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Kramer N, Müller G, Zierold S, Röckel M, Fröhlich W, Schefzyk M, Kumbrink J, Hassel JC, Berking C, Ziemer M, Nashan D, French LE, Vera J, Kerl-French KE, Gutzmer R, Heinzerling L. Checkpoint inhibitor-induced bullous pemphigoid differs from spontaneous bullous pemphigoid. J Eur Acad Dermatol Venereol 2024. [PMID: 38400651 DOI: 10.1111/jdv.19860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/24/2024] [Indexed: 02/25/2024]
Affiliation(s)
- N Kramer
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - G Müller
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - S Zierold
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - M Röckel
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - W Fröhlich
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Schefzyk
- Department of Dermatology and Allergy, Hannover Medical School, Hannover, Germany
| | - J Kumbrink
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - J C Hassel
- Department of Dermatology, National Center for Tumor Diseases (NCT), Heidelberg University Hospital, Heidelberg, Germany
| | - C Berking
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - M Ziemer
- Department of Dermatology, Allergology and Venerology, University Medical Center, Leipzig, Germany
| | - D Nashan
- Department of Dermatology, Hospital Dortmund, Dortmund, Germany
| | - L E French
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
- Dr. Phillip Frost Department of Dermatology and Cutaneous Surgery, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - J Vera
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
| | - K E Kerl-French
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
| | - R Gutzmer
- Department of Dermatology, Johannes Wesling Medical Center, Ruhr University Bochum Campus Minden, Minden, Germany
| | - L Heinzerling
- Department of Dermatology and Allergology, University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology, Uniklinikum Erlangen, Comprehensive Cancer Center Erlangen - EMN, Friedrich-Alexander University Erlangen-Nürnberg, Erlangen, Germany
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Dewenter I, Kumbrink J, Poxleitner P, Smolka W, Liokatis P, Fliefel R, Otto S, Obermeier KT. New insights into redox-related risk factors and therapeutic targets in oral squamous cell carcinoma. Oral Oncol 2023; 147:106573. [PMID: 37951115 DOI: 10.1016/j.oraloncology.2023.106573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/13/2023] [Accepted: 09/18/2023] [Indexed: 11/13/2023]
Abstract
Oral squamous cell carcinoma (OSCC) is the most common cancer in the oral cavity accounting for 90 % of oral cancer with a global incidence of 350.000 new cases per year. Curative resection along with adjuvant radiation therapy or a combination of radiotherapy with chemotherapy remain as gold standard in treating OSCC. Still, local recurrence, lymph nodal recurrence, and complications of radiation remain the main cause of tumor-related mortality. Reactive oxygen species are not only correlated to the etiology of OSCC due to oxidative DNA damage, lipid peroxidation or effecting signal transduction cascades that effect cell proliferation and tumorigenesis, but are also of great interest in the therapy of OSCC patients. As induced oxidative stress can be used therapeutically for the induction of tumor cell death, redox targets might be a therapeutic addition to the conventional treatment options. In this review, we discuss markers of impaired redox homeostasis as well as potential redox-related treatment targets in OSCC.
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Affiliation(s)
- Ina Dewenter
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany.
| | - Joerg Kumbrink
- Institute of Pathology, Faculty of Medicine, Ludwig Maximilians University, Munich, Germany
| | - Philipp Poxleitner
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany
| | - Wenko Smolka
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany
| | - Paris Liokatis
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany
| | - Riham Fliefel
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany
| | - Sven Otto
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany
| | - Katharina Theresa Obermeier
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, University Hospital, Ludwig Maximilians University, 80337 Munich, Germany
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Koehler VF, Achterfeld J, Sandner N, Koch C, Wiegmann JP, Ivanyi P, Käsmann L, Pusch R, Wolf D, Chirica M, Knösel T, Demes MC, Kumbrink J, Vogl TJ, Meyer G, Spitzweg C, Bojunga J, Kroiss M. NTRK fusion events and targeted treatment of advanced radioiodine refractory thyroid cancer. J Cancer Res Clin Oncol 2023; 149:14035-14043. [PMID: 37548775 PMCID: PMC10590332 DOI: 10.1007/s00432-023-05134-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE Pathogenic fusion events involving neurotrophic receptor tyrosine kinase (NTRK) have been described in ~ 2% of differentiated thyroid cancer (DTC). The selective tropomyosin receptor kinase (TRK) inhibitors entrectinib and larotrectinib have been approved in a tumor agnostic manner based on phase 1/2 clinical trials. In a real-world setting at five referral centers, we aimed to describe the prevalence of NTRK gene fusions and the efficacy and safety of TRK inhibitor treatment for non-medullary, advanced thyroid cancer (TC). METHODS A total of 184 TC patients with testing for NTRK gene fusions were included. Progression-free survival (PFS) and overall survival (OS) probabilities were estimated using the Kaplan-Meier method in six patients with NTRK fusion-positive TC who underwent TRK inhibitor therapy. RESULTS 8/184 (4%) patients harbored NTRK gene fusions. Six patients with radioiodine (RAI)-refractory TC harboring NTRK1 (n = 4) and NTRK3 (n = 2) gene fusions were treated with larotrectinib. Five patients (83%) had received ≥ 1 prior systemic therapy and one patient did not receive prior systemic therapy. All patients had morphologically progressive disease before treatment initiation. Objective response rate was 83%, including two complete remissions. Median PFS from start of TRK inhibitor treatment was 23 months (95% confidence interval [CI], 0-57.4) and median OS was not reached (NR) (95% CI, NR). Adverse events were of grade 1-3. CONCLUSION The prevalence of NTRK gene fusions in our cohort of RAI-refractory TC is slightly higher than reported for all TC patients. Larotrectinib is an effective treatment option in the majority of NTRK gene fusion-positive advanced TC patients after prior systemic treatment and has a favorable safety profile.
