Abstract P5-03-02: The dynamic duo: A breast cancer-targeting nanoparticle loaded with a cytotoxic peptide as a treatment for metastatic disease

Metastatic breast cancer is a uniformly fatal disease with a 5-year survival rate of 15 percent. To date there are no effective approaches for targeted therapy. To develop a treatment for metastatic cancer, our group discovered a novel cytotoxic peptide, CT20p, and developed a nanotechnology-based platform to deliver and concentrate CT20p in breast tumors. CT20p was derived from Bax, a member of the Bcl-2 family. Unlike the parent protein, CT20p does not cause apoptosis and its cytotoxicity is independent of caspases and Bcl-2 overexpression. Rather, the intracellular target of CT20p is a protein called chaperonin-containing T-complex (CCT), which is required for the folding of actin and tubulin into their native forms. Inhibition of CCT activity by CT20p, indicated by decreased F-actin and tubulin, impaired the polymerization of microfilaments and microtubules, causing loss of cell migration and adhesion that promoted breast cancer cell death. In contrast, normal, non-transformed cells were resistant to the cytotoxicity of CT20p. On its own, CT20p is not membrane-permeable. To deliver the peptide to cells, we used nanoparticles formed with a novel aliphatic hyperbranched polyester polymer (HBPE-NPs). The surface of HBPE-NPs retains carboxylic acid groups for labeling of targeting ligands to enable accumulation in tumors. To concentrate on breast cancer, we functionalized the HBPE-NPs with either folate (FOL) or glutamate (GLU), which target the folate receptor (FR) or the metabotropic glutamate receptor (GRM-1) respectively. FR and GRM-2 are essential metabolic components that are highly expressed in solid tumors like breast cancer. In vitro targeting studies using triple negative breast cancer cell (TNBC) lines established that folate FOL or GLU-HBPE-NPs loaded with fluorescent dyes were readily up taken at high efficiency by TNBC cells. HBPE-NPs also contain unique hydrophobic cavities especially suited for encapsulating CT20p. We found that once the CT20p-HBPE-NPs were taken up by cancer cells, the peptide was released inside cells under acidic conditions (e.g. endosomes) and directly interacted with its intracellular target, CCT. Studies using primary cells derived from human breast tumors confirmed the targeted uptake of HBPE-NPs as well as demonstrated the cancer-specific cytotoxicity of CT20p. We treated a murine TNBC xenograft model with nanomolar amounts of FOL-CT20p-HBPE-NPs and achieved 100% regression of established tumors as well as prevented tumor growth. These studies indicated that CT20p is a potent and specific anti-cancer agent due to its inhibition of CCT, an essential molecular complex highly expressed in cancer cells, and that the peptide can be efficiently delivered to tumor sites using HBPE-NPs decorated with ligands to receptors, such FR or GRM-1, found on tumor cells.

Citation Format: Vishnubhotla P, Khaled AR, Khaled AS, Perez JM, Bassiouni R, Flores O, Nierenberg D. The dynamic duo: A breast cancer-targeting nanoparticle loaded with a cytotoxic peptide as a treatment for metastatic disease. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-03-02.

A new initiative with multiple sponsors to help prepare medical students to be safe and effective prescribers

Most medical schools in the US, and in other countries as well, continue to struggle to teach their medical students to be safe and effective prescribers before they graduate and set off for their residency programs. We describe a new initiative supported by several national organizations to help medical schools address this need by producing and making available online learning modules that can be used by medical students at any US medical school.

Risk of squamous cell carcinoma of the skin in relation to plasma selenium, alpha-tocopherol, beta-carotene, and retinol: a nested case-control study

