Multiplexed AQUA-based assessment of SWOG 9313 shows prognostic value of continuous ER, PR and HER2 assessment

Abstract #704

Introduction: HER2 is expressed at high levels due to gene amplification in about 15% of breast cancer cases and it has been shown to be a poor prognostic marker. However, HER2 is also expressed in normal breast duct tissue, albeit a much lower levels. We hypothesized that continuous analysis of expression using AQUA will provide prognostic information beyond that attainable with conventional methods.
 Methods: A tissue microarray was made from 2123 cases of the 3122 patients accrued to SWOG 9313, in which sequential doxorubicin and cyclophosphamide (A-C) was compared to combination AC. A multiplexed assessment of HER2 and estrogen receptor (ER) was performed on the same slide using the immunofluoresence-based AQUA® method of automated quantitative analysis. Reproducibility and fidelity of multiplexing were determined for each marker by regression analysis.
 Results: As expected, both ER and PR were significantly predictive of disease-free survival (DFS) when both are tested as continuous variables, both adjusted for node status, tumor size, treatment and menopausal status (p-values 0.005 and <0.001, respectively). HER2, measured as a continuous variable showed a bi-phasic effect. It has been previously reported (Camp et al, Cancer Research 2003, 63;1445) that both the high and low expressers of HER2 have worse outcome (low levels are equivalent to that seen in normal breast ducts). Splitting the SWOG cohort by deciles shows that both the top and bottom decile have worse DFS than the middle 80% (log rank p=0.012). Also, modeling the hazard ratio as a function of concentration shows a U-shape relationship showing both high and low HER2 expression is associated with poorer DFS.
 Conclusions: The AQUA method provides a reproducible method of continuous measurement of ER, and HER2 on the same slide. In this cohort both ER and PR as continuous variable are highly prognostic, as expected, but multiplexing with HER2 did not affect outcome. Quantitative analysis demonstrated that both low and high levels of HER2 expression were associated with poor outcome. Studies are ongoing to determine the significance of this observation with respect to biological classifications of breast cancer and relationships with breast cancer therapies.

Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 704.

Identification and initial evaluation of 4-N-aryl-[1,4]diazepane ureas as potent CXCR3 antagonists

The identification and evaluation of aryl-[1,4]diazepane ureas as functional antagonists of the chemokine receptor CXCR3 are described. Specific examples exhibit IC(50) values of approximately 60 nM in a calcium mobilization functional assay, and dose-dependently inhibit CXCR3 functional response to CXCL11 (interferon-inducible T-cell alpha chemoattractant/I-TAC) as measured by T-cell chemotaxis, with a potency of approximately 100 nM.

Receptor−Ligand Binding in the Cell−Substrate Contact Zone: A Quantitative Analysis Using CX3CR1 and CXCR1 Chemokine Receptors†

Receptor-ligand binding analyses have generally used soluble components to measure thermodynamic binding constants. In their biological context, adhesion receptors bind to an immobile ligand and the binding reaction is confined to the cell-substrate contact zone. We have developed a new procedure based on the spinning disk technology to measure the number of receptor-ligand bonds in the contact zone. Application of this methodology to the CX3CR1-fractalkine and the CXCR1-IL-8 receptor-ligand systems demonstrated that the level of binding to an immobilized ligand is reduced by several orders of magnitude in comparison to solution binding. A comparison of the solution binding and contact zone binding constants shows that the effect of ligand immobilization was similar for each system. In contrast, although the CXCR1-IL-8 bond had the higher affinity, the average bond strength was only 10% of that for the CX3CR1 bond. Because fractalkine can be expressed as a cell surface-bound protein, CX3CR1 has been proposed to function as an adhesion receptor. The higher bond strength suggests that the bond architecture has also evolved to serve an adhesion function.

Genetic anticipation in a large family with pure autosomal dominant hereditary spastic paraplegia

We have reinvestigated a large kindred identified over 25 years ago segregating for a form of pure autosomal dominant hereditary spastic paraplegia (HSP). We have examined additional relatives in order to refine the clinical and genetic characteristics of this disorder, and performed an analysis to determine if anticipation is present in this family. Analysis of onset ages in parent-to-child transmissions of HSP is consistent with anticipation. These results provide support for dynamic mutation as the underlying mechanism of this form of HSP, and suggest a trinucleotide repeat instability occurring primarily in the female germ line.

