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El-Hosainy A, Hosny H, Gabal S, Ahmed S, El-Hinnawy Y. Role of epidermal growth factor receptor in malignant pleural mesothelioma and its value for successful chemical pleurodesis. EGYPTIAN JOURNAL OF CHEST DISEASES AND TUBERCULOSIS 2014. [DOI: 10.1016/j.ejcdt.2014.06.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
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Abstract
PURPOSE OF REVIEW Many driver mutations that determine the malignant behavior of lung cancer have been identified in recent years. The promise of therapies targeted to the specific molecular pathways altered by such mutations has made genetic testing in nonsmall cell lung cancer (NSCLC) attractive to clinicians. We reviewed recent research on clinically relevant genetic and molecular tests for patients with NSCLC, with an emphasis on the tests linked to actionable mutations that influence therapy and improve outcomes. RECENT FINDINGS Mutations in the epidermal growth factor receptor gene (EGFR) and translocations involving the anaplastic lymphoma kinase (ALK) gene have been shown to be common driver mutations in lung adenocarcinoma. The presence or absence of these mutations has been demonstrated to predict response to targeted therapy in many recent studies. Targeted therapies for patients with mutations in the EGFR domain or the echinoderm microtubule-associated protein-like 4 anaplastic lymphoma kinase translocation have been shown to be effective and are approved for use. Ongoing studies continue to define the extent of their utility and may continue to expand their indications. Sufficient tissue for genetic analysis can be obtained from cytologic samples, including those obtained from endobronchial ultrasound-guided transbronchial needle aspiration. SUMMARY Genetic testing for driver mutations is useful in identifying patients with NSCLC who are likely to respond to targeted therapy. These tests are best used in patients with adenocarcinoma who have advanced-stage cancer.
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Kato I, Startup J, Ram JL. Fecal Biomarkers for Research on Dietary and Lifestyle Risk Factors in Colorectal Cancer Etiology. CURRENT COLORECTAL CANCER REPORTS 2013. [DOI: 10.1007/s11888-013-0195-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Deng J, Liang H, Zhang R, Sun D, Pan Y, Liu Y, Zhang L, Hao X. STAT3 is associated with lymph node metastasis in gastric cancer. Tumour Biol 2013; 34:2791-800. [PMID: 23824569 DOI: 10.1007/s13277-013-0837-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2013] [Accepted: 05/01/2013] [Indexed: 12/18/2022] Open
Abstract
This study aims to explore the detailed signal transduction mechanism of epidermal growth factor receptor (EGFR)/signal transducers and activators of transcription 3 (STAT3) that contributes to the progression of gastric cancer (GC). The STAT3 expression, phosphorylated STAT3 (pSTAT3) expression, and EGFR expression were evaluated by using molecular detection methods of GC tissues, adjacent non-tumor tissues, GC cell lines, and normal gastric cell line. Cetuximab was administered in each cell line to demonstrate the correlations among the above biomarkers. Survival and relationship analyses were adopted to demonstrate the important mechanism of EGFR/STAT3 signaling pathway contributing to the progression of GC. STAT3 expression, pSTAT3 expression, and EGFR expression in GC tissues were significantly higher than those in adjacent non-tumor tissues, respectively. Similarly, we found that STAT3 expression, pSTAT3 expression, and EGFR expression were much higher in GC cell lines than those in GES-1 cell line. With cetuximab administration, both STAT3 expression and pSTAT3 expression in all GC cell lines decreased simultaneously. With Cox proportional hazards model analysis, pSTAT3 expression was identified as the independent predictors of the overall survival of GC patients, as was EGFR expression. Furthermore, we found that there were significant associations between STAT3 expression, pSTAT3 expression, EGFR expression, and lymph node metastasis in GC tissues. The activation of EGFR/STAT3 signaling pathway may contribute to lymph node metastasis, which can promote the progression of GC.
