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Razavipour SF, Yoon H, Shin M, McIntosh A, Zhao D, Bagheri A, Van Booven D, Yi C, Slingerland J. Abstract 1461: C-terminally phosphorylated p27 modulates chromatin remodeling in breast cancer. Cancer Res 2023. [DOI: 10.1158/1538-7445.am2023-1461] [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: 04/07/2023]
Abstract
Abstract
Breast Cancer (BC) is the leading cause of cancer-related death in women. Transcriptional deregulation is a frequent characteristic of cancers. Chromatin remodeling determines the accessibility of the chromatin through dynamic modification of chromatin architecture, and thereby regulates gene expression. Alteration in chromatin remodeling is associated with cancer. Therefore, a greater understanding of chromatin remodeling and its role in tumorigenesis could provide a significant cornerstone to develop more effective therapeutic strategies. p27 is an integral regulator of the cell cycle. It plays a dual role in tumorigenesis. p27 acts as a tumor suppressor to restrain the cell cycle, but upon C-terminal phosphorylation at T157 and T198 by PI3K activated kinases, it acts as an oncogene to promote cancer metastasis. We previously showed that p27pT157pT198 (p27pTpT) acts as a transcriptional co-regulator of cJun. Our new data now indicate that p27pTpT also binds to and transcriptionally co-regulates STAT3 to drive cancer stem cell gene programs. We also found that p27 is widely recruited to consensus motifs shared by many other transcription factors, suggesting a broader role in transcriptional regulation. Here we investigated if p27pTpT regulates transcriptional programs in BC through modulating chromatin accessibility. ATACseq was carried out in 231 cells, 231 with overexpression of a cell cycle-defective phosphomimetic p27 (231p27CK-DD), and in 1883 cells with high phospho-activated p27 levels, and 1833 with p27 knockdown and analyzed together with our prior p27 ChIPseq. p27pTpT increased ATAC-seq signals at the promoter of a sub-set of STAT3 target genes, where p27 ChIPseq and ATACseq signals overlapped. These genes are upregulated in 231p27CK-DD and in 1833 compared to 231. Thus, p27 appears to potentiate a more open chromatin state at these binding sites to modulate gene expression. p27 and STAT3 co-occupy at the promoters of the STAT3 target genes including MYC, IL6, and VEGFA, in which p27 knockdown decreased STAT3 recruitment to these sites. Using ENCODE p300 and CBP ChIP-seq data, we found potential co-localization of histone acetyltransferase (HAT), CBP and p300, with p27 and STAT3 on MYC, IL6, and VEGFA promoters. Thus, p27 might recruit HATs to the chromatin to increase chromatin accessibility through H3K27 acetylation (H3K27ac). ChIP-qPCR assays validated that p27, STAT3 and CBP recruitment to the MYC promoter was greater in p27-activated 231p27CK-DD and 1833 lines than in 231, and decreased upon p27 depletion in 1833. Notably, ChIP assays also showed CBP recruitment increased H3K27ac at this site. These data support a model in which p27 enrichment to the promoter of a subset of STAT3 target genes increases both CBP and STAT3 recruitment, to increase chromatin accessibility through H3K27ac and upregulate their expression. This work revealed a novel genome-wide action of p27 in chromatin remodeling.
Citation Format: Seyedeh Fatemeh Razavipour, Hyunho Yoon, Miyoung Shin, Alec McIntosh, Dekuang Zhao, Amir Bagheri, Derek Van Booven, Chunling Yi, Joyce Slingerland. C-terminally phosphorylated p27 modulates chromatin remodeling in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 1461.
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Affiliation(s)
| | | | | | - Alec McIntosh
- 1Georgetown University Medical Center, Washington, DC
| | | | - Amir Bagheri
- 1Georgetown University Medical Center, Washington, DC
| | | | - Chunling Yi
- 1Georgetown University Medical Center, Washington, DC
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Qureshi R, Picon-Ruiz M, Sho M, Van Booven D, Nunes de Paiva V, Diaz-Ruano AB, Ince TA, Slingerland J. Estrone, the major postmenopausal estrogen, binds ERa to induce SNAI2, epithelial-to-mesenchymal transition, and ER+ breast cancer metastasis. Cell Rep 2022; 41:111672. [PMID: 36384125 PMCID: PMC9798480 DOI: 10.1016/j.celrep.2022.111672] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 09/22/2022] [Accepted: 10/25/2022] [Indexed: 11/18/2022] Open
Abstract
Recent work showed that the dominant post-menopausal estrogen, estrone, cooperates with nuclear factor κB (NF-κB) to stimulate inflammation, while pre-menopausal 17β-estradiol opposes NF-κB. Here, we show that post-menopausal estrone, but not 17β-estradiol, activates epithelial-to-mesenchymal transition (EMT) genes to stimulate breast cancer metastasis. HSD17B14, which converts 17β-estradiol to estrone, is higher in cancer than normal breast tissue and in metastatic than primary cancers and associates with earlier metastasis. Treatment with estrone, but not 17β-estradiol, and HSD17B14 overexpression both stimulate an EMT, matrigel invasion, and lung, bone, and liver metastasis in estrogen-receptor-positive (ER+) breast cancer models, while HSD17B14 knockdown reverses the EMT. Estrone:ERα recruits CBP/p300 to the SNAI2 promoter to induce SNAI2 and stimulate an EMT, while 17β-estradiol:ERα recruits co-repressors HDAC1 and NCOR1 to this site. Present work reveals novel differences in gene regulation by these estrogens and the importance of estrone to ER+ breast cancer progression. Upon loss of 17β-estradiol at menopause, estrone-liganded ERα would promote ER+ breast cancer invasion and metastasis.
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Affiliation(s)
- Rehana Qureshi
- Breast Cancer Program, Lombardi Comprehensive Cancer Centre, Department of Oncology, Georgetown University, Washington, DC 20007, USA; Braman Family Breast Cancer Institute, Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, FL 33136, USA; John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
| | - Manuel Picon-Ruiz
- Braman Family Breast Cancer Institute, Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, FL 33136, USA; Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain; Excellence Research Unit "Modeling Nature" (MNat), University of Granada, 18071 Granada, Spain; Biosanitary Institute of Granada (ibs. GRANADA), University of Granada, 18071 Granada, Spain
| | - Maiko Sho
- Breast Cancer Program, Lombardi Comprehensive Cancer Centre, Department of Oncology, Georgetown University, Washington, DC 20007, USA
| | - Derek Van Booven
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Vanessa Nunes de Paiva
- Braman Family Breast Cancer Institute, Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Anna B Diaz-Ruano
- Department of Human Anatomy and Embryology, Faculty of Medicine, University of Granada, 18016 Granada, Spain; Biopathology and Regenerative Medicine Institute (IBIMER), Centre for Biomedical Research (CIBM), University of Granada, 18100 Granada, Spain
| | - Tan A Ince
- Department of Pathology and Laboratory Medicine, Weill Cornell Medicine, New York, NY 10021, USA
| | - Joyce Slingerland
- Breast Cancer Program, Lombardi Comprehensive Cancer Centre, Department of Oncology, Georgetown University, Washington, DC 20007, USA; Braman Family Breast Cancer Institute, Sylvester Comprehensive Cancer Center University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Kurani H, Razavipour SF, Harikumar KB, Dunworth M, Ewald AJ, Nasir A, Pearson G, Van Booven D, Zhou Z, Azzam D, Wahlestedt C, Slingerland J. DOT1L Is a Novel Cancer Stem Cell Target for Triple-Negative Breast Cancer. Clin Cancer Res 2022; 28:1948-1965. [PMID: 35135840 PMCID: PMC9365344 DOI: 10.1158/1078-0432.ccr-21-1299] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Revised: 12/01/2021] [Accepted: 02/04/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE Although chemotherapies kill most cancer cells, stem cell-enriched survivors seed metastasis, particularly in triple-negative breast cancers (TNBC). TNBCs arise from and are enriched for tumor stem cells. Here, we tested if inhibition of DOT1L, an epigenetic regulator of normal tissue stem/progenitor populations, would target TNBC stem cells. EXPERIMENTAL DESIGN Effects of DOT1L inhibition by EPZ-5676 on stem cell properties were tested in three TNBC lines and four patient-derived xenograft (PDX) models and in isolated cancer stem cell (CSC)-enriched ALDH1+ and ALDH1- populations. RNA sequencing compared DOT1L regulated pathways in ALDH1+ and ALDH1- cells. To test if EPZ-5676 decreases CSC in vivo, limiting dilution assays of EPZ-5676/vehicle pretreated ALDH1+ and ALDH1- cells were performed. Tumor latency, growth, and metastasis were evaluated. Antitumor activity was also tested in TNBC PDX and PDX-derived organoids. RESULTS ALDH1+ TNBC cells exhibit higher DOT1L and H3K79me2 than ALDH1-. DOT1L maintains MYC expression and self-renewal in ALDH1+ cells. Global profiling revealed that DOT1L governs oxidative phosphorylation, cMyc targets, DNA damage response, and WNT activation in ALDH1+ but not in ALDH1- cells. EPZ-5676 reduced tumorspheres and ALDH1+ cells in vitro and decreased tumor-initiating stem cells and metastasis in xenografts generated from ALDH1+ but not ALDH1- populations in vivo. EPZ-5676 significantly reduced growth in vivo of one of two TNBC PDX tested and decreased clonogenic 3D growth of two other PDX-derived organoid cultures. CONCLUSIONS DOT1L emerges as a key CSC regulator in TNBC. Present data support further clinical investigation of DOT1L inhibitors to target stem cell-enriched TNBC.
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Affiliation(s)
- Hetakshi Kurani
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, Florida.,Breast Cancer Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, District of Columbia
| | - Seyedeh Fatemeh Razavipour
- Breast Cancer Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, District of Columbia
| | - Kuzhuvelil B. Harikumar
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida.,Cancer Research Program, Rajiv Gandhi Centre for Biotechnology (RGCB), Thiruvananthapuram, Kerala, India
| | - Matthew Dunworth
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Andrew J. Ewald
- Department of Cell Biology, Johns Hopkins University School of Medicine, Baltimore, Maryland.,Cancer Invasion and Metastasis Program, Sidney Kimmel Comprehensive Cancer Center, and Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Apsra Nasir
- Breast Cancer Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, District of Columbia
| | - Gray Pearson
- Breast Cancer Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, District of Columbia
| | - Derek Van Booven
- John P. Hussman Institute of Human Genomics, University of Miami Miller School of Medicine, Miami, Florida
| | - Zhiqun Zhou
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida
| | - Diana Azzam
- Department of Environmental Health Sciences, Florida International University, Miami, Florida
| | - Claes Wahlestedt
- Center for Therapeutic Innovation, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, Florida
| | - Joyce Slingerland
- Breast Cancer Program, Lombardi Comprehensive Cancer Center, Department of Oncology, Georgetown University, Washington, District of Columbia.,Corresponding Author: Joyce Slingerland, Lombardi Comprehensive Cancer Center, Georgetown University, New Research Building, Room E212, 3970 Reservoir Road NW, Washington, DC 20007. Phone: 305-898-9910; E-mail:
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Sharma U, Sun J, Medina-Saenz K, Bare S, Miller P, Picon-Ruiz M, Slingerland J, El-Ashry D, Lippman M. Abstract P5-06-08: Triple-negative breast cancer CAFs induce a metastatic phenotype in MCF-7 cells via the SDF-1/CXCR4 axis. Cancer Res 2022. [DOI: 10.1158/1538-7445.sabcs21-p5-06-08] [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
Background: Metastatic disease is the foremost cause of breast cancer (BC) related mortality in women. One of the crucial challenges in reducing metastasis-related mortality is in identifying and understanding why certain BCs metastasize and recur. Although cancer cell-intrinsic factors are a key determinant in BC metastasis, host-intrinsic factors like the cells of the tumor microenvironment (TME), such as cancer-associated fibroblasts (CAFs) are what might be driving certain BCs to metastasize and recur. We recently showed that CAFs from the primary (TME) enter into circulation as cCAFs, form heterotypic clusters with tumor cells, and arrive at metastatic sites. This interaction between CAFs and tumor cells is crucial in furthering the metastatic cascade. However, the functional heterogeneity of the different CAF phenotypes and how that impacts BC metastasis is unknown. Stromal derived factor-1 (SDF-1/CXCL12) is an important chemokine that is known to be involved in promoting tumor cell invasion and metastasis. In this study, we examine the functional differences between CAF isolated from different molecular subtypes of BC. Furthermore, we elucidate the role of CAF secreted SDF-1 as being one of the mechanisms by which a subset of CAF cells permanently reprograms poorly-metastatic MCF-7 cells to augment EMT-driven genes and become metastatic in vivo. Methods: We used primary CAF cell lines derived from BCs of different molecular subtypes and examined their global gene expression profiles using RNAseq. We used NSG mice xenografted with MCF-7 BC cells and primary CAF cells to evaluate the contribution of two different CAF phenotypes in promoting BC progression and metastasis. We developed dissociated tumor cell lines from CAF co-injected MCF-7 xenografts to determine the molecular changes that CAFs impart to MCF-7 cells in vivo. Using limiting dilution tumor xenograft assays and gene expression profiles we examined the molecular pathways, BC stemness markers, and tumor-initiating capacity of the dissociated tumor cell lines. By long-term SDF-1 treatment of MCF-7 cells in vitro and using these cells in various RNASeq, in vitro, and in vivo assays we determined the role of SDF-1 in altering the phenotype of MCF-7 cells. Results: We found that CAFs from different molecular subtypes have a differential effect on tumor initiation, progression, and metastasis in xenograft assays. We also found that a subset of CAFs has the ability to make the poorly-metastatic MCF-7 cells metastatic in vivo. We also found that this subset of CAF cells has a higher expression of SDF-1 and the tumors formed with the co-injection of MCF-7 cells with this subset of CAF cells are enriched in cancer stem cell-like metastasis initiating cells. We also found that upon serial transplant, the tumors formed by CAF-reprogramed MCF-7 cells have a gene expression profile that shows enrichment for EMT-driven genes and these tumors are robustly metastatic. Furthermore, we found that the SDF-1/CXCR4 axis is one of the critical mechanisms by which this subset of CAF cells permanently reprograms the phenotype of the MCF-7 cells. Conclusions: CAFs are a highly heterogeneous population of cells in the breast TME. This study examines the contribution of the functional heterogeneity of the CAF cells in BC metastasis. We have found that a unique subset of CAF cells has the ability to reprogram a poorly metastatic BC cell to not only become metastatic but induce a permanent EMT-driven phenotypic shift in the BC cells. SDF-1 may be one of the mechanisms that drive this CAF-induced change and understanding the CAF functional landscape and its role in BC metastasis might be crucial to developing new therapeutic modalities to abrogate BC metastasis.