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Affiliation(s)
| | - Josefine Achterfeld
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
| | - Natalie Sandner
- Department of Medicine I, Goethe University Hospital, Frankfurt am Main, Germany
| | - Christine Koch
- Department of Medicine I, Goethe University Hospital, Frankfurt am Main, Germany
| | - Jonas Paul Wiegmann
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Philipp Ivanyi
- Department of Hematology, Hemostasis, Oncology and Stem Cell Transplantation, Hannover Medical School, Hannover, Germany
| | - Lukas Käsmann
- Department of Radiotherapy and Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - Renate Pusch
- Department of Oncology and Hematology, Ordensklinikum Linz, Barmherzige Schwestern, Linz, Austria
| | - Dominik Wolf
- Department of Haematology and Oncology, Medical University Innsbruck, Innsbruck, Austria
| | | | - Thomas Knösel
- Department of Pathology, LMU Munich, Munich, Germany
| | - Melanie-Christin Demes
- Senckenbergisches Institut für Pathologie, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Joerg Kumbrink
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Department of Pathology, LMU Munich, Munich, Germany
| | - Thomas J. Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Gesine Meyer
- Department of Medicine I, Goethe University Hospital, Frankfurt am Main, Germany
| | - Christine Spitzweg
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
- Division of Endocrinology, Diabetes, Metabolism and Nutrition, Adjunct Academic Appointment, Mayo Clinic Rochester, Rochester, MN USA
| | - Joerg Bojunga
- Department of Medicine I, Goethe University Hospital, Frankfurt am Main, Germany
| | - Matthias Kroiss
- Department of Medicine IV, LMU University Hospital, LMU Munich, Munich, Germany
- Department of Internal Medicine I, Division of Endocrinology/Diabetology, University of Würzburg, Würzburg, Germany
- Comprehensive Cancer Center Mainfranken, University of Würzburg, Würzburg, Germany
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4
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Weiss L, Heinrich K, Zhang D, Dorman K, Rühlmann K, Hasselmann K, Klauschen F, Kumbrink J, Jung A, Rudelius M, Mock A, Ormanns S, Kunz WG, Roessler D, Beyer G, Corradini S, Heinzerling L, Haas M, von Bergwelt-Baildon M, Boeck S, Heinemann V, Westphalen CB. Cancer of unknown primary (CUP) through the lens of precision oncology: a single institution perspective. J Cancer Res Clin Oncol 2023:10.1007/s00432-023-04741-y. [PMID: 37062035 PMCID: PMC10374717 DOI: 10.1007/s00432-023-04741-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/02/2023] [Indexed: 04/17/2023]
Abstract
PURPOSE For patients with cancer of unknown primary (CUP), treatment options are limited. Precision oncology, the interplay of comprehensive genomic profiling (CGP) and targeted therapies, aims to offer additional treatment options to patients with advanced and hard-to-treat cancers. We aimed to highlight the use of a molecular tumor board (MTB) in the therapeutic management of CUP patients. METHODS In this single-center observational study, CUP patients, presented to the MTB of the Comprehensive Cancer Center Munich LMU, a tertiary care center, were analyzed retrospectively. Descriptive statistics were applied to describe relevant findings. RESULTS Between June 2016 and February 2022, 61 patients with unfavorable CUP were presented to the MTB, detected clinically relevant variants in 74% (45/61) of patients, of which 64% (29/45) led to therapeutic recommendation. In four out of 29 patients (14%), the treatment recommendations were implemented, unfortunately without resulting in clinical benefit. Reasons for not following the therapeutic recommendation were mainly caused by the physicians' choice of another therapy (9/25, 36%), especially in the context of worsening of general condition, lost to follow-up (7/25, 28%) and death (6/25, 24%). CONCLUSION CGP and subsequent presentation to a molecular tumor board led to a high rate of therapeutic recommendations in patients with CUP. Recommendations were only implemented at a low rate; however, late GCP diagnostic and, respectively, MTB referral were found more frequent for the patients with implemented treatment. This contrast underscores the need for early implementation of CGP into the management of CUP patients.
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Affiliation(s)
- L Weiss
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - K Heinrich
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - D Zhang
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - K Dorman
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - K Rühlmann
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - K Hasselmann
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - F Klauschen
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - J Kumbrink
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - A Jung
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - M Rudelius
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - A Mock
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - Steffen Ormanns
- Institute of Pathology, Faculty of Medicine, LMU Munich, Munich, Germany
| | - W G Kunz
- Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - D Roessler
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - G Beyer
- Department of Medicine II, University Hospital, LMU Munich, Munich, Germany
- Bavarian Cancer Research Center (BZKF), Munich, Germany
| | - S Corradini
- Department of Radiation Oncology, University Hospital, LMU Munich, Munich, Germany
| | - L Heinzerling
- Department of Dermatology, University Hospital, LMU Munich, Munich, Germany
- Department of Dermatology, University Hospital Erlangen, Erlangen, Germany
| | - M Haas
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - M von Bergwelt-Baildon
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - S Boeck
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - V Heinemann
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany
| | - C B Westphalen
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
- Comprehensive Cancer Center Munich, University Hospital, LMU Munich, Munich, Germany.
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany.
- Bavarian Cancer Research Center (BZKF), Munich, Germany.
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Sellmer L, Kovács J, Walter J, Kumbrink J, Neumann J, Kauffmann-Guerrero D, Kiefl R, Schneider C, Jung A, Behr J, Tufman A. 92P Exploring immune dysfunction in surgically treated early stage NSCLC. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Kruger SF, Lohneis A, Abendroth A, Berger AW, Ettrich TJ, Waidmann O, Kapp M, Steiner B, Kumbrink J, Reischer A, Haas M, Westphalen CB, Zhang D, Miller-Phillips L, Burger PJ, Kobold S, Werner J, Subklewe M, von Bergwelt-Baildon M, Kunzmann V, Seufferlein T, Siveke JT, Sinn M, Heinemann V, Ormanns S, Boeck S. Prognosis and tumor biology of pancreatic cancer patients with isolated lung metastases: translational results from the German multicenter AIO-YMO-PAK-0515 study. ESMO Open 2022; 7:100388. [PMID: 35121522 PMCID: PMC8818907 DOI: 10.1016/j.esmoop.2022.100388] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 12/09/2021] [Accepted: 12/31/2021] [Indexed: 12/25/2022] Open
Abstract
Background Pulmonary metastasis (M1-PUL) as first site of dissemination in pancreatic ductal adenocarcinoma (PDAC) is a rare event and may define a distinct biological subgroup. Patients and methods Arbeitsgemeinschaft Internistische Onkologie-Young Medical Oncologists-Pankreas-0515 study (AIO-YMO-PAK-0515) was a retrospective German multicenter study investigating clinical and molecular characteristics of M1-PUL PDAC patients; 115 M1-PUL PDAC patients from 7 participating centers were included. Clinical characteristics and potential prognostic factors were defined within the M1-PUL cohort. Archival tumor samples were analyzed for Her2/neu, HNF1A and KRT81 expression. Additionally, messenger RNA (mRNA) expression analysis (using a 770-gene immune profiling panel) was carried out in the M1-PUL and in a control cohort (M1-ANY). Results Median overall survival in the entire M1-PUL cohort was 20 months; the most favorable prognosis (median survival: 28 months) was observed in the subgroup of 66 PDAC patients with metachronous lung metastases after previous curative-intent surgery. The number of metastatic lesions, uni- or bilateral lung involvement as well as metastasectomy were identified as potential prognostic factors. Her2/neu expression and PDAC subtyping (by HNF1A and KRT81) did not differ between the M1-PUL and the M1-ANY cohort. mRNA expression analysis revealed significant differentially expressed genes between both cohorts: CD63 and LAMP1 were among the top 20 differentially expressed genes and were identified as potential mediators of organotropism and favorable survival outcome of M1-PUL patients. Conclusion M1-PUL represents a clinically favorable cohort in PDAC patients. Site of relapse might already be predetermined at the time of surgery and could potentially be predicted by gene expression profiling. The retrospective multicenter AIO-YMO-PAK-0515 study defines M1-PUL as a clinically favorable subgroup in PDAC. The number of metastatic lesions, bilateral lung involvement and surgical metastasectomy may serve as prognostic factors. Immune-related gene expression differs between patients with isolated pulmonary relapse versus other sites of relapse.
