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Hauer C, Blomberg R, Sompel K, Magin CM, Tennis MA. Hydrogel-embedded precision-cut lung slices support ex vivo culture of in vivo -induced premalignant lung lesions. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.04.29.591698. [PMID: 38746166 PMCID: PMC11092434 DOI: 10.1101/2024.04.29.591698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Lung cancer is the leading cause of global cancer death and prevention strategies are key to reducing mortality. Medical prevention may have a larger impact than treatment on mortality by targeting high-risk populations and reducing their lung cancer risk. Premalignant lesions (PMLs) that can be intercepted by prevention agents are difficult to study in humans but easily accessible in murine preclinical carcinogenesis studies. Precision-cut lung slices (PCLS) are underutilized as an ex vivo model for lung cancer studies due to limited culture time. Embedding PCLS within bioengineered hydrogels extends PCLS viability and functionality for up to six weeks. Here, we embedded PCLS generated from urethane-induced murine PMLs in cell-degradable and non-degradable hydrogels to study viability and activity of the tissues over six weeks. PMLs in hydrogel-embedded PCLS maintained viability, gene expression, and proliferation. Treatment of hydrogel-embedded PCLS containing urethane-induced PMLs with iloprost, a known lung cancer prevention agent, recapitulated in vivo gene expression and activity. These studies also showed that iloprost reduced proliferation and PML size in hydrogel-embedded PCLS, with some differences based on hydrogel formulation and suggested that hydrogel-embedded PCLS models may support long-term culture of in vivo generated PMLs to improve preclinical studies of lung cancer and prevention agents.
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2
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Blomberg R, Sompel K, Hauer C, Smith AJ, Peña B, Driscoll J, Hume PS, Merrick DT, Tennis MA, Magin CM. Hydrogel-Embedded Precision-Cut Lung Slices Model Lung Cancer Premalignancy Ex Vivo. Adv Healthc Mater 2024; 13:e2302246. [PMID: 37953708 PMCID: PMC10872976 DOI: 10.1002/adhm.202302246] [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: 07/14/2023] [Revised: 10/17/2023] [Indexed: 11/14/2023]
Abstract
Lung cancer is the leading global cause of cancer-related deaths. Although smoking cessation is the best prevention, 50% of lung cancer diagnoses occur in people who have quit smoking. Research into treatment options for high-risk patients is constrained to rodent models, which are time-consuming, expensive, and require large cohorts. Embedding precision-cut lung slices (PCLS) within an engineered hydrogel and exposing this tissue to vinyl carbamate, a carcinogen from cigarette smoke, creates an in vitro model of lung cancer premalignancy. Hydrogel formulations are selected to promote early lung cancer cellular phenotypes and extend PCLS viability to six weeks. Hydrogel-embedded PCLS are exposed to vinyl carbamate, which induces adenocarcinoma in mice. Analysis of proliferation, gene expression, histology, tissue stiffness, and cellular content after six weeks reveals that vinyl carbamate induces premalignant lesions with a mixed adenoma/squamous phenotype. Putative chemoprevention agents diffuse through the hydrogel and induce tissue-level changes. The design parameters selected using murine tissue are validated with hydrogel-embedded human PCLS and results show increased proliferation and premalignant lesion gene expression patterns. This tissue-engineered model of human lung cancer premalignancy is the foundation for more sophisticated ex vivo models that enable the study of carcinogenesis and chemoprevention strategies.
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Affiliation(s)
- Rachel Blomberg
- Department of Bioengineering, University of Colorado, Denver |Anschutz, Aurora, CO, 80045, USA
| | - Kayla Sompel
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Caroline Hauer
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Alex J Smith
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Brisa Peña
- Department of Bioengineering, University of Colorado, Denver |Anschutz, Aurora, CO, 80045, USA
- Cardiovascular Institute & Adult Medical Genetics, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Jennifer Driscoll
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, 80206, USA
| | - Patrick S Hume
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Division of Pulmonary, Critical Care, and Sleep Medicine, Department of Medicine, National Jewish Health, Denver, CO, 80206, USA
| | - Daniel T Merrick
- Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Meredith A Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
| | - Chelsea M Magin
- Department of Bioengineering, University of Colorado, Denver |Anschutz, Aurora, CO, 80045, USA
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Pediatrics, University of Colorado, Anschutz Medical Campus, Aurora, CO, 80045, USA
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Miller YE, Ghosh M, Merrick DT, Kubala B, Szabo E, Bengtson L, Kocherginsky M, Helenowski IB, Benante K, Schering T, Kim J, Kim H, Ha D, Bergan RC, Khan SA, Keith RL. Phase Ib trial of inhaled iloprost for the prevention of lung cancer with predictive and response biomarker assessment. Front Oncol 2023; 13:1204726. [PMID: 37711198 PMCID: PMC10499515 DOI: 10.3389/fonc.2023.1204726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/26/2023] [Indexed: 09/16/2023] Open
Abstract
Introduction Iloprost, a prostacyclin analog, has lung cancerpreventive activity in preclinical models and improved dysplasia in former smokers in a phase IIb trial. Oral iloprost is currently unavailable. We performed a phase Ib trial of inhaled iloprost in former smokers to assess tolerance and compliance. Methods Participants self-administered nebulized iloprost (5ug) or placebo four (QID) or two (BID) times daily. As QID dose was well tolerated and due to expiration of the placebo, the BID dosing and placebo were eliminated early on in the trial. Bronchoscopy with biopsyat six standard sites was performed at treatment initiation and two months post-iloprost, with exploratory histological analysis. Bulk RNA sequencing, single cell RNA sequencing and an in vitro assay of epithelial progenitor cell iloprost response were performed on a subset of biopsies in an exploratory investigation of response mechanisms and predictive biomarkers. Results and discussion Thirty-four of a planned 48 participants were recruited to the trial.Inhaled iloprost was well tolerated with no adverse events > grade 2. Compliance was 67% in the QID group. The trial was not powered to detect histologic response and none was found. Bulk RNA sequencing of biopsies pre/post iloprost suggest that iloprost is immunomodulatory and downregulates cell proliferation pathways. Single cell RNA sequencing showed an increase in CD8-positive T cells with upregulation of genes in interferon γ signaling. In vitro iloprost response by epithelial progenitor cells correlated with histologic response with kappa coefficient of 0.81 (95% CI 0.47, 1.0). Inhaled iloprost was well tolerated with suboptimal compliance. Molecular analysis suggested that iloprosthas immunomodulatory and antiproliferative effects.The progenitor cell iloprost response assay may be a promising avenue to develop predictive biomarkers. Clinical trial registration https://clinicaltrials.gov/study/NCT02237183, identifier NCT02237183.
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Affiliation(s)
- York E. Miller
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO, United States
- Pulmonary and Critical Care Section, RMR VAMC Rocky Mountain Regional Veteran Administration Medical Center, Aurora, CO, United States
| | - Moumita Ghosh
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO, United States
| | - Daniel T. Merrick
- Department of Pathology, University of Colorado, Aurora, CO, United States
| | - Brandi Kubala
- Cancer Center Clinical Trial Core, University of Colorado, Aurora, CO, United States
| | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, United States
| | - Lisa Bengtson
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, United States
| | - Masha Kocherginsky
- Department of Preventative Medicine, Northwestern University, Evanston, IL, United States
| | - Irene B. Helenowski
- Department of Preventative Medicine, Northwestern University, Evanston, IL, United States
| | - Kelly Benante
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Evanston, IL, United States
| | - Tia Schering
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Evanston, IL, United States
| | - Jihye Kim
- Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, United States
| | - Hyunmin Kim
- Department of Genetics and Genome Sciences, Case Western Reserve University, Cleveland, OH, United States
| | - Duc Ha
- Pulmonary and Critical Care Section, RMR VAMC Rocky Mountain Regional Veteran Administration Medical Center, Aurora, CO, United States
| | - Raymond C. Bergan
- Fred and Pamela Buffett Cancer Center, Division of Oncology & Hematology, Genitourinary Oncology, University of Nebraska, Evanston, IL, United States
| | - Seema A. Khan
- Department of Surgery, Northwestern University, Omaha, NE, United States
| | - Robert L. Keith
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Aurora, CO, United States
- Pulmonary and Critical Care Section, RMR VAMC Rocky Mountain Regional Veteran Administration Medical Center, Aurora, CO, United States
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4
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Sompel K, Smith AJ, Hauer C, Elango AP, Clamby ET, Keith RL, Tennis MA. Precision Cut Lung Slices as a Preclinical Model for Non-Small Cell Lung Cancer Chemoprevention. Cancer Prev Res (Phila) 2023; 16:247-258. [PMID: 36888650 PMCID: PMC10159904 DOI: 10.1158/1940-6207.capr-23-0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 02/08/2023] [Accepted: 03/06/2023] [Indexed: 03/09/2023]
Abstract
Lung cancer chemoprevention is critical to addressing cancer burden in high-risk populations. Chemoprevention clinical trials rely on data from preclinical models; however, in vivo studies have high financial, technical, and staffing requirements. Precision cut lung slices (PCLS) provide an ex vivo model that maintains the structure and function of native tissues. This model can be used for mechanistic investigations and drug screenings and reduces the number of animals and time required to test hypotheses compared with in vivo studies. We tested the use of PCLS for chemoprevention studies, demonstrating recapitulation of in vivo models. Treatment of PCLS with the PPARγ agonizing chemoprevention agent iloprost produced similar effects on gene expression and downstream signaling as in vivo models. This occurred in both wild-type tissue and Frizzled 9 knockout tissue, a transmembrane receptor required for iloprost's preventive activity. We explored new areas of iloprost mechanisms by measuring immune and inflammation markers in PCLS tissue and media, and immune cell presence with immunofluorescence. To demonstrate the potential for drug screening, we treated PCLS with additional lung cancer chemoprevention agents and confirmed activity markers in culture. PCLS offers an intermediate step for chemoprevention research between in vitro and in vivo models that can facilitate drug screening prior to in vivo studies and support mechanistic studies with more relevant tissue environments and functions than in vitro models. PREVENTION RELEVANCE PCLS could be a new model for premalignancy and chemoprevention research, and this work evaluates the model with tissue from prevention-relevant genetic and carcinogen exposed in vivo mouse models, in addition to evaluating chemoprevention agents.
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Affiliation(s)
- Kayla Sompel
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Alex J. Smith
- Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX
| | - Caroline Hauer
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Alamelu P. Elango
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Eric T. Clamby
- Department of Anesthesiology, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
| | - Robert L. Keith
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
- Rocky Mountain Regional VA Medical Center, Aurora, CO
| | - Meredith A. Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora CO
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5
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Blomberg R, Sompel K, Hauer C, Pe A B, Driscoll J, Hume PS, Merrick DT, Tennis MA, Magin CM. Tissue-engineered models of lung cancer premalignancy. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.03.15.532835. [PMID: 36993773 PMCID: PMC10055140 DOI: 10.1101/2023.03.15.532835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
Lung cancer is the leading global cause of cancer-related deaths. Although smoking cessation is the best preventive action, nearly 50% of all lung cancer diagnoses occur in people who have already quit smoking. Research into treatment options for these high-risk patients has been constrained to rodent models of chemical carcinogenesis, which are time-consuming, expensive, and require large numbers of animals. Here we show that embedding precision-cut lung slices within an engineered hydrogel and exposing this tissue to a carcinogen from cigarette smoke creates an in vitro model of lung cancer premalignancy. Hydrogel formulations were selected to promote early lung cancer cellular phenotypes and extend PCLS viability up to six weeks. In this study, hydrogel-embedded lung slices were exposed to the cigarette smoke derived carcinogen vinyl carbamate, which induces adenocarcinoma in mice. At six weeks, analysis of proliferation, gene expression, histology, tissue stiffness, and cellular content revealed that vinyl carbamate induced the formation of premalignant lesions with a mixed adenoma/squamous phenotype. Two putative chemoprevention agents were able to freely diffuse through the hydrogel and induce tissue-level changes. The design parameters selected using murine tissue were validated with hydrogel-embedded human PCLS and results showed increased proliferation and premalignant lesion gene expression patterns. This tissue-engineered model of human lung cancer premalignancy is the starting point for more sophisticated ex vivo models and a foundation for the study of carcinogenesis and chemoprevention strategies.