Citation Format: Utsav Sharma, Jun Sun, Kelsie Medina-Saenz, Susan Bare, Philip Miller, Manuel Picon-Ruiz, Joyce Slingerland, Dorraya El-Ashry, Marc Lippman. Triple-negative breast cancer CAFs induce a metastatic phenotype in MCF-7 cells via the SDF-1/CXCR4 axis [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-06-08.
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Affiliation(s)
| | - Jun Sun
- University of Miami, Miami, FL
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Mustafi S, Camarena V, Qureshi R, Sant DW, Wilkes Z, Bilbao D, Slingerland J, Kesmodel SB, Wang G. Vitamin C sensitizes triple negative breast cancer to PI3K inhibition therapy. Am J Cancer Res 2021; 11:3552-3564. [PMID: 33664847 PMCID: PMC7914363 DOI: 10.7150/thno.53225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 12/25/2020] [Indexed: 12/22/2022] Open
Abstract
Rationale: The clinical use of PI3K inhibitors, such as buparlisib, has been plagued with toxicity at effective doses. The aim of this study is to determine if vitamin C, a potent epigenetic regulator, can improve the therapeutic outcome and reduce the dose of buparlisib in treating PIK3CA-mutated triple negative breast cancer (TNBC). Methods: The response of TNBC cells to buparlisib was assessed by EC50 measurements, apoptosis assay, clonogenic assay, and xenograft assay in mice. Molecular approaches including Western blot, immunofluorescence, RNA sequencing, and gene silencing were utilized as experimental tools. Results: Treatment with buparlisib at lower doses, along with vitamin C, induced apoptosis and inhibited the growth of TNBC cells in vitro. Vitamin C via oral delivery rendered a sub-therapeutic dose of buparlisib able to inhibit TNBC xenograft growth and to markedly block metastasis in mice. We discovered that buparlisib and vitamin C coordinately reduced histone H3K4 methylation by enhancing the nuclear translocation of demethylase, KDM5, and by serving as a cofactor to promote KDM5-mediated H3K4 demethylation. The expression of genes in the PI3K pathway, such as AKT2 and mTOR, was suppressed by vitamin C in a KDM5-dependent manner. Vitamin C and buparlisib cooperatively blocked AKT phosphorylation. Inhibition of KDM5 largely abolished the effect of vitamin C on the response of TNBC cells to buparlisib. Additionally, vitamin C and buparlisib co-treatment changed the expression of genes, including PCNA and FILIP1L, which are critical to cancer growth and metastasis. Conclusion: Vitamin C can be used to reduce the dosage of buparlisib needed to produce a therapeutic effect, which could potentially ease the dose-dependent side effects in patients.
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Razavipour S, Jang K, Yoon H, Kim M, Shin M, Zhao D, Slingerland J. Abstract 504: p27 transcriptionally coregulates STAT3 to drive cancer stem cells. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-504] [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
p27 is a cell cycle inhibitor and a tumor suppressor. It can also regulate cellular processes including migration and transcription through mechanisms independent of its CDK-inhibitory role. In cancers, p27 C-terminal phosphorylation by PI3K-activated kinases, AKT, RSK1, and SGK1 at T157 and T198 alters p27 protein-protein interactions and shifts p27 from CDK-inhibitor to an oncogene. Previously, our group showed that CDK-binding defective p27pT157pT198 phosphomimetic (p27CK-DD) upregulates epithelial-mesenchymal transition (EMT) and the metastatic potential of cancer cell lines. In addition to its action to promote EMT, p27 appears to promote CSC expansion and or maintenance. Here we demonstrated that C-terminally phosphorylated p27 increases CSC properties, including tumor sphere formation and CSC markers. p27CK-DD increases the expression of several embryonic stem cell transcription factors (ES-TFs), including SOX2, NANOG and cMYC, which are known to drive embryonic stem cell self-renewal and to promote CSC expansion. A human phospho-kinase array showed Pyk2 is activated by p27CK-DD. We demonstrated that Pyk2 activation and its binding to p27 are dependent on phosphorylation of p27 at T198 and T157. Treatment with a Pyk2 inhibitor, and PYK2-knockdown by siRNA or shRNA revealed that Pyk2 is a key mediator of the increase in tumor spheres, ALDH1 activity and ES-TFs in cancer cells expressing abundant C-terminally phosphorylated p27. Pyk2 enhances STAT3 phosphorylation and activation. We identified that C-terminally phosphorylated p27 recruits STAT3 to form p27-Pyk2-STAT3 complex leading to STAT3 activation. p27/STAT3 complexes co-localize to the nucleus and co-occupy chromatin. We confirmed by ChIP-qPCR that p27/STAT3 bind and activate the cMYC promotor. Altogether, in breast cancer cells with high p27pT157pT198 or expressing p27CK−DD, STAT3 is partly activated by Pyk2 and interacts with p27. p27 is a STAT3 coregulator, whose assembly and chromatin association is governed by p27 phosphorylation. These data reveal a novel mechanism whereby p27-driven Pyk2 activation promotes CSC expansion and tumor progression via transcriptionally activation of the STAT3 and its target genes.
Citation Format: Seyedehfatemeh Razavipour, Kibeom Jang, Hyunho Yoon, Minsoon Kim, Miyoung Shin, Dekuang Zhao, Joyce Slingerland. p27 transcriptionally coregulates STAT3 to drive cancer stem cells [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 504.
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St. George SM, Noriega Esquives B, Agosto Y, Kobayashi M, Leite R, Vanegas D, Perez AT, Calfa C, Schlumbrecht M, Slingerland J, Penedo FJ. Development of a multigenerational digital lifestyle intervention for women cancer survivors and their families. Psychooncology 2019; 29:182-194. [DOI: 10.1002/pon.5236] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/28/2019] [Accepted: 09/07/2019] [Indexed: 11/12/2022]
Affiliation(s)
- Sara M. St. George
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | | | - Yaray Agosto
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Marissa Kobayashi
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Rafael Leite
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Dario Vanegas
- Department of Public Health SciencesUniversity of Miami Miller School of Medicine Florida
| | - Alejandra T. Perez
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Carmen Calfa
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Matthew Schlumbrecht
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Joyce Slingerland
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
| | - Frank J. Penedo
- Sylvester Comprehensive Cancer CenterUniversity of Miami Miller School of Medicine Miami Florida
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Mustafi S, Camarena V, Qureshi R, Yoon H, Volmar CH, Huff TC, Sant DW, Zheng L, Brothers SP, Wahlestedt C, Slingerland J, Wang G. Vitamin C supplementation expands the therapeutic window of BETi for triple negative breast cancer. EBioMedicine 2019; 43:201-210. [PMID: 30975544 PMCID: PMC6557781 DOI: 10.1016/j.ebiom.2019.04.006] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [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: 12/29/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 12/25/2022] Open
Abstract
Background Bromodomain and extra-terminal inhibitors (BETi) have shown efficacy for the treatment of aggressive triple negative breast cancer (TNBC). However, BETi are plagued by a narrow therapeutic window as manifested by severe toxicities at effective doses. Therefore, it is a limitation to their clinical implementation in patient care. Methods The impact of vitamin C on the efficacy of small compounds including BETi was assessed by high-throughput screening. Co-treatment of TNBC by BETi especially JQ1 and vitamin C was evaluated in vitro and in vivo. Findings High-throughput screening revealed that vitamin C improves the efficacy of a number of structurally-unrelated BETi including JQ1, I-BET762, I-BET151, and CPI-203 in treating TNBC cells. The synergy between BETi and vitamin C is due to suppressed histone acetylation (H3ac and H4ac), which is in turn caused by upregulated histone deacetylase 1 (HDAC1) expression upon vitamin C addition. Treatment with JQ1 at lower doses together with vitamin C induces apoptosis and inhibits the clonogenic ability of cultured TNBC cells. Oral vitamin C supplementation renders a sub-therapeutic dose of JQ1 able to inhibit human TNBC xenograft growth and metastasis in mice. Interpretation Vitamin C expands the therapeutic window of BETi by sensitizing TNBC to BETi. Using vitamin C as a co-treatment, lower doses of BETi could be used to achieve an increased therapeutic index in patients, which will translate to a reduced side effect profile. Fund University of Miami Sylvester Comprehensive Cancer Center, Bankhead Coley Cancer Research program (7BC10), Flight Attendant Medical Research Institute, and NIH R21CA191668 (to GW) and 1R56AG061911 (to CW and CHV).
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Affiliation(s)
- Sushmita Mustafi
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Vladimir Camarena
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Rehana Qureshi
- Braman Family Breast Cancer Institute at Sylvester, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Hyunho Yoon
- Braman Family Breast Cancer Institute at Sylvester, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Claude-Henry Volmar
- Center for Therapeutic Innovation and Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Tyler C Huff
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - David W Sant
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Lihong Zheng
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Shaun P Brothers
- Center for Therapeutic Innovation and Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Claes Wahlestedt
- Center for Therapeutic Innovation and Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Joyce Slingerland
- Braman Family Breast Cancer Institute at Sylvester, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - Gaofeng Wang
- John P. Hussman Institute for Human Genomics, Dr. John T. Macdonald Foundation Department of Human Genetics, University of Miami Miller School of Medicine, Miami, FL 33136, USA; Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA.
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Sandoval Leon AC, Medina Saenz K, Miller P, Benson A, Calfa C, Mahtani R, Slingerland J, Perez A, Vogel C, Valdes-Albini F, El-Ashry D, Lippman M. Abstract P4-01-07: A comprehensive liquid biopsy in patients undergoing neoadjuvant therapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p4-01-07] [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
Background: Precision medicine is revolutionizing breast cancer (BC) care. Comprehensive liquid biopsies are a tool for personalized care in patients with locally advanced breast cancer (LABC). Identifying robust biomarkers as part of a comprehensive liquid biopsy to predict response to treatment is of immense clinical interest.
Methods: After obtaining IRB approval, serial blood samples were collected from patients with LABC undergoing neoadjuvant therapy. Paired biopsies were collected prior to treatment and were sent to Foundation Medicine for next-generation sequencing (NGS). We used a sized-base microfilter technology to capture circulating tumor cells (CTCs) and circulating cancer associated fibroblasts (cCAFs). Patients with one or more CTCs or cCAFs were deemed positive for these tests. Additionally, in collaboration with Foundation Medicine, we extracted circulating tumor DNA (ctDNA) and we analyzed it using the FoundationACT platform. Patients with a detectable genomic alteration in their plasma were considered as having a positive ctDNA test. Our primary objective is to determine if a comprehensive liquid biopsy can serve as a prognostic marker of pathologic complete response (pCR).
Results: For this analysis we describe our findings in the initial blood draw of the first 18 patients enrolled. The mean age is 54 years (38-70). All patients who had their tumors sequenced had a detectable mutation. Consistent with the findings of others, we found TP53 mutations to be the most prevalent at 83.3%. We found that 44% of patients had ctDNA, 68.4% had cCAFs and 78.9% had CTCs. Many patients also had clusters of cells, consisting of one cell type, or co-clusters, consisting of both. 38.9% had CTC clusters, 16.7% had cCAF clusters and 16.7% had co-clusters (CTCs and cCAFs together). Some patients with CTCs did not have cCAFs and vice versa. The number of CTCs and cCAFS did not correlate with stage of disease or receptor status.
Conclusions: We describe a comprehensive liquid biopsy combining a sized-based microfilter technology for CTC and cCAFs identification and the FoundationACT platform for ctDNA analysis is feasible and these biomarkers can be detected in patients with LABC prior to the initiation of neoadjuvant therapy. Our study is accruing rapidly, and we will update our results with the longitudinal collection and the prognostic value of a comprehensive liquid biopsy at the time of the meeting.
Citation Format: Sandoval Leon AC, Medina Saenz K, Miller P, Benson A, Calfa C, Mahtani R, Slingerland J, Perez A, Vogel C, Valdes-Albini F, El-Ashry D, Lippman M. A comprehensive liquid biopsy in patients undergoing neoadjuvant therapy [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-01-07.
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Affiliation(s)
- AC Sandoval Leon
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - K Medina Saenz
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - P Miller
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - A Benson
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - C Calfa
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - R Mahtani
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - J Slingerland
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - A Perez
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - C Vogel
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - F Valdes-Albini
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - D El-Ashry
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
| | - M Lippman
- University of Miami, Miami, Fl; Foundation Medicine, Inc, Cambridge, MA; University of Minnesota, Minneapolis, MN
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Miller P, Sharma U, Medina-Saenz K, Yeasky T, Picon-Ruiz M, Morata-Tarifa C, Seagroves T, Slingerland J, Lippman M, El-Ashry D. Abstract P2-01-10: Circulating CAF/CTC complexes and breast cancer metastasis. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p2-01-10] [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
Background: Metastatic disease in breast cancer (BC) is the leading cause of cancer-related mortality among women worldwide. Synergy between cancer cells and non-cancer cells of the tumor microenvironment (TME) are vital for disease progression. Cancer associated fibroblasts (CAFs) are the major cell type in the stroma of BC and are critical mediators of tumor progression and metastasis. Transport of circulating tumor cells (CTCs) and CTC clusters through the vasculature seeds metastasis and clinical and preclinical studies demonstrate that CTC clusters have a higher metastatic potential than individual CTCs. More recently, circulating cancer stem cells (cCSCs) have been implicated as more metastatic than non-CSC CTCs. In our lab, we have demonstrated that CAFs also circulate (cCAFs). We have observed cCAFs in peripheral blood from breast cancer patients and in murine models of breast cancer. Furthermore, we have observed that cCAFs are present in circulation as both individual cells and as well as in complexes with CTCs. Given the integral role of CAFs in BC metastasis, we hypothesize that cCAFs complex with CTCs/cCSCs to bolster BC metastasis.
