Establishment of tumor cell lines as an independent prognostic factor for survival time in patients with small-cell lung cancer

FAVL elevation in human tumors disrupts Fanconi anemia pathway signaling and promotes genomic instability and tumor growth

Fanconi anemia (FA) is a rare human genetic disease caused by mutations in any one of 13 known genes that encode proteins functioning in one common signaling pathway, the FA pathway, or in unknown genes. One characteristic of FA is an extremely high incidence of cancer, indicating the importance of the FA pathway in tumor suppression. However, the role of this pathway in the development and progression of human cancers in individuals who do not have FA has not been clearly determined. Here, we report that elevated expression of what we believe to be a novel splice variant of FA complementation group L (FANCL), which we identified and named FAVL, can impair the FA pathway in non-FA human tumor cells and act as a tumor promoting factor. FAVL expression was elevated in half of the human carcinoma cell lines and carcinoma tissue samples tested. Expression of FAVL resulted in decreased FANCL expression by sequestering FANCL to the cytoplasm and enhancing its degradation. Importantly, this impairment of the FA pathway by FAVL elevation provided human cancer cells with a growth advantage, caused chromosomal instability in vitro, and promoted tumor development in a xenograft mouse model. These data indicate that FAVL impairment of the FA pathway likely contributes to the development of non-FA human cancers and therefore add a challenging layer of complexity to the pathogenesis of human cancer. We further believe that these data will prove useful for developing additional tools for fighting human cancer.

Cancer Vaccine Potency: Is There a Dose/Response Relationship for Patient-Specific Vaccines and Clinical Outcomes?

PURPOSE

Determination of potency is a challenging problem for patient-specific products derived from autologous cells. For several years, we have been investigating the safety and therapeutic potential of patient- specific vaccines derived from short-term autologous cell lines. We investigated whether clinical potency of these vaccines could be determined by retrospective correlation between the numbers of cells injected (quantity of tumor antigens) and clinical outcome.

METHODS

The averages and standard deviations of irradiated tumor cells were determined for those patients who received the first 3 weekly injections, and for the subset that had a recording of results from tumor delayed-type hypersensitivity testing (DTH). Correlations were made between the numbers of cells injected and DTH conversion and survival.

RESULTS

One hundred fifty-six patients received the vaccine product, 136 of whom received the first 3 weekly vaccinations. The most common reason for not receiving 3 injections or having a repeat tumor DTH test was rapidly progressive disease. Ninety-nine patients had cell count data for all 3 injections; 73 had a tumor DTH test at baseline and at week 4. The average number of cells injected over 3 weeks, in millions per patient, by quartile were: 6.0 +/- 1.8, 10.2 +/- 1.4, 15.1 +/- 1.4, and 31.2 +/- 9.8, with respective median survivals of 24.7, 25.5, 24.0, and 21.0 months, with the respective number of DTH conversions being 4, 8, 4, and 6. There were no statistical differences in survival or in the number of patients who had a positive tumor DTH test at week 4.

CONCLUSIONS

We were unable to define potency--based on a relationship between the number of tumor cells injected as part of vaccination and survival or the reactivity to pure autologous tumor--in a tumor DTH test, over the range of 2-30 million injected cells over 3 weeks.

High frequency expressions of CD44 standard and variant forms in non-small cell lung cancers, but not in small cell lung cancers

BACKGROUND AND OBJECTIVES

Organ specificity has been demonstrated in the mode of CD44 expression among several cancers.

METHODS

We examined the expressions of CD44 standard (CD44s) and CD44 variants (CD44v) in 14 cell lines (small cell lung cancer (SCLC): 5, non-small cell lung cancer (NSCLC): 9 and 20 surgically resected samples (SCLC: 7, NSCLC: 13) of lung cancer using reverse transcription polymerase chain reaction and immunohistochemistry.