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Affiliation(s)
- S F Kruger
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany.
| | - A Lohneis
- Charité-Universitätsmedizin Berlin, Department of Medical Oncology and Hematology, Berlin, Germany; Department of Internal Medicine I, University Hospital Cologne, Cologne, Germany
| | - A Abendroth
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - A W Berger
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - T J Ettrich
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - O Waidmann
- Department of Internal Medicine I, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany; University Cancer Centre Frankfurt, University Hospital Frankfurt, Johann Wolfgang Goethe-University, Frankfurt am Main, Germany
| | - M Kapp
- Division of Medical Oncology, Department of Internal Medicine II, University Hospital Wuerzburg and Comprehensive Cancer Center Mainfranken, Wuerzburg, Germany
| | - B Steiner
- Department of Hematology and Oncology, University of Rostock, Rostock, Germany
| | - J Kumbrink
- Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - A Reischer
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - M Haas
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - C B Westphalen
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - D Zhang
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - L Miller-Phillips
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - P J Burger
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - S Kobold
- German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany; Center for Integrated Protein Science Munich and Division of Clinical Pharmacology, Department of Medicine IV, Klinikum der Ludwig-Maximilians-University of Munich, Munich, Germany
| | - J Werner
- Department of General, Visceral, Transplantation, Vascular and Thoracic Surgery, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - M Subklewe
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - M von Bergwelt-Baildon
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - V Kunzmann
- Division of Medical Oncology, Department of Internal Medicine II, University Hospital Wuerzburg and Comprehensive Cancer Center Mainfranken, Wuerzburg, Germany
| | - T Seufferlein
- Department of Internal Medicine I, Ulm University, Ulm, Germany
| | - J T Siveke
- Department of Medical Oncology, West German Cancer Center, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - M Sinn
- Charité-Universitätsmedizin Berlin, Department of Medical Oncology and Hematology, Berlin, Germany; Department of Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - V Heinemann
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - S Ormanns
- Institute of Pathology, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
| | - S Boeck
- Department of Internal Medicine III and Comprehensive Cancer Center, Klinikum Grosshadern, Ludwig-Maximilians-University of Munich, Munich, Germany; German Cancer Consortium (DKTK), Partner Site Munich, Munich, Germany
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Stahler A, Heinemann V, Schuster V, Alig AHS, Fischer LE, Weiss L, Heinrich K, Kurreck A, Jelas I, von Einem JC, Giessen-Jung C, Fischer von Weikersthal L, Vehling-Kaiser U, Decker T, Neumann J, Kirchner T, Jung A, Kumbrink J, Stintzing S, Modest DP. Consensus molecular subtypes and RAS status as biomarker of treatment intensity with fluoropyrimidine, bevacizumab, and irinotecan in metastatic colorectal cancer (XELAVIRI, AIO KRK 0110). J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.3552] [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: 11/20/2022] Open
Abstract
3552 Background: Prognostic biomarkers beside RAS/BRAF status are necessary to identify metastatic colorectal cancer (mCRC) patients who benefit from combined (COMB) versus sequential (SEQ) treatment with fluoropyrimidine, bevacizumab and irinotecan (randomized phase III XELAVIRI trial). Methods: mRNA was extracted from formalin-fixed paraffin embedded (FFPE) tumor tissue of 337 patients, gene expression was measured by the Nanostring PanCancer Progression Panel. Consensus molecular subtypes (CMS) classification was re-derived using a multinomial regression model. Data of Guinney et al. (Nat. Med. 2015. 21:1350-6) and FIRE-3 served as training and validation set. RAS/BRAF MUT were assessed by pyrosequencing. Median overall (OS) and progression free survival (PFS), hazard ratios (HR) and 95% confidence interval (CI) were estimated by Kaplan-Meier method and univariate Cox regression. Results: The multinomial regression model employed in the present analysis correctly predicted CMS labels in 98.3 % of the original Guinney- and 100.0 % of FIRE-3 population. In XELAVIRI, CMS subgroups were predicted as follows: CMS1: n = 62 (18.4 %); CMS2: n = 174 (51.6 %); CMS3: n = 9 (2.7 %); CMS4: n = 92 (27.3 %). A general prognostic impact of CMS was not observed when all patients were analysed. In RAS/BRAF WT mCRC patients, substantial benefit of COMB versus SEQ treatment was shown for OS and PFS in CMS2 and CMS4, but not in CMS1. Conversely, OS was significantly longer for COMB treatment in patients with RAS MUT and CMS1 mCRC, while SEQ treatment was not inferior in RAS MUT and CMS2 or CMS4 subgroups (see TABLE). Additional data for overall response rates, early tumor shrinkage and sidedness might be presented at the meeting. Conclusions: This retrospective analysis of XELAVIRI suggests that CMS may serve as biomarker that predicts response to initially combined versus less intensive sequential chemotherapy in patients with RAS/BRAF WT mCRC.[Table: see text]
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Affiliation(s)
- Arndt Stahler
- Medical Department, Division of Hematology, Oncology and Tumor Immunology (CCM), Charité Universitaetsmedizin Berlin, Berlin, Germany
| | | | - Veronika Schuster