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6
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Sompel K, Dwyer-Nield LD, Smith AJ, Elango AP, Vanderlinden LA, Kopf K, Keith RL, Tennis MA. Loss of Frizzled 9 in Lung Cells Alters Epithelial Phenotype and Promotes Premalignant Lesion Development. Front Oncol 2022; 12:815737. [PMID: 35924166 PMCID: PMC9343062 DOI: 10.3389/fonc.2022.815737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 06/21/2022] [Indexed: 11/23/2022] Open
Abstract
The transmembrane receptor Frizzled 9 (FZD9) is important for fetal neurologic and bone development through both canonical and non-canonical WNT/FZD signaling. In the adult lung, however, Fzd9 helps to maintain a normal epithelium by signaling through peroxisome proliferator activated receptor γ (PPARγ). The effect of FZD9 loss on normal lung epithelial cells and regulators of its expression in the lung are unknown. We knocked down FZD9 in human bronchial epithelial cell (HBEC) lines and found that downstream EMT targets and PPARγ activity are altered. We used a FZD9-/- mouse in the urethane lung adenocarcinoma model and found FZD9-/- adenomas had more proliferation, increased EMT signaling, decreased activation of PPARγ, increased expression of lung cancer associated genes, increased transformed growth, and increased potential for invasive behavior. We identified PPARγ as a transcriptional regulator of FZD9. We also demonstrated that extended cigarette smoke exposure in HBEC leads to decreased FZD9 expression, decreased activation of PPARγ, and increased transformed growth, and found that higher exposure to cigarette smoke in human lungs leads to decreased FZD9 expression. These results provide evidence for the role of FZD9 in lung epithelial maintenance and in smoking related malignant transformation. We identified the first transcriptional regulator of FZD9 in the lung and found FZD9 negative lesions are more dangerous. Loss of FZD9 creates a permissive environment for development of premalignant lung lesions, making it a potential target for intervention.
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Affiliation(s)
- Kayla Sompel
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Lori D Dwyer-Nield
- Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Alex J Smith
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Alamelu P Elango
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Lauren A Vanderlinden
- School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Katrina Kopf
- Office of Academic Affairs, National Jewish Health, Denver, CO, United States
| | - Robert L Keith
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
- Division of Pulmonary Sciences and Critical Care Medicine, Rocky Mountain Regional Medical Center, Aurora, CO, United States
| | - Meredith A Tennis
- School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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7
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Sompel K, Dwyer-Nield LD, Smith AJ, Elango A, Backos DS, Zhang B, Gross J, Ternyak K, Matsuda JL, Kopf K, Keith RL, Tennis MA. Iloprost requires the Frizzled-9 receptor to prevent lung cancer. iScience 2022; 25:104442. [PMID: 35707728 PMCID: PMC9189122 DOI: 10.1016/j.isci.2022.104442] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 04/27/2022] [Accepted: 05/13/2022] [Indexed: 12/31/2022] Open
Abstract
Prevention of premalignant lesion progression is a promising approach to reducing lung cancer burden in high-risk populations. Substantial preclinical and clinical evidence has demonstrated efficacy of the prostacyclin analogue iloprost for lung cancer chemoprevention. Iloprost activates peroxisome proliferator-activated receptor gamma (PPARG) to initiate chemopreventive signaling and in vitro, which requires the transmembrane receptor Frizzled9 (FZD9). We hypothesized a Fzd 9 -/- mouse would not be protected by iloprost in a lung cancer model. Fzd 9 -/- mice were treated with inhaled iloprost in a urethane model of lung adenoma. We found that Fzd 9 -/- mice treated with iloprost were not protected from adenoma development compared to wild-type mice nor did they demonstrate increased activation of iloprost signaling pathways. Our results established that iloprost requires FZD9 in vivo for lung cancer chemoprevention. This work represents a critical advancement in defining iloprost's chemopreventive mechanisms and identifies a potential response marker for future clinical trials.
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Affiliation(s)
- Kayla Sompel
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Lori D. Dwyer-Nield
- Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alex J. Smith
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alamelu Elango
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Don S. Backos
- Skaggs School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | | | | | | | | | - Robert L. Keith
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Rocky Mountain Regional VA Medical Center, Aurora, CO, USA
| | - Meredith A. Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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8
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Keith RL, Miller YE, Ghosh M, Franklin WA, Nakachi I, Merrick DT. Lung cancer: Premalignant biology and medical prevention. Semin Oncol 2022; 49:S0093-7754(22)00013-6. [PMID: 35305831 DOI: 10.1053/j.seminoncol.2022.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 02/08/2022] [Indexed: 11/11/2022]
Abstract
Lung cancer (both adenocarcinoma and squamous cell) progress through a series of pre-malignant histologic changes before the development of invasive disease. Each of these carcinogenic cascades is defined by genetic and epigenetic alterations in pulmonary epithelial cells. Additionally, alterations in the immune response, progenitor cell function, mutational burden, and microenvironmental mediated survival of mutated clones contribute to the risk of pre-malignant lesions progressing to cancer. Medical preventions studies have been completed and current and future trials are informed by the improved understanding of pre-malignancy. This will lead to precision chemoprevention trials based on lesional biology and histologic characteristics.
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Affiliation(s)
- R L Keith
- Division of Pulmonary Sciences and Critical Care Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO.
| | - Y E Miller
- Division of Pulmonary Sciences and Critical Care Medicine, Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO; Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - M Ghosh
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - Wilbur A Franklin
- Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora, CO
| | - I Nakachi
- Department of Pulmonary Medicine, Keio University, Tokyo, Japan
| | - D T Merrick
- Department of Pathology, University of Colorado, Anschutz Medical Campus, Aurora, CO
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9
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miR-520a-5p regulates Frizzled 9 expression and mediates effects of cigarette smoke and iloprost chemoprevention. Sci Rep 2022; 12:2388. [PMID: 35149732 PMCID: PMC8837775 DOI: 10.1038/s41598-022-06292-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 01/20/2022] [Indexed: 12/19/2022] Open
Abstract
Expression of Frizzled 9 (FZD9) is critical to the activity of the lung cancer chemoprevention agent and prostacyclin analogue, iloprost. FZD9 is required in lung epithelial cells for iloprost to activate peroxisome proliferator activated receptor gamma (PPARG) and related anti-tumor signaling. We aimed to investigate which miRNA regulate FZD9 in the context of cigarette smoke exposure and iloprost treatment. We found that miR-520a-5p binds the FZD9 3’UTR in lung cell lines and alters activity and expression of FZD9 downstream targets. Cigarette smoke condensate (CSC) increases expression of miR-520a-5p, while iloprost decreases expression. Cancer promoting effects of a miR-520a-5p mimic were rescued with iloprost treatment, and effects of cigarette smoke were partially rescued with a miR-520a-5p inhibitor. Here we confirm miR-520a-5p as a regulator of FZD9 activity and a mediator of CSC and iloprost effects in the lung. Targeting miR-520a-5p could be an approach to restoring FZD9 expression and improving response to iloprost lung cancer chemoprevention.
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10
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Kassie F, Jian Bagherpoor A, Kovacs K, Seelig D. Combinatory lung tumor inhibition by myo-inositol and iloprost/rapamycin: association with immunomodulation. Carcinogenesis 2022; 43:547-556. [PMID: 35147705 DOI: 10.1093/carcin/bgac019] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 01/06/2022] [Accepted: 02/09/2022] [Indexed: 11/12/2022] Open
Abstract
Although both preclinical and clinical studies have suggested that myo-inositol (MI) may be a safe and effective lung cancer chemopreventive agent, its efficacy is moderate. To test whether the chemopreventive agents iloprost (IL) or rapamycin enhance the lung tumor inhibitory effects of MI, A/J mice were treated with the tobacco smoke carcinogen 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone (NNK) and, beginning one week after the end of NNK treatment, given MI, IL, rapamycin, MI+IL or MI+rapamycin for 17 weeks. Analyses of the number and size of tumors on the surface of the lung have indicated that MI, IL, rapamycin, MI+IL and MI+rapamycin reduced the multiplicity of NNK-induced lung tumors by 41%, 34%, 46%, 79% and 67%, respectively, and larger tumors (lung tumors with a diameter of 1-2 mm or > 2 mm) were absent in the MI+IL and MI+rapamycin groups. These results clearly indicated that MI+IL and MI+rapamycin are more effective than MI alone in inhibiting the formation and growth of lung tumors. Assessment of the immunomodulatory effects of the drugs showed that whereas MI+rapamycin and MI+IL increased the infiltration of lung tumors by CD4 + and CD8 + T cells, MI+rapamycin reduced the expression of the immune checkpoint protein programmed-death ligand-1 (PD-L1). Moreover, all treatments, except IL, increased apoptosis, whereas cell proliferation was markedly suppressed in all treated groups. In summary, these results suggest that IL and rapamycin could enhance the efficacy of MI in lung cancer chemoprevention trials.
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Affiliation(s)
- Fekadu Kassie
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.,College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
| | | | - Katalin Kovacs
- College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
| | - Davis Seelig
- Masonic Cancer Center, University of Minnesota, Minneapolis, MN 55455, USA.,College of Veterinary Medicine, University of Minnesota, Saint Paul, MN 55108, USA
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11
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Tennis MA, Smith AJ, Dwyer-Nield LD, Keith RL. Intranasal iloprost prevents tumors in a murine lung carcinogenesis model. Cancer Prev Res (Phila) 2021; 15:11-16. [PMID: 34556494 DOI: 10.1158/1940-6207.capr-21-0086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 04/12/2021] [Accepted: 09/09/2021] [Indexed: 11/16/2022]
Abstract
Lung cancer chemoprevention with the prostacyclin analogue iloprost is the most promising approach to date for intercepting progression of premalignant lung lesions in former smokers. Previous pre-clinical studies of iloprost used oral delivery, but a study modeling delivery directly to the target organ was needed. In vivo and in vitro studies have identified gene expression changes following iloprost treatment, including increased E-cadherin and PPAR𝛄 and decreased COX2 and Vimentin. We used tumor counts and gene expression to demonstrate the effectiveness of intranasal delivery of iloprost in a murine model of premalignant adenomas. Intranasal delivery of iloprost reduced adenoma multiplicity14 weeks after urethane exposure in FVB mice compared to untreated urethane controls. Intranasal iloprost reversed urethane-induced gene expression changes in tumors and whole lung. These results correspond to previous studies of oral iloprost and in vitro treatment of human bronchial epithelial cells. This study demonstrates that intranasal delivery of iloprost in a mouse model of lung premalignant lesions is effective chemoprevention. This will be an essential tool for exploring mechanisms and outcomes of iloprost chemoprevention, along with supporting ongoing clinical trials of inhaled iloprost chemoprevention.
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Affiliation(s)
- Meredith A Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus
| | - Alex J Smith
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus
| | | | - Robert L Keith
- Medicine/Division of Pulmonary Sciences, Eastern Colorado Veterans Affairs Medical Center
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12
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Sompel K, Elango A, Smith AJ, Tennis MA. Cancer chemoprevention through Frizzled receptors and EMT. Discov Oncol 2021; 12:32. [PMID: 34604862 PMCID: PMC8429367 DOI: 10.1007/s12672-021-00429-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Accepted: 08/31/2021] [Indexed: 12/11/2022] Open
Abstract
Frizzled (FZD) transmembrane receptors are well known for their role in β-catenin signaling and development and now understanding of their role in the context of cancer is growing. FZDs are often associated with the process of epithelial to mesenchymal transition (EMT) through β-catenin, but some also influence EMT through non-canonical pathways. With ten different FZDs, there is a wide range of activity from oncogenic to tumor suppressive depending on the tissue context. Alterations in FZD signaling can occur during development of premalignant lesions, supporting their potential as targets of chemoprevention agents. Agonizing or antagonizing FZD activity may affect EMT, which is a key process in lesion progression often targeted by chemoprevention agents. Recent studies identified a specific FZD as important for activity of an EMT inhibiting chemopreventive agent and other studies have highlighted the previously unrecognized potential for targeting small molecules to FZD receptors. This work demonstrates the value of investigating FZDs in chemoprevention and here we provide a review of FZDs in cancer EMT and their potential as chemoprevention targets.
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Affiliation(s)
- K. Sompel
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E 19th AVE, RC2 Box C272, Aurora, CO 80045 USA
| | - A. Elango
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E 19th AVE, RC2 Box C272, Aurora, CO 80045 USA
| | - A. J. Smith
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E 19th AVE, RC2 Box C272, Aurora, CO 80045 USA
| | - M. A. Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Campus, 12700 E 19th AVE, RC2 Box C272, Aurora, CO 80045 USA
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13
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Li Y, Lin H, Chen L, Chen Z, Li W. Novel Therapies for Tongue Squamous Cell Carcinoma Patients with High-Grade Tumors. Life (Basel) 2021; 11:813. [PMID: 34440557 PMCID: PMC8398384 DOI: 10.3390/life11080813] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/05/2021] [Accepted: 08/07/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Tongue squamous cell carcinoma (TSCC) patients with high-grade tumors usually suffer from high occurrence and poor prognosis. The current study aimed at finding the biomarkers related to tumor grades and proposing potential therapies by these biomarkers. METHODS The mRNA expression matrix of TSCC samples from The Cancer Genome Atlas (TCGA) database was analyzed to identify hub proteins related to tumor grades. The mRNA expression patterns of these hub proteins between TSCC and adjacent control samples were validated in three independent TSCC data sets (i.e., GSE9844, GSE30784, and GSE13601). The correlation between cell cycle index and immunotherapy efficacy was tested on the IMvigor210 data set. Based on the structure of hub proteins, virtual screening was applied to compounds to find the potential inhibitors. RESULTS A total of six cell cycle biomarkers (i.e., BUB1, CCNB2, CDC6, CDC20, CDK1, and MCM2) were selected as hub proteins by protein-protein interaction (PPI) analysis. In the validation data sets, the mRNA expression levels of these hub proteins were higher in tumor samples versus normal controls. The cell cycle index was constructed by the mRNA expression levels of these hub proteins, and patients with a high cell cycle index demonstrated favorable drug response to the immunotherapy. Three small molecules (i.e., ZINC100052685, ZINC8214703, and ZINC85537014) were found to bind with hub proteins and selected as drug candidates. CONCLUSION The cell cycle index might provide a novel reference for selecting appropriate cancer patient candidates for immunotherapy. The current research might contribute to the development of precision medicine and improve the prognosis of TSCC.