RESULTS

Although both NSCLC and SCLC expressed CD44s, the frequency and intensity of CD44s expression in NSCLC were different from those in SCLC: cell lines, 89% vs. 40%; tumor samples, 100% (diffusely stained) vs. 57% (focally stained). CD44s expression was partially or completely repressed in SCLC. However, NSCLC frequently expressed CD44v, but SCLC expressed infrequently: cell lines, 67% vs. 20%; tumor samples, 69% vs. 0%. The N-417 line, which only expressed some CD44v in SCLC, falls SCLC and NSCLC both in biomarkers and in growth patterns.

CONCLUSIONS

CD44 expression was repressed in SCLC but was enhanced in NSCLC.

Stimulatory effect of reconstituted basement membrane components (matrigel) on the colony formation of a panel of human lung cancer cell lines in soft agar

Lung cancers have been distinguished into small-cell lung cancer (SCLC) and non-small cell-lung cancer (NSCLC) types on the basis of their clinical behaviors and their responses to treatment. Moreover, growth of most SCLC cell lines in liquid culture medium is nonadherent, while that of most NSCLC cell lines is adherent. In this study, we examined the effect of matrigel (reconstituted basement membrane components), which is known to have growth-stimulatory activity on various human tumor cell lines in immunodeficient mice, on soft-agar colony formation of a panel of SCLC and NSCLC cell lines to clarify its mechanism of growth stimulation of cancer cells. Matrigel enhanced colony formation of all 9 NSCLC cell lines and 4 of 9 SCLC cell lines. There was a statistically significant difference (P < 0.01) between colony formations with and without matrigel of NSCLC cell lines, but not for SCLC cell lines. In liquid culture medium, all 9 NSCLC lines and 3 of 9 SCLC lines adhered to plastic dishes, whereas the other SCLC lines did not. Matrigel enhanced colony formation of all 3 adherent-type SCLC lines and 1 of 6 nonadherent-type NSCLC lines. Matrigel enhanced colony formation of both of 2 adherent-type non-lung cancer cell lines and 1 of 2 nonadherent-type leukemia cell lines. Neither transforming growth factor beta, collagen type IV, fibronectin, nor laminin, which are components of matrigel, enhanced colony formation of an NSCLC cell line in soft agar. The increase in the colony number of the NSCLC cell line by matrigel was abrogated by the protein kinase inhibitors staurosporine and UCN-01.

Integrated clinical and basic studies related to circumventing non-small cell lung cancer drug resistance

Consideration of a range of clinical and basic studies conducted at the National Cancer Institute which explore the nature of the tumor biology of lung identify the limitations of using chemotherapy for the treatment of advanced lung cancer. No single mechanistic explanation for lung cancer's chemoresistance is apparent, although considerable information about the biology of lung cancer and some of its clinical consequences have been elucidated. In contrast to previous works from our group, this presentation will focus principally on studies of the nature of drug resistance with non-small cell cancer. An alternative combined modality strategy for lung cancer control is to focus on epithelial progression of lung cancer using local modalities while it is still confined to the bronchial epithelium. Particular high risk populations may be appropriate to determine if local tools such as photodynamic laser therapy can be effective in this application. To deal with the underlying biochemical perturbations resulting from critical exposure of the bronchial epithelium to carcinogens, rational biochemical intervention with 13 cis retinoic acid are being evaluated in several clinical trials. An evolution towards more effective lung cancer control may involve the combined modalities of laser ablation of accessible dysplastic epithelium and chronic administration of intervention agents, such as retinoids, to neutralize cancer promotion dynamics in the more remote areas of the lung epithelium.

Analysis of long-term survivors with small-cell lung cancer

Survival among patients with small-cell lung cancer (SCLC) appears to have improved over the last 15 years. However, 2- to 3-year survival is still only 10% to 25% for patients with limited disease and 1% to 2% for those with extensive disease. Moreover, relapse of SCLC and the development of other cancers are common in patients surviving beyond 2 years. Clearly, new innovative therapy is needed, and continued research with recently developed agents is warranted. Modern multimodality therapy may have a role in patients with surgically resectable stage I or II disease, but development of better chemotherapy, bone marrow transplantation, hyperfractionation radiotherapy, and radiosensitizers will be necessary for most SCLC patients. Recently discovered prognostic indicators should help target individual SCLC patients for specific intensive treatments designed to prolong survival and achieve a cure.