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Annabel Helga Sophie Alig
- Medical Department, Divison of Hematology, Oncology, and Tumor Immunology (CCM), Charité Universitaetsmedizin, Berlin, Germany
| | | | - Lena Weiss
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
| | - Kathrin Heinrich
- Department of Medicine III, University Hospital, LMU Munich, München, Germany, Munich, Germany
| | | | - Ivan Jelas
- Charité Comprehensive Cancer Center, Berlin, Germany
| | | | - Clemens Giessen-Jung
- Department of Medicine III, University Hospital, LMU Munich, München, Germany, Munich, Germany
| | | | | | | | - Jens Neumann
- Department of Pathology, University of Munich, Munich, Germany
| | - Thomas Kirchner
- Department of Pathology, University of Munich, Munich, Germany
| | - Andreas Jung
- Department of Pathology, University of Munich, Munich, Germany
| | | | - Sebastian Stintzing
- Medical Department, Division of Hematology, Oncology, and Tumor Immunology (CCM), Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Dominik Paul Modest
- Department of Medicine III, University Hospital, LMU Munich, Munich, Germany
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8
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Ni H, Kumbrink J, Mayr D, Seiler A, Hagemann F, Degenhardt T, Sagebiel S, Wuerstlein R, Harbeck N, Eggersmann T. 55P Molecular risk factors for distant metastases in premenopausal patients with HR+/HER2- EBC. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Sultova E, Westphalen CB, Jung A, Kumbrink J, Kirchner T, Mayr D, Rudelius M, Ormanns S, Heinemann V, Metzeler KH, Greif PA, Hester A, Mahner S, Harbeck N, Wuerstlein R. Implementation of Precision Oncology for Patients with Metastatic Breast Cancer in an Interdisciplinary MTB Setting. Diagnostics (Basel) 2021; 11:733. [PMID: 33924134 PMCID: PMC8074310 DOI: 10.3390/diagnostics11040733] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/07/2021] [Accepted: 04/13/2021] [Indexed: 12/19/2022] Open
Abstract
The advent of molecular diagnostics and the rising number of targeted therapies have facilitated development of precision oncology for cancer patients. In order to demonstrate its impact for patients with metastatic breast cancer (mBC), we initiated a Molecular Tumor Board (MTB) to provide treatment recommendations for mBC patients who had disease progression under standard treatment. NGS (next generation sequencing) was carried out using the Oncomine multi-gene panel testing system (Ion Torrent). The MTB reviewed molecular diagnostics' results, relevant tumor characteristics, patient's course of disease and made personalized treatment and/or diagnostic recommendations for each patient. From May 2017 to December 2019, 100 mBC patients were discussed by the local MTB. A total 72% of the mBC tumors had at least one molecular alteration (median 2 per case, range: 1 to 6). The most frequent genetic changes were found in the following genes: PIK3CA (19%) and TP53 (17%). The MTB rated 53% of these alterations as actionable and treatment recommendations were made accordingly for 49 (49%) patients. Sixteen patients (16%) underwent the suggested therapy. Nine out of sixteen patients (56%; 9% of all) experienced a clinical benefit with a progression-free survival ratio ≥ 1.3. Personalized targeted therapy recommendations resulting from MTB case discussions could provide substantial benefits for patients with mBC and should be implemented for all suitable patients.
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Affiliation(s)
- Elena Sultova
- Department of Obstetrics and Gynecology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (E.S.); (A.H.); (S.M.); (N.H.)
| | - C. Benedikt Westphalen
- Department of Internal Medicine III and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (C.B.W.); (V.H.); (K.H.M.); (P.A.G.)
| | - Andreas Jung
- Institute of Pathology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (A.J.); (J.K.); (T.K.); (D.M.); (M.R.); (S.O.)
| | - Joerg Kumbrink
- Institute of Pathology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (A.J.); (J.K.); (T.K.); (D.M.); (M.R.); (S.O.)
| | - Thomas Kirchner
- Institute of Pathology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (A.J.); (J.K.); (T.K.); (D.M.); (M.R.); (S.O.)
| | - Doris Mayr
- Institute of Pathology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (A.J.); (J.K.); (T.K.); (D.M.); (M.R.); (S.O.)
| | - Martina Rudelius
- Institute of Pathology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (A.J.); (J.K.); (T.K.); (D.M.); (M.R.); (S.O.)
| | - Steffen Ormanns
- Institute of Pathology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (A.J.); (J.K.); (T.K.); (D.M.); (M.R.); (S.O.)
| | - Volker Heinemann
- Department of Internal Medicine III and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (C.B.W.); (V.H.); (K.H.M.); (P.A.G.)
| | - Klaus H. Metzeler
- Department of Internal Medicine III and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (C.B.W.); (V.H.); (K.H.M.); (P.A.G.)
| | - Philipp A. Greif
- Department of Internal Medicine III and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (C.B.W.); (V.H.); (K.H.M.); (P.A.G.)
| | - Anna Hester
- Department of Obstetrics and Gynecology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (E.S.); (A.H.); (S.M.); (N.H.)
| | - Sven Mahner
- Department of Obstetrics and Gynecology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (E.S.); (A.H.); (S.M.); (N.H.)
- Gynecologic Oncology Center and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany
| | - Nadia Harbeck
- Department of Obstetrics and Gynecology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (E.S.); (A.H.); (S.M.); (N.H.)
- Breast Center and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany
| | - Rachel Wuerstlein
- Department of Obstetrics and Gynecology and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany; (E.S.); (A.H.); (S.M.); (N.H.)