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Affiliation(s)
- Yinghua Li
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
| | - Hao Lin
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
| | - Lu Chen
- School of Clinical Medicine, Baotou Medical College, Baotou 014040, China;
| | - Zihao Chen
- Department of Urology, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
| | - Weizhong Li
- Department of Oral and Maxillofacial Surgery, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China;
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14
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Mao JT, Xue B, Fan S, Neis P, Qualls C, Massie L, Fiehn O. Leucoselect Phytosome Modulates Serum Eicosapentaenoic Acid, Docosahexaenoic Acid, and Prostaglandin E3 in a Phase I Lung Cancer Chemoprevention Study. Cancer Prev Res (Phila) 2021; 14:619-626. [PMID: 33707173 DOI: 10.1158/1940-6207.capr-20-0585] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/11/2021] [Accepted: 03/08/2021] [Indexed: 11/16/2022]
Abstract
Grape seed procyanidin extract (GSE) has been shown to exert antineoplastic properties in preclinical studies. Recently, we reported findings from a modified phase I, open-label, dose escalation clinical study conducted to evaluate the safety, tolerability, MTD, and potential chemopreventive effects of leucoselect phytosome, a standardized GSE complexed with soy phospholipids to enhance bioavailability, in heavy active and former smokers. Three months of leucoselect phytosome treatment significantly decreased bronchial Ki-67 labeling index (LI), a marker of cell proliferation on the bronchial epithelium. Because GSE is widely used as a supplement to support cardiovascular health, we evaluate the impact of oral leucoselect phytosome on the fasting serum complex lipid metabolomics profiles in our participants. One month of leucoselect phytosome treatment significantly increased eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA), the omega-3 polyunsaturated fatty acids (n-3 PUFA) with well-established anticancer properties. Leucoselect phytosome also significantly increased unsaturated phosphatidylcholines (PC), likely from soy phospolipids in the phytosome and functioning as transporters for these PUFAs. Furthermore, 3-month leucoselect phytosome treatment significantly increased serum prostaglandin (PG) E3 (PGE3), a metabolite of EPA with anti-inflammatory and antineoplastic properties. Such increases in PGE3 correlated with reductions of bronchial Ki-67 LI (r = -0.9; P = 0.0374). Moreover, posttreatment plasma samples from trial participants significantly inhibited proliferation of human lung cancer cell lines A549 (adenocarcinoma), H520 (squamous cell carcinoma), DMS114 (small cell carcinoma), and 1198 (preneoplastic cell line). Our findings further support the potential utility of leucoselect phytosome in reducing cardiovascular and neoplastic risks in heavy former and active smokers. PREVENTION RELEVANCE: In this correlative study of leucoselect phytosome for lung cancer chemoprevention in heavy active and former smokers, we demonstrate for the first time, favorable modulations of n-3PUFA and downstream PGE3 in fasting serum, further supporting the chemopreventive potential of leucoselect phytosome against lung cancer.
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Affiliation(s)
- Jenny T Mao
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico.
| | - Bingye Xue
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Sili Fan
- UC Davis Genome Center, Davis, California
| | - Patricia Neis
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Clifford Qualls
- Biostatistics, Biomedical Research Institute of New Mexico, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Larry Massie
- Pathology and Clinical Laboratory Services, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
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15
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Schenk EL, Patil T, Pacheco J, Bunn PA. 2020 Innovation-Based Optimism for Lung Cancer Outcomes. Oncologist 2021; 26:e454-e472. [PMID: 33179378 PMCID: PMC7930417 DOI: 10.1002/onco.13590] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 11/05/2020] [Indexed: 12/13/2022] Open
Abstract
Lung cancer is the leading cause of cancer death in both males and females in the U.S. and worldwide. Owing to advances in prevention, screening/early detection, and therapy, lung cancer mortality rates are decreasing and survival rates are increasing. These innovations are based on scientific discoveries in imaging, diagnostics, genomics, molecular therapy, and immunotherapy. Outcomes have improved in all histologies and stages. This review provides information on the clinical implications of these innovations that are practical for the practicing physicians, especially oncologists of all specialities who diagnose and treat patients with lung cancer. IMPLICATIONS FOR PRACTICE: Lung cancer survival rates have improved because of new prevention, screening, and therapy methods. This work provides a review of current standards for each of these areas, including targeted and immunotherapies. Treatment recommendations are provided for all stages of lung cancer.
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Affiliation(s)
- Erin L. Schenk
- Division of Medical Oncology, University of Colorado Cancer CenterAuroraColoradoUSA
| | - Tejas Patil
- Division of Medical Oncology, University of Colorado Cancer CenterAuroraColoradoUSA
| | - Jose Pacheco
- Division of Medical Oncology, University of Colorado Cancer CenterAuroraColoradoUSA
| | - Paul A. Bunn
- Division of Medical Oncology, University of Colorado Cancer CenterAuroraColoradoUSA
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16
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Kalinke L, Thakrar R, Janes SM. The promises and challenges of early non-small cell lung cancer detection: patient perceptions, low-dose CT screening, bronchoscopy and biomarkers. Mol Oncol 2020; 15:2544-2564. [PMID: 33252175 PMCID: PMC8486568 DOI: 10.1002/1878-0261.12864] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 11/04/2020] [Accepted: 11/26/2020] [Indexed: 12/14/2022] Open
Abstract
Lung cancer survival statistics are sobering with survival ranking among the poorest of all cancers despite the addition of targeted therapies and immunotherapies. However, improvements in tools for early detection hold promise. The Nederlands–Leuvens Longkanker Screenings Onderzoek (NELSON) trial recently corroborated the findings from the previous National Lung Screening Trial low‐dose Computerised Tomography (NLST) screening trial in reducing lung cancer mortality. Biomarker research and development is increasing at pace as the molecular life histories of lung cancers become further unravelled. Low‐dose CT screening (LDCT) is effective but targets only those at the highest risk and is burdensome on healthcare. An optimally designed CT screening programme at best will only detect a low proportion of overall lung cancers as only those at very high‐risk meet screening criteria. Biomarkers that help risk stratify suitable patients for LDCT screening, and those that assist in determining which LDCT detected nodules are likely to represent malignant disease are needed. Some biomarkers have been proposed as standalone lung cancer diagnosis tools. Bronchoscopy technology is improving, with better capacity to identify and obtain samples from early lung cancers. Clinicians need to be aware of each early lung cancer detection method’s inherent limitations. We anticipate that the future of early lung cancer diagnosis will involve a synergistic, multimodal approach, combining several early detection methods.
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Affiliation(s)
- Lukas Kalinke
- Lungs for Living Research Centre, University College London, UK
| | - Ricky Thakrar
- Lungs for Living Research Centre, University College London, UK
| | - Sam M Janes
- Lungs for Living Research Centre, University College London, UK
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17
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Johnson AM, Kleczko EK, Nemenoff RA. Eicosanoids in Cancer: New Roles in Immunoregulation. Front Pharmacol 2020; 11:595498. [PMID: 33364964 PMCID: PMC7751756 DOI: 10.3389/fphar.2020.595498] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Accepted: 10/07/2020] [Indexed: 12/16/2022] Open
Abstract
Eicosanoids represent a family of active biolipids derived from arachidonic acid primarily through the action of cytosolic phospholipase A2-α. Three major downstream pathways have been defined: the cyclooxygenase (COX) pathway which produces prostaglandins and thromboxanes; the 5-lipoxygenase pathway (5-LO), which produces leukotrienes, lipoxins and hydroxyeicosatetraenoic acids, and the cytochrome P450 pathway which produces epoxygenated fatty acids. In general, these lipid mediators are released and act in an autocrine or paracrine fashion through binding to cell surface receptors. The pattern of eicosanoid production is cell specific, and is determined by cell-specific expression of downstream synthases. Increased eicosanoid production is associated with inflammation and a panel of specific inhibitors have been developed designated non-steroidal anti-inflammatory drugs. In cancer, eicosanoids are produced both by tumor cells as well as cells of the tumor microenvironment. Earlier studies demonstrated that prostaglandin E2, produced through the action of COX-2, promoted cancer cell proliferation and metastasis in multiple cancers. This resulted in the development of COX-2 inhibitors as potential therapeutic agents. However, cardiac toxicities associated with these agents limited their use as therapeutic agents. The advent of immunotherapy, especially the use of immune checkpoint inhibitors has revolutionized cancer treatment in multiple malignancies. However, the majority of patients do not respond to these agents as monotherapy, leading to intense investigation of other pathways mediating immunosuppression in order to develop rational combination therapies. Recent data have indicated that PGE2 has immunosuppressive activity, leading to renewed interest in targeting this pathway. However, little is known regarding the role of other eicosanoids in modulating the tumor microenvironment, and regulating anti-tumor immunity. This article reviews the role of eicosanoids in cancer, with a focus on their role in modulating the tumor microenvironment. While the role of PGE2 will be discussed, data implicating other eicosanoids, especially products produced through the lipoxygenase and cytochrome P450 pathway will be examined. The existence of small molecular inhibitors and activators of eicosanoid pathways such as specific receptor blockers make them attractive candidates for therapeutic trials, especially in combination with novel immunotherapies such as immune checkpoint inhibitors.
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Affiliation(s)
| | | | - Raphael A. Nemenoff
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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18
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Salehi-Rad R, Li R, Paul MK, Dubinett SM, Liu B. The Biology of Lung Cancer: Development of More Effective Methods for Prevention, Diagnosis, and Treatment. Clin Chest Med 2020; 41:25-38. [PMID: 32008627 DOI: 10.1016/j.ccm.2019.10.003] [Citation(s) in RCA: 44] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Lung cancer is a heterogeneous disease with abundant genomic alterations. Chronic dysregulated airway inflammation facilitates lung tumorigenesis. In contrast, antitumor host immune responses apply continuous selective pressure on the tumor cells during the evolutionary course of the disease. Unprecedented advances in integrative genomic, epigenomic, and cellular profiling of lung cancer and the tumor microenvironment are enhancing the understanding of pulmonary tumorigenesis. This understanding in turn has led to advancements in lung cancer prevention and early detection strategies, and the development of effective targeted therapies and immunotherapies with survival benefit in selected patients.
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Affiliation(s)
- Ramin Salehi-Rad
- Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-22 CHS, Los Angeles, CA 90095-1690, USA; Department of Medicine, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
| | - Rui Li
- Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-22 CHS, Los Angeles, CA 90095-1690, USA
| | - Manash K Paul
- Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-22 CHS, Los Angeles, CA 90095-1690, USA
| | - Steven M Dubinett
- Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-22 CHS, Los Angeles, CA 90095-1690, USA; Department of Medicine, VA Greater Los Angeles Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, 757 Westwood Plaza, Los Angeles, CA 90095, USA; Jonsson Comprehensive Cancer Center, University of California Los Angeles, 8-684 Factor Building, Box 951781, Los Angeles, CA 90095-1781, USA; Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, 650 Charles E Young Dr S, 23-120 CHS, Los Angeles, CA 90095, USA.
| | - Bin Liu
- Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, 43-22 CHS, Los Angeles, CA 90095-1690, USA.
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19
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Dwyer-Nield LD, McArthur DG, Tennis MA, Merrick DT, Keith RL. An Improved Murine Premalignant Squamous Cell Model: Tobacco Smoke Exposure Augments NTCU-Induced Murine Airway Dysplasia. Cancer Prev Res (Phila) 2020; 14:307-312. [PMID: 33115782 DOI: 10.1158/1940-6207.capr-20-0332] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/25/2020] [Accepted: 10/22/2020] [Indexed: 12/31/2022]
Abstract
Tobacco smoke-induced squamous cell lung cancer (SCC) develops from endobronchial dysplastic lesions that progress to invasive disease. A reproducible murine model recapitulating histologic progression observed in current and former smokers will advance testing of new preventive and therapeutic strategies. Previous studies show that prolonged topical application of N-nitroso-tris-chloroethylurea (NTCU) generates a range of airway lesions in sensitive mice similar to those induced by chronic tobacco smoke exposure in humans. To improve the current NTCU model and better align it with human disease, NTCU was applied to mice twice weekly for 4-5 weeks followed by a recovery period before cigarette smoke (CS) or ambient air (control) exposure for an additional 3-6 weeks. Despite the short time course, the addition of CS led to significantly more premalignant lesions (PML; 2.6 vs. 0.5; P < 0.02) and resulted in fewer alveolar macrophages (52,000 macrophages/mL BALF vs. 68,000; P < 0.05) compared with control mice. This improved NTCU + CS model is the first murine SCC model to incorporate tobacco smoke and is more amenable to preclinical studies because of the increased number of PML, decreased number of mice required, and reduced time needed for PML development.