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Affiliation(s)
- Jingyu Deng
- Department of Gastric Cancer Surgery, Tianjin Cancer Hospital, Key Laboratory of Cancer Prevention and Therapy, Tianjin Medical University, Tianjin, China
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Chen L, Chen DT, Kurtyka C, Rawal B, Fulp WJ, Haura EB, Cress WD. Tripartite motif containing 28 (Trim28) can regulate cell proliferation by bridging HDAC1/E2F interactions. J Biol Chem 2012; 287:40106-18. [PMID: 23060449 DOI: 10.1074/jbc.m112.380865] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Trim28 appears up-regulated in many cancers. RESULTS In early stage lung tumors high Trim28 correlates with increased overall survival and Trim28 reduces cell proliferation in model lung cancer cell lines through E2F interactions. CONCLUSION Trim28 may have a tumor suppressing role in the early stages of lung cancer. SIGNIFICANCE These results suggest a complex role for Trim28 in lung cancer. Trim28 is a poorly understood transcriptional co-factor with pleiotropic biological activities. Although Trim28 mRNA is found in many studies to be up-regulated in both lung and breast cancer tissues relative to normal adjacent tissue, we found that within a panel of early-stage lung adenocarcinomas high levels of Trim28 protein correlate with better overall survival. This surprising observation suggests that Trim 28 may have anti-proliferative activity within tumors. To test this hypothesis, we used shRNAi to generate Trim28-knockdown breast and lung cancer cell lines and found that Trim28 depletion led to increased cell proliferation. Likewise, overexpression of Trim28 led to decreased cell proliferation. Confocal microscopy indicated co-localization of E2F3 and E2F4 with Trim28 within the cell nucleus, and co-immunoprecipitation assays demonstrated that Trim28 can bind both E2F3 and E2F4. Trim28 overexpression inhibited the transcriptional activity of E2F3 and E2F4, whereas Trim28 deficiency enhanced their activity. Co-immunoprecipitations further indicated that Trim28 bridges an interaction between E2Fs 3 and 4 and HDAC1. Promoter-reporter assays demonstrated that the ability of HDAC1 to repress E2F3 and E2F4-driven transcription is dependent on Trim28. Trim28 depletion increased E2F3 and E2F4 DNA binding activity, as measured by chromatin-immunoprecipitation (ChIP) assays while simultaneously reducing HDAC1 binding. Finally, ChIP-ReChIP experiments demonstrated that Trim/E2F complexes exist on several E2F-regulated promoters. Taken together, these results suggest that Trim28 has anti-proliferative activity in lung cancers via repression of members of the E2F family that are critical for cell proliferation.
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Affiliation(s)
- Lu Chen
- Molecular Oncology Program, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA
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Sekine A, Kato T, Hagiwara E, Shinohara T, Komagata T, Iwasawa T, Satoh H, Tamura K, Kasamatsu T, Hayashihara K, Saito T, Takahashi H, Ogura T. Metastatic brain tumors from non-small cell lung cancer with EGFR mutations: distinguishing influence of exon 19 deletion on radiographic features. Lung Cancer 2012; 77:64-9. [PMID: 22335887 DOI: 10.1016/j.lungcan.2011.12.017] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Revised: 12/21/2011] [Accepted: 12/26/2011] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Miliary brain metastasis is a rarity and refers to the presence of numerous small tumors in a perivascular distribution without intraparenchymal invasion and focal edema. Although the presence of epidermal growth factor receptor (EGFR) mutation and good response to gefitinib have been reported in non-small cell lung cancer (NSCLC) patients with miliary brain metastases, the influence of the EGFR mutations on the radiographic features remains unclear. PATIENTS AND METHODS All NSCLC patients with synchronous brain metastases detected at the time of a new diagnosis of NSCLC from March 2005 through May 2011 were divided according to EGFR mutation status. The number of brain tumors, size of the largest brain tumors, and size of peritumoral brain edema were compared among the groups. RESULTS Fifty-seven patients who met the criteria were divided into three groups: wild-type EGFR group (31 patients), exon 19 deletion group (18 patients), and exon 21 point mutation group (8 patients). The exon 19 deletion group had more multiple and smaller brain tumors with smaller peritumoral brain edema than did the wild-type group (P = 0.024, P = 0.0016, and P = 0.0036, respectively). The exon 21 point mutation group showed no significant difference in any of the radiographic values when compared with the wild-type group. CONCLUSION Our results indicate that NSCLC patients with the exon 19 deletion have such a peculiar pattern of brain metastases as multiple small metastases with small brain edema. This metastatic pattern may be similar to that of miliary brain metastases. Because it is unclear whether or not severe neurologic symptoms develop during their clinical courses like miliary brain metastases, regular evaluation with brain magnetic resonance imaging (MRI) should be considered, regardless of the presence of neurologic symptoms. Accumulation of knowledge about specific pattern of brain metastasis will help approach to "individual" management.