Methods: cCAF/CTC clusters were identified and enumerated from peripheral blood of patients with BC, and associations with clinical features and disease outcomes were evaluated. Blood was collected by cardiac puncture from PyMT mice from 4 weeks through to the presence of metastases (10 weeks) and cCAF/CTC clusters enumerated. We co-injected CAFs with MCF-7 cellsl into NSG mice, blood collected by cardiac puncture, and cCAF/CTC clusters were enumerated. At time of final sacrifice, tumors were removed and assessed for presence of CSCs. Using our established model of cCAF/CTC clustering in vitro we interrogated cCAF/CTC complexing with both metastatic and poorly metastatic BC cells.
Results: Circulating cCAFs/CTCs clusters are significantly increased in the blood of patients with advanced stage BC and associate not only with severity of disease but also with poorer clinical outcomes. In the spontaneous PyMT mouse model, the appearance of circulating cCAF/CTC clusters increased significantly as tumors grew but prior to metastasis. We demonstrate that metastatic BC cells form clusters with CAFs in vitro while non-metastatic BC cells do not form complexes with CAFs in vitro. Enriching for stem cells from MCF7 mammospheres, resulted in CAF/CSC clusters in vitro. In mice that were co-injected with non-metastatic MCF7 cells and CAFs from a TNBC/Basal-like BC (CAF23) we observed disease metastasis, an enrichment for cancer stem cell (CSC)-like CTCs, and the presence of circulating cCAF/MCF7-CSC clusters.
Conclusions: Circulating clusters of CTCs and cCAFs are characteristic, and potentially causative, of BC metastasis. Observations of cCAF/CTC clusters from preclinical and clinical samples are corroborated by our determination that the ability of BC cells to form complexes with CAFs in vitro is related to the intrinsic metastatic ability of the breast cancer cells. Both in vitro and in circulation, the BC cells in cCAF/cBC clusters are CSCs, so cCAF/cCSC clusters. Disrupting the formation of cCAF/CTC complexes may be a potential strategy to reduce treat or prevent breast cancer metastasis.
Citation Format: Miller P, Sharma U, Medina-Saenz K, Yeasky T, Picon-Ruiz M, Morata-Tarifa C, Seagroves T, Slingerland J, Lippman M, El-Ashry D. Circulating CAF/CTC complexes and breast cancer metastasis [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P2-01-10.
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Affiliation(s)
- P Miller
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - U Sharma
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - K Medina-Saenz
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - T Yeasky
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - M Picon-Ruiz
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - C Morata-Tarifa
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - T Seagroves
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - J Slingerland
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - M Lippman
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
| | - D El-Ashry
- Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL; Masonic Cancer Center, University of Minnesota, Minneapolis, MN; University of Tennessee Health Science Center, Memphis, TN
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Pei XH, Chan HL, Liu S, Scott A, Pimentel E, Slingerland J, Robbins D, Capobianco A, Bai F. Abstract P6-08-08: GATA3 inhibits breast basal-like tumorigenesis. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p6-08-08] [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
BACKGROUND: Breast cancer can be broadly categorized into two groups depending on the cell type affected. Luminal-type tumors are typically estrogen receptor (ER) positive that are associated with better survival and respond to hormone therapies whereas basal-like tumors are ER negative, more aggressive, and associated with a poor prognosis. GATA3 is a transcription factor well studied for its role as a master regulator of cellular differentiation and stem cell self renewal. Loss of Gata3 in mouse mammary glands blocks luminal cell differentiation and induces growth defects, and low levels of GATA3 are associated with basal-like and metastatic human breast cancers with epithelial-to-mesenchymal transition (EMT). Importantly, luminal cells have been shown to be the origin of some basal-like breast cancers. Due to the proliferation defects caused by GATA3 deficiency, it remains elusive how loss of function of GATA3 contributes to breast cancers development and progression.
METHODS: We previously demonstrated that p18Ink4c (p18), a cell cycle inhibitor, is a downstream target of GATA3 in regulating mammary luminal cell proliferation and loss of p18 leads to luminal type tumorigenesis. To test the role of Gata3 deficiency in tumorigenesis, we generated p18-/-;Gata3+/- mice. Mammary gland development and tumorigenesis were characterized in vivo using a panel of cellular and molecular assays. Results were further confirmed in vitro with well established cell lines.
RESULTS: Loss of p18 rescued mammary growth defects caused by Gata3 heterozygosity. Gata3 heterozygosity impaired luminal, but promoted basal gene expression in mammary epithelial cells. Gata3 heterozygosity in p18 null mice accelerated spontaneous mammary tumorigenesis, reducing the average latency of tumor onset. More importantly, Gata3 heterozygosity transformed the luminal type tumors of p18 null mice into heterogeneous basal-like breast cancers with activated EMT. Conversely, reintroduction of GATA3 inhibited tumor growth and reduced expression of EMT markers in basal-like tumor xenografts. We discovered that expression of GATA3 and Vimentin, an EMT marker, is inversely related in human breast cancers.
CONCLUSION: Our data indicates that GATA3 promotes luminal but suppresses basal cell differentiation in the mammary gland and in tumor development.
Mechanisms underlying the role of GATA3 in suppressing basal-like tumor development are under investigation.BACKGROUND: Breast cancer can be broadly categorized into two groups depending on the cell type affected. Luminal-type tumors are typically estrogen receptor (ER) positive that are associated with better survival and respond to hormone therapies whereas basal-like tumors are ER negative, more aggressive, and associated with a poor prognosis. GATA3 is a transcription factor well studied for its role as a master regulator of cellular differentiation and stem cell self renewal. Loss of Gata3 in mouse mammary glands blocks luminal cell differentiation and induces growth defects, and low levels of GATA3 are associated with basal-like and metastatic human breast cancers with epithelial-to-mesenchymal transition (EMT). Importantly, luminal cells have been shown to be the origin of some basal-like breast cancers. Due to the proliferation defects caused by GATA3 deficiency, it remains elusive how loss of function of GATA3 contributes to breast cancers development and progression.
METHODS: We previously demonstrated that p18Ink4c (p18), a cell cycle inhibitor, is a downstream target of GATA3 in regulating mammary luminal cell proliferation and loss of p18 leads to luminal type tumorigenesis. To test the role of Gata3 deficiency in tumorigenesis, we generated p18-/-;Gata3+/- mice. Mammary gland development and tumorigenesis were characterized in vivo using a panel of cellular and molecular assays. Results were further confirmed in vitro with well established cell lines.
RESULTS: Loss of p18 rescued mammary growth defects caused by Gata3 heterozygosity. Gata3 heterozygosity impaired luminal, but promoted basal gene expression in mammary epithelial cells. Gata3 heterozygosity in p18 null mice accelerated spontaneous mammary tumorigenesis, reducing the average latency of tumor onset. More importantly, Gata3 heterozygosity transformed the luminal type tumors of p18 null mice into heterogeneous basal-like breast cancers with activated EMT. Conversely, reintroduction of GATA3 inhibited tumor growth and reduced expression of EMT markers in basal-like tumor xenografts. We discovered that expression of GATA3 and Vimentin, an EMT marker, is inversely related in human breast cancers.
CONCLUSION: Our data indicates that GATA3 promotes luminal but suppresses basal cell differentiation in the mammary gland and in tumor development.
Mechanisms underlying the role of GATA3 in suppressing basal-like tumor development are under investigation.
Citation Format: Pei X-H, Chan HL, Liu S, Scott A, Pimentel E, Slingerland J, Robbins D, Capobianco A, Bai F. GATA3 inhibits breast basal-like tumorigenesis [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-08-08.
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Affiliation(s)
- X-H Pei
- University of Miami, Miami, FL
| | - HL Chan
- University of Miami, Miami, FL
| | - S Liu
- University of Miami, Miami, FL
| | - A Scott
- University of Miami, Miami, FL
| | | | | | | | | | - F Bai
- University of Miami, Miami, FL
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Slingerland J, Picon-Ruiz M, Jang K, Morata-Tarifa C, Pan C, Besser A, Kim M, Ince TA, Howard GA, El-Ashry D. Abstract P1-03-02: Estrogens contribute to cytokine upregulation and cancer stem cell recruitment upon breast cancer contact with mature human mammary adipocytes: Effects of estrogen type and adipocyte donor weight. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-p1-03-02] [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
Consequences of the obesity epidemic on cancer morbidity and mortality are not fully appreciated. While obesity confers increased cancer risk and worse outcome, mechanisms thereof are not fully known. We show prolonged co-culture of fat cells (human adipocyte stem cells, differentiated adipocytes or mature adipocytes) from breast tissue together with breast cancer lines or cultured primary dissociated human breast tumor cells increases secretion of six different pro-inflammatory cytokines, each of which contributes to tumor progression through cancer stem cell recruitment. Prolonged exposure to fat cells or to each cytokine increases the proportion of cells that form mammosphere and express ALDH1 activity in vitro and that can initiate primary orthotopic tumors and metastasis in vivo. Adipocyte and cytokine exposures activate Src, and Src family kinase activity leads to induction of embryonic transcription factors that upregulate miR302b. miR302b induction is Sox2-dependent, promotes cytokine-driven sphere formation, and in turn, stimulates cMYC and SOX2 expression. Src is not only activated by adipocyte or cytokine exposures, it is also required to sustain cytokine induction, since Src inhibitors decrease cytokine production after co-culture. Cytokine upregulation was much greater after co-culture of ER+ breast cancer cells with mature, aromatase positive, adipocytes than with adipocyte stem cells. Cytokine induction was estrogen regulated. The mechanisms of cytokine induction, ER-coactivation and effects of different estrogenic ligands will be presented.
Present data illuminate the increased risk of breast cancer after menopause, particularly in obese women and the increased breast cancer mortality with obesity: cancer cell invasion into local fat, in the presence of high local aromatase and intracellular estrogen would establish feed-forward loops to activate Src, maintain pro-inflammatory cytokine production and increase tumor initiating cell abundance, tumor growth and metastasis. These data link obesity related pro-inflammatory cytokines to Src activation and cancer initiating cell abundance, and provide a novel rationale for Src inhibitors together with endocrine therapy for breast cancer.
Citation Format: Slingerland J, Picon-Ruiz M, Jang K, Morata-Tarifa C, Pan C, Besser A, Kim M, Ince TA, Howard GA, El-Ashry D. Estrogens contribute to cytokine upregulation and cancer stem cell recruitment upon breast cancer contact with mature human mammary adipocytes: Effects of estrogen type and adipocyte donor weight. [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 P1-03-02.
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Affiliation(s)
- J Slingerland
- University of Miami Miller School of Medicine, Miami, FL
| | - M Picon-Ruiz
- University of Miami Miller School of Medicine, Miami, FL
| | - K Jang
- University of Miami Miller School of Medicine, Miami, FL
| | | | - C Pan
- University of Miami Miller School of Medicine, Miami, FL
| | - A Besser
- University of Miami Miller School of Medicine, Miami, FL
| | - M Kim
- University of Miami Miller School of Medicine, Miami, FL
| | - TA Ince
- University of Miami Miller School of Medicine, Miami, FL
| | - GA Howard
- University of Miami Miller School of Medicine, Miami, FL
| | - D El-Ashry
- University of Miami Miller School of Medicine, Miami, FL
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Obeid J, Stoyanova R, Patel M, Padgett K, Slingerland J, Takita C, Pollack A, Alperin N, Yepes M, Zeidan Y. Multiparametric Evaluation of Preoperative MRI in Early-Stage Breast Cancer: Prognostic Impact of Peritumoral Fat. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.611] [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: 11/17/2022]
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Hew K, Miller P, Sun J, Wei Z, Zhang G, Lu Y, Mills G, Slingerland J, El-Ashry D, Simpkins F. Abstract AS31: MEK inhibition reverses antiestrogen resistance in ovarian cancer (OVCA) via alteration of cell cycle pathways and MAPK/estrogen regulated gene expression. Clin Cancer Res 2015. [DOI: 10.1158/1557-3265.ovcasymp14-as31] [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
BACKGROUND: It is estimated that 67% of epithelial OVCAs are estrogen receptor (ER) positive. However, the response to anti-estrogen therapy in OVCA remains marginal. The Ras/Raf/MEK/MAPK pathway is hyperactivated in 40% of OVCAs. We have previously shown that estrogens further activate kinases such as Src, ER and Src kinase binding in the cytoplasm suggesting a non-genomic role or ER in OVCA. We postulated that estrogens further activate MAPK signaling and combination ER blockade with MEK inhibition would block cross-talk and increase the efficacy of ER blockade.
METHODS: The effects of treatment with MEK inhibitor (AZD6244) and anti-estrogen (Fulvestrant), each alone or together, on cell cycle and cell survival were evaluated in ER+ OVCA lines in vitro. Drug effects on xenograft tumor growth were assayed in vivo in NOD/SCIDs. Reverse phase protein lysate array (RPPA) analysis and gene expression analysis (GEA) were performed to evaluate biomarkers of drug response. Finally, a previously reported MAPK gene signature identified in breast cancer was analyzed in the OVCA lines treated with AZD6244 and combination treatment. And using alteration of gene expression upon MEKi treatment as suggestive of MAPK regulation, we define a MAPK gene signature originating from ovarian cancer cells.