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Affiliation(s)
- Lori D Dwyer-Nield
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Debbie G McArthur
- Research Division, Rocky Mountain Regional Veterans Administration Medical Center, Aurora, Colorado
| | - Meredith A Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Daniel T Merrick
- Division of Pathology, School of Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
| | - Robert L Keith
- Research Division, Rocky Mountain Regional Veterans Administration Medical Center, Aurora, Colorado. .,Division of Pulmonary Sciences and Critical Care Medicine, School of Medicine, University of Colorado Anschutz Medical Center, Aurora, Colorado
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20
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Njatcha C, Farooqui M, Almotlak AA, Siegfried JM. Prevention of Tobacco Carcinogen-Induced Lung Tumor Development by a Novel STAT3 Decoy Inhibitor. Cancer Prev Res (Phila) 2020; 13:735-746. [PMID: 32655003 PMCID: PMC7485626 DOI: 10.1158/1940-6207.capr-20-0033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 05/01/2020] [Accepted: 07/01/2020] [Indexed: 12/17/2022]
Abstract
The STAT3 pathway is frequently overactive in non-small cell lung cancer (NSCLC), an often fatal disease with known risk factors including tobacco and chemical exposures. Whether STAT3 can be downmodulated to delay or prevent development of lung cancer resulting from an environmental exposure has not been previously tested. A circular oligonucleotide STAT3 decoy (CS3D) was used to treat mice previously exposed to the tobacco carcinogen nitrosamine 4-(methylnitrosamino)-1-(3-pyridyl)-1-butanone. CS3D contains a double-stranded STAT3 DNA response element sequence and interrupts STAT3 signaling by binding to STAT3 dimers, rendering them unable to initiate transcription at native STAT3 DNA binding sites. An intermittent course of CS3D decreased the development of airway preneoplasias by 42% at 1 week posttreatment, reduced the progression of preneoplasia to adenomas by 54% at 8 weeks posttreatment, and reduced the size and number of resulting lung tumors by 49.7% and 29.5%, respectively, at 20 weeks posttreatment. No toxicity was detected. A mutant cyclic oligonucleotide with no STAT3 binding ability was used as a control. Chemopreventive effects were independent of the KRAS mutational status of the tumors. In lungs harvested during and after the treatment course with CS3D, airway preneoplasias had reduced STAT3 signaling. Chemopreventive effects were accompanied by decreased VEGFA expression, ablated IL6, COX-2, and p-NF-κB, and decreased pulmonary M2 macrophages and myeloid-derived suppressor cells. Thus, downmodulation of STAT3 activity using a decoy molecule both reduced oncogenic signaling in the airway epithelium and favored a lung microenvironment with reduced immunosuppression.
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Affiliation(s)
- Christian Njatcha
- Department of Pharmacology, Medical School, and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Mariya Farooqui
- Department of Pharmacology, Medical School, and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
| | - Abdulaziz A Almotlak
- Department of Pharmacology, Medical School, and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota
- Department of Pharmacology, College of Clinical Pharmacy, Imam Abdulrahman Bin Faisal University, Saudi Arabia
| | - Jill M Siegfried
- Department of Pharmacology, Medical School, and Masonic Cancer Center, University of Minnesota, Minneapolis, Minnesota.
- Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, Pennsylvania
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21
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Vishnoi K, Viswakarma N, Rana A, Rana B. Transcription Factors in Cancer Development and Therapy. Cancers (Basel) 2020. [PMID: 32824207 DOI: 10.339/cancers12082296] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cancer is a multi-step process and requires constitutive expression/activation of transcription factors (TFs) for growth and survival. Many of the TFs reported so far are critical for carcinogenesis. These include pro-inflammatory TFs, hypoxia-inducible factors (HIFs), cell proliferation and epithelial-mesenchymal transition (EMT)-controlling TFs, pluripotency TFs upregulated in cancer stem-like cells, and the nuclear receptors (NRs). Some of those, including HIFs, Myc, ETS-1, and β-catenin, are multifunctional and may regulate multiple other TFs involved in various pro-oncogenic events, including proliferation, survival, metabolism, invasion, and metastasis. High expression of some TFs is also correlated with poor prognosis and chemoresistance, constituting a significant challenge in cancer treatment. Considering the pivotal role of TFs in cancer, there is an urgent need to develop strategies targeting them. Targeting TFs, in combination with other chemotherapeutics, could emerge as a better strategy to target cancer. So far, targeting NRs have shown promising results in improving survival. In this review, we provide a comprehensive overview of the TFs that play a central role in cancer progression, which could be potential therapeutic candidates for developing specific inhibitors. Here, we also discuss the efforts made to target some of those TFs, including NRs.
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Affiliation(s)
- Kanchan Vishnoi
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Navin Viswakarma
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA
| | - Ajay Rana
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA.,University of Illinois Hospital and Health Sciences System Cancer Center, University of Illinois at Chicago, Chicago, IL 60612, USA.,Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Basabi Rana
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA.,University of Illinois Hospital and Health Sciences System Cancer Center, University of Illinois at Chicago, Chicago, IL 60612, USA.,Jesse Brown VA Medical Center, Chicago, IL 60612, USA
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22
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Vishnoi K, Viswakarma N, Rana A, Rana B. Transcription Factors in Cancer Development and Therapy. Cancers (Basel) 2020; 12:cancers12082296. [PMID: 32824207 PMCID: PMC7464564 DOI: 10.3390/cancers12082296] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/04/2020] [Accepted: 08/12/2020] [Indexed: 12/12/2022] Open
Abstract
Cancer is a multi-step process and requires constitutive expression/activation of transcription factors (TFs) for growth and survival. Many of the TFs reported so far are critical for carcinogenesis. These include pro-inflammatory TFs, hypoxia-inducible factors (HIFs), cell proliferation and epithelial-mesenchymal transition (EMT)-controlling TFs, pluripotency TFs upregulated in cancer stem-like cells, and the nuclear receptors (NRs). Some of those, including HIFs, Myc, ETS-1, and β-catenin, are multifunctional and may regulate multiple other TFs involved in various pro-oncogenic events, including proliferation, survival, metabolism, invasion, and metastasis. High expression of some TFs is also correlated with poor prognosis and chemoresistance, constituting a significant challenge in cancer treatment. Considering the pivotal role of TFs in cancer, there is an urgent need to develop strategies targeting them. Targeting TFs, in combination with other chemotherapeutics, could emerge as a better strategy to target cancer. So far, targeting NRs have shown promising results in improving survival. In this review, we provide a comprehensive overview of the TFs that play a central role in cancer progression, which could be potential therapeutic candidates for developing specific inhibitors. Here, we also discuss the efforts made to target some of those TFs, including NRs.
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Affiliation(s)
- Kanchan Vishnoi
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA; (K.V.); (N.V.); (A.R.)
| | - Navin Viswakarma
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA; (K.V.); (N.V.); (A.R.)
| | - Ajay Rana
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA; (K.V.); (N.V.); (A.R.)
- University of Illinois Hospital and Health Sciences System Cancer Center, University of Illinois at Chicago, Chicago, IL 60612, USA
- Jesse Brown VA Medical Center, Chicago, IL 60612, USA
| | - Basabi Rana
- Department of Surgery, Division of Surgical Oncology, University of Illinois at Chicago, Chicago, IL 60612, USA; (K.V.); (N.V.); (A.R.)
- University of Illinois Hospital and Health Sciences System Cancer Center, University of Illinois at Chicago, Chicago, IL 60612, USA
- Jesse Brown VA Medical Center, Chicago, IL 60612, USA
- Correspondence:
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23
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Ashraf-Uz-Zaman M, Bhalerao A, Mikelis CM, Cucullo L, German NA. Assessing the Current State of Lung Cancer Chemoprevention: A Comprehensive Overview. Cancers (Basel) 2020; 12:E1265. [PMID: 32429547 PMCID: PMC7281533 DOI: 10.3390/cancers12051265] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/06/2020] [Accepted: 05/14/2020] [Indexed: 12/14/2022] Open
Abstract
Chemoprevention of lung cancer is thought to significantly reduce the risk of acquiring these conditions in the subpopulation of patients with underlying health issues, such as chronic obstructive pulmonary disorder and smoking-associated lung problems. Many strategies have been tested in the previous decades, with very few translating to successful clinical trials in specific subpopulations of patients. In this review, we analyze these strategies, as well as new approaches that have emerged throughout the last few years, including synthetic lethality concept and microbiome-induced regulation of lung carcinogenesis. Overall, the continuous effort in the area of lung chemoprevention is required to develop practical therapeutical approaches. Given the inconsistency of results obtained in clinical trials targeting lung cancer chemoprevention in various subgroups of patients that differ in the underlying health condition, race, and gender, we believe that individualized approaches will have more promise than generalized treatments.
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Affiliation(s)
- Md Ashraf-Uz-Zaman
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA; (M.A.-U.-Z.); (A.B.); (C.M.M.); (L.C.)
| | - Aditya Bhalerao
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA; (M.A.-U.-Z.); (A.B.); (C.M.M.); (L.C.)
| | - Constantinos M. Mikelis
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA; (M.A.-U.-Z.); (A.B.); (C.M.M.); (L.C.)
- Center for Blood-Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA
| | - Luca Cucullo
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA; (M.A.-U.-Z.); (A.B.); (C.M.M.); (L.C.)
- Center for Blood-Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA
| | - Nadezhda A. German
- Department of Pharmaceutical Sciences, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA; (M.A.-U.-Z.); (A.B.); (C.M.M.); (L.C.)
- Center for Blood-Brain Barrier Research, Texas Tech University Health Sciences Center, Amarillo, TX 79106, USA
- Center of Excellence for Translational Neuroscience and Therapeutics, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
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24
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Chang CM, Cheng YC, Cho TM, Mishina EV, Del Valle-Pinero AY, van Bemmel DM, Hatsukami DK. Biomarkers of Potential Harm: Summary of an FDA-Sponsored Public Workshop. Nicotine Tob Res 2020; 21:3-13. [PMID: 29253243 DOI: 10.1093/ntr/ntx273] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/12/2017] [Indexed: 12/11/2022]
Abstract
Introduction Since 2009, the United States (US) Food and Drug Administration (FDA) Center for Tobacco Products (CTP) has had the authority to regulate the manufacture, distribution, and marketing of tobacco products in order to reduce the death and disease caused by tobacco use. Biomarkers could play an important role across a number of FDA regulatory activities, including assessing new and modified risk tobacco products and identifying and evaluating potential product standards. Methods On April 4-5, 2016, FDA/CTP hosted a public workshop focused on biomarkers of potential harm (BOPH) with participants from government, industry, academia, and other organizations. The workshop was divided into five sessions focused on: (1) overview of BOPH; (2) cardiovascular disease (CVD); (3) chronic obstructive pulmonary disease (COPD); (4) cancer; and (5) new areas of research. Results and Conclusions The deliberations from the workshop noted some promising BOPH but also highlighted the lack of systematic effort to identify BOPH that would have utility and validity for evaluating tobacco products. Research areas that could further strengthen the applicability of BOPH to tobacco regulatory science include the exploration of composite biomarkers as predictors of disease risk, "omics" biomarkers, and examining biomarkers using existing cohorts, surveys, and experimental studies. Implications This paper synthesizes the main findings from the 2016 FDA-sponsored workshop focused on BOPH and highlights research areas that could further strengthen the science around BOPH and their applicability to tobacco regulatory science.
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Affiliation(s)
- Cindy M Chang
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Yu-Ching Cheng
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Taehyeon M Cho
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Elena V Mishina
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | | | - Dana M van Bemmel
- Office of Science, Center for Tobacco Products, Food and Drug Administration, Silver Spring, MD
| | - Dorothy K Hatsukami
- Department of Psychiatry, Tobacco Research Programs, University of Minnesota, Minneapolis, MN
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25
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Prevention and Early Detection for NSCLC: Advances in Thoracic Oncology 2018. J Thorac Oncol 2019; 14:1513-1527. [DOI: 10.1016/j.jtho.2019.06.011] [Citation(s) in RCA: 55] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Revised: 05/24/2019] [Accepted: 06/07/2019] [Indexed: 02/06/2023]
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26
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Mao JT, Lu QY, Xue B, Neis P, Zamora FD, Lundmark L, Qualls C, Massie L. A Pilot Study of a Grape Seed Procyanidin Extract for Lung Cancer Chemoprevention. Cancer Prev Res (Phila) 2019; 12:557-566. [PMID: 31138523 PMCID: PMC7990077 DOI: 10.1158/1940-6207.capr-19-0053] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 04/19/2019] [Accepted: 05/21/2019] [Indexed: 12/25/2022]
Abstract
Grape seed procyanidin extract (GSE) had been reported to exert antineoplastic properties in preclinical studies. A modified phase I, open-label, dose-escalation clinical study was conducted to evaluate the safety, tolerability, MTD, and potential chemopreventive effects of leucoselect phytosome (LP), a standardized GSE complexed with soy phospholipids to enhance bioavailability, in heavy active and former smokers. Eight subjects ages 46-68 years were enrolled into the study and treated with escalating oral doses of LP for 3 months. Bronchoscopies with bronchoalveolar lavage and bronchial biopsies were performed before and after 3 months of LP treatment. Hematoxylin and eosin stain for histopathology grading and IHC examination for Ki-67 proliferative labeling index (Ki-67 LI) were carried out on serially matched bronchial biopsy samples from each subject to determine responses to treatment. Two subjects were withdrawn due to issues unrelated to the study medication, and a total of 6 subjects completed the full study course. In general, 3 months of LP, reaching the highest dose per study protocol was well tolerated and no dosing adjustment was necessary. Such a treatment regimen significantly decreased bronchial Ki-67 LI by an average of 55% (P = 0.041), with concomitant decreases in serum miR-19a, -19b, and -106b, which were oncomirs previously reported to be downregulated by GSE, including LP, in preclinical studies. In spite of not reaching the original enrollment goal of 20, our findings nonetheless support the continued clinical translation of GSE as an antineoplastic and chemopreventive agent against lung cancer.
