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Mori H, Tanoue S, Takaji R, Ueda S, Okahara M, Ueda SS. Arterial Administration of DNA Crosslinking Agents with Restraint of Homologous Recombination Repair by Intravenous Low-Dose Gemcitabine Is Effective for Locally Advanced Pancreatic Cancer. Cancers (Basel) 2022; 14:cancers14010220. [PMID: 35008384 PMCID: PMC8750330 DOI: 10.3390/cancers14010220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/30/2021] [Accepted: 12/31/2021] [Indexed: 02/05/2023] Open
Abstract
Simple Summary Pancreatic cancer is considered incurable, and most cases are detected in the advanced stages. Establishing a new, effective interventional treatment for advanced pancreatic cancer is a pressing issue. Pretreatment with gemcitabine had a restraining effect on the homologous DNA recombination repair (HRR) of DNA crosslinking, inhibiting the function of Rad51, of which expression is found to be increased in pancreatic cancer. The aim of our prospective study was to assess the potential value of the arterial administration of DNA crosslinking agents after intravenous administration of low-dose gemcitabine for patients with advanced pancreatic cancer. We confirmed, among forty-five patients with unresectable advanced pancreatic cancer, that a patient subgroup of locally advanced pancreatic cancer (LAPC, 10 patients) who underwent these treatment courses successively more than twice in the first 6 months had 33 months of overall survival, 31 months of local progression free survival, and a complete response of 40%. This treatment can be a new treatment option for LAPC. Abstract (1) Background: Pretreatment by Rad51-inhibitory substances such as gemcitabine followed by arterial chemotherapy using antineoplastic agents causing DNA crosslink might be more beneficial for patients with locally advanced pancreatic cancers than conventional treatments. The efficacy of arterial administration of DNA crosslinking agents with pretreatment of intravenous low-dose gemcitabine for patients with unresectable locally advanced or metastatic pancreatic cancer (LAPC or MPC) is evaluated. (2) Methods: A single-arm, single-center, institutional review board-approved prospective study was conducted between 2005 and 2015. Forty-five patients (23 LAPC, 22 MPC) were included. Patients received a weekly low dose of gemcitabine intravenously for three weeks followed by arterial administration of mitomycin C and epirubicin hydrochloride at tumor-supplying arteries on the fifth or sixth week. This treatment course was repeated at 1.5-to-2-month intervals. Overall survival (OS), local progression-free survival (LPFS), and therapeutic response were evaluated. LAPC or MPC were divided according to treatment compliance, excellent or poor (1 or 2), to subgroups L1, L2, M1, and M2. (3) Results: OS of LAPC and MPC were 23 months and 13 months, respectively. The OS of LAPC with excellent treatment compliance (subgroup L1, 10 patients) was 33 months with 31 months of LPFS, and four patients (40%) had a complete response (CR). The OS of the L1 subgroup was significantly longer than those of other subgroups L2, M1, and M2, which were 17 months, 17 months, and 8 months, respectively. As Grade 3 adverse effects, severe bone marrow suppression, interstitial pneumonitis, and hemolytic uremic syndrome were observed in six (13.0%), three (6.5%), and three (6.5%) patients, respectively. (4) Conclusions: Arterial DNA crosslinking with the systemic restraint of homologous recombination repair can be a new treatment option for LAPC.
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Affiliation(s)
- Hiromu Mori
- Department of Radiology, Nagato Memorial Hospital, Saiki 876-0835, Japan;
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (S.T.); (R.T.); (M.O.)
- Correspondence: ; Tel.: +81-80-4270-0753
| | - Shuichi Tanoue
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (S.T.); (R.T.); (M.O.)
