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Hansen JE, Zhang S, Shirali A, May C, Cuffari B, Dubljevic V, Campbell JA, Zhou J. Abstract PD13-08: An ENT2-dependent, cell-penetrating, and DNA-damaging lupus autoantibody crosses the blood-brain barrier to target breast cancer brain metastases. Cancer Res 2021. [DOI: 10.1158/1538-7445.sabcs20-pd13-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Antibody-based immunotherapy has potential to change paradigms in the management of breast cancer brain metastases, if the blood-brain barrier (BBB) can be overcome. The autoimmune disease systemic lupus erythematosus offers an unexpected new approach to this problem. 3E10 is a lupus anti-DNA autoantibody that localizes to DNA at tumors, penetrates cells via the ENT2 nucleoside transporter, inhibits DNA repair, and is synthetically lethal to BRCA1/2 or PTEN-deficient cancer cells with impaired homologous recombination (HR). Breast cancer brain metastases exhibit increased HR defects and PTEN loss compared to primary breast tumors, and ENT2 expressed in brain endothelial cells (BECs) regulates nucleoside flux at the BBB. Further, 3E10 has previously delivered cargo protein to ischemic brain. We hypothesized that ENT2 may facilitate transport of 3E10 across the BBB, and that 3E10 could be used to treat breast cancer brain metastases. Deoxymab-1 (also known as PAT-DX1 or DX1) is a re-engineered and optimized fragment of 3E10 in pre-clinical development for use against HR-deficient tumors. In the present study we examined the ability of DX1 to cross the BBB and suppress breast cancer brain metastases.
BBB study results: ENT2-dependent transport of DX1 across the BBB was evaluated in vitro and in vivo. DX1 penetrated hCMEC/D3 BECs and crossed from apical to basolateral chambers in an hCMEC/D3 transwell model of the BBB. Integrity of the model was confirmed by measuring transendothelial electrical resistance and demonstrating the barrier prevented movement of control protein into the basolateral chamber. Expression of ENT2 in hCMEC/D3 cells was confirmed by immunostaining, and the ENT2 inhibitor dipyridamole (DP) inhibited both penetration by DX1 into the cells and its transport across the BBB transwell model. Immunodeficient mice with orthotopic GBM tumors were treated with IV and IP control buffer (n=2), IV DX1 (20 mg/kg) and IP control buffer (n=4), or IV DX1 (20 mg/kg) and IP DP (ENT2 inhibitor, 70 mg/kg) (n=4). DX1 was labeled with Alexa Fluor 750 (AF750) to allow detection by IVIS. Twenty-four hours after treatment, mice treated with DX1 in the absence of DP exhibited strong AF750 signal in the brain correlating to tumor. Co-treatment with DP reduced uptake of DX1 into the brain tumors by ~78% (P<0.001). These findings are consistent with DX1 crossing the BBB and localizing into brain tumors in an ENT2-dependent manner.
Efficacy study results: The 231-BR brain-seeking subclone of the MDA-MB-231 triple negative breast cancer cell line exhibits PTEN loss relative to parental cells. DX1 penetrated and killed 231-BR cells in vitro. For in vivo testing, brain metastases were generated in immunodeficient mice by intracardiac injection of 231-BR cells engineered for expression of luciferase. Brain metastases were confirmed by IVIS one week later, and then mice were treated with IV control buffer (PBS, n=7) or DX1 (20 mg/kg, n=7). In separate studies DX1 was delivered as a single cycle or as four consecutive cycles, with one cycle defined as control or DX1 3X/week. DX1 significantly suppressed tumor growth, evidenced by weekly IVIS. At week 5 brain radiance efficiencies (x105) in the single cycle study in control and DX1-treated mice were 264.8±72.0 and 71.9±31.3 (P<0.04), and 320±66 and 20.2±8.5 (P≤0.01) in the four-cycle study. One cycle of DX1 yielded a non-significant increase in median survival from 30 to 35 days (P=0.42). Four cycles of DX1 had greater impact, with median survival increased by 14 days (from 31 to 45) (P<0.002). DX1 was not associated with nonspecific toxicity.
Conclusion: Our findings support an ENT2-mediated mechanism of BBB penetration by DX1 and establish proof of concept for use of a DNA-targeting autoantibody against breast cancer brain metastases.
Citation Format: James E Hansen, Shenqi Zhang, Anupama Shirali, Christopher May, Benedette Cuffari, Valentina Dubljevic, James A Campbell, Jiangbing Zhou. An ENT2-dependent, cell-penetrating, and DNA-damaging lupus autoantibody crosses the blood-brain barrier to target breast cancer brain metastases [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PD13-08.