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Affiliation(s)
- Jenny T Mao
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico.
| | - Qing-Yi Lu
- UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Bingye Xue
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Patricia Neis
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Felix D Zamora
- Pulmonary, Critical Care and Sleep Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Laurie Lundmark
- Pathology and Clinical Laboratory Services, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Clifford Qualls
- Biostatistics, Biomedical Research Institute of New Mexico, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Larry Massie
- Pathology and Clinical Laboratory Services, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
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27
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Keith RL, Blatchford PJ, Merrick DT, Bunn PA, Bagwell B, Dwyer-Nield LD, Jackson MK, Geraci MW, Miller YE. A Randomized Phase II Trial of Pioglitazone for Lung Cancer Chemoprevention in High-Risk Current and Former Smokers. Cancer Prev Res (Phila) 2019; 12:721-730. [PMID: 31308004 DOI: 10.1158/1940-6207.capr-19-0006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/01/2019] [Accepted: 07/08/2019] [Indexed: 02/06/2023]
Abstract
Lung cancer chemoprevention, especially in high-risk former smokers, has great potential to reduce lung cancer incidence and mortality. Thiazolidinediones prevent lung cancer in preclinical studies, and diabetics receiving thiazolidinediones have lower lung cancer rates which led to our double-blind, randomized, phase II placebo-controlled trial of oral pioglitazone in high-risk current or former smokers with sputum cytologic atypia or known endobronchial dysplasia. Bronchoscopy was performed at study entry and after completing 6 months of treatment. Biopsies were histologically scored, and primary endpoint analysis tested worst biopsy scores (Max) between groups; Dysplasia index (DI) and average score (Avg) changes were secondary endpoints. Biopsies also received an inflammation score. The trial accrued 92 subjects (47 pioglitazone, 45 placebo), and 76 completed both bronchoscopies (39 pioglitazone, 37 placebo). Baseline dysplasia was significantly worse for current smokers, and 64% of subjects had mild or greater dysplasia at study entry. Subjects receiving pioglitazone did not exhibit improvement in bronchial dysplasia. Former smokers treated with pioglitazone exhibited a slight improvement in Max, while current smokers exhibited slight worsening. While statistically significant changes in Avg and DI were not observed in the treatment group, former smokers exhibited a slight decrease in both Avg and DI. Negligible Avg and DI changes occurred in current smokers. A trend toward decreased Ki-67 labeling index occurred in former smokers with baseline dysplasia receiving pioglitazone. While pioglitazone did not improve endobronchial histology in this high-risk cohort, specific lesions showed histologic improvement, and further study is needed to better characterize responsive dysplasia.
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Affiliation(s)
- Robert L Keith
- Division of Pulmonary Sciences and Critical Care Medicine, Eastern Colorado VA Healthcare System, Rocky Mountain Regional VA Medical Center, Aurora, Colorado. .,Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Patrick J Blatchford
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Daniel T Merrick
- Division of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Paul A Bunn
- Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Brandi Bagwell
- Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lori D Dwyer-Nield
- Department of Pharmaceutical Sciences, Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mary K Jackson
- Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mark W Geraci
- Department of Medicine, IU School of Medicine, Indianapolis, Indiana
| | - York E Miller
- Division of Pulmonary Sciences and Critical Care Medicine, Eastern Colorado VA Healthcare System, Rocky Mountain Regional VA Medical Center, Aurora, Colorado.,Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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28
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Premalignant lesions of squamous cell carcinoma of the lung: The molecular make-up and factors affecting their progression. Lung Cancer 2019; 135:21-28. [PMID: 31446997 DOI: 10.1016/j.lungcan.2019.07.001] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 06/23/2019] [Accepted: 07/01/2019] [Indexed: 01/06/2023]
Abstract
Squamous cell carcinoma (SCC), one of the most common forms of lung cancer, shows accelerated progression and aggressive growth and usually is observed at advanced stages. SCC originates from morphological changes in the bronchial epithelium that occur during chronic inflammation: basal cell hyperplasia, squamous metaplasia, and dysplasia I-III. However, the process is not inevitable; it can be stopped at any stage, remain in the stable state indefinitely and either progress or regress. The reasons and mechanisms of different scenarios of the evolution of premalignant lesions in the respiratory epithelium are not fully understood. In this review, we summarized the literature data (including our own data) regarding genetic, epigenetic, transcriptomic and proteomic profiles of the premalignant lesions and highlighted factors (environmental causes, inflammation, and gene polymorphism) that may govern their progression or regression. In conclusion, we reviewed strategies for lung cancer prevention and proposed new models and research directions for studying premalignant lesions and developing new tools to predict the risk of their malignant transformation.
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29
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Kleczko EK, Kwak JW, Schenk EL, Nemenoff RA. Targeting the Complement Pathway as a Therapeutic Strategy in Lung Cancer. Front Immunol 2019; 10:954. [PMID: 31134065 PMCID: PMC6522855 DOI: 10.3389/fimmu.2019.00954] [Citation(s) in RCA: 73] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/15/2019] [Indexed: 12/20/2022] Open
Abstract
Lung cancer is the leading cause of cancer death in men and women. Lung adenocarcinoma (LUAD), represents approximately 40% of all lung cancer cases. Advances in recent years, such as the identification of oncogenes and the use of immunotherapies, have changed the treatment of LUAD. Yet survival rates still remain low. Additionally, there is still a gap in understanding the molecular and cellular interactions between cancer cells and the immune tumor microenvironment (TME). Defining how cancer cells with distinct oncogenic drivers interact with the TME and new strategies for enhancing anti-tumor immunity are greatly needed. The complement cascade, a central part of the innate immune system, plays an important role in regulation of adaptive immunity. Initially it was proposed that complement activation on the surface of cancer cells would inhibit cancer progression via membrane attack complex (MAC)-dependent killing. However, data from several groups have shown that complement activation promotes cancer progression, probably through the actions of anaphylatoxins (C3a and C5a) on the TME and engagement of immunoevasive pathways. While originally shown to be produced in the liver, recent studies show localized complement production in numerous cell types including immune cells and tumor cells. These results suggest that complement inhibitory drugs may represent a powerful new approach for treatment of NSCLC, and numerous new anti-complement drugs are in clinical development. However, the mechanisms by which complement is activated and affects tumor progression are not well understood. Furthermore, the role of local complement production vs. systemic activation has not been carefully examined. This review will focus on our current understanding of complement action in LUAD, and describe gaps in our knowledge critical for advancing complement therapy into the clinic.
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Affiliation(s)
- Emily K Kleczko
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Jeff W Kwak
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Erin L Schenk
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Raphael A Nemenoff
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
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30
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Beane JE, Mazzilli SA, Campbell JD, Duclos G, Krysan K, Moy C, Perdomo C, Schaffer M, Liu G, Zhang S, Liu H, Vick J, Dhillon SS, Platero SJ, Dubinett SM, Stevenson C, Reid ME, Lenburg ME, Spira AE. Molecular subtyping reveals immune alterations associated with progression of bronchial premalignant lesions. Nat Commun 2019; 10:1856. [PMID: 31015447 PMCID: PMC6478943 DOI: 10.1038/s41467-019-09834-2] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Accepted: 03/28/2019] [Indexed: 12/13/2022] Open
Abstract
Bronchial premalignant lesions (PMLs) are precursors of lung squamous cell carcinoma, but have variable outcome, and we lack tools to identify and treat PMLs at risk for progression to cancer. Here we report the identification of four molecular subtypes of PMLs with distinct differences in epithelial and immune processes based on RNA-Seq profiling of endobronchial biopsies from high-risk smokers. The Proliferative subtype is enriched with bronchial dysplasia and exhibits up-regulation of metabolic and cell cycle pathways. A Proliferative subtype-associated gene signature identifies subjects with Proliferative PMLs from normal-appearing uninvolved large airway brushings with high specificity. In progressive/persistent Proliferative lesions expression of interferon signaling and antigen processing/presentation pathways decrease and immunofluorescence indicates a depletion of innate and adaptive immune cells compared with regressive lesions. Molecular biomarkers measured in PMLs or the uninvolved airway can enhance histopathological grading and suggest immunoprevention strategies for intercepting the progression of PMLs to lung cancer.
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MESH Headings
- Antineoplastic Agents, Immunological/pharmacology
- Antineoplastic Agents, Immunological/therapeutic use
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Biopsy
- Bronchi/diagnostic imaging
- Bronchi/immunology
- Bronchi/pathology
- Bronchoscopy
- Carcinoma, Bronchogenic/genetics
- Carcinoma, Bronchogenic/immunology
- Carcinoma, Bronchogenic/pathology
- Carcinoma, Bronchogenic/prevention & control
- Cohort Studies
- Datasets as Topic
- Disease Progression
- Early Detection of Cancer/methods
- Gene Expression Profiling
- Gene Expression Regulation, Neoplastic/immunology
- Gene Regulatory Networks/genetics
- Gene Regulatory Networks/immunology
- Humans
- Immunity, Cellular/drug effects
- Immunity, Cellular/genetics
- Lung Neoplasms/genetics
- Lung Neoplasms/immunology
- Lung Neoplasms/pathology
- Lung Neoplasms/prevention & control
- Mass Screening/methods
- Middle Aged
- Precancerous Conditions/diagnostic imaging
- Precancerous Conditions/genetics
- Precancerous Conditions/immunology
- Precancerous Conditions/pathology
- RNA, Messenger/genetics
- Respiratory Mucosa/cytology
- Respiratory Mucosa/diagnostic imaging
- Respiratory Mucosa/immunology
- Respiratory Mucosa/pathology
- Sequence Analysis, RNA
- T-Lymphocytes/immunology
- Tomography, X-Ray Computed
- Up-Regulation
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Affiliation(s)
| | | | | | - Grant Duclos
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Kostyantyn Krysan
- David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | | | | | | | - Gang Liu
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Sherry Zhang
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Hanqiao Liu
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Jessica Vick
- Boston University School of Medicine, Boston, MA, 02118, USA
| | | | | | - Steven M Dubinett
- David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA
| | | | - Mary E Reid
- Roswell Park Comprehensive Cancer Center, Buffalo, NY, 14203, USA
| | - Marc E Lenburg
- Boston University School of Medicine, Boston, MA, 02118, USA
| | - Avrum E Spira
- Boston University School of Medicine, Boston, MA, 02118, USA
- Johnson and Johnson Innovation, Cambridge, MA, 02142, USA
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31
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New ML, White CM, McGonigle P, McArthur DG, Dwyer-Nield LD, Merrick DT, Keith RL, Tennis MA. Prostacyclin and EMT Pathway Markers for Monitoring Response to Lung Cancer Chemoprevention. Cancer Prev Res (Phila) 2018; 11:643-654. [PMID: 30045935 PMCID: PMC6170683 DOI: 10.1158/1940-6207.capr-18-0052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/02/2018] [Accepted: 07/16/2018] [Indexed: 12/17/2022]
Abstract
Lung cancer is the leading cause of cancer death worldwide and global burden could be reduced through targeted application of chemoprevention. The development of squamous lung carcinoma has been linked with persistent, high-grade bronchial dysplasia. Bronchial histology improved in former smokers in a chemoprevention trial with the prostacyclin analogue iloprost. Prostacyclin acts through peroxisome proliferator-activated receptor gamma (PPARγ) to reverse epithelial to mesenchymal transition and promote anticancer signaling. We hypothesized that the prostacyclin signaling pathway and EMT could provide response markers for prostacyclin chemoprevention of lung cancer. Human bronchial epithelial cells were treated with cigarette smoke condensate (CSC) or iloprost for 2 weeks, CSC for 16 weeks, or CSC for 4 weeks followed by 4 weeks of CSC and/or iloprost, and RNA was extracted. Wild-type or prostacyclin synthase transgenic mice were exposed to 1 week of cigarette smoke or one injection of urethane, and RNA was extracted from the lungs. We measured potential markers of prostacyclin and iloprost efficacy in these models. We identified a panel of markers altered by tobacco carcinogens and inversely affected by prostacyclin, including PPARγ, 15PGDH, CES1, COX-2, ECADHERIN, SNAIL, VIMENTIN, CRB3, MIR34c, and MIR221 These data introduce a panel of potential markers for monitoring interception of bronchial dysplasia progression during chemoprevention with prostacyclin. Chemoprevention is a promising approach to reduce lung cancer mortality in a high-risk population. Identifying markers for targeted use is critical for success in future clinical trials of prostacyclin for lung cancer chemoprevention. Cancer Prev Res; 11(10); 643-54. ©2018 AACR.