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Affiliation(s)
- Akimasa Sekine
- Department of Respiratory Medicine, Kanagawa Prefectural Cardiovascular and Respiratory Center, Yokohama, Japan.
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Kim HS, Park YH, Lee J, Ahn JS, Kim J, Shim YM, Kim JH, Park K, Han J, Ahn MJ. Clinical impact of phosphorylated signal transducer and activator of transcription 3, epidermal growth factor receptor, p53, and vascular endothelial growth factor receptor 1 expression in resected adenocarcinoma of lung by using tissue microarray. Cancer 2010; 116:676-85. [PMID: 20052735 DOI: 10.1002/cncr.24748] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The signal transducer and activator of transcription 3 (STAT3) play a key role in the downstream pathway of the epidermal growth factor receptor (EGFR) in nonsmall cell lung cancer and promote cell proliferation, invasion, and angiogenesis. The clinical significance of phosphorylated STAT3 (pSTAT3), EGFR, p53, and vascular endothelial growth factor receptor 1 (VEGFR-1) expression in patients with completely resected lung adenocarcinoma was evaluated to determine the effects of pSTAT3 in tumor angiogenesis and proliferation. METHODS The expressions of pSTAT3, EGFR, p53, and VEGFR-1 were evaluated by immunohistochemical staining of tissue microarrays from 162 samples of resected lung adenocarcinoma. RESULTS The median age of the 162 patients was 62 years, the median disease-free survival was 41.7 months, and the median OS (OS) was 80.2 months. Expression of pSTAT3, EGFR, p53, and VEGFR-1 was detected in 51.2%, 71%, 35.2%, and 35.2% of the samples, respectively. pSTAT3 expression was correlated significantly with VEGFR-1 expression (P = .025). The coexpression of pSTAT3 and VEGFR-1 was correlated with increased lymph node involvement (P = .021) and a trend toward a short OS (P = .085). In multivariate analysis, the expression levels of p53 and VEGFR-1 were identified as independent prognostic factors that affected OS. CONCLUSIONS The results of this study suggested that pSTAT3 and VEGFR-1 expression may play roles in the tumor progression and angiogenesis of lung adenocarcinoma. Further studies are needed, however, to uncover the detailed mechanisms that underlie the roles of these proteins in lung adenocarcinoma.