RESULTS: RPPA analysis of high grade serous tumors from the TCGA (n=408) demonstrates that over 70% of tumors have phosphorylated MEK and MAPK, and patients with ER+ cancers and high pMAPK or pMEK (top50%), have a worse overall survival than those with low pMAPK or pMEK. Estrogen (E2) increases phosphorylation of MEK in ER+ OVCA cells. Fulvestrant caused minimal growth arrest after treatment demonstrating intrinsic resistance. AZD6244 caused loss of pMAPK, partial G1 cell cycle arrest and a modest increase in p27 levels in a dose dependent manner after treatment. However, responsiveness of OVCA cells to fulvestrant increased by addition of AZD6244 in vitro, with synergistic cell cycle arrest mediated by p27 binding to Cyclin E/cdk2 and much greater inhibition of MAPK activity. Gene enrichment analysis showed an increase in the ERB4/MAPK gene set with Fulv alone and the addition of AZD6244 showed that the top 20 gene sets downregulated were all related to replication and cell cycle (ie FOXM1, CyclinE). RPPA confirmed that combination was more effective in decreasing cell cycle promoting proteins (ie FOXM1, Cyclin B1) and upregulating p27. AZD6244 treatment of OVCA lines resulted in differential expression of about ¼ of the breast cancer defined MAPK gene expression signature, and of these, fulvestrant addition to MEK inhibition (MEKi) differentially affected 19 genes, reflective of these being E2 regulated genes. Similarly, of the total MEKi affected genes, a subset were differentially regulated by the addition of fulvestrant indicating putative E2 regulation underlying these genes. Xenograft data showed the greatest decrease in tumor volume with the drug combination compared to either drug alone.
CONCLUSION: Given the majority of primary OVCAs express high MEK/MAPK activity may underlie failure of anti-estrogen therapy. MEK inhibition reverses anti-estrogen resistance in our OVCA models. These data support further pre-clinical and clinical evaluation of combined fulvestrant and MEK inhibition in OVCA.
Citation Format: K. Hew, P. Miller, J. Sun, Z. Wei, G. Zhang, Y. Lu, G. Mills, J. Slingerland, MD, PhD, D. El-Ashry, F. Simpkins. MEK inhibition reverses antiestrogen resistance in ovarian cancer (OVCA) via alteration of cell cycle pathways and MAPK/estrogen regulated gene expression [abstract]. In: Proceedings of the 10th Biennial Ovarian Cancer Research Symposium; Sep 8-9, 2014; Seattle, WA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(16 Suppl):Abstract nr AS31.
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Affiliation(s)
- K. Hew
- 1Dept. of OB-GYN, University of Miami,
| | - P. Miller
- 2Braman Family Breast Cancer Institute, Sylvester Cancer Center,
| | - J. Sun
- 2Braman Family Breast Cancer Institute, Sylvester Cancer Center,
| | - Z. Wei
- 3Dept. of Computer Science, New Jersey Institute of Technology,
| | | | - Y. Lu
- 5Dept. of Systems Biology MD Anderson Cancer Center,
| | - G. Mills
- 5Dept. of Systems Biology MD Anderson Cancer Center,
| | - J. Slingerland
- 2Braman Family Breast Cancer Institute, Sylvester Cancer Center,
| | - D. El-Ashry
- 2Braman Family Breast Cancer Institute, Sylvester Cancer Center,
| | - F. Simpkins
- 6Department of OB-GYN, University of Pennsylvania
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Khushman M, Slingerland J, Fan YS, Garcia-Buitrago M, Bustinza E, Restrepo M, Sussman D, Rocha-Lima C, Hosein P. Abstract A01: Exploring phosphatase and tensin homolog (PTEN) loss as a potential predictive marker for response to everolimus in patients with pancreatic neuroendocrine tumors (PNETs). Mol Cancer Ther 2015. [DOI: 10.1158/1538-8514.pi3k14-a01] [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: Identification of patients with exquisite sensitivity and/or durable responses to targeted therapies may lead to improved patient selection and allow for more rational treatment designs. Loss of PTEN tumor suppressor gene function, usually due to deletion, leads to activation of phosphatidylinositol 3-kinase/Akt and mammalian target of rapamycin (mTOR) signaling. The RADIANT-3 trial of everolimus in advanced PNETs demonstrated a significant prolongation of progression-free survival (PFS) from 4.6 months with placebo versus 11 months with everolimus. Despite the improvement in PFS, the response rate was only 5% among patients receiving everolimus. The index case for our study was an exceptional responder who had a significant radiological response as well as a PFS of 24 months, which were both better than expected from the literature. This led to the hypothesis that there may be mutational changes in genes affecting the mTOR pathway that could predict sensitivity to mTOR inhibitors. In this study, we specifically explored the role of PTEN loss as a potential predictive marker.
Methods and Materials: Between 2010 and 2014, patients with well-differentiated unresectable and metastatic PNETs treated at the University of Miami/Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital with everolimus were identified. Eight patients had pathology specimens available for testing. PTEN loss detected by Fluorescence In Situ Hybridization (FISH) was carried out using a commercially available probe for cytoband 10q23. Patients' response to everolimus was evaluated through June 2014. The primary outcome was PFS. PTEN expression by immunohistochemistry (IHC) will also be performed and the results will be compared to those obtained by FISH.
Results: The median age was 60 years (range 45-78). 50% of the patients were females and 50% were males. Two patients had gastrinomas, 1 patient had an insulinoma, and five patients had non-functional PNETs. All patients had unresectable metastases to the liver. In addition to sandostatin LAR, the patients received everolimus starting at a dose of 10mg daily. Three patients were found to have deletion of PTEN. Of those, one patient did not tolerate everolimus and the PFS for the other two was 8 and 24 months respectively. Detection of PTEN loss by FISH yielded no results in 2 patients due to insufficient tumor left in the specimen. PFS in these 2 patients was 24 and 4 months respectively. Testing is ongoing in the last 3 patients and the PFS for these patients is 3, 10 and 13 months. PTEN expression by IHC is also ongoing and will be reported at the meeting.
Conclusion: The index case for this study had a PTEN deletion and had a partial response to treatment and prolonged disease control for 2 years with everolimus. Testing is ongoing in additional cases to determine if there is a consistent correlation between PTEN loss by FISH and PFS.
Citation Format: Moh'd Khushman, Joyce Slingerland, Yao-Shan Fan, Monica Garcia-Buitrago, Ernesto Bustinza, Maria Restrepo, Daniel Sussman, Caio Rocha-Lima, Peter Hosein. Exploring phosphatase and tensin homolog (PTEN) loss as a potential predictive marker for response to everolimus in patients with pancreatic neuroendocrine tumors (PNETs). [abstract]. In: Proceedings of the AACR Special Conference: Targeting the PI3K-mTOR Network in Cancer; Sep 14-17, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(7 Suppl):Abstract nr A01.
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Affiliation(s)
- Moh'd Khushman
- The University of Miami/Sylvester Cancer Center, Miami, FL
| | | | - Yao-Shan Fan
- The University of Miami/Sylvester Cancer Center, Miami, FL
| | | | | | - Maria Restrepo
- The University of Miami/Sylvester Cancer Center, Miami, FL
| | - Daniel Sussman
- The University of Miami/Sylvester Cancer Center, Miami, FL
| | | | - Peter Hosein
- The University of Miami/Sylvester Cancer Center, Miami, FL
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Hew K, Miller P, El-Ashry D, Wei Z, Sun J, Zhang G, Guo W, Brafford P, Mills G, Slingerland J, Simpkins F. The effects of combined MEK inhibition and antiestrogen therapy in the treatment of ovarian cancer. Gynecol Oncol 2015. [DOI: 10.1016/j.ygyno.2015.01.457] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Zhao D, Besser AH, Wander SA, Sun J, Zhou W, Wang B, Ince T, Durante MA, Guo W, Mills G, Theodorescu D, Slingerland J. Cytoplasmic p27 promotes epithelial-mesenchymal transition and tumor metastasis via STAT3-mediated Twist1 upregulation. Oncogene 2015; 34:5447-59. [PMID: 25684140 PMCID: PMC4537852 DOI: 10.1038/onc.2014.473] [Citation(s) in RCA: 75] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Revised: 11/24/2014] [Accepted: 12/19/2014] [Indexed: 12/12/2022]
Abstract
p27 restrains normal cell growth, but PI3K-dependent C-terminal phosphorylation of p27 at threonine 157 (T157) and T198 promotes cancer cell invasion. Here, we describe an oncogenic feedforward loop in which p27pT157pT198 binds Janus kinase 2 (JAK2) promoting STAT3 (signal transducer and activator of transcription 3) recruitment and activation. STAT3 induces TWIST1 to drive a p27-dependent epithelial-mesenchymal transition (EMT) and further activates AKT contributing to acquisition and maintenance of metastatic potential. p27 knockdown in highly metastatic PI3K-activated cells reduces STAT3 binding to the TWIST1 promoter, TWIST1 promoter activity and TWIST1 expression, reverts EMT and impairs metastasis, whereas activated STAT3 rescues p27 knockdown. Cell cycle-defective phosphomimetic p27T157DT198D (p27CK-DD) activates STAT3 to induce a TWIST1-dependent EMT in human mammary epithelial cells and increases breast and bladder cancer invasion and metastasis. Data support a mechanism in which PI3K-deregulated p27 binds JAK2, to drive STAT3 activation and EMT through STAT3-mediated TWIST1 induction. Furthermore, STAT3, once activated, feeds forward to further activate AKT.
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Affiliation(s)
- D Zhao
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Sheila and David Fuente Graduate Program in Cancer Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - A H Besser
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Sheila and David Fuente Graduate Program in Cancer Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - S A Wander
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Sheila and David Fuente Graduate Program in Cancer Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - J Sun
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA
| | - W Zhou
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - B Wang
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - T Ince
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Pathology, Stem Cell Research Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - M A Durante
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Sheila and David Fuente Graduate Program in Cancer Biology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - W Guo
- Department of Bioinformatics and Computational Biology, and Department of Systems Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - G Mills
- Department of Bioinformatics and Computational Biology, and Department of Systems Biology, MD Anderson Cancer Center, Houston, TX, USA
| | - D Theodorescu
- University of Colorado Cancer Center, University of Colorado, Aurora, CO, USA
| | - J Slingerland
- Braman Family Breast Cancer Institute at Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA.,Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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18
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Khushman MM, Gomez Arteaga A, Diaz L, Tinoco G, Dawar R, Bustinza E, Garcia MT, Fan YS, Restrepo M, Merchan JR, Sussman DA, Slingerland J, Rocha Lima CMS, Hosein PJ. Exploring phosphatase and tensin homolog (PTEN) loss via immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) as a potential predictive marker for response to everolimus in patients (pts) with neuroendocrine tumors (NET). J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.3_suppl.333] [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
333 Background: Identification of pts with exquisite sensitivity and/or durable responses to targeted therapies may lead to improved patient selection and allow for more rational treatment designs. Exceptional responders to everolimus in NET including pancreatic (PNET) were observed in our cohort of pts. PTEN is a key negative regulator of the phosphatidylinositol 3-kinase(PI3K)/Akt and mammalian target of rapamycin (mTOR) pathway. Loss of PTEN tumor suppressor gene function, usually due to deletion, leads to PI3K/Akt/mTOR pathway activation. Inthis study, we explored the role of PTEN as a potential predictive marker of everolimus in pts with NET including PNET. Methods: Between 2010 and 2014, pts with well-differentiated unresectable and metastatic gastrointestinal NET treated at our institution with everolimus were identified. 17 patients had pathology specimens available for testing. PTEN loss detection by FISH was carried out using a commercially available probe for cytoband 10q23, and by IHC using a commercially available antibody. Patients’ response to everolimus was evaluated through August 2014. The primary outcome was PFS and PTEN status was correlated with PFS for any potential association. Results: The median age was 59 years (range 45-78); 7 were male; 8 had PNET (2 gastrinomas, 1 insulinoma and 5 non-functional); 7 had small bowel NET and 2 unknown primary. All pts received everolimus starting at 10mg daily and octreotide LAR. Of the pts with PNETs, 3 had PTEN loss by FISH. Of those, one did not tolerate everolimus. The PFS for the other two pts was 8 and 24 months respectively. Among the 4 pts with intact PTEN; PFS was 14, 26, 3 and 12 months. 1 patient had insufficient tumor for testing. PTEN FISH is ongoing in the 9 non-pancreatic NET pts. PTEN expression by IHC is also ongoing and will be reported at the meeting. Conclusions: Testing for PTEN loss by FISH is feasible. Due to the small sample size, the role of PTEN loss could not be defined as a predictive marker in PNET. Testing on additional cases is ongoing and will be presented at the meeting.
