The synthetic rexinoid bexarotene increased survival significantly among a subset of patients in two RCTs (p<0.014, <0.087). CONCLUSIONS There is a lack of evidence to support the use of naturally occurring retinoids for the treatment and prevention of lung cancers. The rexinoid bexarotene may hold promise for use among a subset of patients, and deserves further study.
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Affiliation(s)
- Heidi Fritz
- Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
| | - Deborah Kennedy
- Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, The University of Toronto, Toronto, Ontario, Canada
| | - Dean Fergusson
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Rochelle Fernandes
- Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Laboratory Medicine and Pathobiology (LMP), The University of Toronto, Toronto, Ontario, Canada
| | - Steve Doucette
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Kieran Cooley
- Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Leslie Dan Faculty of Pharmacy, The University of Toronto, Toronto, Ontario, Canada
| | - Andrew Seely
- Department of Surgery, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Stephen Sagar
- Department of Medicine, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
| | - Raimond Wong
- Department of Medicine, Juravinski Cancer Centre, McMaster University, Hamilton, Ontario, Canada
| | - Dugald Seely
- Department of Research and Epidemiology, The Canadian College of Naturopathic Medicine, Toronto, Ontario, Canada
- Clinical Epidemiology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
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Méndez M, Custodio A, Provencio M. New molecular targeted therapies for advanced non-small-cell lung cancer. J Thorac Dis 2011; 3:30-56. [PMID: 22263060 PMCID: PMC3256501 DOI: 10.3978/j.issn.2072-1439.2010.12.03] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Accepted: 12/10/2010] [Indexed: 12/13/2022]
Abstract
Non-small-cell lung cancer (NSCLC) is a uniformly fatal disease and most patients will present with advanced stage. Treatment outcomes remain unsatisfactory, with low long-term survival rates. Standard treatment, such as palliative chemotherapy and radiotherapy, offers a median survival not exceeding 1 year. Hence, considerable efforts have started to be made in order to identify new biological agents which may safely and effectively be administered to advanced NSCLC patients. Two cancer cell pathways in particular have been exploited, the epidermal growth factor receptor (EGFR) and the vascular endothelial growth factor receptor (VEGFR) pathways. However, novel targeted therapies that interfere with other dysregulated pathways in lung cancer are already in the clinic. This review outlines the most promising research approaches to the treatment of NSCLC, discussed according to the specific molecular pathway targeted.
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11
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Bushue N, Wan YJY. Retinoid pathway and cancer therapeutics. Adv Drug Deliv Rev 2010; 62:1285-98. [PMID: 20654663 DOI: 10.1016/j.addr.2010.07.003] [Citation(s) in RCA: 238] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Revised: 07/08/2010] [Accepted: 07/14/2010] [Indexed: 12/18/2022]
Abstract
The retinoids are a class of compounds that are structurally related to vitamin A. Retinoic acid, which is the active metabolite of retinol, regulates a wide range of biological processes including development, differentiation, proliferation, and apoptosis. Retinoids exert their effects through a variety of binding proteins including cellular retinol-binding protein (CRBP), retinol-binding proteins (RBP), cellular retinoic acid-binding protein (CRABP), and nuclear receptors i.e. retinoic acid receptor (RAR) and retinoid x receptor (RXR). Because of the pleiotropic effects of retinoids, understanding the function of these binding proteins and nuclear receptors assists us in developing compounds that have specific effects. This review summarizes our current understanding of how retinoids are processed and act with an emphasis on the application of retinoids in cancer treatment and prevention.
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Affiliation(s)
- Nathan Bushue
- Department of Pharmacology, Toxicology and Therapeutics, University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS 66160, USA
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12
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Bogos K, Renyi-Vamos F, Kovacs G, Tovari J, Dome B. Role of retinoic receptors in lung carcinogenesis. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2008; 27:18. [PMID: 18625040 PMCID: PMC2483255 DOI: 10.1186/1756-9966-27-18] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/06/2008] [Accepted: 07/14/2008] [Indexed: 12/31/2022]
Abstract
Several in vitro and in vivo studies have examined the positive and negative effects of retinoids (vitamin A analogs) in premalignant and malignant lesions. Retinoids have been used as chemopreventive and anticancer agents because of their pleiotropic regulator function in cell differentiation, growth, proliferation and apoptosis through interaction with two types of nuclear receptors: retinoic acid receptors and retinoid X receptors. Recent investigations have gradually elucidated the function of retinoids and their signaling pathways and may explain the failure of earlier chemopreventive studies. In this review we have compiled basic and recent knowledge regarding the role of retinoid receptors in lung carcinogenesis. Sensitive and appropriate biological tools are necessary for screening the risk population and monitoring the efficacy of chemoprevention. Investigation of retinoid receptors is important and may contribute to the establishment of new strategies in chemoprevention for high-risk patients and in the treatment of lung cancer.