We conducted a nested case-control study of squamous cell skin cancer (SCC) to determine whether risk was related to plasma concentrations of selenium, alpha-tocopherol, beta-carotene, and retinol. We derived the study sample from participants in our Skin Cancer Prevention Study, all of whom had at least one basal cell or squamous cell skin cancer before study entry. Those who developed a new squamous cell skin cancer during the 3-5-year follow-up period were selected as cases (n = 132). Controls (n = 264) were chosen at random, with matching by age, sex, and study center, from among those who did not develop SCC but were being followed actively at the time the SCC case was diagnosed. Prediagnostic plasma samples were analyzed for alpha-tocopherol, beta-carotene, and retinol using high-performance liquid chromatography. Selenium determinations were made using instrumental neutron activation analysis. Odds ratios were computed using conditional logistic regression for matched samples. We found no consistent pattern of SCC risk associated with any of the nutrients examined. The odds ratios (95% confidence intervals) for the highest versus the lowest quartiles of beta-carotene, retinol, alpha-tocopherol, and selenium were 0.73 (0.38-1.41), 1.43 (0.77-2.64), 0.89 (0.43-1.85), and 0.86 (0.47-1.58), respectively. Thus, our data add to the growing body of evidence that these nutrients, at the concentrations we evaluated, are not related strongly to SCC risk.

Acute short-term memory loss from trimethyltin exposure

We report a case of organic tin exposure in a graduate chemistry student. The inhalational and transcutaneous exposure occurred following a laboratory explosion. The patient initially presented with first and second degree burns of the face and chest, and developed an acute loss of short-term memory 72 hours after exposure. The memory loss gradually improved over the course of several months.

Continuous intratumoral infusion of methotrexate for recurrent glioblastoma: a pilot study

Five patients with documented recurrences of glioblastoma multiforme were given continuous infusions of methotrexate delivered intratumorally using implantable catheters and subcutaneous refillable pumps. A continuous infusion of methotrexate (1 mg/d) was begun with concomitant oral administration of folinic acid. The methotrexate dose was increased every 2 weeks to 3, 10, 30, and, ultimately, 75 mg/d in two patients. Samples of serum and ventricular cerebrospinal fluid (CSF) were obtained to determine the levels of methotrexate and total bioactive folates, and brain tissue was obtained from two patients for determination of methotrexate concentration. The patients survived from 7 to 49 weeks after the implantation of the infusion device. Neither the clinical examination nor sequential radiological studies gave clear evidence of reduction in tumor size. Pneumonia developed in one patient, and mild hepatitis and increased seizure frequency in another. Methotrexate was stable in the delivery system over 12 days, and ventricular CSF reached steady-state levels by 5 days. Steady-state ventricular CSF levels of methotrexate were higher than serum levels in some patients, while the reverse was true in others. Levels of total bioactive folates in the CSF did not increase above the normal range. Methotrexate concentrations were highest at the center of the tumor, but measurable amounts of methotrexate were detectable in all areas of the brain. At autopsy in four patients, variable liquefactive necrosis of the brain tumors was seen, and viable tumor was found at the periphery of the tumor bed. These preliminary results suggest that it is technically feasible to infuse methotrexate into brain tumor cavities, and show that little central nervous system or systemic toxicity was encountered in five patients. Better delineation of the safety and efficacy of this therapeutic approach will require further clinical trials.

Disparate effects of heparin on free thyroxine as measured by two radioimmunoassays: concise communication

Free thyroxine (FT4) has been measured in two groups of patients, before and after heparin, using equilibrium dialysis (ED) and two radioimmunoassays, RIA-I and RIA-II. In Group A, nine patients were tested before and after 12-24 hr of intravenous heparin, FT4 (ED) rose from 1.9 +/- 0.5 to 2.8 +/- 3.0 ng/dl, and RIA-I from 1.37 +/- 0.37 to 1.89 +/- 1.21 ng/dl, whereas RIA-II results fell from 0.97 +/- 0.38 to 0.66 +/- 0.32 ng/dl. In Group B, ten patients were tested before and after 15 min of intravenous heparin. FT4 (ED) rose from 1.7 +/- 0.7 to 3.2 +/- 1.6 ng/dl (p less than 0.02), and RIA-I rose from 1.3 +/- 0.46 to 2.02 +/- 0.01 ng/dl (P less than 0.05), whereas RIA-II results fell from 1.07 +/- 0.38 to 0.63 +/- 0.31 ng/dl (P less than 0.02). The correlation coefficient between FT4 (ED) and RIA-I in 38 paired results was 0.96, but there was no correlation between FT4 (ED) and RIA-II results.