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Affiliation(s)
- Moh'd M. Khushman
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | | | - Liege Diaz
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Gabriel Tinoco
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Richa Dawar
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Ernesto Bustinza
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | | | - Yao-Shan Fan
- University of Miami, Sylvester Comprehensive Cancer Center, Miami, FL
| | - Maria Restrepo
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
| | - Jaime R. Merchan
- Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL
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19
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Perez A, Neskey DM, Wen J, Goodwin JW, Slingerland J, Pereira L, Weigand S, Franzmann EJ. Abstract 2521: Targeting CD44 in head and neck squamous cell carcinoma (HNSCC) with a new humanized antibody RO5429083. Immunology 2014. [DOI: 10.1158/1538-7445.am2012-2521] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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20
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Emmenegger U, Sousa B, Hoang V, Chow A, Clemons M, Dent S, Wong N, Kerbel R, Trudeau M, Slingerland J, Eisen A, Ebos J, Chan K, Gardner S, Pritchard K. Generation of a Plasma Microrna (Mirna) Signature Predicting Response to Metronomic Chemotherapy (Mc) for Advanced Breast Cancer (Abc). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu326.12] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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21
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Abstract
Ovarian cancer (OVCA) is the most lethal gynecological malignancy. It is often diagnosed in advanced stages and despite therapy, 70% relapse within 2years with incurable disease. Regimens with clinical benefit and minimal toxicity are urgently needed. More effective hormonal therapies would be appealing in this setting. Estrogens (E2) are implicated in the etiology of OVCA. Estrogens drive proliferation and anti-estrogens inhibit ovarian cancer growth in vitro and in vivo. Despite estrogen receptor (ER) expression in 67% of OVCAs, small anti-estrogen therapy trials have been disappointing and the benefit of hormonal therapy has not been systematically studied in large well-designed trials. OVCAs often manifest de novo anti-estrogen resistance and those that initially respond invariably develop resistance. Estrogens stimulate ovarian cancer progression by transcriptional activation and cross talk between liganded ER and mitogenic pathways, both of which drive cell cycle progression. Estrogen deprivation and estrogen receptor (ER) blockade cause cell cycle arrest in susceptible OVCAs by increasing the cell cycle inhibitor, p27. This review summarizes and discusses scientific and epidemiological evidence supporting estrogen's role in ovarian carcinogenesis, provides an overview of clinical trials of ER blockade and aromatase inhibitors in OVCA and reviews potential causes of antiestrogen resistance. Anti-estrogen resistance was recently shown to be reversed by dual ER and Src signaling blockade. Blocking cross-talk between ER and constitutively activated kinase pathways may improve anti-estrogen therapeutic efficacy in OVCA, as has been demonstrated in other cancers. Novel strategies to improve benefit from anti-estrogens by combining them with targeted therapies are reviewed.
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Affiliation(s)
- Fiona Simpkins
- Division of Gynecology Oncology, University of Miami, Miller School of Medicine, Miami, FL, United States.
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22
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23
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Montero AJ, Diaz-Montero CM, Deutsch YE, Hurley J, Koniaris LG, Rumboldt T, Yasir S, Jorda M, Garret-Mayer E, Avisar E, Slingerland J, Silva O, Welsh C, Schuhwerk K, Seo P, Pegram MD, Glück S. Phase 2 study of neoadjuvant treatment with NOV-002 in combination with doxorubicin and cyclophosphamide followed by docetaxel in patients with HER-2 negative clinical stage II-IIIc breast cancer. Breast Cancer Res Treat 2011; 132:215-23. [PMID: 22138748 DOI: 10.1007/s10549-011-1889-0] [Citation(s) in RCA: 73] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2011] [Accepted: 11/15/2011] [Indexed: 02/07/2023]
Abstract
NOV-002 (a formulation of disodium glutathione disulfide) modulates signaling pathways involved in tumor cell proliferation and metastasis and enhances anti-tumor immune responsiveness in tumor models. The addition of NOV-002 to chemotherapy has been shown to increase anti-tumor efficacy in animal models and some early phase oncology trials. We evaluated the clinical effects of NOV-002 in primary breast cancer, whether adding NOV-002 to standard preoperative chemotherapy increased pathologic complete response rates (pCR) at surgery, and determined whether NOV-002 mitigated hematologic toxicities of chemotherapy and whether levels of myeloid derived suppressor cells (MDSC) were predictive of response. Forty-one women with newly diagnosed stages II-IIIc HER-2 negative breast cancer received doxorubicin-cyclophosphamide followed by docetaxel (AC → T) every 3 weeks and concurrent daily NOV-002 injections. The trial was powered to detect a doubling of pCR rate from 16 to 32% with NOV-002 plus AC → T (α = 0.05, β = 80%). Weekly complete blood counts were obtained as well as circulating MDSC levels on day 1 of each cycle were quantified. Of 39 patients with 40 evaluable tumors, 15 achieved a pCR (38%), meeting the primary endpoint of the trial. Concurrent NOV-002 resulted in pCR rates for AC → T chemotherapy higher than previously reported. Patients with lower levels of circulating MDSCs at baseline and on the last cycle of chemotherapy had significantly higher probability of a pCR (P = 0.02). Further evaluation of NOV-002 in a randomized study is warranted.
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Affiliation(s)
- A J Montero
- Sylvester Comprehensive Cancer Center, University of Miami, 1475 NW 12th Avenue, Suite 3510 (D8-4), Miami, FL 33136, USA.
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24
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Rosenblatt AE, Garcia MI, Lyons L, Xie Y, Maiorino C, Désiré L, Slingerland J, Burnstein KL. Inhibition of the Rho GTPase, Rac1, decreases estrogen receptor levels and is a novel therapeutic strategy in breast cancer. Endocr Relat Cancer 2011; 18:207-19. [PMID: 21118977 PMCID: PMC3644524 DOI: 10.1677/erc-10-0049] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Rac1, a Rho GTPase, modulates diverse cellular processes and is hyperactive in some cancers. Estrogen receptor-alpha (ERα) in concert with intracellular signaling pathways regulates genes associated with cell proliferation, tumor development, and breast cancer cell survival. Therefore, we examined the possibility of Rac1 and ERα crosstalk in breast cancer cells. We found that Rac1 enhanced ERα transcriptional activity in breast cancer cells. Vav3, a Rho guanine nucleotide exchange factor that activates Rac1, was an upstream mediator, and P21/Cdc42/Rac1 activating kinase-1 (Pak-1) was a downstream effector of Rac1 enhancement of ERα activity. These results suggest that Rac1 may prove to be a therapeutic target. To test this hypothesis, we used a small molecule Rac inhibitor, EHT 1864, and found that EHT 1864 inhibited ERα transcriptional activity. Furthermore, EHT 1864 inhibited estrogen-induced cell proliferation in breast cancer cells and decreased tamoxifen-resistant breast cancer cell growth. EHT 1864 decreased activity of the promoter of the ERα gene resulting in down-regulation of ERα mRNA and protein levels. Therefore, ERα down-regulation by EHT 1864 is the likely mechanism of EHT 1864-mediated inhibition of ERα activity and estrogen-stimulated breast cancer cell proliferation. Since ERα plays a critical role in the pathogenesis of breast cancer and the Rac inhibitor EHT 1864 down-regulates ERα expression and breast cancer cell proliferation, further investigation of the therapeutic potential of Rac1 targeting in the treatment of breast cancer is warranted.
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Affiliation(s)
- Adena E Rosenblatt
- Department of Molecular and Cellular Pharmacology, University of Miami Miller School of Medicine, 1600 Northwest 10th Avenue (R-189), Miami, Florida 33136, USA
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25
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Sudhindra A, Dammarich D, Ochoa R, Takita C, Mendiola MF, Hurley J, Gluck S, Welsh C, Slingerland J, Richman S, Gomez-Fernandez C, Timothee P, Diaz A, Silva OE. Abstract P3-11-09: Body Mass Index (BMI) and Survival: A Retrospective Review of Women with Triple Negative Breast Cancer (An Update). Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p3-11-09] [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
Body Mass Index (BMI) has been reported as a risk factor for recurrence and decreased survival in women with breast cancer. At the Inter-American Breast Cancer Conference we presented data showing the effect BMI has on overall survival in women with triple negative breast cancer (TNBC). Here we present an update of this data which to our knowledge is the only study addressing the effect BMI has on outcomes in TNBC. We conducted a retrospective review of 170 patients with TNBC seen at the University of Miami Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital between December of 1999 and April 2010. Charts were reviewed looking at BMI at the time of diagnosis and overall survival defined as date of last contact or date of death when known. 163 patients were included in the study. BMI was defined as normal (BMI 18.5-24.9) and overweight or obese (25 or greater). The average age at diagnosis was 50.96 years with a mean OS of 44.67 months. 21 patients (13%) had stage I disease, 61 (37.4%) had stage II disease, 81 (49.6%) had stage III disease. In patients with stage I disease 33% had a normal BMI with a mean OS of 51.7 months. 67% were overweight or obese with a mean OS of 60.2 months. In patients with stage II disease 33% had a normal BMI with a mean OS of 30.8 months. 67% were overweight or obese with a mean OS of 48.4 months. In patients with stage III disease 28% had a normal BMI with a mean OS of 37.2 months. 72% were overweight or obese with a mean OS of 43.1 months.
Survival in patients with TNBC does not appear to be negatively impacted by the patients BMI at diagnosis. While not statistically significant (p=0.274) patients with stage I TNBC that were overweight or obese tended to have an increased OS compared to those with a normal BMI. In patients with stage II disease there was a statistically significant (p=0.010) increase in OS in overweight or obese patients compared to those with a normal BMI. In the patients with stage III disease there was no significant difference in the OS (p=0.458) between patients with a normal BMI and those that were overweight or obese.
Our study shows that increased BMI at the time of diagnosis may have a positive impact on OS in patients with TNBC. Overweight and obese patients with stage I and II TNBC have an increased OS compared to those with a normal BMI. In those with stage II disease the difference was statistically significant. Although this study was limited by small sample size, if confirmed, it might suggest a relationship between obesity and survival in TNBC. Further studies are needed to evaluate these findings.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P3-11-09.
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Affiliation(s)
- A Sudhindra
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - D Dammarich
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - R Ochoa
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - C Takita
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - MF Mendiola
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - J Hurley
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - S Gluck
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - C Welsh
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - J Slingerland
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - S Richman
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - C Gomez-Fernandez
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - P Timothee
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - A Diaz
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
| | - OE. Silva
- Jackson Memorial Hospital, Miami, FL; University of Miami Sylvester Comprehensive Cancer Center, FL
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26
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Montero AJ, Diaz CM, Slingerland J, Pegram M, Hurley J, Welsh CF, Avisar E, Seo P, Vogel CL, Garrett-Mayer E, Hermann V, Baker MK, Silva O, Koniaris L, Rodgers S, Schuhwerk K, Pazoles CJ, Moffat F, Cole DJ, Gluck S. Abstract P1-11-05: Phase 2 Study of Neoadjuvant Treatment with Cellular Redox Modulator NOV-002 in Combination with Doxorubicin and Cyclophosphamide Followed by Docetaxel (AC→T) in Patients with Stage II-III HER-2 (-) Breast Cancer. Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p1-11-05] [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
Background: NOV-002 (a formulation of disodium glutathione disulfide) modulates signaling pathways involved in tumor cell proliferation and metastasis and enhances anti-tumor immune responsiveness in tumor models. The addition of NOV-002 to a range of cytotoxic chemotherapeutic regimens has been shown to increase their anti-tumor efficacy in several early phase oncology trials and in animal models. Pathological complete response (pCR) has been demonstrated to be associated with favorable overall survival in primary breast cancer, and neoadjuvant treatment of early breast cancer aims at achieving high rates of pCR. In patients with HER-2 (-) breast cancer pCR rates with anthracycline and taxane combinations have been reported to be approximately 10-20% depending on hormone receptor status. We conducted a clinical trial in HER-2 negative patients (pts) combining daily N0V-002 with AC→T. Methods: Women with newly diagnosed stages II-III HER-2 (-) breast cancer received AC x 4 [60/600 mg/m2] followed by T [100 mg/m2] x 4 every 3 weeks in conjunction with daily N0V-002 [60mg IV day 1 and subcutaneously days 2-21 of each cycle]. The primary endpoint is pCR, defined as: (i) ypN0, and (ii) ypT0 or presence of invasive tumor <10mm.
Sample size (n=46 total patients) was calculated using a Simon 2-stage optimal design assuming a doubling of the historical pCR rate with the addition of NOV-002 to AC→T from a p0 of 0.16 to a p1 of 0.32. If a total of 12 or more patients experience a pCR by the end of the trial, then the treatment regimen will be declared active. The calculation assumes an alpha of 0.05 and 80% power.
Results: A total of 39 pts have been enrolled to date across three study sites, with 31 patients having completed chemotherapy and undergone surgery. One patient dropped out during cycle 1 and was not assessable for response; 5 are currently receiving chemotherapy; and 2 patients have completed all chemotherapy, but have not yet undergone surgery. A total of 292 chemotherapy cycles have been administered, with 92% of all patients being able to complete all 8 cycles of planned chemotherapy. Of the 31 evaluable patients, 12 achieved a pCR (39%), meeting the primary endpoint of the trial. In patients with residual invasive primary breast tumor <10mm and ypN0 (19%) mean residual tumor size was 4.4 mm. Interestingly, of the 17 patients with biopsy-proven axillary involvement, 4 (23%) had no residual invasive tumor in axillary nodes at time of surgery. In 26 patients with estrogen positive breast cancer, which is least sensitive to chemotherapy, 42% achieved a pCR. The most common toxicities included: nausea, sensory neuropathy, emesis, fatigue, and hand-foot syndrome. Conclusions: The addition of NOV-002 has to date resulted in a doubling of previously published pCR rates with AC→T in HER-2 (-) breast cancer patients. Subsequent investigation of NOV-002 in conjunction with neoadjuvant chemotherapy in breast cancer is warranted. Updated clinical data on all 39 patients as well as immunologic correlative markers will be presented.
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P1-11-05.