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Affiliation(s)
- Melissa L New
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Collin M White
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Polly McGonigle
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | | | - Lori D Dwyer-Nield
- Department of Pharmaceutical Sciences, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Daniel T Merrick
- Department of Pathology, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
| | - Robert L Keith
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado
- Eastern Colorado Veterans Affairs Medical Center, Aurora, Colorado
| | - Meredith A Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, Colorado.
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32
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Merrick DT, Edwards MG, Franklin WA, Sugita M, Keith RL, Miller YE, Friedman MB, Dwyer-Nield LD, Tennis MA, O'Keefe MC, Donald EJ, Malloy JM, van Bokhoven A, Wilson S, Koch PJ, O'Shea C, Coldren C, Orlicky DJ, Lu X, Baron AE, Hickey G, Kennedy TC, Powell R, Heasley L, Bunn PA, Geraci M, Nemenoff RA. Altered Cell-Cycle Control, Inflammation, and Adhesion in High-Risk Persistent Bronchial Dysplasia. Cancer Res 2018; 78:4971-4983. [PMID: 29997230 PMCID: PMC6147150 DOI: 10.1158/0008-5472.can-17-3822] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Revised: 05/16/2018] [Accepted: 07/06/2018] [Indexed: 01/01/2023]
Abstract
Persistent bronchial dysplasia is associated with increased risk of developing invasive squamous cell carcinoma (SCC) of the lung. In this study, we hypothesized that differences in gene expression profiles between persistent and regressive bronchial dysplasia would identify cellular processes that underlie progression to SCC. RNA expression arrays comparing baseline biopsies from 32 bronchial sites that persisted/progressed to 31 regressive sites showed 395 differentially expressed genes [ANOVA, FDR ≤ 0.05). Thirty-one pathways showed significantly altered activity between the two groups, many of which were associated with cell-cycle control and proliferation, inflammation, or epithelial differentiation/cell-cell adhesion. Cultured persistent bronchial dysplasia cells exhibited increased expression of Polo-like kinase 1 (PLK1), which was associated with multiple cell-cycle pathways. Treatment with PLK1 inhibitor induced apoptosis and G2-M arrest and decreased proliferation compared with untreated cells; these effects were not seen in normal or regressive bronchial dysplasia cultures. Inflammatory pathway activity was decreased in persistent bronchial dysplasia, and the presence of an inflammatory infiltrate was more common in regressive bronchial dysplasia. Regressive bronchial dysplasia was also associated with trends toward overall increases in macrophages and T lymphocytes and altered polarization of these inflammatory cell subsets. Increased desmoglein 3 and plakoglobin expression was associated with higher grade and persistence of bronchial dysplasia. These results identify alterations in the persistent subset of bronchial dysplasia that are associated with high risk for progression to invasive SCC. These alterations may serve as strong markers of risk and as effective targets for lung cancer prevention.Significance: Gene expression profiling of high-risk persistent bronchial dysplasia reveals changes in cell-cycle control, inflammatory activity, and epithelial differentiation/cell-cell adhesion that may underlie progression to invasive SCC. Cancer Res; 78(17); 4971-83. ©2018 AACR.
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Affiliation(s)
- Daniel T Merrick
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
| | - Michael G Edwards
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Wilbur A Franklin
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Michio Sugita
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Robert L Keith
- Department of Medicine/Division of Pulmonary Medicine, Denver Veterans Affairs Medical Center, Aurora, Colorado
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - York E Miller
- Department of Medicine/Division of Pulmonary Medicine, Denver Veterans Affairs Medical Center, Aurora, Colorado
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Micah B Friedman
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lori D Dwyer-Nield
- Department of Medicine/Division of Pulmonary Medicine, Denver Veterans Affairs Medical Center, Aurora, Colorado
- School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Meredith A Tennis
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mary C O'Keefe
- Department of Pathology, Denver Health Medical Center, Denver, Colorado
| | - Elizabeth J Donald
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Jessica M Malloy
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Adrie van Bokhoven
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Storey Wilson
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Peter J Koch
- Department of Regenerative Medicine and Stem Cell Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Charlene O'Shea
- Department of Regenerative Medicine and Stem Cell Research, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - David J Orlicky
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Xian Lu
- Department of Biostatistics and Informatics, Colorado School of Public Health, Denver, Colorado
| | - Anna E Baron
- Department of Biostatistics and Informatics, Colorado School of Public Health, Denver, Colorado
| | - Greg Hickey
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Timothy C Kennedy
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Roger Powell
- School of Pharmacy, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lynn Heasley
- Department of Craniofacial Biology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Paul A Bunn
- Department of Medicine/Division of Medical Oncology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Mark Geraci
- Department of Medicine, Indiana University, Bloomington, Indiana
| | - Raphael A Nemenoff
- Department of Medicine/Division of Pulmonary Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
- Department of Medicine, Division of Renal Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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33
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Gresele P, Momi S, Malvestiti M, Sebastiano M. Platelet-targeted pharmacologic treatments as anti-cancer therapy. Cancer Metastasis Rev 2018; 36:331-355. [PMID: 28707198 DOI: 10.1007/s10555-017-9679-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Platelets act as multifunctional cells participating in immune response, inflammation, allergy, tissue regeneration, and lymphoangiogenesis. Among the best-established aspects of a role of platelets in non-hemostatic or thrombotic disorders, there is their participation in cancer invasion and metastasis. The interaction of many different cancer cells with platelets leads to platelet activation, and on the other hand platelet activation is strongly instrumental to the pro-carcinogenic and pro-metastatic activities of platelets. It is thus obvious that over the last years a lot of interest has focused on the possible chemopreventive effect of platelet-targeted pharmacologic treatments. This article gives an overview of the platelet-targeted pharmacologic approaches that have been attempted in the prevention of cancer development, progression, and metastasis, including the application of anti-platelet drugs currently used for cardiovascular disease and of new and novel pharmacologic strategies. Despite the fact that very promising results have been obtained with some of these approaches in pre-clinical models, with the exclusion of aspirin, clinical evidence of a beneficial effect of anti-platelet agents in cancer is however still largely missing. Future studies with platelet-targeted drugs in cancer must carefully deal with design issues, and in particular with the careful selection of patients, and/or explore novel platelet targets in order to provide a solution to the critical issue of the risk/benefit profile of long-term anti-platelet therapy in the prevention of cancer progression and dissemination.
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Affiliation(s)
- P Gresele
- Section of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Via Enrico dal Pozzo, 06126, Perugia, Italy.
| | - S Momi
- Section of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Via Enrico dal Pozzo, 06126, Perugia, Italy
| | - M Malvestiti
- Section of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Via Enrico dal Pozzo, 06126, Perugia, Italy
| | - M Sebastiano
- Section of Internal and Cardiovascular Medicine, Department of Medicine, University of Perugia, Via Enrico dal Pozzo, 06126, Perugia, Italy
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Li HY, McSharry M, Walker D, Johnson A, Kwak J, Bullock B, Neuwelt A, Poczobutt JM, Sippel TR, Keith RL, Weiser-Evans MCM, Clambey E, Nemenoff RA. Targeted overexpression of prostacyclin synthase inhibits lung tumor progression by recruiting CD4+ T lymphocytes in tumors that express MHC class II. Oncoimmunology 2018; 7:e1423182. [PMID: 29721380 DOI: 10.1080/2162402x.2017.1423182] [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] [Received: 07/10/2017] [Revised: 12/23/2017] [Accepted: 12/28/2017] [Indexed: 12/31/2022] Open
Abstract
Lung-specific overexpression of prostacyclin synthase (PGIS) decreases tumor initiation in murine lung cancer models. Prostacyclin analogs prevent lung tumor formation in mice and reverse bronchial dysplasia in former smokers. However, the effect of prostacyclin on lung cancer progression has not been well studied. We investigated the effects of pulmonary PGIS overexpression in an orthotopic immunocompetent mouse model of lung cancer using two murine lung cancer cell lines. Pulmonary PGIS overexpression significantly inhibited CMT167 lung tumor growth, increased CXCL9 expression, and increased CD4+ tumor-infiltrating lymphocytes. Immunodepletion of CD4+ T cells abolished the inhibitory effect of pulmonary PGIS overexpression on CMT167 lung tumor growth. In contrast, pulmonary PGIS overexpression failed to inhibit growth of a second murine lung cancer cell line, Lewis Lung Carcinoma (LLC) cells, and failed to increase CXCL9 expression or CD4+ T lymphocytes in LLC lung tumors. Transcriptome profiling of CMT167 cells and LLC cells recovered from tumor-bearing mice demonstrated that in vivo, CMT167 cells but not LLC cells express MHC class II genes and cofactors necessary for MHC class II processing and presentation. These data demonstrate that prostacyclin can inhibit lung cancer progression and suggest that prostacyclin analogs may serve as novel immunomodulatory agents in a subset of lung cancer patients. Moreover, expression of MHC Class II by lung cancer cells may represent a biomarker for response to prostacyclin.
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Affiliation(s)
- Howard Y Li
- Department of Medicine, Veterans Affairs Medical Center, Denver, CO, USA.,Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Maria McSharry
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deandra Walker
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Amber Johnson
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Jeff Kwak
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Bonnie Bullock
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Alexander Neuwelt
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Joanna M Poczobutt
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Trisha R Sippel
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Robert L Keith
- Department of Medicine, Veterans Affairs Medical Center, Denver, CO, USA.,Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Mary C M Weiser-Evans
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Departments of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Eric Clambey
- Departments of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Raphael A Nemenoff
- Departments of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.,Departments of Pharmacology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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35
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Pantanowitz L, Preffer F, Wilbur DC. Advanced imaging technology applications in cytology. Diagn Cytopathol 2018; 47:5-14. [DOI: 10.1002/dc.23898] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Accepted: 01/25/2018] [Indexed: 12/13/2022]
Affiliation(s)
- Liron Pantanowitz
- Department of Pathology; University of Pittsburgh Medical Center; Pittsburgh Pennsylvania
| | - Frederic Preffer
- Department of Pathology. Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
| | - David C. Wilbur
- Department of Pathology. Massachusetts General Hospital; Harvard Medical School; Boston Massachusetts
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36
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GERACI MARKW. TARGETING THE PROSTACYCLIN/PEROXISOME PROLIFERATOR-ACTIVATED RECEPTOR GAMMA AXIS IN LUNG CANCER CHEMOPREVENTION. TRANSACTIONS OF THE AMERICAN CLINICAL AND CLIMATOLOGICAL ASSOCIATION 2018; 129:48-55. [PMID: 30166698 PMCID: PMC6116597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Lung cancer remains an important target of cancer research, and accounts for most deaths of any cancer type in the United States. Chemoprevention refers to the use of agents to prevent the development of cancer in high-risk populations, often in patients with predisposing lesions. In the following, we describe our ongoing work examining the role of the eicosanoid prostacyclin in lung cancer chemoprevention. Our findings include the fact that most adenocarcinomas lose the expression of prostacyclin synthase through methylation silencing. In addition, transgenic mice with overexpression of prostacyclin synthase are protected from tumorigenesis in multiple preclinical lung cancer models. Our phase IIb clinical trial using iloprost, a prostacyclin analogue, showed the reversal of airway dysplasia in high-risk individuals. This trial represents the first to show regression of airway dysplasia from the administration of a chemoprevention agent and forms the basis for future trials in lung cancer chemoprevention.