- Department of Radiology, School of Medicine, Kurume University, Kurume 830-0011, Japan
| | - Ryo Takaji
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (S.T.); (R.T.); (M.O.)
| | - Shinya Ueda
- Department of Radiology, Nagato Memorial Hospital, Saiki 876-0835, Japan;
- San-Ai Medical Center, Department of Radiology, Oita 870-1151, Japan
- Department of Radiology, Shin-Beppu Hospital, Beppu 874-8538, Japan
| | - Mika Okahara
- Department of Radiology, Faculty of Medicine, Oita University, Yufu 879-5593, Japan; (S.T.); (R.T.); (M.O.)
- Department of Radiology, Shin-Beppu Hospital, Beppu 874-8538, Japan
| | - Saori Sugi Ueda
- Department of Gastroenterology, Shin-Beppu Hospital, Beppu 874-8538, Japan;
- San-Ai Medical Center, Department of Gastroenterology, Oita 870-115, Japan
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Pan C, Otsuka Y, Sridharan B, Woo M, Leiton CV, Babu S, Torrente Gonçalves M, Kawalerski RR, K. Bai JD, Chang DK, Biankin AV, Scampavia L, Spicer T, Escobar‐Hoyos LF, Shroyer KR. An unbiased high-throughput drug screen reveals a potential therapeutic vulnerability in the most lethal molecular subtype of pancreatic cancer. Mol Oncol 2020; 14:1800-1816. [PMID: 32533886 PMCID: PMC7400780 DOI: 10.1002/1878-0261.12743] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/26/2020] [Accepted: 06/03/2020] [Indexed: 01/05/2023] Open
Abstract
Pancreatic ductal adenocarcinoma (PDAC) is predicted to become the second leading cause of cancer-related deaths in the United States by 2020, due in part to innate resistance to widely used chemotherapeutic agents and limited knowledge about key molecular factors that drive tumor aggression. We previously reported a novel negative prognostic biomarker, keratin 17 (K17), whose overexpression in cancer results in shortened patient survival. In this study, we aimed to determine the predictive value of K17 and explore the therapeutic vulnerability in K17-expressing PDAC, using an unbiased high-throughput drug screen. Patient-derived data analysis showed that K17 expression correlates with resistance to gemcitabine (Gem). In multiple in vitro and in vivo models of PDAC, spanning human and murine PDAC cells, and orthotopic xenografts, we determined that the expression of K17 results in a more than twofold increase in resistance to Gem and 5-fluorouracil, key components of current standard-of-care chemotherapeutic regimens. Furthermore, through an unbiased drug screen, we discovered that podophyllotoxin (PPT), a microtubule inhibitor, showed significantly higher sensitivity in K17-positive compared to K17-negative PDAC cell lines and animal models. In the clinic, another microtubule inhibitor, paclitaxel (PTX), is used in combination with Gem as a first-line chemotherapeutic regimen for PDAC. Surprisingly, we found that when combined with Gem, PPT, but not PTX, was synergistic in inhibiting the viability of K17-expressing PDAC cells. Importantly, in preclinical models, PPT in combination with Gem effectively decreased tumor growth and enhanced the survival of mice bearing K17-expressing tumors. This provides evidence that PPT and its derivatives could potentially be combined with Gem to enhance treatment efficacy for the ~ 50% of PDACs that express high levels of K17. In summary, we reported that K17 is a novel target for developing a biomarker-based personalized treatment for PDAC.