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Affiliation(s)
- AJ Montero
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - CM Diaz
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - J Slingerland
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - M Pegram
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - J Hurley
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - CF Welsh
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - E Avisar
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - P Seo
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - CL Vogel
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - E Garrett-Mayer
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - V Hermann
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - MK Baker
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - O Silva
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - L Koniaris
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - S Rodgers
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - K Schuhwerk
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - CJ Pazoles
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - F Moffat
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - DJ Cole
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
| | - S. Gluck
- University of Miami Sylvester Comprehensive Cancer Center, FL; Medical University of South Carolina, Charleston; Novelos Therapeutics, Newton, MA
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27
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Pegram M, Silva O, Higgins C, Tukia K, Avisar E, Stuart M, Slingerland J. Abstract P2-19-03: Src Kinase Inhibition with AZD0530 Plus Anastrozole in Postmenopausal Hormone Receptor Positive (HR+) Metastatic Breast Cancer (MBC). Cancer Res 2010. [DOI: 10.1158/0008-5472.sabcs10-p2-19-03] [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
Background: p27 is a negative regulator of cell cycle that is frequently decreased in primary human breast cancer (BC) due to accelerated proteolysis. In HR+ BC, p27 function is required to promote G1 arrest following anti-estrogen treatment. cSrc is overexpressed/activated in up to 70% of BC. Src kinase phosphorylates p27 reducing its inhibitory function toward cyclin E-Cdk2, thereby facilitating p27 degradation. AZD0530 is a potent, orally available dual inhibitor of Abl and Src family kinases. Preclinical data indicate AZD0530 cooperates with anastrozole to inhibit BC cell growth in vitro and in vivo (Chen, et al., Clin Cancer Res 2009). We hypothesized that Src inhibition would augment p27 to promote antiproliferative effects of anastrozole in HR+ BC. Methods: This is an NCI funded investigator-initiated, open label phase IB clinical trial conducted under an investigator IND. Target population: postmenopausal HR+ relapsed or MBC who are candidates for aromatase inhibitor therapy. Key Inclusion: postmenopausal females, age ≥18, advanced or locally relapsed unresectable HR+ measurable/evaluable (RECIST) disease, ECOG 0-2, informed consent. Cohorts of 3 patients were initiated with AZD0530 175mg PO/day in combination with anastrozole 1mg PO daily in a planned dose de-escalation study design with subsequent cohort expansion to 12 subjects for PK assessment (both AZD0530 and anastrozole) performed at 6, 12, 24, 48, and 72 hours, 8, 15 and 22 days.
Results: Among 12 patients enrolled, AZD0530 plus anastrozole was well tolerated (no dose limiting toxicities) without need for dose de-escalation. Drug related adverse events: grade 3 lymphopenia (N=3), neutropenia (N=2), anemia (N=1) and reversible grade 1/2 transaminase elevation (N=9). Serious adverse events were observed in 2 patients (urosepsis and CNS hemorrhage due to CNS metastasis), neither considered drug-related. Interstitial pneumonitis was not observed. PK assessment: mean day 21 serum concentration = 298±38.4 ng/ml for AZD0530 and 51±5.6 ng/ml for anastrozole, indicating no evidence for drug-drug interaction between the 2 agents. Clinical efficacy: There were no RECIST clinical responses in this heavily pretreated population. However, notably patients with bone metastasis reported improvement in bone pain, and 2 patients had prolonged disease stability (>7 and 10 months with improvement of PET and bone scans) despite prior hormone refractory disease. Conclusions: Src kinase inhibition with AZD0530 combined with anastrozole was well tolerated without significant PK interaction. The recommended phase II dose is AZD0530 175mg PO plus anastrozole 1mg PO daily. A randomized phase II study of this combination is currently underway in the neoadjuvant setting including complete PK/PD assessment and molecular correlative studies to evaluate predictors of response. Supported by NIH 1R21CA133884-01A1
Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-19-03.
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Affiliation(s)
- M Pegram
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
| | - O Silva
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
| | - C Higgins
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
| | - K Tukia
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
| | - E Avisar
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
| | - M Stuart
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
| | - J. Slingerland
- Miller School of Medicine, University of Miami, FL; AstraZeneca Pharmaceuticals, London, United Kingdom
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Abstract
Approximately 20% of new diagnosed breast cancers overexpress the human epidermal growth factor receptor 2 (EGFR2), also known as erythroblastic leukemia viral oncogene homolog 2 (ERBB2) protein, as a consequence of ERBB2 gene amplification, resulting in a poor prognosis. Clinical outcome can be substantially improved by ERBB2-targeted therapy. Lapatinib is a potent, orally bioavailable small molecule that reversibly and selectively inhibits epidermal growth factor receptor (EGFR1 or ERBB1) and ERBB2 tyrosine kinases. Lapatinib binds the adenosine triphosphate-binding site of the receptor's intracellular domain to inhibit tumor cell growth. This review summarizes the pharmacology, pharmacokinetics, efficacy, and tolerability of lapatinib, and reviews both Food and Drug Administration-approved and investigational uses of lapatinib in breast cancer therapy. The drug is generally well tolerated in patients, with diarrhea and rashes being the most common (usually mild or moderate) adverse effects. Unlike trastuzumab, lapatinib has infrequent adverse effects on cardiac function. Lapatinib has substantial activity for advanced ERBB2-positive breast cancer, particularly in combination with capecitabine, following progression after anthracyclines, taxanes, and trastuzumab. Lapatinib combined with capecitabine yielded significant improvements in time to progression and response rate compared with capecitabine alone. This drug can also be combined with letrozole for the treatment of postmenopausal women with ERBB2-positive breast cancer, for whom hormonal therapy is indicated. Lapatinib has shown early promise in treatment of central nervous system metastasis and is being further evaluated in various clinical settings.
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Affiliation(s)
- Julia Liao
- Braman Family Breast Cancer institute, University of Miami Sylvester Comprehensive Cancer Center, USA
| | - Michelle Gallas
- Braman Family Breast Cancer institute, University of Miami Sylvester Comprehensive Cancer Center, USA
| | - Mark Pegram
- Braman Family Breast Cancer institute, University of Miami Sylvester Comprehensive Cancer Center, USA ; Division of Hematology/Oncology, University of Miami Sylvester Comprehensive Cancer Center, USA ; Departments of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Joyce Slingerland
- Braman Family Breast Cancer institute, University of Miami Sylvester Comprehensive Cancer Center, USA ; Division of Hematology/Oncology, University of Miami Sylvester Comprehensive Cancer Center, USA ; Departments of Medicine, University of Miami Miller School of Medicine, Miami, FL, USA ; Biochemistry and Molecular Biology, University of Miami Miller School of Medicine, Miami, FL, USA
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Pegram MD, Silva OE, Higgins C, Tukia K, Stuart M, Slingerland J. Phase IB pharmacokinetic (PK) study of Src kinase inhibitor AZD0530 plus anastrozole in postmenopausal hormone receptor positive (HR+) metastatic breast cancer (MBC). J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e13074] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Glück S, Lobo C, Lopes G, Castrellon A, Hurley J, Reis I, Richman S, Silva O, Slingerland J, Welsh C. 470 Final results of a phase II study of combination with nab-paclitaxel, bevacizumab, and gemcitabine as first-line therapy in patients with HER2-negative metastatic breast cancer. EJC Suppl 2010. [DOI: 10.1016/s1359-6349(10)70491-2] [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: 10/19/2022] Open
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Wong NS, Buckman RA, Clemons M, Verma S, Dent S, Trudeau ME, Roche K, Ebos J, Kerbel R, Deboer GE, Sutherland DJA, Emmenegger U, Slingerland J, Gardner S, Pritchard KI. Phase I/II trial of metronomic chemotherapy with daily dalteparin and cyclophosphamide, twice-weekly methotrexate, and daily prednisone as therapy for metastatic breast cancer using vascular endothelial growth factor and soluble vascular endothelial growth factor receptor levels as markers of response. J Clin Oncol 2009; 28:723-30. [PMID: 20026801 DOI: 10.1200/jco.2009.24.0143] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
PURPOSE Preclinical studies indicate that metronomic chemotherapy is antiangiogenic and synergistic with other antiangiogenic agents. We designed a phase I/II study to evaluate the safety and activity of adding dalteparin and prednisone to metronomic cyclophosphamide and methotrexate in women with measurable metastatic breast cancer (MBC). PATIENTS AND METHODS Patients received daily dalteparin and oral cyclophosphamide, twice-weekly methotrexate, and daily prednisone (dalCMP). The primary study end point was clinical benefit rate (CBR), a combination of complete response (CR), partial response (PR), and prolonged stable disease for > or = 24 weeks (pSD). Secondary end points included time to progression (TTP), duration of response, and overall survival (OS). Biomarker response to treatment was assessed by using plasma vascular endothelial growth factor (VEGF) and soluble VEGF receptors (sVEGFRs) -1 and -2. Results Forty-one eligible patients were accrued. Sixteen (39%) had no prior chemotherapy for MBC; 15 (37%) had two or more chemotherapy regimens for MBC. Toxicities were minimal except for transient grade 3 elevation of liver transaminases in 11 patients (27%) and grade 3 vomiting in one patient (2%). One patient (2%) had CR, six (15%) had PR, and three (7%) had pSD, for a CBR of 10 (24%) of 41 patients. Median TTP was 10 weeks (95% CI, 8 to 17 weeks), and median OS was 48 weeks (95% CI, 32 to 79 weeks). VEGF levels decreased but not significantly, whereas sVEGFR-1 and -2 levels increased significantly after 2 weeks of therapy. There was no correlation between response and VEGF, sVEGFR-1, or sVEGFR-2 levels. CONCLUSION Metronomic dalCMP is safe, well tolerated, and clinically active in MBC.
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Affiliation(s)
- Nan Soon Wong
- Sunnybrook Odette Cancer Centre, Ontario Clinical Oncology Group, University of Toronto, 2075 Bayview Ave, Toronto M4N3M5, Ontario, Canada
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Gluck S, Lobo C, Reis I, Lopes G, Carmody C, Tukia K, Hurley J, Seo P, Silva O, Slingerland J, Welsh C. Phase II study of nab-paclitaxel, bevacizumab, and gemcitabine for first-line therapy of patients with HER2-negative metastatic breast cancer (MBC). J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.1089] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Silva O, Lopes G, Morgenzstern D, Lobo C, Doliny P, Santos E, Abdullah S, Gautam U, Reis I, Welsh C, Slingerland J, Hurley J, Gluck S. A Phase II Trial of Split, Low-Dose Docetaxel and Low-Dose Capecitabine: A Tolerable and Efficacious Regimen in the First-Line Treatment of Patients with HER2/neu–Negative Metastatic Breast Cancer. Clin Breast Cancer 2008; 8:162-7. [DOI: 10.3816/cbc.2008.n.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Han HS, Doliny P, Blaya M, Gluck S, Slingerland J, Silva O, Welsh C, Hurley J. Dose-dense docetaxel, carboplatinum and trastuzumab (ddTCH) as neoadjuvant therapy for human epidermal receptor 2 (HER2) positive breast cancer. J Clin Oncol 2007. [DOI: 10.1200/jco.2007.25.18_suppl.11003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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
11003 Background: Docetaxel, cisplatin, and trastuzumab given every 21 days in Her 2-postitive breast cancer demonstrates a pathologic complete response (pCR) rate of 23%. Decreasing the interval between doses of chemotherapy has lead to improvement in survival in the adjuvant setting. In one study dose dense chemotherapy improved response only in patients whose tumors overexpressed her-2. We conducted a phase II trial to evaluate the efficacy and safety of neoadjuvant dose-dense TCH for HER 2-positive breast cancer. Methods: Patients with T2–4 N0–3 M0 HER-2 positive (by FISH) breast cancers were eligible. Neoadjuvant therapy consisted of carboplatinum (AUC 6) Day 1,15,29,43, docetaxel (75mg/m2) Day 1,15,29, 43 and weekly trastuzumab for 10 weeks 4mg/kg Day 1 then 2mg/kg Day 8,15,22,29,36,43,50,57,64, Pegfilgastrim Day 2,16,30,44. The primary end point was the rate of pCR. Results: Twenty patients are evaluable for response. The median age was 51.5 years (range 29–73). Mean tumor size was 5.6 cm. Patients had stage IIA (30%), IIB (15%), IIIA (45%), IIIB (5%), and IIIC (5%). Estrogen receptors were positive in 36% of tumors. No grade 4 or 5 toxicity occurred. The most frequent toxicity was hand-foot syndrome (Grade I 15%, Grade II 10%, Grade III 15%). Neutropenia occurred in 5 patients (Grade II 10%, Grade III 15%) There were no episodes of febrile neutropenia or hospitalizations. Grade I cardiotoxicity was seen in 30%. The rate of pCR was 40% in the breast and 35% in both breast and axilla. 16/20 patients (80%) had pathologically negative lymph nodes. Conclusions: Changing the scheduling of TCH from every 21 days to every 14 days improves the pCR rate from 23 to 40%. The regimen was well tolerated. No significant financial relationships to disclose.
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35
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Govindarajan B, Sligh JE, Vincent BJ, Li M, Canter JA, Nickoloff BJ, Rodenburg RJ, Smeitink JA, Oberley L, Zhang Y, Slingerland J, Arnold RS, Lambeth JD, Cohen C, Hilenski L, Griendling K, Martínez-Diez M, Cuezva JM, Arbiser JL. Overexpression of Akt converts radial growth melanoma to vertical growth melanoma. J Clin Invest 2007; 117:719-29. [PMID: 17318262 PMCID: PMC1797605 DOI: 10.1172/jci30102] [Citation(s) in RCA: 221] [Impact Index Per Article: 13.0] [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: 08/17/2006] [Accepted: 12/12/2006] [Indexed: 12/17/2022] Open
Abstract
Melanoma is the cancer with the highest increase in incidence, and transformation of radial growth to vertical growth (i.e., noninvasive to invasive) melanoma is required for invasive disease and metastasis. We have previously shown that p42/p44 MAP kinase is activated in radial growth melanoma, suggesting that further signaling events are required for vertical growth melanoma. The molecular events that accompany this transformation are not well understood. Akt, a signaling molecule downstream of PI3K, was introduced into the radial growth WM35 melanoma in order to test whether Akt overexpression is sufficient to accomplish this transformation. Overexpression of Akt led to upregulation of VEGF, increased production of superoxide ROS, and the switch to a more pronounced glycolytic metabolism. Subcutaneous implantation of WM35 cells overexpressing Akt led to rapidly growing tumors in vivo, while vector control cells did not form tumors. We demonstrated that Akt was associated with malignant transformation of melanoma through at least 2 mechanisms. First, Akt may stabilize cells with extensive mitochondrial DNA mutation, which can generate ROS. Second, Akt can induce expression of the ROS-generating enzyme NOX4. Akt thus serves as a molecular switch that increases angiogenesis and the generation of superoxide, fostering more aggressive tumor behavior. Targeting Akt and ROS may be of therapeutic importance in treatment of advanced melanoma.