- Gynecologic Oncology Center and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany
- Breast Center and CCC Munich LMU University Hospital, Ludwig Maximilians University (LMU), 81377 Munich, Germany
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10
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Ni H, Kurt A, Kumbrink J, Seiler A, Mayr D, Hagemann F, Degenhardt T, Würstlein R, Harbeck N, Eggersmann T. Gene expression profiles in premenopausal women with HR+ HER2- early breast cancer. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1717863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- H Ni
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - A Kurt
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - J Kumbrink
- Faculty of Medicine, Institute of Pathology, University of Munich (LMU)
| | - A Seiler
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - D Mayr
- Faculty of Medicine, Institute of Pathology, University of Munich (LMU)
| | - F Hagemann
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - T Degenhardt
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - R Würstlein
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - N Harbeck
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
| | - T Eggersmann
- Breast Center, Department of Gynecology and Obstetrics and Comprehensive Cancer Center
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11
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Ni H, Kurt A, Kumbrink J, Seiler A, Mayr D, Degenhardt T, Hagemann F, Würstlein R, Harbeck N, Eggersmann T. Gene expression profiles in premenopausal women with HR+ HER2− early breast cancer. Eur J Cancer 2020. [DOI: 10.1016/s0959-8049(20)30731-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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12
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Sultova E, CB W, Jung A, Kirchner T, Mayr D, Rudelius M, Ormanns S, Kumbrink J, Heinemann V, Metzeler K, PA G, Trillsch F, Mahner S, Harbeck N, Würstlein R. Panel-guided personalized medicine in metastatic breast and gynecological cancer: First experiences at the CCC Munich and clinically relevant changes over time. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1718188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Sultova
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
| | - Westphalen CB
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - A Jung
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - T Kirchner
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - D Mayr
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - M Rudelius
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - S Ormanns
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - J Kumbrink
- LMU Klinikum der Universität München, Pathologisches Institut und CCC München
| | - V Heinemann
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - K Metzeler
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - Greif PA
- LMU Klinikum der Universität München, Medizinische Klinik und Poliklinik III und CCC München
| | - F Trillsch
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Gynäkologisches Krebszentrum und CCC München
| | - S Mahner
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Gynäkologisches Krebszentrum und CCC München
| | - N Harbeck
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Brustzentrum und CCC München
| | - R Würstlein
- LMU Klinikum der Universität München, Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe und CCC München
- LMU Klinikum der Universität München, Gynäkologisches Krebszentrum und CCC München
- LMU Klinikum der Universität München, Brustzentrum und CCC München
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13
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Sultova E, Westphalen B, Jung A, Kirchner T, Mayr D, Rudelius M, Ormanns S, Kumbrink J, Heinemann V, Metzeler K, Greif PA, Trillsch F, Mahner S, Harbeck N, Wuerstlein R. Personalisierte Medizin bei metastasierten Brust- und gynäkologischen Krebserkrankungen. Erste Ergebnisse in CCC LMU München. Geburtshilfe Frauenheilkd 2020. [DOI: 10.1055/s-0040-1713978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Affiliation(s)
- E Sultova
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - B Westphalen
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - A Jung
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - T Kirchner
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - D Mayr
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - M Rudelius
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - S Ormanns
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - J Kumbrink
- Pathologisches Institut der LMU und CCC München LMU, Klinikum der Universität München
| | - V Heinemann
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - K Metzeler
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - P A Greif
- Medizinische Klinik und Poliklinik III und CCC München LMU, Klinikum der Universität München
| | - F Trillsch
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - S Mahner
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - N Harbeck
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
| | - R Wuerstlein
- Klinik und Poliklinik für Frauenheilkunde und Geburtshilfe, Brustzentrum und CCC München LMU, Klinikum der Universität München
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14
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Fliefel R, El Ashwah A, Entekhabi S, Kumbrink J, Ehrenfeld M, Otto S. Bifunctional effect of Zoledronic Acid (ZA) on human mesenchymal stem cells (hMSCs) based on the concentration level. J Stomatol Oral Maxillofac Surg 2020; 121:634-641. [PMID: 32171967 DOI: 10.1016/j.jormas.2020.03.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Revised: 03/02/2020] [Accepted: 03/04/2020] [Indexed: 12/19/2022]
Abstract
BACKGROUND Treatment of massive bone defects is a great challenge. Mesenchymal stem cells (MSCs) enhance bone regeneration by differentiating into osteoblasts. Bisphosphonates (BPs) are antiresorptives reducing bone resorption. Despite Medication-related osteonecrosis of the jaw (MRONJ) is a known side effect of antiresorptives, evidences suggest that BPs have positive effect on bone formation. The aims of this study were to investigate the effect of zoledronic acid (ZA) and geranylgeraniol (GGOH) on human mesenchymal stem cells (hMSCs) being a part of the bone microenvironment and evaluate whether low dose of bisphosphonate has enhanced osteogenic differentiation of hMSCs. MATERIALS AND METHODS The effect of ZA and GGOH on MSCs was investigated in addition to the effect of low doses of ZA on osteogenic differentiation of MSCs and analysed by WST-1, Live/Dead staining and coefficient of drug index (CDI). The osteogenic differentiation of the cells was confirmed by ALP activity, xylenol orange and alizarin red staining, microarray and PCR with levels of statistical significance indicated at *P<0.05, **P<0.01 and ***P<0.0001. MAIN FINDINGS Although, high concentration of ZA had significantly decreased the cell viability in MSCs, GGOH reversed the action of ZA on the cells while at very high concentration; it caused severe reduction in the cell viability. CDI showed antagonism or synergism depending on the concentrations of ZA and GGOH. CONCLUSION The treatment of cells with ZA has increased the mineralization and osteogenic differentiation of MSCs. Our study supported the hypothesis that zoledronic acid plays a bifunctional role depending on the concentration.
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Affiliation(s)
- R Fliefel
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Lindwurmstrasse 2a, 80337 Munich, Germany; Department of Oral and Maxillofacial Surgery, Alexandria-University, Champollion Street, 21500 Alexandria, Egypt.