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Rattray Z, Deng G, Zhang S, Shirali A, May C, Liu J, Zou P, Cuffari B, Rattray N, Johnson C, Dubljevic V, Campbell J, Huttner A, Baehring J, Zhou J, Hansen J. 64. AN ENT2-DEPENDENT, CELL-PENETRATING, AND DNA-DAMAGING LUPUS AUTOANTIBODY CROSSES THE BLOOD-BRAIN BARRIER TO TARGET BRAIN TUMORS. Neurooncol Adv 2020. [PMCID: PMC7401412 DOI: 10.1093/noajnl/vdaa073.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
The blood-brain barrier (BBB) limits conventional antibody-based approaches to brain tumors. ENT2, an equilibrative nucleoside transporter, facilitates penetration of autoantibodies into live cells and is expressed in the BBB. PAT-DX1 (also known as Deoxymab-1 or DX1) is an ENT2-dependent, cell-penetrating, and DNA-damaging lupus autoantibody that is synthetically lethal to cancer cells with defects in the DNA damage response. PTEN loss renders sensitivity to DX1 and is common in primary and metastatic brain tumors. We show that DX1 is toxic to spheroids derived from primary PTEN-deficient glioblastoma (GBM), and crosses the BBB to suppress the growth of orthotopic GBM and breast cancer brain metastases. Mechanistically, we find the ENT2 inhibitor dipyridamole blocks DX1 penetration into brain endothelial cells and transport across the BBB in vitro and in vivo, consistent with ENT2-mediated uptake of DX1 into brain tumors. Autoantibodies that hijack nucleoside transporters to cross cell membranes may open new frontiers in brain tumor therapy.
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Affiliation(s)
| | - Gang Deng
- Yale School of Medicine, New Haven, CT, USA
| | | | | | | | - Jun Liu
- Yale School of Medicine, New Haven, CT, USA
| | - Pan Zou
- Yale School of Medicine, New Haven, CT, USA
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Palmeri R, Rizzo AG, Cuffari B, Lo Forti B, Di Pietro N, Gorgone S, Sampiero G, Barbuscia M, Dattola P. [ Tissue and blood CEA levels in stomach cancer]. MINERVA CHIR 1993; 48:153-6. [PMID: 8479651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The assays of serum CEA is a useful prognostic marker in patients with stomach cancer. In this study pre-operative serum CEA and tissue CEA in tumour or biopsy were assayed in a group of patients with gastric carcinoma in order to assess their prognostic roles. Based on an analysis of the results the authors affirm that high serum CEA levels in patients with advanced stages of stomach cancer indicate a fatal prognosis, and likewise the finding of tissue CEA in loco-regional lymph nodes at the same concentration as that in the primary tumour is also the sign of a severe prognosis.
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Affiliation(s)
- R Palmeri
- Istituto di Chirurgia Generale, Università degli Studi di Messina
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Gorgone S, Rizzo AG, Navarra G, Rigoli L, Cuffari B, Palmeri R, Di Pietro N, Sampiero G, Caruso R, Barbuscia M. [Anatomo-clinical considerations on early gastric cancer]. Ann Ital Chir 1992; 63:615-8. [PMID: 1290367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
After having asserted the still rising interest for an as early as possible diagnosis of gastric cancer, authors refer on a group of patients who are carriers of Early gastric cancer. After having touched upon localization and histological characteristics of neoplasms, linger on the rules that leaded their therapeutic choice and they report the results of a follow-up dragged ten years long. They terminate affirming only a timeliness diagnosis can consent a really decisive therapeutic approach.
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Affiliation(s)
- S Gorgone
- Istituto di Chirurgia Generale, Università degli Studi di Messina
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Dattola P, Barbuscia M, Gorgone S, Sampiero G, Di Pietro N, Cuffari B, Dattola A. [Preoperative prevention of nosocomial infections]. MINERVA CHIR 1992; 47:339-43. [PMID: 1594137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- P Dattola
- Istituto di Chirurgia Generale, Università degli Studi di Messina
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Sampiero GM, Papalia G, Caruso R, Rando L, Rizzo AG, Cuffari B, Lo Forti B, Di Pietro N, Gorgone S, Barbuscia M. [Study of the APUD cells of the gastric mucosa]. G Chir 1990; 11:539-41. [PMID: 1981138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The results of an histochemical and microscopic study of the APUD cells carried on gastric biopsies are reported. Endocrine cell hyperplasia, microscopically detected, was particularly evident in atrophic gastritis (type A chronic gastritis) and adenomas. The presence of the APUD cells confirmed by electronmicroscopy, which revealed granules of 200 NM with a central nucleus and a membrane-separating electron-lucent ring, gives a further contribution to the hypothesis of a possible association between endocrine cell hyperplasia and intestinal metaplasia.