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Affiliation(s)
- Hyeong Su Kim
- Division of Hematology and Oncology, Department of Internal Medicine, Hallym University Medical Center, Hallym University College of Medicine, Seoul, Korea
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Kato I, Badsha KZ, Land S, Nechvatal JM, Matherly LH, Tarca AL, Majumdar AP, Basson MD, Ram JL. DNA/RNA markers for colorectal cancer risk in preserved stool specimens: a pilot study. TUMORI JOURNAL 2009; 95:753-761. [PMID: 20210241 PMCID: PMC4932904 DOI: 10.1177/030089160909500619] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
AIMS AND BACKGROUND Exfoliated cells in human stool offer excellent opportunities to non-invasively detect molecular markers associated with colorectal tumorigenesis, and to evaluate the effects of exposures to exogenous and endogenous carcinogenic or chemopreventive substances. This pilot study investigated the feasibility of determining DNA methylation and RNA expression simultaneously in stool specimens treated with a single type of nucleic acid preservatives. METHODS Stool specimens from 56 volunteers that were preserved up to a week with RNA later were used in this study. Bisulfite sequencing was used to determine methylation at 27 CpG loci on the estrogen receptor 1 (ESR1) promoter. Taqman assay was used for quantitative reverse transcription polymerase chain reactions to measure cyclooxygenase 2 (COX2) and epidermal growth factor receptor (EGFR) mRNA expression. Subjects' basic demographic and other selected risk factors for colorectal cancer were captured through questionnaires and correlated with the levels of these markers. RESULTS Less than 10% of the samples failed in individual assays. Overall, 24.0% of the CpG loci on the ESR1 promoter were methylated. COX2 expression and alcohol use were positively correlated; an inverse association was present between EGFR expression and cigarette smoking; and subjects using anti-diabetic medication had higher ESR1 methylation. In addition, higher EGFR expression levels were marginally associated with history of polyps and family history of colorectal cancer. CONCLUSIONS The present study demonstrates that simultaneous analyses for DNA and RNA markers are feasible in stool samples treated with a single type of nucleotide preservatives. Among several associations observed, the association between EGFR expression and polyps deserves further investigation as a potential target for colorectal cancer screening. Larger studies are warranted to confirm some of our observations.
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Affiliation(s)
- Ikuko Kato
- Karmanos Cancer Institute, Wayne State University, 110 East Warren Avenue, Detroit, MI 48201, USA.
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López-Malpartida AV, Ludeña MD, Varela G, García Pichel J. Differential ErbB receptor expression and intracellular signaling activity in lung adenocarcinomas and squamous cell carcinomas. Lung Cancer 2008; 65:25-33. [PMID: 19046792 DOI: 10.1016/j.lungcan.2008.10.009] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2008] [Revised: 08/06/2008] [Accepted: 10/10/2008] [Indexed: 10/21/2022]
Abstract
EGFR (ErbB1) and ErbB2 receptors stimulate several intracellular signaling pathways in non-small-cell lung cancer (NSCLC). Adenocarcinomas (AC) and squamous cell carcinomas (SCC) are NSCLC subtypes with distinct clinico-pathological features, and responses to ErbB-targeted inhibitors treatment. To evaluate the causes of these differences, tissue microarrays with samples from NSCLC patients (189 AC and 56 SCC) were used to study EGFR and ErbB2 expression and phospho-activation of ERK1/2, AKT, STAT3 and SRC ErbB-mediators by immunohistochemistry and Western blot, and EGFR and ErbB2 gene amplification by FISH. EGFR expression was higher in SCC than in AC (P<0.001), while ErbB2 showed similar low levels. Phosphorylated (p) ERK, pAKT, pSTAT3 and pSRC levels were prevalent in AC (P< or =0.002). EGFR levels and signaling mediators activation were differentially associated with each of the pathologies. Whereas in AC the expression and amplification of EGFR were linked to AKT activation (P< or =0.050), in SCC its expression was correlated with pSTAT3 (P=0.024). In addition, pSTAT3 was correlated with pERK and pAKT only in AC (P< or =0.045). Biomarker levels were also differentially associated with the clinico-pathologic variables. In AC, EGFR and pSRC increasing scores correlated with female sex and the smoking habit (P< or =0.008), while ErbB2 amplification increased with advanced age and tumor stage (P< or =0.047), and pERK1/2 and pSTAT3 levels correlated with early tumor stage (P< or =0.045). In SCC, EGFR amplification was stronger in younger patients (P=0.013), pERK1/2 in the older ones (P=0.050), and pSTAT3 amplification was stronger in women (P=0.001). These data support that AC and SCC lung tumors are distinct entities at the molecular level, and that their signaling status in combination with their clinico-pathologic variables may be considered for differential targeted therapies.