| | - A El Ashwah
- Department of Oral and Maxillofacial Surgery, Alexandria-University, Champollion Street, 21500 Alexandria, Egypt
| | - S Entekhabi
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany
| | - J Kumbrink
- Institute of Pathology, Medical Faculty, Ludwig-Maximilians-University, 36,Thalkirchner street, 80337 Munich Germany
| | - M Ehrenfeld
- Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Lindwurmstrasse 2a, 80337 Munich, Germany
| | - S Otto
- Experimental Surgery and Regenerative Medicine (ExperiMed), Ludwig-Maximilians-University, Nussbaumstrasse 20, 80336 Munich, Germany; Department of Oral and Maxillofacial Surgery and Facial Plastic Surgery, Ludwig-Maximilians-University, Lindwurmstrasse 2a, 80337 Munich, Germany
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15
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Eggersmann TK, Seiler A, Würstlein R, Kumbrink J, Mayr D, Mahner S, Harbeck N. Long-term distant recurrence in premenopausal receptor-positive early stage breast cancer: Prognostic impact of molecular subtypes, risk of recurrence score, and clinical-pathological factors. Geburtshilfe Frauenheilkd 2018. [DOI: 10.1055/s-0038-1671515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- TK Eggersmann
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - A Seiler
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - R Würstlein
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - J Kumbrink
- University of Munich (LMU), Institute of Pathology, Faculty of Medicine, Munich, Deutschland
| | - D Mayr
- University of Munich (LMU), Institute of Pathology, Faculty of Medicine, Munich, Deutschland
| | - S Mahner
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
| | - N Harbeck
- University of Munich (LMU), Breast Center, Dept. Of Gynecology and Obstetrics and CCC Munich, Munich, Deutschland
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16
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Guenther M, Veninga V, Kumbrink J, Haas M, Westphalen CB, Kruger S, Heinemann V, Kirchner T, Boeck S, Jung A, Ormanns S. POLE gene hotspot mutations in advanced pancreatic cancer. J Cancer Res Clin Oncol 2018; 144:2161-2166. [DOI: 10.1007/s00432-018-2746-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Accepted: 09/04/2018] [Indexed: 12/12/2022]
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17
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Heinzmann D, Mueller K, Klingel K, Kumbrink J, Kirchner T, Gawaz M, Seizer P. 5925Regulation of NADPH oxidases in tachycardia-induced heart failure. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy566.5925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- D Heinzmann
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
| | - K Mueller
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
| | - K Klingel
- Eberhard-Karls University of Tubingen, Cardiopathology, Institute for Pathology and Neuropathology, Tubingen, Germany
| | - J Kumbrink
- Ludwig-Maximilians University, Institute of Pathology, Munich, Germany
| | - T Kirchner
- Ludwig-Maximilians University, Institute of Pathology, Munich, Germany
| | - M Gawaz
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
| | - P Seizer
- Eberhard-Karls University of Tubingen, Department of Cardiology and Circulatory Disorders, Tubingen, Germany
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18
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Stahler A, Stintzing S, Urbischek M, Modest D, von Weikersthal LF, Kumbrink J, Heinemann V, Kirchner T, Jung A. Targeting FGF2 expression against chemoresistance in colorectal cancer (CRC) cell lines - a potential prognostic biomarker in patients with metastatic colorectal cancer (mCRC) treated with FUFIRI or mIrOx (FIRE1). Ann Oncol 2016. [DOI: 10.1093/annonc/mdw370.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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19
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Stahler A, Stintzing S, Urbischek M, Modest DP, Fischer von Weikersthal L, Kumbrink J, Heinemann V, Kirchner T, Jung A. Influence of mRNA expression of fibroblast growth factor 2 (FGF2) in colorectal cancer (CRC) cell lines and in patients with metastatic colorectal cancer (mCRC) treated with FUFIRI or mIrOx (FIRE1). J Clin Oncol 2016. [DOI: 10.1200/jco.2016.34.15_suppl.3570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Sebastian Stintzing
- Department of Hematology and Oncology, Klinikum Grosshadern and Comprehensive Cancer Center, University Hospital Grosshadern, LMU Munich, Munich, Germany
| | | | - Dominik Paul Modest
- Department of Hematology and Oncology, Klinikum Grosshadern, University of Munich, Munich, Germany
| | | | | | - Volker Heinemann
- Department of Hematology and Oncology, Klinikum Grosshadern and Comprehensive Cancer Center, University Hospital Grosshadern, LMU Munich, Munich, Germany
| | - Thomas Kirchner
- Department of Pathology, University of Munich, Muenchen, Germany
| | - Andreas Jung
- Department of Pathology, University of Munich, Munich, Germany
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20
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Rouka E, Simister PC, Janning M, Kumbrink J, Konstantinou T, Muniz JRC, Joshi D, O'Reilly N, Volkmer R, Ritter B, Knapp S, von Delft F, Kirsch KH, Feller SM. Differential Recognition Preferences of the Three Src Homology 3 (SH3) Domains from the Adaptor CD2-associated Protein (CD2AP) and Direct Association with Ras and Rab Interactor 3 (RIN3). J Biol Chem 2015; 290:25275-92. [PMID: 26296892 DOI: 10.1074/jbc.m115.637207] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Indexed: 11/06/2022] Open
Abstract
CD2AP is an adaptor protein involved in membrane trafficking, with essential roles in maintaining podocyte function within the kidney glomerulus. CD2AP contains three Src homology 3 (SH3) domains that mediate multiple protein-protein interactions. However, a detailed comparison of the molecular binding preferences of each SH3 remained unexplored, as well as the discovery of novel interactors. Thus, we studied the binding properties of each SH3 domain to the known interactor Casitas B-lineage lymphoma protein (c-CBL), conducted a peptide array screen based on the recognition motif PxPxPR and identified 40 known or novel candidate binding proteins, such as RIN3, a RAB5-activating guanine nucleotide exchange factor. CD2AP SH3 domains 1 and 2 generally bound with similar characteristics and specificities, whereas the SH3-3 domain bound more weakly to most peptide ligands tested yet recognized an unusually extended sequence in ALG-2-interacting protein X (ALIX). RIN3 peptide scanning arrays revealed two CD2AP binding sites, recognized by all three SH3 domains, but SH3-3 appeared non-functional in precipitation experiments. RIN3 recruited CD2AP to RAB5a-positive early endosomes via these interaction sites. Permutation arrays and isothermal titration calorimetry data showed that the preferred binding motif is Px(P/A)xPR. Two high-resolution crystal structures (1.65 and 1.11 Å) of CD2AP SH3-1 and SH3-2 solved in complex with RIN3 epitopes 1 and 2, respectively, indicated that another extended motif is relevant in epitope 2. In conclusion, we have discovered novel interaction candidates for CD2AP and characterized subtle yet significant differences in the recognition preferences of its three SH3 domains for c-CBL, ALIX, and RIN3.