Identification and molecular characterization of fractalkine receptor CX3CR1, which mediates both leukocyte migration and adhesion

Leukocyte trafficking at the endothelium requires both cellular adhesion molecules and chemotactic factors. Fractalkine, a novel transmembrane molecule with a CX3C-motif chemokine domain atop a mucin stalk, induces both adhesion and migration of leukocytes. Here we identify a seven-transmembrane high-affinity receptor for fractalkine and show that it mediates both the adhesive and migratory functions of fractalkine. The receptor, now termed CX3CR1, requires pertussis toxin-sensitive G protein signaling to induce migration but not to support adhesion, which also occurs without other adhesion molecules but requires the architecture of a chemokine domain atop the mucin stalk. Natural killer cells predominantly express CX3CR1 and respond to fractalkine in both migration and adhesion. Thus, fractalkine and CX3CR1 represent new types of leukocyte trafficking regulators, performing both adhesive and chemotactic functions.

Primary structure and mRNA localization of protein F1, a growth-related protein kinase C substrate associated with synaptic plasticity

Protein F1 is a neuron-specific, synaptic-enriched, membrane-bound substrate of protein kinase C (PKC) whose phosphorylation is related to synaptic plasticity in the adult. The sequence of 26 N-terminal amino acids was determined from purified rat protein F1. A 78-mer synthetic oligonucleotide designed from the partial N-terminal sequence enabled identification of protein F1 cDNA clones in a rat brain library. F1 protein is a 226 amino acid protein encoded by a 1.5 kb brain-specific, developmentally-regulated mRNA. Transcripts for protein F1 can be detected at birth, and their level declines after maturation. A full-length cDNA clone was transcribed and translated in vitro. Translation products could be immunoprecipitated with anti-F1 antibodies. In situ hybridization analysis revealed protein F1 transcripts in hippocampal pyramidal cells, but not in granule cells. In cerebellum, granule cells contained protein F1 mRNA, while Purkinje cells did not. Co-localization of protein F1 with protein kinase C-II [PKC-II (beta)], rather than PKC-I (gamma) suggests that PKC-II may phosphorylate protein F1.

Non-invasive measurement of renal blood flow with 99mTc DTPA: comparison with radiolabelled microspheres

This technique for non-invasive measurement of renal blood flow is based on the principle of fractionation of cardiac output, and applicable with any recirculating gamma activity tracer. It effectively determines the count rate that would be recorded over the kidney if the tracer behaved like radiolabelled microspheres and was completely trapped in the kidney on first pass. After correction for kidney depth, the estimated first pass activity plateau, expressed as a fraction of the injected dose, is equal to the kidney's fraction of cardiac output. The principle of the technique was validated by comparison with renal blood flow based on radiolabelled microspheres. Nine separate comparisons were made in two anaesthetised dogs. A known dose of 99mTc radiolabelled microspheres (particle size 23-45 microns) was injected into the left ventricle and the count rate over each kidney recorded. A known dose of 99mTc diethylenetriaminepenta acetic acid (DTPA) was then given as an intravenous bolus and the data recorded dynamically with a gamma camera online to a computer. After subtraction of the stable signal arising from the preceding radiolabelled microspheres, the theoretical first pass activity plateau from the DTPA that would have been recorded if the DTPA, after reaching the systemic circulation, had behaved like radiolabelled microspheres and become completely trapped in the renal vascular bed, was estimated. Using doses based on syringe counts before and after injection the ratio of renal blood flow values given by the two techniques (DTPA:RLMS) was 1.14 (SD 0.22) for the left kidney and 1.1(0.17) for the right. Using doses based on whole body counts, corresponding ratios were 1.05(0.11) and 1.02(0.13).(ABSTRACT TRUNCATED AT 250 WORDS)

Bone-marrow transplantation in acute leukaemia

Survival in 33 patients with resistant leukaemia treated by marrow transplantation was compared with that of 37 matched patients treated by conventional and experimental chemotherapy. All patients in the transplant group were rendered free of detectable leukaemia for periods of from 36 days to more than 2 1/2 years, while only 6 patients in the chemotherapy group achieved a haematological remission. Overall survival in both groups was poor; however, 5 patients (15%) in the transplant group remain alive and in haematological remission 1--2 1/2 years after transplantation, while no patient in the chemotherapy group survived longer than 13 months. Bone-marrow transplantation appears to offer a small but distinct possibility of long-term survival in patients with acute leukaemia resistant to conventional therapy.