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Affiliation(s)
- Ana Victoria López-Malpartida
- Instituto de Biología Molecular y Celular del Cáncer, Consejo Superior de Investigaciones Científicas--Universidad de Salamanca, Salamanca 37007, Spain
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Expression of EGFR in gastric stromal tumors: a clinicopathologic study. Appl Immunohistochem Mol Morphol 2008; 16:310-5. [PMID: 18528288 DOI: 10.1097/pai.0b013e318159b877] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Epidermal growth factor receptor (EGFR) plays an important role in cancer biology and offers a promising molecular therapeutic target. The expression profile of EGFR in gastrointestinal stromal tumors (GISTs) is derived from a limited number of small series samples and case reports. We evaluated the involvement of EGFR in human gastric GISTs. Tissue microarray sections representing 33 gastric GISTs with known follow-up were surveyed by immunohistochemistry, using antibodies specific for EGFR. Expression of EGFR was identified in 8/33 (24.2%) cases, and tended to be present in tumors of smaller size (3.69+/-0.66 cm vs. 10.69+/-1.52 cm, P=0.0001), fewer mitoses (3.5+/-1.0/50 high power field vs. 23.44+/-7.61, P=0.0073), and lower necrosis percentages (0% vs. 5.37+/-1.37%, P=0.0003); the expression was more frequently seen in the benign/probably benign category (6/8, 75%, P=0.047), than in gastric GISTs that lacked EGFR expression. Expression showed a trend as a favorable prognostic indicator but did not reach statistical significance, although the number of cases was limited. This observation suggests that EGFR is present in some gastric GISTs, especially in small tumors, and might participate in the growth regulation of human gastric GISTs. Expression of EGFR in some gastric GISTs might be of clinical significance with the recent emergence of EGFR-targeted therapies.
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Ding J, Wu K, Zhang D, Luo W, Li J, Ouyang W, Song L, Huang C. Activation of both nuclear factor of activated T cells and inhibitor of nuclear factor-kappa B kinase beta-subunit-/nuclear factor-kappa B is critical for cyclooxygenase-2 induction by benzo[a]pyrene in human bronchial epithelial cells. Cancer Sci 2007; 98:1323-9. [PMID: 17640307 PMCID: PMC11159518 DOI: 10.1111/j.1349-7006.2007.00530.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2007] [Revised: 04/22/2007] [Accepted: 05/07/2007] [Indexed: 11/28/2022] Open
Abstract
The carcinogenic effect of benzo[a]pyrene (B[a]P), presenting mainly in cigarette smoke and air pollution, has been well demonstrated both in vitro and in vivo. However, it is still not well understood how B[a]P facilitates pulmonary carcinogenesis. To explore this, we investigated the effect of B[a]P on the induction of cyclooxygenase-2 (COX-2), a critical enzyme implicated in inflammation and cancer development, as well as upstream signaling pathways leading to its expression in human bronchial epithelial cells (Beas-2B). We found that exposure of Beas-2B to B[a]P caused significant COX-2 induction at both the transcriptional and protein levels. B[a]P also switched on the nuclear factor of activated T cells (NFAT) and nuclear factor kappaB (NF-kappaB) signaling pathways. B[a]P-induced COX-2 expression was significantly blocked by inhibition of the NFAT pathway, and impairment of the NF-kappaB signaling pathway by ectopic expression of an inhibitor of nuclear factor-kappaB kinase beta-subunit (IKKbeta) kinase inactive mutant (IKKbeta-KM) also dramatically inhibited COX-2 induction. The IKKbeta/NF-kappaB-dependent COX-2 induction was further confirmed in mouse embryonic fibroblasts with IKKbeta deficiency (IKKbeta(-/-)) and in those that expressed reconstituted IKKbeta. However, activation of the NFAT and NF-kappaB signaling pathways by B[a]P were independent of each other, as blocking one signaling pathway didn't interrupt the activation of the other one. Mutation of either NFAT or NF-kappaB binding sites significantly blocked COX-2 promoter induction by B[a]P. Taken together, these data indicate that exposure of Beas-2B to B[a]P can upregulate COX-2 expression by increasing its transcription, which requires activation of both the NFAT and NF-kappaB signaling pathways.