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Affiliation(s)
- Evgenia Rouka
- From the Weatherall Institute of Molecular Medicine, Department of Oncology, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - Philip C Simister
- From the Weatherall Institute of Molecular Medicine, Department of Oncology, University of Oxford, Oxford OX3 9DS, United Kingdom,
| | - Melanie Janning
- From the Weatherall Institute of Molecular Medicine, Department of Oncology, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - Joerg Kumbrink
- the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Tassos Konstantinou
- From the Weatherall Institute of Molecular Medicine, Department of Oncology, University of Oxford, Oxford OX3 9DS, United Kingdom
| | - João R C Muniz
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom
| | - Dhira Joshi
- the Peptide Chemistry Laboratory, London Research Institute Cancer Research UK, London WC2A 3LY, United Kingdom
| | - Nicola O'Reilly
- the Peptide Chemistry Laboratory, London Research Institute Cancer Research UK, London WC2A 3LY, United Kingdom
| | - Rudolf Volkmer
- the Institute of Medical Immunology, Charité-Universitätsmedizin Berlin, 10115 Berlin, Germany
| | - Brigitte Ritter
- the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Stefan Knapp
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom
| | - Frank von Delft
- the Structural Genomics Consortium, Nuffield Department of Clinical Medicine, University of Oxford, Oxford OX3 7DQ, United Kingdom, the Diamond Light Source Ltd., Harwell Science and Innovation Campus, Didcot OX11 0QX, United Kingdom, and the Department of Biochemistry, University of Johannesburg, Auckland Park 2006, South Africa
| | - Kathrin H Kirsch
- the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Stephan M Feller
- From the Weatherall Institute of Molecular Medicine, Department of Oncology, University of Oxford, Oxford OX3 9DS, United Kingdom, the Institute of Molecular Medicine, Martin Luther University Halle-Wittenberg, D-06120 Halle, Germany,
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Kumbrink J, Soni S, Laumbacher B, Loesch B, Kirsch KH. Identification of Novel Crk-associated Substrate (p130Cas) Variants with Functionally Distinct Focal Adhesion Kinase Binding Activities. J Biol Chem 2015; 290:12247-55. [PMID: 25805500 DOI: 10.1074/jbc.m115.649947] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Indexed: 01/08/2023] Open
Abstract
Elevated levels of p130(Cas) (Crk-associated substrate)/BCAR1 (breast cancer antiestrogen resistance 1 gene) are associated with aggressiveness of breast tumors. Following phosphorylation of its substrate domain, p130(Cas) promotes the integration of protein complexes involved in multiple signaling pathways and mediates cell proliferation, adhesion, and migration. In addition to the known BCAR1-1A (wild-type) and 1C variants, we identified four novel BCAR1 mRNA variants, generated by alternative first exon usage (1B, 1B1, 1D, and 1E). Exons 1A and 1C encode for four amino acids (aa), whereas 1D and 1E encode for 22 aa and 1B1 encodes for 50 aa. Exon 1B is non-coding, resulting in a truncated p130(Cas) protein (Cas1B). BCAR1-1A, 1B1, and variant 1C mRNAs were ubiquitously expressed in cell lines and a survey of human tissues, whereas 1B, 1D, and 1E expression was more restricted. Reconstitution of all isoforms except for 1B in p130(Cas)-deficient murine fibroblasts induced lamellipodia formation and membrane ruffling, which was unrelated to the substrate domain phosphorylation status. The longer isoforms exhibited increased binding to focal adhesion kinase (FAK), a molecule important for migration and adhesion. The shorter 1B isoform exhibited diminished FAK binding activity and significantly reduced migration and invasion. In contrast, the longest variant 1B1 established the most efficient FAK binding and greatly enhanced migration. Our results indicate that the p130(Cas) exon 1 variants display altered functional properties. The truncated variant 1B and the longer isoform 1B1 may contribute to the diverse effects of p130(Cas) on cell biology and therefore will be the target of future studies.
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Affiliation(s)
- Joerg Kumbrink
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Shefali Soni
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118
| | - Barbara Laumbacher
- the Immunotherapy Research Center, Pettenkoferstrasse 8, 80336 Munich, Germany, and
| | - Barbara Loesch
- Immunis e.V., Pettenkoferstrasse 8, 80336 Munich, Germany
| | - Kathrin H Kirsch
- From the Department of Biochemistry, Boston University School of Medicine, Boston, Massachusetts 02118,
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Zhao Y, Kumbrink J, Lin BT, Bouton AH, Yang S, Toselli PA, Kirsch KH. Expression of a phosphorylated substrate domain of p130Cas promotes PyMT-induced c-Src-dependent murine breast cancer progression. Carcinogenesis 2013; 34:2880-90. [PMID: 23825155 DOI: 10.1093/carcin/bgt238] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Elevated expression of p130Cas (Crk-associated substrate)/BCAR1 (breast cancer antiestrogen resistance 1) in human breast tumors is a marker of poor prognosis and poor overall survival. p130Cas is a downstream target of the tyrosine kinase c-Src. Signaling mediated by p130Cas through its phosphorylated substrate domain (SD) and interaction with effector molecules directly promotes tumor progression. We previously developed a constitutively phosphorylated p130Cas SD molecule, Src*/SD (formerly referred to as Src*/CasSD), which acts as decoy molecule and attenuates the transformed phenotype in v-crk-transformed murine fibroblasts and human breast cancer cells. To test the function of this molecule in vivo, we established mouse mammary tumor virus (MMTV)-long terminal repeat-Src*/SD transgenic mice in which mammary gland development and tumor formation were analyzed. Transgenic expression of the Src*/SD molecule under the MMTV-long terminal repeat promoter did not interfere with normal mammary gland development or induce tumors in mice observed for up to 11 months. To evaluate the effects of the Src*/SD molecule on tumor development in vivo, we utilized the MMTV-polyoma middle T-antigen (PyMT) murine breast cancer model that depends on c-Src. PyMT mice crossed with Src*/SD mice displayed accelerated tumor formation. The earlier onset of tumors can be explained by the interaction of the Src* domain with PyMT and targeting the fused phosphorylated SD to the membrane. At membrane compartments, it might integrate membrane-associated active signaling complexes leading to increased proliferation measured by phospho-Histone H3 staining. Although these results were unexpected, they emphasize the importance of preventing the membrane association of Src*/SD when employed as decoy molecule.
