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Aristarco V, Serrano D, Maisonneuve P, Guerrieri-Gonzaga A, Lazzeroni M, Feroce I, Macis D, Cavadini E, Albertazzi E, Jemos C, Omodeo Salè E, Cortesi L, Massarut S, Gulisano M, Daidone MG, Johansson H, Bonanni B. Fenretinide in Young Women at Genetic or Familial Risk of Breast Cancer: A Placebo-Controlled Biomarker Trial. Cancer Prev Res (Phila) 2024; 17:255-263. [PMID: 38530139 DOI: 10.1158/1940-6207.capr-23-0422] [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: 10/11/2023] [Revised: 02/15/2024] [Accepted: 03/22/2024] [Indexed: 03/27/2024]
Abstract
Fenretinide, a retinoid with a low-toxicity profile that accumulates in the breast, has been shown to prevent second breast cancer in young women. Fenretinide exhibits apoptotic and antiinvasive properties and it improves insulin sensitivity in overweight premenopausal women with insulin resistance. This study aimed to further characterize its role in cancer prevention by measuring circulating biomarkers related to insulin sensitivity and breast cancer risk.Sixty-two women, ages 20 to 46 years, healthy or who had already undergone breast cancer surgery, with a known BRCA1/2 mutation or a likelihood of mutation ≥20% according to the BRCAPRO model, were randomly assigned to receive fenretinide (200 mg/day) or placebo for 5 years (trial registration: EudraCT No. 2009-010260-41). Fasting blood samples were drawn at baseline, 12 and 36 months, and the following biomarkers were analyzed: retinol, leptin, adiponectin, retinol-binding protein 4 (RBP-4), total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, glucose, insulin, insulin-like growth factor (IGF-1), IGF-binding protein 3, sex hormone binding globulin (SHBG), testosterone, and vascular endothelial growth factor (VEGF).After 12 months of treatment, we observed a favorable effect of fenretinide on glucose (decrease; P = 0.005), insulin (decrease; P = 0.03), homeostatic model assessment index (decrease; P = 0.004), HDL cholesterol (increase; P = 0.002), even though these effects were less prominent after 36 months. Retinol and retinol-binding protein 4 markedly decreased (P < 0.0001) throughout the study. None of the other measured biomarkers changed. PREVENTION RELEVANCE Fenretinide exhibits beneficial effects on the metabolic profile, supporting its clinical use in breast cancer prevention especially in premenopausal women with a positive family history and pathogenic variants in BRCA1/2 genes. This finding requires further investigations in larger trials to confirm its role in breast cancer prevention.
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Affiliation(s)
- Valentina Aristarco
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Davide Serrano
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Patrick Maisonneuve
- Division of Epidemiology and Biostatistics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Aliana Guerrieri-Gonzaga
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Matteo Lazzeroni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Irene Feroce
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Debora Macis
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Elena Cavadini
- Molecular Pharmacology Unit, Department of Experimental Oncology, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan. Italy
| | - Elena Albertazzi
- San Raffaele Telethon Institute for Gene Therapy (SR-TIGET), IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Costantino Jemos
- Division of Pharmacy, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | | | - Laura Cortesi
- Division of Medical Oncology, Department of Oncology and Hematology, University Hospital of Modena, Modena, Italy
| | - Samuele Massarut
- Department of Medical Oncology, CRO-Centro di Riferimento Oncologico, Aviano (PN), Italy
| | | | - Maria Grazia Daidone
- Scientific Directorate, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Harriet Johansson
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
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Rocha M, Bañuls C, Bellod L, Rovira-Llopis S, Morillas C, Solá E, Víctor VM, Hernández-Mijares A. Association of serum retinol binding protein 4 with atherogenic dyslipidemia in morbid obese patients. PLoS One 2013; 8:e78670. [PMID: 24223837 PMCID: PMC3817034 DOI: 10.1371/journal.pone.0078670] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2013] [Accepted: 09/14/2013] [Indexed: 12/30/2022] Open
Abstract
Retinol binding protein 4 (RBP4) is an adipokine that may contribute to the development of insulin resistance. However, how this adipokine is affected and its possible involvement in lipid metabolism in obese patients with varying degrees of insulin resistance is yet to be determined. A total of 299 middle-aged morbid obese patients (BMI>40 kg/m(2)) were divided in euglycemic, metabolic syndrome or type 2 diabetic. Anthropometric measurements, biochemical variables and systemic RBP4 levels were determined. RBP4 levels were significantly higher in patients with metabolic syndrome and type 2 diabetes than in euglycemic subjects (42.9±14.6; 42.3±17.0 and 37.4±11.7 µg/ml, respectively) and correlated with triglycerides but not with those of HOMA-IR in the whole population. The multivariate regression model revealed that triglycerides were the strongest predictor of systemic RBP4 levels. Analysis of lipoprotein subfractions in a subpopulation of 80 subjects showed an altered profile of insulin resistant states characterized by higher VLDL, sdLDL and small HDL percentages and lower large HDL percentage. Although RBP4 levels correlated significantly with LDL particle size and small HDL percentage, the latter parameter was independently associated only with RBP4. Our study reveals that systemic RBP4 levels could play an important role in lipid metabolism in morbid obesity, increasing triglyceride levels and contributing to the formation of small HDL.
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Affiliation(s)
- Milagros Rocha
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
- CIBER CB06/04/0071 Research Group. CIBER Hepatic and Digestive Diseases, Faculty of Medicine, University of Valencia, Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
| | - Celia Bañuls
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
- Department of Medicine, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Lorena Bellod
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
| | - Susana Rovira-Llopis
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
| | - Carlos Morillas
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
- Department of Medicine, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Eva Solá
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
- Department of Medicine, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Víctor M. Víctor
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
- CIBER CB06/04/0071 Research Group. CIBER Hepatic and Digestive Diseases, Faculty of Medicine, University of Valencia, Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
- Department of Physiology, Faculty of Medicine, University of Valencia, Valencia, Spain
| | - Antonio Hernández-Mijares
- Service of Endocrinology, University Hospital Dr. Peset, Valencia, Spain
- Foundation for the Promotion of Healthcare and Biomedical Research in the Valencian Community (FISABIO), Valencia, Spain
- Institute of Health Research INCLIVA, Valencia, Spain
- Department of Medicine, Faculty of Medicine, University of Valencia, Valencia, Spain
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