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Affiliation(s)
- Jin Ding
- Nelson Institute of Environmental Medicine, New York University School of Medicine, 57 Old Forge Road, Tuxedo, NY 10987, USA
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Weydert JA, Cohen MB. Small peripheral pulmonary adenocarcinoma: morphologic and molecular update. Adv Anat Pathol 2007; 14:120-8. [PMID: 17471118 DOI: 10.1097/pap.0b013e3180324519] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The dichotomous histopathologic separation of lung carcinoma into "small cell" and "nonsmall cell" categories is validated by marked clinical and biologic differences between these groups of tumors. However, nonsmall cell carcinoma represents a heterogenous group of tumors, and the subclassification of nonsmall cell lung carcinoma at the molecular, morphologic, and epidemiologic levels has led to the promise of precise treatment and better prognostication. Histomorphologic aspects of small peripheral adenocarcinomas that represent good prognosis include pure bronchioloalveolar carcinoma, minimal invasion within a mixed invasive and lepidic growth pattern tumor, and minimal scar within a lepidic growth pattern tumor. Activating mutations and increased gene copy number of the epidermal growth factor receptor protein and locus, respectively, have been shown to help predict responsiveness to small molecule receptor tyrosine kinase inhibitors in lung adenocarcinoma. These important concepts of morphology and molecular pathology are reviewed, and recommendations for application of these concepts to the practice of surgical pathology are provided.
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Affiliation(s)
- Jamie A Weydert
- Department of Pathology, The University of Iowa Carver College of Medicine, Iowa City, IA 52242-1087, USA.
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Cortas T, Eisenberg R, Fu P, Kern J, Patrick L, Dowlati A. Activation state EGFR and STAT-3 as prognostic markers in resected non-small cell lung cancer. Lung Cancer 2006; 55:349-55. [PMID: 17161498 DOI: 10.1016/j.lungcan.2006.11.003] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2006] [Revised: 09/13/2006] [Accepted: 10/26/2006] [Indexed: 11/26/2022]
Abstract
BACKGROUND Total EGFR expression by immunohistochemistry (IHC) has failed to demonstrate prognostic importance. We hypothesized that activation (phosphorylated) state of EGFR (p-EGFR) and its activated downstream signal pathway (p-STAT-3) will have prognostic value in NSCLC. METHODS 145 patients underwent lung resection for NSCLC at University Hospitals from 1998-2002. A database with TNM stage, gender, age, time to recurrence, and survival was established. p-EGFR and p-STAT-3 levels were quantified by IHC. Specimens were divided into negative, 1+, 2+, or 3+ (5-19%, 20-50%, >50% of tumor cells staining respectively). Cox proportional hazard model was used for multivariate analysis. RESULTS Median age was 70 years. 58% were female and 54% had adenocarcinoma. Pathologic stage was as follows: stage I: 54%, stage II: 31%, stage III: 15%. 32% were positive for p-EGFR (squamous 36%, adenocarcinoma 29%). p-STAT-3 staining was seen in 38% and was higher in adenocarcinoma (46%) versus squamous cell (27%, p=0.02) and was higher in patients >70 years than compared to those <70 years (p=0.06). There was a trend toward co-expression of p-EGFR and p-STAT-3 (p=0.09). The 5-year Kaplan-Meier probabilities of overall survival were not different amongst patients with activated versus no activation of EGFR and STAT-3. CONCLUSIONS Although EGFR is commonly expressed in NSCLC ( approximately 70%), p-EGFR is seen in only 1/3 of patients. p-EGFR and p-STAT-3 were commonly co-expressed in tumors compatible with known signal transduction pathways in lung cancer. However, EGFR and STAT-3 activation status does not provide prognostic information in resected disease.