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Affiliation(s)
- Baskaran Govindarajan
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - James E. Sligh
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Bethaney J. Vincent
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Meiling Li
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jeffrey A. Canter
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Brian J. Nickoloff
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Richard J. Rodenburg
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jan A. Smeitink
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Larry Oberley
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Yuping Zhang
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Joyce Slingerland
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Rebecca S. Arnold
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - J. David Lambeth
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Cynthia Cohen
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Lu Hilenski
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Kathy Griendling
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Marta Martínez-Diez
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - José M. Cuezva
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
| | - Jack L. Arbiser
- Department of Dermatology, Emory University School of Medicine, and Atlanta Veterans Administration Medical Center, Atlanta, Georgia, USA.
Division of Dermatology and Center for Human Genetics Research, Vanderbilt University Medical Center and VA Tennessee Valley Healthcare System, Nashville, Tennessee, USA.
Cardinal Bernardin Cancer Center, Loyola University Health System, Chicago, Illinois, USA.
Nijmegen Centre for Mitochondrial Disorders, Department of Paediatrics, Radboud University Medical Centre Nijmegen, Nijmegen, The Netherlands.
Free Radical and Radiation Biology Program, Department of Radiation Oncology, University of Iowa, Iowa City, Iowa, USA.
Department of Medicine, University of Miami Leonard M. Miller School of Medicine, Miami, Florida, USA.
Department of Pathology and Laboratory Medicine and
Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia, USA.
Departamento de Biología Molecular, Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid, Madrid, Spain
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Chu I, Sun J, Arnaout A, Kahn H, Hanna W, Narod S, Sun P, Tan CK, Hengst L, Slingerland J. p27 phosphorylation by Src regulates inhibition of cyclin E-Cdk2. Cell 2007; 128:281-94. [PMID: 17254967 PMCID: PMC1961623 DOI: 10.1016/j.cell.2006.11.049] [Citation(s) in RCA: 284] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2006] [Revised: 10/03/2006] [Accepted: 11/20/2006] [Indexed: 01/02/2023]
Abstract
The kinase inhibitor p27Kip1 regulates the G1 cell cycle phase. Here, we present data indicating that the oncogenic kinase Src regulates p27 stability through phosphorylation of p27 at tyrosine 74 and tyrosine 88. Src inhibitors increase cellular p27 stability, and Src overexpression accelerates p27 proteolysis. Src-phosphorylated p27 is shown to inhibit cyclin E-Cdk2 poorly in vitro, and Src transfection reduces p27-cyclin E-Cdk2 complexes. Our data indicate that phosphorylation by Src impairs the Cdk2 inhibitory action of p27 and reduces its steady-state binding to cyclin E-Cdk2 to facilitate cyclin E-Cdk2-dependent p27 proteolysis. Furthermore, we find that Src-activated breast cancer lines show reduced p27 and observe a correlation between Src activation and reduced nuclear p27 in 482 primary human breast cancers. Importantly, we report that in tamoxifen-resistant breast cancer cell lines, Src inhibition can increase p27 levels and restore tamoxifen sensitivity. These data provide a new rationale for Src inhibitors in cancer therapy.
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Affiliation(s)
- Isabel Chu
- Braman Family Breast Cancer Institute, and Department of Biochemistry and Molecular Biology, U. of Miami Miller School of Medicine, Miami, Florida; U.S.A
- Departments of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
| | - Jun Sun
- Braman Family Breast Cancer Institute, and Department of Biochemistry and Molecular Biology, U. of Miami Miller School of Medicine, Miami, Florida; U.S.A
| | - Angel Arnaout
- Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Harriette Kahn
- Pathobiology and Lab Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Wedad Hanna
- Pathobiology and Lab Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Steven Narod
- Pathobiology and Lab Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ping Sun
- Pathobiology and Lab Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Cheng-Keat Tan
- Braman Family Breast Cancer Institute, and Department of Biochemistry and Molecular Biology, U. of Miami Miller School of Medicine, Miami, Florida; U.S.A
| | - Ludger Hengst
- Division of Medical Biochemistry, Biocenter - Innsbruck Medical University, Innsbruck, Austria
| | - Joyce Slingerland
- Braman Family Breast Cancer Institute, and Department of Biochemistry and Molecular Biology, U. of Miami Miller School of Medicine, Miami, Florida; U.S.A
- Departments of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada
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37
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Silva OE, Lopes G, Morgensztern D, Lobo C, Abdullah S, Doliny P, Slingerland J, Gluck S, Santos E, Welsh C, Hurley J. Split, low-dose docetaxel (D) and low-dose capecitabine (C) is an active regimen in metastatic breast cancer with minimal toxicity. J Clin Oncol 2006. [DOI: 10.1200/jco.2006.24.18_suppl.10618] [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
10618 Background: Successful therapeutic regimens in metastatic breast cancer must balance efficacy and tolerability. D and C is an active and commonly used doublet in this setting. D upregulates thymidine phosphorylase and thus potentiates the anti-tumor effects of C. A schedule with split, low-dose D in combination with low dose C could improve the therapeutic index of this regimen without compromising its clinical activity. Methods: Patients with previously untreated her2-neu negative metastatic breast cancer were included. A Simon 2-stage Phase II clinical trial was designed to assess the response rate (primary end-point), and toxicity of docetaxel 25 mg/m2 on days 1 and 8 in combination with capecitabine 750 mg/m2 bid on days 1–14 of a 21-day cycle. RECIST criteria were used for response assessment, which was performed every 2 cycles. Results: Thirty-one women have been enrolled. Median age was 55. Twenty patients had hormone receptor positive disease. Sites of metastasis were as follows: bone, 24 patients; liver, 14; lungs or pleura 14. A total of 189 cycles have been delivered (median: 4 cycles, range 1–33). Grade 3 and 4 toxicities were as follows: peripheral neuropathy, 2 patients; edema, 1 patient; skin, 1 patient. Two women had fever without neutropenia. Another patient had a gastric perforation but recovered without sequela. Twenty-two patients are available for response evaluation. One patient with a single bone metastasis had a complete response after chemotherapy followed by radiation. Partial responses were seen in 10 patients, for an overall response rate of 50% (95% CI, 30 to 70). Four women had stable disease and 7 had progressed at the time of first assessment. With a median follow-up of 15 months (range 1–26), the median time to treatment failure (all patients) was 7 months (range 1–26+). Median survival has not yet been reached. Out of 8 patients older than 65, seven were evaluable and 4 had a partial response. Conclusions: Split, low-dose Docetaxel and low-dose Capecitabine is an effective combination in the first-line treatment of patients with metastatic breast cancer. Toxicity with this schedule was minimal, making it an attractive regimen for further study. [Table: see text]
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Affiliation(s)
| | | | | | - C. Lobo
- University of Miami, Miami, FL
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38
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Dhananjayan SC, Ramamoorthy S, Khan OY, Ismail A, Sun J, Slingerland J, O'Malley BW, Nawaz Z. WW domain binding protein-2, an E6-associated protein interacting protein, acts as a coactivator of estrogen and progesterone receptors. Mol Endocrinol 2006; 20:2343-54. [PMID: 16772533 DOI: 10.1210/me.2005-0533] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [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] [Indexed: 11/19/2022] Open
Abstract
WW domain binding protein-2 (WBP-2) was cloned as an E6-associated protein interacting protein, and its role in steroid hormone receptors functions was investigated. We show that WBP-2 specifically enhanced the transactivation functions of progesterone receptor (PR) and estrogen receptor (ER), whereas it did not have any significant effect on the androgen receptor, glucocorticoid receptor, or the activation functions of p53 and VP-16. Depletion of endogenous WBP-2 with small interfering RNAs indicated that WBP-2 was required for the proper functioning of PR and ER. We also demonstrated that WBP-2 contains an intrinsic activation domain. Moreover, chromatin immunoprecipitation assays demonstrate the hormone-dependent recruitment of WBP-2 onto an estrogen-responsive promoter. Mutational analysis suggests that one of three polyproline (PY) motifs of WBP-2 is essential for its coactivation and intrinsic activation functions. We show that WBP-2 and E6-associated protein each enhance PR function, and their effect on PR action are additive when coexpressed, suggesting a common signaling pathway. In this study, we also demonstrate that the WBP-2 binding protein, Yes kinase-associated protein (YAP) enhances PR transactivation, but YAP's coactivation function is absolutely dependent on WBP-2. Taken together, our data establish the role of WBP-2 and YAP as coactivators for ER and PR transactivation pathways.
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Affiliation(s)
- Sarath C Dhananjayan
- Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, Miami, Florida 33136, USA
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39
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Sandhu C, Connor M, Kislinger T, Slingerland J, Emili A. Global Protein Shotgun Expression Profiling of Proliferating MCF-7 Breast Cancer Cells. J Proteome Res 2005; 4:674-89. [PMID: 15952714 DOI: 10.1021/pr0498842] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [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: 02/08/2023]
Abstract
Protein expression becomes altered in breast epithelium during malignant transformation. Knowledge of these perturbations should provide insight into the molecular basis of breast cancer, as well as reveal possible new therapeutic targets. To this end, we have performed an extensive comparative proteomic survey of global protein expression patterns in proliferating MCF-7 breast cancer cells and normal human mammary epithelial cells using gel-free shotgun tandem mass spectrometry. Pathophysiological alterations associated with the malignant breast cancer phenotype were detected, including differences in the apparent levels of key regulators of the cell cycle, signal transduction, apoptosis, transcriptional regulation, and cell metabolism.
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Affiliation(s)
- Charanjit Sandhu
- Program in Proteomics and Bioinformatics, Banting and Best Department of Medical Research, University of Toronto, Toronto, Ontario, Canada
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40
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Sheng W, Wang G, Wang Y, Liang J, Wen J, Zheng PS, Wu Y, Lee V, Slingerland J, Dumont D, Yang BB. The roles of versican V1 and V2 isoforms in cell proliferation and apoptosis. Mol Biol Cell 2005; 16:1330-40. [PMID: 15635104 PMCID: PMC551496 DOI: 10.1091/mbc.e04-04-0295] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2004] [Revised: 12/10/2004] [Accepted: 12/12/2004] [Indexed: 01/17/2023] Open
Abstract
Versican is a large chondroitin sulfate proteoglycan belonging to the lectican family. Alternative splicing of versican generates at least four isoforms named V0, V1, V2, and V3. We have shown that the versican V1 isoform not only enhanced cell proliferation, but also modulated cell cycle progression and protected the cells from apoptosis. Futhermore, the V1 isoform was able to not only activate proto-oncogene EGFR expression and modulate its downstream signaling pathway, but also induce p27 degradation and enhance CDK2 kinase activity. As well, the V1 isoform down-regulated the expression of the proapoptotic protein Bad. By contrast, the V2 isoform exhibited opposite biological activities by inhibiting cell proliferation and down-regulated the expression of EGFR and cyclin A. Furthermore, V2 did not contribute apoptotic resistance to the cells. In light of these results, we are reporting opposite functions for the two versican isoforms whose expression is differentially regulated. Our studies suggest that the roles of these two isoforms are associated with the subdomains CSbeta and CSalpha, respectively. These results were confirmed by silencing the expression of versican V1 with small interfering RNA (siRNA), which abolished V1-enhanced cell proliferation and V1-induced reduction of apoptosis.
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Affiliation(s)
- Wang Sheng
- Sunnybrook & Women's College Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada
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41
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Chu I, Blackwell K, Chen S, Slingerland J. The dual ErbB1/ErbB2 inhibitor, lapatinib (GW572016), cooperates with tamoxifen to inhibit both cell proliferation- and estrogen-dependent gene expression in antiestrogen-resistant breast cancer. Cancer Res 2005; 65:18-25. [PMID: 15665275] [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: 05/01/2023]
Abstract
Effective treatment of estrogen receptor (ER)-positive breast cancers with tamoxifen is often curtailed by the development of drug resistance. Antiestrogen-resistant breast cancers often show increased expression of the epidermal growth factor receptor family members, ErbB1 and ErbB2. Tamoxifen activates the cyclin-dependent kinase inhibitor, p27 to mediate G(1) arrest. ErbB2 or ErbB1 overexpression can abrogate tamoxifen sensitivity in breast cancer lines through both reduction in p27 levels and inhibition of its function. Here we show that the dual ErbB1/ErbB2 inhibitor, lapatinib (GW572016), can restore tamoxifen sensitivity in ER-positive, tamoxifen-resistant breast cancer models. Treatment of MCF-7(pr), T-47D, and ZR-75 cells with lapatinib or tamoxifen alone caused an incomplete cell cycle arrest. Treatment with both drugs led to a more rapid and profound cell cycle arrest in all three lines. Mitogen-activated protein kinase and protein kinase B were inhibited by lapatinib. The two drugs together caused a greater reduction of cyclin D1 and a greater p27 increase and cyclin E-cdk2 inhibition than observed with either drug alone. In addition to inhibiting mitogenic signaling and cell cycle progression, lapatinib inhibited estrogen-stimulated ER transcriptional activity and cooperated with tamoxifen to further reduce ER-dependent transcription. Lapatinib in combination with tamoxifen effectively inhibited the growth of tamoxifen-resistant ErbB2 overexpressing MCF-7 mammary tumor xenografts. These data provide strong preclinical data to support clinical trials of ErbB1/ErbB2 inhibitors in combination with tamoxifen in the treatment of human breast cancer.