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Wildi JD, Baggstrom MQ, Suresh R, Read W, Fracasso PM, Govindan R. A Phase I Study of Docetaxel and Bexarotene. Chemotherapy 2008; 54:125-30. [DOI: 10.1159/000119706] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Accepted: 06/03/2007] [Indexed: 11/19/2022]
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14
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Altucci L, Leibowitz MD, Ogilvie KM, de Lera AR, Gronemeyer H. RAR and RXR modulation in cancer and metabolic disease. Nat Rev Drug Discov 2007; 6:793-810. [PMID: 17906642 DOI: 10.1038/nrd2397] [Citation(s) in RCA: 393] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Retinoic acid receptors (RARs) are ligand-controlled transcription factors that function as heterodimers with retinoid X receptors (RXRs) to regulate cell growth and survival. The success of RAR modulation in the treatment of acute promyelocytic leukaemia (APL) has stimulated considerable interest in the development of RAR and RXR modulators. This has been aided by recent advances in the understanding of the biological role of RARs and RXRs and in the design of selective receptor modulators that might overcome the limitations of current drugs. Here, we discuss the challenges and opportunities for therapeutic strategies based on RXR and RAR modulators, with a focus on cancer and metabolic diseases such as diabetes and obesity.
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Affiliation(s)
- Lucia Altucci
- Dipartimento di Patologia Generale, Seconda Università degli Studi di Napoli, Vico Luigi de Crecchio 7, 80138 Napoli, Italy
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Tanaka T, Suh KS, Lo AM, De Luca LM. p21WAF1/CIP1 is a common transcriptional target of retinoid receptors: pleiotropic regulatory mechanism through retinoic acid receptor (RAR)/retinoid X receptor (RXR) heterodimer and RXR/RXR homodimer. J Biol Chem 2007; 282:29987-97. [PMID: 17656367 DOI: 10.1074/jbc.m701700200] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The divergent response and the molecular mechanisms underlying the anti-cancer effects of retinoid X receptor (RXR) ligand (rexinoid) therapy are poorly understood. This study demonstrates that ligand-activated RXR homodimer facilitated G(1) arrest by up-regulation of p21 in vitro and in vivo but failed to induce G(1) arrest when p21 expression was blocked by p21 small interfering RNA. RXR ligand-dependent p21 up-regulation was transcriptionally controlled through the direct binding of RXR homodimers to two consecutive retinoid X response elements in the p21 promoter. Structural overlap of a retinoic acid response element with these retinoid X response elements led to a high affinity binding of retinoic acid receptor/RXR heterodimer to the retinoic acid response element, resulting in the prevention of RXR ligand-mediated p21 transactivation. These data show that p21 is a potential and novel molecular target for RXR ligand-mediated anti-cancer therapy and that the expression level of retinoic acid receptor and RXR in tumors may be crucial to induce p21-mediated cell growth arrest in RXR ligand therapy.
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Affiliation(s)
- Takemi Tanaka
- NCI, National Institutes of Health, Bethesda, Maryland 20892-4255, USA.
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Abstract
Targeted therapies will advance the treatment of NSCLC as we improve our understanding of the underlying biology of NSCLC and enhance our ability to clinically target the optimal therapy to an individual's cancer. Ongoing translational research including tissue arrays, genomic, and proteomic studies will help to identify clinically useful biomarkers that will allow further classification of NSCLC and may allow accurate prediction of response to specific chemotherapeutic regimens. Advances in targeted therapy in NSCLC are already yielding exciting results, and promises to become an increasingly important adjunct to surgical management of NSCLC.
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Affiliation(s)
- Philip W Smith
- University of Virginia, School of Medicine, P.O. Box 800679, Lee Street, Charlottesville, VA 22908-0679, USA
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