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Affiliation(s)
- MARK W. GERACI
- Correspondence and reprint requests: Mark W. Garaci, MD, Department of Medicine, Indiana University,
545 Barnhill Dr., Emerson Hall 305, Indianapolis, Indiana 46202317-274-8438317-274-1437
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Dwyer-Nield L, Hickey GA, Friedman M, Choo K, McArthur DG, Tennis MA, New ML, Geraci M, Keith RL. The Second-Generation PGI2 Analogue Treprostinil Fails to Chemoprevent Tumors in a Murine Lung Adenocarcinoma Model. Cancer Prev Res (Phila) 2017; 10:671-679. [PMID: 28851689 DOI: 10.1158/1940-6207.capr-17-0050] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 07/07/2017] [Accepted: 08/23/2017] [Indexed: 11/16/2022]
Abstract
Prostacyclin (prostaglandin I2, PGI2) overproduction in FVB/N mice prevents the formation of carcinogen and tobacco smoke-induced adenomas, and administration of the oral prostacyclin analogue iloprost to wild-type mice also prevented carcinogen-induced mouse lung adenoma formation. Former smokers taking oral iloprost showed improved bronchial dysplasia histology compared with placebo. Next-generation oral prostacyclin analogues, like treprostinil, were developed for the treatment of pulmonary arterial hypertension (PAH). On the basis of our prior studies with iloprost, we performed preclinical studies examining the ability of treprostinil to chemoprevent urethane-induced murine lung adenocarcinoma. We determined the MTD in chow (prior studies had delivered treprostinil by gavage), and this dose produced serum levels in the experimental animals similar to those found in PAH patients treated with treprostinil. We then examined the chemopreventive efficacy of treprostinil exposure initiated both before (1 week) and after (6 weeks) urethane exposure to better model chemoprevention studies conducted in former smokers. Neither of these dosing strategies prevented murine lung cancer; however, we did detect changes in pulmonary inflammatory cell infiltrate and expression of CXCR4 (a chemokine receptor previously shown to increase in response to treprostinil exposure) in tumor-bearing, treprostinil-treated animals, indicating that the drug was bioavailable. One potential explanation stems from iloprost and treprostinil differentially activating cell surface prostaglandin receptors and intracellular peroxisome proliferator-activated receptors. When murine lung tumor cells were treated with treprostinil, their proliferation rate increased; in contrast, iloprost had no effect on proliferation. Future investigations comparing these two agents will provide insight into iloprost's chemopreventive mechanisms. Cancer Prev Res; 10(11); 671-9. ©2017 AACR.
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Affiliation(s)
- Lori Dwyer-Nield
- Skaggs School of Pharmacy and Pharmaceutical Science, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Gregory A Hickey
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Eastern Colorado Veterans Affairs Medical Center, Denver, Colorado
| | - Micah Friedman
- Eastern Colorado Veterans Affairs Medical Center, Denver, Colorado
| | - Kevin Choo
- Eastern Colorado Veterans Affairs Medical Center, Denver, Colorado
| | | | - Meredith A Tennis
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Melissa L New
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.,Eastern Colorado Veterans Affairs Medical Center, Denver, Colorado
| | - Mark Geraci
- Department of Medicine, Indiana University, Indianapolis, Indiana
| | - Robert L Keith
- Division of Pulmonary Sciences and Critical Care Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado. .,Eastern Colorado Veterans Affairs Medical Center, Denver, Colorado
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38
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Preinvasive disease of the airway. Cancer Treat Rev 2017; 58:77-90. [DOI: 10.1016/j.ctrv.2017.05.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 05/23/2017] [Accepted: 05/27/2017] [Indexed: 01/20/2023]
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39
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Vachani A, Sequist LV, Spira A. AJRCCM: 100-Year Anniversary. The Shifting Landscape for Lung Cancer: Past, Present, and Future. Am J Respir Crit Care Med 2017; 195:1150-1160. [PMID: 28459327 PMCID: PMC5439022 DOI: 10.1164/rccm.201702-0433ci] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 03/16/2017] [Indexed: 12/13/2022] Open
Abstract
The past century has witnessed a transformative shift in lung cancer from a rare reportable disease to the leading cause of cancer death among men and women worldwide. This historic shift reflects the increase in tobacco consumption worldwide, spurring public health efforts over the past several decades directed at tobacco cessation and control. Although most lung cancers are still diagnosed at a late stage, there have been significant advances in screening high-risk smokers, diagnostic modalities, and chemopreventive approaches. Improvements in surgery and radiation are advancing our ability to manage early-stage disease, particularly among patients considered unfit for traditional open resection. Arguably, the most dramatic progress has occurred on the therapeutic side, with the development of targeted and immune-based therapy over the past decade. This article reviews the major shifts in the lung cancer landscape over the past 100 years. Although many ongoing clinical challenges remain, this review will also highlight emerging molecular and imaging-based approaches that represent opportunities to transform the prevention, early detection, and treatment of lung cancer in the years ahead.
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Affiliation(s)
- Anil Vachani
- Division of Pulmonary, Allergy, and Critical Care Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Lecia V. Sequist
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; and
| | - Avrum Spira
- Section of Computational Biomedicine, Department of Medicine, Boston University Medical Center, Boston, Massachusetts
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40
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Bunn PA. Karnofsky Award 2016: A Lung Cancer Journey, 1973 to 2016. J Clin Oncol 2016; 35:243-252. [PMID: 28056194 DOI: 10.1200/jco.2016.70.4064] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Affiliation(s)
- Paul A Bunn
- From University of Colorado Cancer Center, Aurora, CO
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41
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Al Rabadi L, Bergan R. A Way Forward for Cancer Chemoprevention: Think Local. Cancer Prev Res (Phila) 2016; 10:14-35. [PMID: 27780807 DOI: 10.1158/1940-6207.capr-16-0194] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2016] [Revised: 10/04/2016] [Accepted: 10/19/2016] [Indexed: 11/16/2022]
Abstract
As cells progress through carcinogenesis, the associated exponential expansion of genetic and molecular aberrations and resultant heterogeneity make therapeutic success increasingly unattainable. Therapeutic intervention at early stages of carcinogenesis that occurs within the primary organ and in the face of a lower burden of molecular aberrations, constitutes a basic tenet of cancer chemoprevention, and provides a situation that favors a greater degree of therapeutic efficacy compared with that of advanced cancer. A longstanding barrier to chemoprevention relates to the requirement for essentially no systemic toxicity, and the fact that when large numbers of people are treated, the emergence of systemic toxicity is almost universal. A rational means to address this in fact relates to a second basic tenet of the chemopreventive strategy: the focus of therapeutic intervention is to disrupt a process that is in essence localized to a single organ. Based upon this consideration, a strategy which is based upon local delivery of therapeutics to an at-risk organ will achieve therapeutic efficacy while avoiding systemic delivery and its associated toxicity. This article will review the rationale for undertaking such an approach, describe successful clinical achievements based on this strategy, describe ongoing efforts to expand the impact of this approach, and together will highlight the high impact that this approach has already had on the field as well as its extremely high potential for future impact. Cancer Prev Res; 10(1); 14-35. ©2016 AACR.
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Affiliation(s)
- Luai Al Rabadi
- Division of Hematology/Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon
| | - Raymond Bergan
- Division of Hematology/Oncology, Knight Cancer Institute, Oregon Health & Science University, Portland, Oregon.
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42
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Kensler TW, Spira A, Garber JE, Szabo E, Lee JJ, Dong Z, Dannenberg AJ, Hait WN, Blackburn E, Davidson NE, Foti M, Lippman SM. Transforming Cancer Prevention through Precision Medicine and Immune-oncology. Cancer Prev Res (Phila) 2016; 9:2-10. [PMID: 26744449 DOI: 10.1158/1940-6207.capr-15-0406] [Citation(s) in RCA: 112] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
We have entered a transformative period in cancer prevention (including early detection). Remarkable progress in precision medicine and immune-oncology, driven by extraordinary recent advances in genome-wide sequencing, big-data analytics, blood-based technologies, and deep understanding of the tumor immune microenvironment (TME), has provided unprecedented possibilities to study the biology of premalignancy. The pace of research and discovery in precision medicine and immunoprevention has been astonishing and includes the following clinical firsts reported in 2015: driver mutations detected in circulating cell-free DNA in patients with premalignant lesions (lung); clonal hematopoiesis shown to be a premalignant state; molecular selection in chemoprevention randomized controlled trial (RCT; oral); striking efficacy in RCT of combination chemoprevention targeting signaling pathway alterations mechanistically linked to germline mutation (duodenum); molecular markers for early detection validated for lung cancer and showing promise for pancreatic, liver, and ovarian cancer. Identification of HPV as the essential cause of a major global cancer burden, including HPV16 as the single driver of an epidemic of oropharyngeal cancer in men, provides unique opportunities for the dissemination and implementation of public health interventions. Important to immunoprevention beyond viral vaccines, genetic drivers of premalignant progression were associated with increasing immunosuppressive TME; and Kras vaccine efficacy in pancreas genetically engineered mouse (GEM) model required an inhibitory adjuvant (Treg depletion). In addition to developing new (e.g., epigenetic) TME regulators, recent mechanistic studies of repurposed drugs (aspirin, metformin, and tamoxifen) have identified potent immune activity. Just as precision medicine and immune-oncology are revolutionizing cancer therapy, these approaches are transforming cancer prevention. Here, we set out a brief agenda for the immediate future of cancer prevention research (including a "Pre-Cancer Genome Atlas" or "PCGA"), which will involve the inter-related fields of precision medicine and immunoprevention - pivotal elements of a broader domain of personalized public health.
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Affiliation(s)
- Thomas W Kensler
- University of Pittsburgh, Pittsburgh, Pennsylvania and Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | | | | | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, Rockville, Maryland
| | - J Jack Lee
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Zigang Dong
- The Hormel Institute, University of Minnesota, Minneapolis, Minnesota
| | | | - William N Hait
- Janssen Research & Development, LLC, Raritan, New Jersey
| | | | - Nancy E Davidson
- University of Pittsburgh Cancer Institute, Pittsburgh, Pennsylvania
| | - Margaret Foti
- American Association for Cancer Research, Philadelphia, Pennsylvania
| | - Scott M Lippman
- Moores Cancer Center, University of California San Diego, La Jolla, California.
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43
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Mao JT, Smoake J, Park HK, Lu QY, Xue B. Grape Seed Procyanidin Extract Mediates Antineoplastic Effects against Lung Cancer via Modulations of Prostacyclin and 15-HETE Eicosanoid Pathways. Cancer Prev Res (Phila) 2016; 9:925-932. [PMID: 27658889 DOI: 10.1158/1940-6207.capr-16-0122] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 08/19/2016] [Accepted: 09/06/2016] [Indexed: 01/10/2023]
Abstract
Grape seed procyanidin extract (GSE) has been reported to exert antineoplastic properties via the inhibition of cyclooxygenase-2 (COX-2)/prostaglandin E2 (PGE2) eicosanoid pathways. In addition, ample data link carcinogenesis to inflammatory events involving other major eicosanoid metabolic pathways, including prostacyclin (PGI2) and 15-hydroxyeicosatetraenoic acid (15-HETE). We therefore evaluated the effects of GSE on prostacyclin synthase (PTGIS)/PGI2 and 15-lipoxigenase-2 (15-LOX-2)/15-HETE productions by human lung premalignant and malignant cells and correlated the findings with antiproliferative or proapoptotic effects of GSE. The effects of GSE on PGI2 and 15-HETE productions by human bronchoalveolar lavage (BAL) cells ex vivo were also determined. We further evaluated the bioactivity of oral administration of leucoselect phytosome (a standardized GSE) in the lungs of subjects participating in a lung cancer chemoprevention trial, by comparing the antiproliferative effects of coculturing matched pre- versus posttreatment BAL fluids with lung premalignant and malignant cells. GSE significantly increased PGI2 (as measured by 6-keto PGF1α) and 15-HETE productions by these cells. Transfections of PTGIS or 15-LOX-2-specific siRNA partially abrogated the antiproliferative or proapoptotic effects of GSE in lung premalignant and malignant cells, respectively. GSE also increased PTGIS and inhibition of caspase-3, and transfection of 15-LOX-2 siRNA abrogated the GSE-induced apoptosis in A549 cells. In addition, culture supernatants from ex vivo GSE-treated baseline BAL cells, as well as BAL fluids from subjects treated with leucoselect phytosome, significantly decreased proliferations of lung premalignant and malignant cells. Our findings support the continued investigation of GSE as an anti-neoplastic and chemopreventive agent against lung cancer. Cancer Prev Res; 9(12); 925-32. ©2016 AACR.