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Affiliation(s)
- Yingshe Zhao
- Department of Biochemistry, Boston University School of Medicine, Boston, MA 02118, USA
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Kumbrink J, Kirsch KH. p130Cas acts as survival factor during PMA-induced apoptosis in HL-60 promyelocytic leukemia cells. Int J Biochem Cell Biol 2012; 45:531-5. [PMID: 23287717 DOI: 10.1016/j.biocel.2012.12.017] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2012] [Revised: 12/03/2012] [Accepted: 12/18/2012] [Indexed: 01/10/2023]
Abstract
Phorbol 12-myristate 13-acetate (PMA) stimulates the differentiation of promyelocytic leukemia HL-60 cells by inducing adhesion followed by cell aggregation and, importantly, apoptosis. p130Cas (Crk-associated substrate) is an adapter molecule that controls cell growth, attachment and apoptotic programs. Notably, elevated p130Cas activity is associated with leukemias and lymphomas. Since p130Cas regulates cell adhesion, we tested the hypothesis that it participates in the differentiation of hematopoietic cells. Here we show that PMA mediates the late induction of p130Cas expression in HL-60 cells, which coincided with cell aggregation and the onset of apoptosis. Ectopic p130Cas expression led to increased cell adhesion and earlier cell aggregation potentially contributing to the observed increased cell viability in these transductants. p130Cas expression concurred with the induction of its own regulator the transcription factor EGR1, its coregulator NAB2, and apoptosis. NF-κB inhibition in PMA-treated HL-60 cells promoted the loss of cell aggregation and cell death. We further showed a reduction of p130Cas, EGR1, and NAB2 levels in response to NF-κB inhibition during PMA treatment. Hence, p130Cas acts as survival factor by limiting PMA-mediated cell cluster disruption and resulting cell death in HL-60 cells.
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Affiliation(s)
- Joerg Kumbrink
- Department of Biochemistry, Boston University School of Medicine, Boston, MA 02118, USA
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Kumbrink J, Kirsch KH, Johnson JP. EGR1, EGR2, and EGR3 activate the expression of their coregulator NAB2 establishing a negative feedback loop in cells of neuroectodermal and epithelial origin. J Cell Biochem 2011; 111:207-17. [PMID: 20506119 DOI: 10.1002/jcb.22690] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
The inducible zinc finger transcription factors EGR1, EGR2, and EGR3 regulate the expression of numerous genes involved in differentiation, growth, and response to extracellular signals. Their activity is modulated in part through NAB2 which is induced by the same stimuli. In melanoma and carcinoma cells EGR1 activates NAB2 expression. In T lymphocytes EGR2 and EGR3 have been shown to inhibit NAB2 expression. Therefore, we investigated the influence of EGR2 and EGR3 on NAB2 expression in melanoma and carcinoma cells. Here, we show that like EGR1, EGR2 and EGR3 induced NAB2 expression in these cells. EGR1 and EGR3 act in concert on the NAB2 promoter and are more potent activators of NAB2 transcription than EGR2. EGR1-, EGR2-, and EGR3-induced NAB2 promoter activity is mediated through similar cis-regulatory elements and the activation by each EGR is repressed by NAB2. Kinetic studies suggest that induction of EGR1 leads to low NAB2 expression, while EGR2 and EGR3 are necessary for maximal and sustained expression. As already shown for EGR1, reduction of EGR2 or EGR3 expression by siRNAs reduced endogenous NAB2 levels. Depletion of EGR3 also resulted in a reduction of EGR2 levels confirming EGR2 as a target gene of EGR3. Our results suggest that in many cells of neuroectodermal and epithelial origin EGR1, EGR2, and EGR3 activate NAB2 transcription which is in turn repressed by NAB2, thus establishing a negative feedback loop. This points to a complex relationship between the EGR factors and NAB2 expression likely depending on the cellular context.
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Affiliation(s)
- Joerg Kumbrink
- Institute for Immunology, University of Munich, Munich 80336, Germany
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Kumbrink J, Gerlinger M, Johnson JP. Egr-1 Induces the Expression of Its Corepressor Nab2 by Activation of the Nab2 Promoter Thereby Establishing a Negative Feedback Loop. J Biol Chem 2005; 280:42785-93. [PMID: 16260776 DOI: 10.1074/jbc.m511079200] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The transcription factor Egr-1 regulates the expression of numerous genes involved in differentiation, growth, and in response to environmental signals. Egr-1 activity is modulated in part through the binding of corepressors Nab1 and Nab2. Nab2 appears crucial for controlling Egr-1-mediated transactivation because it is a delayed early response gene, induced by the same stimuli that induce the immediate early gene Egr-1. To identify important elements regulating Nab2 expression, we cloned the human Nab2 gene and investigated the 5'-region. The TATA- and initiator-less Nab2 promoter, located from -679 to -74 bp, contains a total of 11 Egr binding sites, including a cluster of multiple overlapping Egr/Sp1 sites between -329 and -260 bp. This region is critical for basal promoter activity as well as for maximum induction by phorbol esters. Electromobility shifts show that Sp1 binds to this region in normal and stimulated cells, whereas stimulation induces binding of Egr-1. In addition Egr-1 activates the Nab2 promoter in a pattern similar to phorbol esters, suggesting that Egr-1 is a major inducer of protein kinase C-mediated Nab2 induction. Depletion of Egr-1 by each of two distinct Egr-1 short-interfering RNAs reduces Nab2 expression and inducibility, confirming that Egr-1 is an important regulator of Nab2 expression. Transfection experiments show that Egr-1-induced Nab2 promoter activity is itself repressed by Nab2. These results indicate that Egr-1 mediates the induction of its own repressor, thereby preventing a permanent transactivation of Egr-1 target genes and a damaging overreaction in response to environmental signals.
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MESH Headings
- Base Sequence
- Binding Sites
- Cell Differentiation
- Cell Line
- Cell Line, Tumor
- Cell Nucleus/metabolism
- Cloning, Molecular
- DNA, Complementary/metabolism
- Dose-Response Relationship, Drug
- Early Growth Response Protein 1/metabolism
- Early Growth Response Protein 1/physiology
- Feedback, Physiological
- Gene Deletion
- Genes, Reporter
- Genome
- HeLa Cells
- Humans
- Luciferases/metabolism
- Models, Genetic
- Molecular Sequence Data
- Neoplasm Proteins/biosynthesis
- Neoplasm Proteins/genetics
- Phorbol Esters/chemistry
- Promoter Regions, Genetic
- Protein Binding
- Protein Kinase C/metabolism
- RNA, Small Interfering/metabolism
- Repressor Proteins/biosynthesis
- Repressor Proteins/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Time Factors
- Transcription, Genetic
- Transcriptional Activation
- Transfection
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Affiliation(s)
- Joerg Kumbrink
- Institute for Immunology, University of Munich, Munich 80336, Germany
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