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Affiliation(s)
- Isabel Chu
- The Braman Breast Cancer Institute, UM Sylvester Comprehensive Cancer Center, University of Miami School of Medicine, Miami, FL 33136, USA
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42
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Chu I, Blackwell K, Chen S, Slingerland J. The Dual ErbB1/ErbB2 Inhibitor, Lapatinib (GW572016), Cooperates with Tamoxifen to Inhibit Both Cell Proliferation- and Estrogen-Dependent Gene Expression in Antiestrogen-Resistant Breast Cancer. Cancer Res 2005. [DOI: 10.1158/0008-5472.18.65.1] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.0] [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
Effective treatment of estrogen receptor (ER)-positive breast cancers with tamoxifen is often curtailed by the development of drug resistance. Antiestrogen-resistant breast cancers often show increased expression of the epidermal growth factor receptor family members, ErbB1 and ErbB2. Tamoxifen activates the cyclin-dependent kinase inhibitor, p27 to mediate G1 arrest. ErbB2 or ErbB1 overexpression can abrogate tamoxifen sensitivity in breast cancer lines through both reduction in p27 levels and inhibition of its function. Here we show that the dual ErbB1/ErbB2 inhibitor, lapatinib (GW572016), can restore tamoxifen sensitivity in ER-positive, tamoxifen-resistant breast cancer models. Treatment of MCF-7pr, T-47D, and ZR-75 cells with lapatinib or tamoxifen alone caused an incomplete cell cycle arrest. Treatment with both drugs led to a more rapid and profound cell cycle arrest in all three lines. Mitogen-activated protein kinase and protein kinase B were inhibited by lapatinib. The two drugs together caused a greater reduction of cyclin D1 and a greater p27 increase and cyclin E-cdk2 inhibition than observed with either drug alone. In addition to inhibiting mitogenic signaling and cell cycle progression, lapatinib inhibited estrogen-stimulated ER transcriptional activity and cooperated with tamoxifen to further reduce ER-dependent transcription. Lapatinib in combination with tamoxifen effectively inhibited the growth of tamoxifen-resistant ErbB2 overexpressing MCF-7 mammary tumor xenografts. These data provide strong preclinical data to support clinical trials of ErbB1/ErbB2 inhibitors in combination with tamoxifen in the treatment of human breast cancer.
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Affiliation(s)
- Isabel Chu
- 1The Braman Breast Cancer Institute, UM Sylvester Comprehensive Cancer Center and
- 3Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada; and
| | - Kimberly Blackwell
- 4Division of Medical Oncology, Department of Medicine, Duke University Comprehensive Cancer Center, Durham, North Carolina
| | - Susie Chen
- 1The Braman Breast Cancer Institute, UM Sylvester Comprehensive Cancer Center and
| | - Joyce Slingerland
- 1The Braman Breast Cancer Institute, UM Sylvester Comprehensive Cancer Center and
- 2Department of Biochemistry and Molecular Biology, University of Miami School of Medicine, Miami, Florida
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Abstract
p27 is a key regulator of G1-to-S phase progression. It prevents premature activation of cyclin E-cdk2 in G1 and promotes the assembly and activation of D-type cyclin-cdks. While the p27 gene is rarely mutated in human cancers, the action of p27 is impaired in breast and other human cancers through accelerated p27 proteolysis, sequestration by cyclin D-cdks, and by p27 mislocalization in tumor cell cytoplasm. Reduced p27 protein is strongly associated with high histopathologic tumor grade, reflecting a lack of tumor differentiation. Loss of p27 is also an indicator of poor patient outcome in a majority of breast cancer studies, including node negative disease. The broad application of p27 in the clinical evaluation of breast cancer prognosis will require a consensus on methods of tumor fixation, staining, and scoring. This review will focus on mechanisms of p27 regulation in normal cells and how deregulation of p27 may arise in breast and other human cancers. The prognostic significance of p27 in human breast cancer and the possible therapeutic implications of these findings will also be reviewed.
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Affiliation(s)
- A Alkarain
- Molecular and Cell Biology, Sunnybrook and Women's Health Sciences Centre, University of Toronto, Bayview Avenue, Toronto, Ontario, Canada
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44
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Abstract
p27 is a key regulator of progression from G1 to S phase. Although the gene encoding p27 is rarely mutated in human cancers, p27 is functionally inactivated in a majority of human cancers through accelerated p27 proteolysis, through sequestration by cyclin D-cyclin-dependent kinase complexes and by cytoplasmic mislocalization. Here we review mechanisms whereby oncogenic activation of receptor tyrosine kinase and Ras pathways lead to accelerated p27 proteolysis and p27 mislocalization in cancer cells. The prognostic significance of p27 in human breast cancer is also reviewed.
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Affiliation(s)
- Angel Alkarain
- Sunnybrook and Women's Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada
| | - Joyce Slingerland
- Braman Breast Cancer Institute, University of Miami School of Medicine, Miami, FL, USA
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45
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Slingerland J. [Hyperglycemia in the cat]. Tijdschr Diergeneeskd 2003; 128:392-5. [PMID: 12838761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
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46
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Abstract
Skp2 is a member of the F-box family of substrate-recognition subunits of SCF ubiquitin-protein ligase complexes that has been implicated in the ubiquitin-mediated degradation of several key regulators of mammalian G(1) progression, including the cyclin-dependent kinase inhibitor p27, a dosage-dependent tumor suppressor protein. In this study, we examined Skp2 and p27 protein expression by immunohistochemistry in normal oral epithelium and in different stages of malignant oral cancer progression, including dysplasia and oral squamous cell carcinoma. We found that increased levels of Skp2 protein are associated with reduced p27 in a subset of oral epithelial dysplasias and carcinomas compared with normal epithelial controls. Tumors with high Skp2 (>20% positive cells) expression invariably showed reduced or absent p27 and tumors with high p27 (>20% positive cells) expression rarely showed Skp2 positivity. Increased Skp2 protein levels were not always correlated with increased cell proliferation (assayed by Ki-67 staining), suggesting that alterations of Skp2 may contribute to the malignant phenotype without affecting proliferation. Skp2 protein overexpression may lead to accelerated p27 proteolysis and contribute to malignant progression from dysplasia to oral epithelial carcinoma. Moreover, we also demonstrate that Skp2 has oncogenic potential by showing that Skp2 cooperates with H-Ras(G12V) to malignantly transform primary rodent fibroblasts as scored by colony formation in soft agar and tumor formation in nude mice. The observations that Skp2 can mediate transformation and is up-regulated during oral epithelial carcinogenesis support a role for Skp2 as a protooncogene in human tumors.
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Affiliation(s)
- M Gstaiger
- Friedrich Miescher Institut, Maulbeerstrasse 66, CH-4058 Basel, Switzerland
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47
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Sandhu C, Slingerland J. Deregulation of the cell cycle in cancer. Cancer Detect Prev 2001; 24:107-18. [PMID: 10917130] [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: 02/17/2023]
Abstract
Mitogenic and growth-inhibitory signals influence cell-cycle progression through their action on a family of cyclin-dependent kinases (cdks). The activity of cdk complexes is regulated in part by the association of a cyclin partner that acts as a positive effector and by two families of cdk inhibitors, the kinase inhibitor proteins (KIP) and the inhibitors of cdk4 (INK4), which act as negative effectors. In human malignancies, increased expression of cyclins is frequently observed. Cyclin D1 and E are frequently overexpressed in breast cancers, and cyclin E overexpression has been correlated with a poor prognostic outcome. The abrogated expression or the acquisition of mutations that render cdk inhibitors functionally inactive have similarly been found in human malignancies. The p16 gene is frequently deleted or mutated in cancers. Although normal epithelial cells express high levels of p27 protein, reduced levels of p27 have been observed in several human cancers, and this has been consistently correlated with a poor prognostic outcome. In this review, we will provide a brief overview of the cell cycle regulators and then discuss their deregulation in cancers.
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Affiliation(s)
- C Sandhu
- Division of Cancer Biology Research, Sunnybrook and Women's College Health Science Centre, Toronto, Ontario, Canada
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48
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Chappuis PO, Kapusta L, Bégin LR, Wong N, Brunet JS, Narod SA, Slingerland J, Foulkes WD. Germline BRCA1/2 mutations and p27(Kip1) protein levels independently predict outcome after breast cancer. J Clin Oncol 2000; 18:4045-52. [PMID: 11118465 DOI: 10.1200/jco.2000.18.24.4045] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.1] [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: 11/20/2022] Open
Abstract
PURPOSE Decreased levels of the cyclin-dependent kinase inhibitor p27(Kip1) in breast cancer are associated with a poor outcome. The prognostic significance of BRCA1/2 mutations is less clear, and the relationship between BRCA1/2 mutation status, p27(Kip1) protein levels, and outcome has not been studied. PATIENTS AND METHODS Pathology blocks from 202 consecutive Ashkenazi Jewish women with primary invasive breast cancer were studied. Tumor DNA was tested for the three common BRCA1/2 founder mutations present in Ashkenazi Jews, and p27(Kip1) expression was evaluated by immunohistochemistry. The median follow-up was 6.4 years. RESULTS Thirty-two tumors (16%) were positive for a BRCA1/2 mutation. Low p27(Kip1) expression was seen in 110 tumors (63%) and was significantly associated with BRCA1/2 mutations (odds ratio, 4.0; 95% confidence interval [CI], 1.4 to 11.1; P =.009). BRCA1/2 mutation carriers had a significantly worse 5-year distant disease-free survival (DDFS) compared with women without BRCA1/2 mutations (58% v 82%; P =.003). Similar results were seen for women whose tumors expressed low levels of p27(Kip1), compared with those with high levels (5-year DDFS, 68% v 93%; P<.0001). In a multivariate analysis, both BRCA1/2 mutation and low p27(Kip1) expression were associated with a shorter DDFS (relative risk [RR], 2.1; 95% CI, 1.0 to 4.3; P =.05; and RR, 3.9; 95% CI, 1.4 to 11.1; P =.01, respectively). CONCLUSION In this study, we showed that BRCA1/2 mutations were associated with low levels of p27(Kip1) in breast cancer. Both BRCA1/2 and p27(Kip1) status were identified as independent prognostic factors.
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Affiliation(s)
- P O Chappuis
- Department of Medicine, Sir M.B. Davis-Jewish General Hospital, McGill University Health Centre Research Institute, McGill University, Montreal, Quebec, Canada
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Sandhu C, Donovan J, Bhattacharya N, Stampfer M, Worland P, Slingerland J. Reduction of Cdc25A contributes to cyclin E1-Cdk2 inhibition at senescence in human mammary epithelial cells. Oncogene 2000; 19:5314-23. [PMID: 11103932 DOI: 10.1038/sj.onc.1203908] [Citation(s) in RCA: 42] [Impact Index Per Article: 1.8] [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] [Indexed: 11/08/2022]
Abstract
Replicative senescence may be an important tumor suppressive mechanism for human cells. We investigated the mechanism of cell cycle arrest at senescence in human mammary epithelial cells (HMECs) that have undergone a period of 'self-selection', and as a consequence exhibit diminished p16INK4A levels. As HMECs approached senescence, the proportion of cells with a 2N DNA content increased and that in S phase decreased progressively. Cyclin D1-cdk4, cyclin E-cdk2 and cyclin A-cdk2 activities were not abruptly inhibited, but rather diminished steadily with increasing population age. In contrast to observations in fibroblast, p21Cip1 was not increased at senescence in HMECs. There was no increase in p27Kip1 levels nor in KIP association with targets cdks. While p15INK4B and its binding to both cdk4 and cdk6 increased with increasing passage, some cyclin D1-bound cdk4 and cdk6 persisted in senescent cells, whose inhibition could not be attributed to p15INK4B. The inhibition of cyclin E-cdk2 in senescent HMECs was accompanied by increased inhibitory phosphorylation of cdk2, in association with a progressive loss of Cdc25A. Recombinant Cdc25A strongly reactivated cyclin E-cdk2 from senescent HMECs suggesting that reduction of Cdc25A contributes to cyclin E-cdk2 inhibition and G1 arrest at senescence. Although ectopic expression of Cdc25A failed to extend the lifespan of HMECs, the exogenous Cdc25A appeared to lack activity in these cells, since it neither shortened the G1-to-S phase interval nor activated cyclin E-cdk2. In contrast, in the breast cancer-derived MCF-7 line, Cdc25A overexpression increased both cyclin E-cdk2 activity and the S phase fraction. Thus, mechanisms leading to HMEC immortalization may involve not only the re-induction of Cdc25A expression, but also activation of this phosphatase.
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Affiliation(s)
- C Sandhu
- Cancer Research, Sunnybrook and Women's College Health Sciences Centre, Toronto, Ontario, Canada
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50
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Abstract
The activation of cell cycle checkpoints in response to genotoxic stressors is essential for the maintenance of genomic integrity. Although most prior studies of cell cycle effects of UV irradiation have used UVC, this UV range does not penetrate the earth's atmosphere. Thus, we have investigated the mechanisms of ultraviolet B (UVB) irradiation-induced cell cycle arrest in a biologically relevant target cell type, the early stage human melanoma cell line, WM35. Irradiation of WM35 cells with UVB resulted in arrests throughout the cell cycle: at the G1/S transition, in S phase and in G2. G1 arrest was accompanied by increased association of p21 with cyclin E/cdk2 and cyclin A/cdk2, increased binding of p27 to cyclin E/cdk2 and inhibition of these kinases. A loss of Cdc25A expression was associated with an increased inhibitory phosphotyrosine content of cyclin E- and cyclin A-associated cdk2 and may also contribute to G1 arrest following UVB irradiation. The association of Cdc25A with 14-3-3 was increased by UVB. Reduced cyclin D1 protein and increased binding of p21 and p27 to cyclin D1/cdk4 complexes were also observed. The loss of cyclin D1 could not be attributed to inhibition of either MAPK or PI3K/PKB pathways, since both were activated by UVB. Cdc25B levels fell and the remaining protein showed an increased association with 14-3-3 in response to UVB. Losses in cyclin B1 expression and an increased binding of p21 to cyclin B1/cdk1 complexes also contributed to inhibition of this kinase activity, and G2/M arrest. Oncogene (2000) 19, 4480 - 4490.
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Affiliation(s)
- T Petrocelli
- Division of Cancer Biology Research, Toronto Sunnybrook Regional Cancer Centre, Sunnybrook and Women's College Health Sciences Centre and University of Toronto, Toronto, Ontario, Canada
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