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Affiliation(s)
- Tania Cortas
- From the Department of Medicine, Divisions of Hematology/Oncology, Case Comprehensive Cancer Center, Case Western Reserve University and University Hospitals of Cleveland, OH 44106, United States
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Abstract
Epidermal growth factor receptor (EGFR) is overexpressed in several epithelial malignancies, including head and neck squamous cell carcinoma (HNSCC), which exhibits EGFR overexpression in up to 90% of tumors. EGFR ligands such as transforming growth factor alpha are also overexpressed in HNSCC. EGFR plays a critical role in HNSCC growth, invasion, metastasis and angiogenesis. However, EGFR inhibitors as monotherapy have yielded only modest clinical outcomes. Potential mechanisms for lack of response to EGFR inhibition in HNSCC include constitutive activation of signaling pathways independent of EGFR, as well as genetic aberrations causing dysregulation of the cell cycle. EGFR-directed therapy may be optimized by identifying and selecting those HNSCC patients most likely to benefit from EGFR inhibition. Resistance to EGFR inhibition may be circumvented by combination therapy employing EGFR inhibitors together with other treatment modalities.
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Affiliation(s)
- Shailaja Kalyankrishna
- Department of Otolaryngology, University of Pittsburgh Cancer Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Haura EB, Zheng Z, Song L, Cantor A, Bepler G. Activated epidermal growth factor receptor-Stat-3 signaling promotes tumor survival in vivo in non-small cell lung cancer. Clin Cancer Res 2006; 11:8288-94. [PMID: 16322287 DOI: 10.1158/1078-0432.ccr-05-0827] [Citation(s) in RCA: 179] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
PURPOSE Signal transducers and activators of transcription 3 (Stat3), a member of the STAT family of transcription factors, regulates multiple oncogenic pathways, including pathways regulating tumor cell survival. We evaluated Stat3 activation in early stage non-small cell lung cancers (NSCLC) and how this relates to upstream epidermal growth factor receptor (EGFR) activation, tumor apoptosis, and prognosis. EXPERIMENTAL DESIGN High-density tissue microarrays using tissues from 176 surgically resected NSCLC were evaluated for expression of phosphorylated Stat3 (pStat3) and epidermal growth factor receptor (pEGFR) along with tumor apoptosis. Using NSCLC cell lines, we evaluated how pStat3 expression relates to EGFR mutations and sensitivity of cells to gefitinib. RESULTS We identified nuclear pStat3 expression in 54% of tumors. pStat3 expression was correlated with smaller tumors (P < 0.0001) and with limited smoking history (P = 0.02). We identified a trend toward higher pStat3 expression in adenocarcinomas compared with other tumor histology (P = 0.09). No relationship was found between pStat3 and prognosis following surgical resection. Importantly, we found a strong positive correlation between pEGFR expression and pStat3 expression (P <0.0001) and an inverse correlation between pStat3 and apoptosis (P = 0.01) consistent with less apoptosis in tumors expressing high amounts of pStat3. Cell lines with mutant EGFR have increased levels of pStat3 compared with cell lines without mutant EGFR and this correlates with their sensitivity to gefitinib. Finally, antisense-mediated knockdown of Stat3 induces apoptosis in EGFR mutant lung cancer cells. CONCLUSIONS Early-stage NSCLC tumors have activated EGFR-Stat3 signaling with low apoptosis. Our findings suggest that pStat3 expression may be helpful in identifying patients appropriate for treatment with EGFR tyrosine kinase inhibitors.
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Affiliation(s)
- Eric B Haura
- Thoracic Oncology Program and Biostatistics Core, The H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612-9497, USA
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