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Affiliation(s)
- G M Sampiero
- Istituto di Chirurgia Generale, Università degli Studi di Messina
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Lemma F, Cuffari B, Rizzo AG, Giordano T, Trovato M, D'Anna F. [Minimal breast carcinoma (the authors' experience)]. Chir Ital 1990; 42:95-9. [PMID: 1966244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The authors relate their experience about twenty-one cases of impalpable lesions of the breast come to their observation during the years 84-88. After expanding therapeutical tactics carried out by them, the promoters infer asserting that a wide diffusion of screening programmes allowed a more verifications of the minute lesions of the breast, addressing the surgeon towards operations more and more conservatives.
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Affiliation(s)
- F Lemma
- I Clinica Chirurgica e Terapia Chirurgica, Università degli Studi di Messina
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Lo Forti B, Sampiero MG, Gorgone S, Di Pietro N, Cuffari B, Lazzara S, Trimboli C, Trovato M, Lemma F. [Unilateral polycystic renal dysplasia]. G Chir 1990; 11:307-9. [PMID: 2248874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Authors report two cases of unilateral multicystic kidney dysplasia comparing the etiopathogenetic and clinical characteristics with those of polycystic kidney disease. They conclude with some considerations on the current therapeutic trend in these cases.
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Affiliation(s)
- B Lo Forti
- I Clinica Chirurgica, Università degli Studi di Messina
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Lemma F, Di Pietro N, Cuffari B, Lazzara S, Navarra G, Rizzo AG, Giordano T, Rifatto P, Terrazzini A. [Role of screening as an index of predictability in the early diagnosis of nonpalpable lesions of the breast]. G Chir 1990; 11:279-84. [PMID: 2248868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Authors, on the basis of their personal experience and supported by more significative data from the international literature, underline the validity of the screening in detecting non palpable lesions of the breast. They conclude by asserting that mortality for breast cancer may be further reduced if more and more women undergo screening programmes.
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Affiliation(s)
- F Lemma
- I Clinica Chirurgica Generale e Terapia Chirurgica, Università degli Studi di Messina
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Lo Forti B, Arsena A, Dattola P, Sampiero MG, Gorgone S, Di Pietro N, Cuffari B, Cancellieri A, Valente G. [Tumors of the testicle]. G Chir 1990; 11:247-9. [PMID: 2223518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The authors describe, in the light of the current literature, the clinical, diagnostic, and therapeutic characteristic of testicular cancer. They remark the good results of adjuvant therapy in this type of tumor.
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Affiliation(s)
- B Lo Forti
- I Clinica Chirurgica, Università degli Studi di Messina
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Lemma F, Dattola P, Barbuscia M, Sampiero G, Gorgone S, Di Pietro N, Cuffari B, Lo Forti B, Navarra G. [Autologous dermal graft in the treatment of hernia of the abdominal wall. A clinical contribution]. G Chir 1990; 11:29-32. [PMID: 2223466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The A.A. after reporting the different methods of treatment of the abdomen wall herniation relate about the advantages of autologous dermis graft. Pointing out their experience they conclude that dermis for its perfect tolerability and absence of complications gives considerable probabilities of success.
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Affiliation(s)
- F Lemma
- Istituto di Chirurgia Generale, Università degli Studi di Messina
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Lo Forti B, Barbuscia M, Sampiero MG, Gorgone S, Di Pietro N, Cuffari B, Navarra G, Rifatto P, Rizzo AG. [Wilms' tumor in adults]. G Chir 1990; 11:47-50. [PMID: 2171619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The Authors report a case of Wilms' tumor in a 38-year-old woman. Through a review of such neoplastic condition some etiopathogenetic and clinical considerations are made. It is concluded that postsurgical adjuvant therapy in adulthood must not differ from that of childhood.
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Affiliation(s)
- B Lo Forti
- Istituto di Chirurgia Generale, Università degli Studi di Messina
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Lemma F, Dattola P, Sferlazzas G, Cuffari B, Signati M, Navarra G, Di Mauro S. [Current trends in the treatment of neoplastic occlusion of the colon]. Minerva Med 1989; 80:733-6. [PMID: 2779831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- F Lemma
- Istituto di Chirurgia Generale, Università di Messina
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Lemma F, Dattola P, Arsena A, Barbuscia M, Cuffari B, Salibra M, Torchia U, Filippone GF, Punturiero R, Terrazzini A. [Clinico-therapeutic considerations on primary gastric lymphoma]. G Chir 1989; 10:111-3. [PMID: 2518535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The Authors report four cases of primary gastric lymphomas. They stress the anatomopathological, clinical and therapeutic problems related to this disease because, at present, they are still discussed.
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Lemma F, Barbuscia M, Dattola P, Gorgone S, Di Pietro N, Labruto G, Cuffari B, Trovato M. [Multiple primary tumors of the breast: our experience]. G Chir 1988; 9:587-90. [PMID: 3155224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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