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Affiliation(s)
- Chun‐Hao Pan
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
- Molecular and Cellular Biology Graduate ProgramStony Brook UniversityNYUSA
| | | | | | - Melissa Woo
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
- Simons Summer Research ProgramStony Brook UniversityNYUSA
| | - Cindy V. Leiton
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
| | - Sruthi Babu
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
- Department of Family, Population & Preventive MedicineRenaissance School of MedicineStony Brook UniversityNYUSA
| | | | - Ryan R. Kawalerski
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
| | - Ji Dong K. Bai
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
| | - David K. Chang
- Wolfson Wohl Cancer Research CentreInstitute of Cancer SciencesUniversity of GlasgowUK
- West of Scotland Pancreatic UnitGlasgow Royal InfirmaryUK
| | - Andrew V. Biankin
- Wolfson Wohl Cancer Research CentreInstitute of Cancer SciencesUniversity of GlasgowUK
- West of Scotland Pancreatic UnitGlasgow Royal InfirmaryUK
| | | | | | - Luisa F. Escobar‐Hoyos
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
- Department of Therapeutic RadiologySchool of MedicineYale UniversityNew HavenCTUSA
- David M. Rubenstein Center for Pancreatic Cancer ResearchMemorial Sloan Kettering Cancer CenterNew YorkNYUSA
- Genetic Toxicology and Cytogenetics Research GroupDepartment of BiologySchool of Natural Sciences and EducationUniversidad del CaucaPopayánColombia
| | - Kenneth R. Shroyer
- Department of PathologyRenaissance School of MedicineStony Brook UniversityNYUSA
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Huang M, Zhu H, Yi C, Yan J, Wei L, Yang X, Chen S, Huang Y. A novel TRAIL mutant-TRAIL-Mu3 enhances the antitumor effects by the increased affinity and the up-expression of DR5 in pancreatic cancer. Cancer Chemother Pharmacol 2018; 82:829-838. [PMID: 30167846 DOI: 10.1007/s00280-018-3658-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Accepted: 07/23/2018] [Indexed: 02/05/2023]
Abstract
PURPOSE Pancreatic cancer is a malignant tumor of the digestive system with poor prognosis and high mortality, and the treatment of pancreatic cancer still remains a major challenge. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) can induce apoptosis selectively in cancer cells while causing virtually no damage to normal cells, which is promising for cancer therapy. However, many primary tumors and cancer cell lines including various human pancreatic cancer cell lines were found to be resistant to TRAIL-induced apoptosis. Therefore, the purpose of the study was to improve antitumor effect of TRAIL on pancreatic cancer. METHODS The 114-121 amino acid coding sequence "VRERGPQR" of wild type TRAIL protein that was selected changed into "RRRRRRRR", and the novel membrane-penetrating peptide-alike mutant protein was named TRAIL-Mu3. The antitumor effect of TRAIL-Mu3 was analyzed both in vitro and in vivo. Western blotting, immunofluorescence and flow cytometry were used to investigate the underlying mechanisms. RESULTS TRAIL-Mu3 could enhance the antitumor effects on pancreatic cancer cell lines, and the antitumor effect of TRAIL-Mu3 was stronger than gemcitabine in vivo. The immunofluorescence results suggested that TRAIL-Mu3 could remarkably enhance the affinity to pancreatic cancer cells. The Western blot results showed that treatment with TRAIL-Mu3 caused a clear cleavage of caspase-3 and caspase-8. In addition, both the Western blot and flow cytometry suggested a significantly up-expression of DR5 in TRAIL-Mu3 group. CONCLUSIONS Membrane-penetrating peptide-alike mutant-TRAIL-Mu3 induced pancreatic cancer cell death more efficiently than TRAIL, and this effect was supposed to be mediated by the increased affinity to cell membrane, the up-regulation of DR5 and the enhancement of activated caspase.
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Affiliation(s)
- Min Huang
- Department of Pathophysiology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
- Department of Physiology, Chengdu Medical College, Chengdu, 610500, Sichuan, People's Republic of China
| | - Hong Zhu
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Cheng Yi
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Juan Yan
- Chengdu Huachuang Biotechnology Co., Ltd., Chengdu, Sichuan, People's Republic of China
| | - Lijia Wei
- Chengdu Huachuang Biotechnology Co., Ltd., Chengdu, Sichuan, People's Republic of China
| | - Xi Yang
- Department of Medical Oncology, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China
| | - Shouchun Chen
- Chengdu Huachuang Biotechnology Co., Ltd., Chengdu, Sichuan, People's Republic of China.
| | - Ying Huang
- Department of Pathophysiology, West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu, 610041, Sichuan, People's Republic of China.
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