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Affiliation(s)
- Jenny T Mao
- Pulmonary, Critical Care, and Sleep Medicine Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico.
| | - Jane Smoake
- Pulmonary, Critical Care, and Sleep Medicine Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Heesung K Park
- Pulmonary, Critical Care, and Sleep Medicine Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
| | - Qing-Yi Lu
- UCLA Center for Human Nutrition, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Bingye Xue
- Pulmonary, Critical Care, and Sleep Medicine Section, New Mexico Veterans Administration Health Care System, and University of New Mexico, Albuquerque, New Mexico
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Lam S, Mandrekar SJ, Gesthalter Y, Allen Ziegler KL, Seisler DK, Midthun DE, Mao JT, Aubry MC, McWilliams A, Sin DD, Shaipanich T, Liu G, Johnson E, Bild A, Lenburg ME, Ionescu DN, Mayo J, Yi JE, Tazelaar H, Harmsen WS, Smith J, Spira AE, Beane J, Limburg PJ, Szabo E. A Randomized Phase IIb Trial of myo-Inositol in Smokers with Bronchial Dysplasia. Cancer Prev Res (Phila) 2016; 9:906-914. [PMID: 27658890 DOI: 10.1158/1940-6207.capr-15-0254] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/19/2016] [Accepted: 09/14/2016] [Indexed: 02/03/2023]
Abstract
Previous preclinical studies and a phase I clinical trial suggested that myo-inositol may be a safe and effective lung cancer chemopreventive agent. We conducted a randomized, double blind, placebo-controlled phase IIb study to determine the chemopreventive effects of myo-inositol in smokers with bronchial dysplasia. Smokers with ≥1 site of dysplasia identified by autofluorescence bronchoscopy-directed biopsy were randomly assigned to receive oral placebo or myo-inositol, 9 g once a day for 2 weeks, and then twice a day for 6 months. The primary endpoint was change in dysplasia rate after 6 months of intervention on a per-participant basis. Other trial endpoints reported herein include Ki-67 labeling index, blood and bronchoalveolar lavage fluid (BAL) levels of proinflammatory, oxidant/antioxidant biomarkers, and an airway epithelial gene expression signature for PI3K activity. Seventy-four (n = 38 myo-inositol and n = 36 placebo) participants with a baseline and 6-month bronchoscopy were included in all efficacy analyses. The complete response and the progressive disease rates were 26.3% versus 13.9% and 47.4% versus 33.3%, respectively, in the myo-inositol and placebo arms (P = 0.76). Compared with placebo, myo-inositol intervention significantly reduced IL6 levels in BAL over 6 months (P = 0.03). Among those with a complete response in the myo-inositol arm, there was a significant decrease in a gene expression signature reflective of PI3K activation within the cytologically normal bronchial airway epithelium (P = 0.002). The heterogeneous response to myo-inositol suggests a targeted therapy approach based on molecular alterations is needed in future clinical trials to determine the efficacy of myo-inositol as a chemopreventive agent. Cancer Prev Res; 9(12); 906-14. ©2016 AACR.
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Affiliation(s)
- Stephen Lam
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
| | | | | | | | | | | | - Jenny T Mao
- New Mexico Veteran's Health Care System, Albuquerque, New Mexico
| | | | | | - Don D Sin
- St. Paul's Hospital, Vancouver, British Columbia, Canada
| | | | - Gang Liu
- Boston University Medical Center, Boston, Massachusetts
| | - Evan Johnson
- Boston University Medical Center, Boston, Massachusetts
| | | | | | - Diana N Ionescu
- British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - John Mayo
- Vancouver General Hospital, Vancouver, British Columbia
| | | | | | | | - Judith Smith
- Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, Maryland
| | - Avrum E Spira
- Boston University Medical Center, Boston, Massachusetts
| | | | | | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, NIH, Bethesda, Maryland
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45
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Tennis MA, New ML, McArthur DG, Merrick DT, Dwyer-Nield LD, Keith RL. Prostacyclin reverses the cigarette smoke-induced decrease in pulmonary Frizzled 9 expression through miR-31. Sci Rep 2016; 6:28519. [PMID: 27339092 PMCID: PMC4919780 DOI: 10.1038/srep28519] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 06/02/2016] [Indexed: 01/14/2023] Open
Abstract
Half of lung cancers are diagnosed in former smokers, leading to a significant treatment burden in this population. Chemoprevention in former smokers using the prostacyclin analogue iloprost reduces endobronchial dysplasia, a premalignant lung lesion. Iloprost requires the presence of the WNT receptor Frizzled 9 (Fzd9) for inhibition of transformed growth in vitro. To investigate the relationship between iloprost, cigarette smoke, and Fzd9 expression, we used human samples, mouse models, and in vitro studies. Fzd9 expression was low in human lung tumors and in progressive dysplasias. In mouse models and in vitro studies, tobacco smoke carcinogens reduced expression of Fzd9 while prostacyclin maintained or increased expression. Expression of miR-31 repressed Fzd9 expression, which was abrogated by prostacyclin. We propose a model where cigarette smoke exposure increases miR-31 expression, which leads to decreased Fzd9 expression and prevents response to iloprost. When smoke is removed miR-31 is reduced, prostacyclin can increase Fzd9 expression, and progression of dysplasia is inhibited. Fzd9 and miR-31 are candidate biomarkers for precision application of iloprost and monitoring of treatment progress. As we continue to investigate the mechanisms of prostacyclin chemoprevention and identify biomarkers for its use, we will facilitate clinical trials and speed implementation of this valuable prevention approach.
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Affiliation(s)
- M. A. Tennis
- University of Colorado Denver, Aurora, Colorado, USA
| | - M. L. New
- University of Colorado Denver, Aurora, Colorado, USA
| | - D. G. McArthur
- Denver Veterans Administration Medical Center, Denver, Colorado, USA
| | - D. T. Merrick
- University of Colorado Denver, Aurora, Colorado, USA
| | | | - R. L. Keith
- University of Colorado Denver, Aurora, Colorado, USA
- Denver Veterans Administration Medical Center, Denver, Colorado, USA
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46
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Lam S, Szabo E. Preinvasive Endobronchial Lesions: Lung Cancer Precursors and Risk Markers? Am J Respir Crit Care Med 2016; 192:1411-3. [PMID: 26669471 DOI: 10.1164/rccm.201508-1668ed] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Affiliation(s)
- Stephen Lam
- 1 British Columbia Cancer Agency Vancouver, British Columbia, Canada.,2 University of British Columbia Vancouver, British Columbia, Canada and.,3 National Cancer Institute National Institutes of Health Rockville, Maryland
| | - Eva Szabo
- 1 British Columbia Cancer Agency Vancouver, British Columbia, Canada.,2 University of British Columbia Vancouver, British Columbia, Canada and.,3 National Cancer Institute National Institutes of Health Rockville, Maryland
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Merrick DT, Gao D, Miller YE, Keith RL, Baron AE, Feser W, Kennedy TC, Blatchford PJ, Braudrick S, Hirsch FR, Heasley L, Bunn PA, Franklin WA. Persistence of Bronchial Dysplasia Is Associated with Development of Invasive Squamous Cell Carcinoma. Cancer Prev Res (Phila) 2016; 9:96-104. [PMID: 26542061 PMCID: PMC4706769 DOI: 10.1158/1940-6207.capr-15-0305] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2015] [Accepted: 10/26/2015] [Indexed: 12/22/2022]
Abstract
Bronchial dysplasia (BD), a presumed precursor of pulmonary squamous cell carcinoma (SCC), rarely progresses to invasive cancer. A high-risk cohort at the University of Colorado provided an opportunity to directly sample airway epithelium at mapped sites on successive bronchoscopies. We have hypothesized that persistent dysplastic lesions showing a similar or higher level of dysplasia on follow-up biopsy, are associated with increased risk for the development of SCC. Endoscopic biopsies from 188 high-risk subjects were histologically classified according to the current WHO classification for BD using a numeric histology score ranging from 1 to 8 representing normal bronchial mucosa through invasive lung cancer. Differences in follow-up histology scores were compared between sites classified by clinical, histologic, and immunohistochemical variables. Subjects with a higher frequency of sites that persist or progress to high-grade dysplasia (≥37.5% persist/progress, N = 35 versus <37.5% persist/progress, N = 114) show a significant association with development of incident invasive SCC (adjusted HR, 7.84; 95% confidence interval, 1.56-39.39), and those with incident lung SCC have adjusted mean follow-up histology scores 1.55 U higher than in subjects without lung cancer. Current smoking, elevated Ki67 growth fraction, histologic features of angiogenic squamous dysplasia (ASD) and higher histology score in baseline biopsies are significantly associated with increased follow-up histology scores. These results show that persistent BD is associated with the development of invasive SCC. Furthermore, increased expression of Ki67, the presence of angiogenic change and degree of baseline atypia are associated with persistence of BD.
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Affiliation(s)
- Daniel T Merrick
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
| | - Dexiang Gao
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - York E Miller
- Division of Pulmonary Medicine, Department of Medicine, Denver Veterans Affairs Medical Center, Denver, Colorado. Division of Pulmonary Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Robert L Keith
- Division of Pulmonary Medicine, Department of Medicine, Denver Veterans Affairs Medical Center, Denver, Colorado. Division of Pulmonary Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Anna E Baron
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
| | - William Feser
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
| | - Timothy C Kennedy
- Division of Pulmonary Medicine, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Patrick J Blatchford
- Department of Pediatrics, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Braudrick
- Department of Biostatistics and Informatics, Colorado School of Public Health, Aurora, Colorado
| | - Fred R Hirsch
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Lynn Heasley
- Department of Craniofacial Biology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Paul A Bunn
- Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Wilbur A Franklin
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, Colorado
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Fedirko V, Bradshaw PT, Figueiredo JC, Sandler RS, Barry EL, Ahnen DJ, Milne GL, Bresalier RS, Baron JA. Urinary metabolites of prostanoids and risk of recurrent colorectal adenomas in the Aspirin/Folate Polyp Prevention Study (AFPPS). Cancer Prev Res (Phila) 2015; 8:1061-8. [PMID: 26304466 DOI: 10.1158/1940-6207.capr-15-0212] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2015] [Accepted: 08/18/2015] [Indexed: 12/15/2022]
Abstract
Aspirin has been shown to protect against colorectal neoplasms; however, the optimal chemopreventive dose and underlying mechanisms are unclear. We aimed to study the relationship between prostanoid metabolites and aspirin's effect on adenoma occurrence. We used data from the Aspirin/Folate Polyp Prevention Study, in which 1,121 participants with a recent adenoma were randomized to placebo or two doses of aspirin (81 or 325 mg/d) to be taken until the next surveillance colonoscopy, anticipated about 3 years later. Urinary metabolites of prostanoids (PGE-M, PGI-M, and dTxB2) were measured using liquid chromatography/mass spectrometry or GC/NICI-MS in 876 participants near the end of treatment follow-up. Poisson regression with a robust error variance was used to calculate relative risks and 95% confidence intervals. PGE-M, PGI-M, and dTxB2 levels were 28%, 37%, and 60% proportionately lower, respectively, in individuals who took 325 mg of aspirin compared with individuals who took placebo (all P < 0.001). Similarly, among individuals who took 81 mg of aspirin, PGE-M, PGI-M, and dTxB2 were, respectively, 18%, 30%, and 57% proportionally lower compared with placebo (all P < 0.005). None of the metabolites or their ratios were statistically significantly associated with the risk of adenoma occurrence. The effect of aspirin in reducing adenoma risk was independent of prostanoid levels. Aspirin use is associated with lower levels of urinary prostanoid metabolites. However, our findings do not support the hypothesis that these metabolites are associated with adenoma occurrence, suggesting that COX-dependent mechanisms may not completely explain the chemopreventive effect of aspirin on colorectal neoplasms.
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Affiliation(s)
- Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Winship Cancer Institute, Emory University, Atlanta, Georgia.
| | - Patrick T Bradshaw
- Department of Nutrition, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina
| | - Jane C Figueiredo
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Robert S Sandler
- Department of Medicine, University of North Carolina, Chapel Hill, North Carolina
| | - Elizabeth L Barry
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
| | - Dennis J Ahnen
- Department of Veterans Affairs Medical Center, Denver, Colorado
| | - Ginger L Milne
- Division of Clinical Pharmacology, Vanderbilt University, Nashville, Tennessee
| | - Robert S Bresalier
- Department of Gastrointestinal Medicine and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - John A Baron
- Department of Medicine, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
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49
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de-Torres JP, Zulueta JJ. The association with COPD. Lung Cancer 2015. [DOI: 10.1183/2312508x.10009314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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50
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Wnt7a is a novel inducer of β-catenin-independent tumor-suppressive cellular senescence in lung cancer. Oncogene 2015; 34:5317-28. [PMID: 25728679 PMCID: PMC4558401 DOI: 10.1038/onc.2015.2] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Revised: 09/18/2014] [Accepted: 10/14/2014] [Indexed: 12/14/2022]
Abstract
Cellular senescence is an initial barrier for carcinogenesis. However, the signaling mechanisms that trigger cellular senescence are incompletely understood, particularly in vivo. Here we identify Wnt7a as a novel upstream inducer of cellular senescence. In two different mouse strains (C57Bl/6J and FVB/NJ), we show that the loss of Wnt7a is a major contributing factor for increased lung tumorigenesis owing to reduced cellular senescence, and not reduced apoptosis, or autophagy. Wnt7a-null mice under de novo conditions and in both the strains display E-cadherin-to-N-cadherin switch, reduced expression of cellular senescence markers and reduced expression of senescence-associated secretory phenotype, indicating a genetic predisposition of these mice to increased carcinogen-induced lung tumorigenesis. Interestingly, Wnt7a induced an alternate senescence pathway, which was independent of β-catenin, and distinct from that of classical oncogene-induced senescence mediated by the well-known p16INK4a and p19ARF pathways. Mechanistically, Wnt7a induced cellular senescence via inactivation of S-phase kinase-associated protein 2, an important alternate regulator of cellular senescence. Additionally, we identified Iloprost, a prostacyclin analog, which initiates downstream signaling cascades similar to that of Wnt7a, as a novel inducer of cellular senescence, presenting potential future clinical translational strategies. Thus pro-senescence therapies using either Wnt7a or its mimic, Iloprost, might represent a new class of therapeutic treatments for lung cancer.
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