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Puig-Blasco L, Piotrowski KB, Michaelsen SR, Bager NS, Areškevičiūtiė A, Thorseth ML, Sun XF, Keller UAD, Kristensen BW, Madsen DH, Gnosa SP, Kveiborg M. Loss of cancer cell-derived ADAM15 alters the tumor microenvironment in colorectal tumors. Int J Cancer 2023; 153:2068-2081. [PMID: 37602921 DOI: 10.1002/ijc.34695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 06/18/2023] [Accepted: 07/12/2023] [Indexed: 08/22/2023]
Abstract
Tumor progression and response to treatment are highly affected by interactions between cancer cells and the tumor microenvironment (TME). Many of the soluble factors and signaling receptors involved in this crosstalk are shed by a disintegrin and metalloproteinases (ADAMs). Upregulation of ADAM15 has been linked to worse survival in cancer patients and a tumor-promoting function both in vitro and in murine cancer models. Although ADAM15 has been involved in cell-cell and cell-extracellular matrix interactions, its role in the crosstalk between cancer cells and the TME in vivo remains unexplored. Therefore, we aimed to understand how ADAM15 regulates the cell composition of the TME and how it affects tumor progression. Here, we showed an upregulation of ADAM15 in tumor tissues from rectal cancer patients. Subcutaneous injection of wildtype and ADAM15-knockout CT26 colon cancer cells in syngeneic mice confirmed the protumorigenic role of ADAM15. Profiling of tumors revealed higher immune cell infiltration and cancer cell apoptosis in the ADAM15-deficient tumors. Specifically, loss of ADAM15 led to a reduced number of granulocytes and higher infiltration of antigen-presenting cells, including dendritic cells and macrophages, as well as more T cells. Using in vitro assays, we confirmed the regulatory effect of ADAM15 on macrophage migration and identified ADAM15-derived CYR61 as a potential molecular mediator of this effect. Based on these findings, we speculate that targeting ADAM15 could increase the infiltration of immune cells in colorectal tumors, which is a prerequisite for effective immunotherapy.
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Affiliation(s)
- Laia Puig-Blasco
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Krzysztof B Piotrowski
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Signe R Michaelsen
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Nicolai S Bager
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Aušrinė Areškevičiūtiė
- Danish Reference Center for Prion Diseases, Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Marie-Louise Thorseth
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
| | - Xiao-Feng Sun
- Department of Oncology and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Ulrich Auf dem Keller
- Department of Biotechnology and Biomedicine, Technical University of Denmark, Lyngby, Denmark
| | - Bjarne W Kristensen
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Daniel H Madsen
- National Center for Cancer Immune Therapy (CCIT-DK), Department of Oncology, Copenhagen University Hospital, Herlev and Gentofte, Copenhagen, Denmark
| | - Sebastian P Gnosa
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
- Minerva Imaging, Ølstykke, Denmark
| | - Marie Kveiborg
- Biotech Research and Innovation Centre (BRIC), University of Copenhagen, Copenhagen, Denmark
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Harwood DS, Michaelsen SR, Kristensen BW. Abstract 1842: Drug repurposing screen reveals glioblastoma cell line susceptibility to statins. Cancer Res 2022. [DOI: 10.1158/1538-7445.am2022-1842] [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: The standard therapy for glioblastoma patients is tumor resection followed by radiotherapy and temozolomide chemotherapy. Although glioblastoma has been extensively molecularly profiled along with other cancers, this knowledge has not yet been translated into improved survival outcomes. We used a bioinformatics approach to identify potential novel therapeutic strategies for glioblastoma. Objectives: Comprehensive online datasets which have assessed up to 1376 cancer cell lines in multiple ways were interrogated to identify potential drug candidates for glioblastoma.
Methods: Datasets included were from the cancer cell line encyclopedia (mRNA expression), the Achillies project (cell viability following Crispr-Cas9 knockout) and PRISM (drug treatment). A t-test comparing cell viability of glioblastoma cell lines versus other cancers was used to identify potential drug candidates, followed by the use of multiple statistical tools to investigate potential mechanism of action and status of biomarkers.
Results: Fluvastatin and pitavastatin were amongst the drugs with the most significant effects against glioblastoma cell lines while also being FDA approved. These effects were found in both glioblastoma cells and other cancer types with a mesenchymal-like expression phenotype. The anti-cancer properties of statins have previously been attributed to the inhibition of HMG-Coa reductase. Here, we found their effects correlated with the gene knockout of UBIAD1, which participates in non-mitochondrial ubiquinone and menaquinone-4 synthesis. We tested the effects of statins on patient-derived glioblastoma cell lines with a mesenchymal (n = 2) and non-mesenchymal phenotype (n=2). Mesenchymal-like glioblastoma cells lines were found to be particularly susceptible to multiple statins.
Conclusion: Statins appeared to be especially effective against glioblastoma lines and the effect could be linked to the direct or indirect inhibition of UBIAD1. In vitro validation of this finding is ongoing.
Citation Format: Dylan S. Harwood, Signe R. Michaelsen, Bjarne W. Kristensen. Drug repurposing screen reveals glioblastoma cell line susceptibility to statins [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1842.
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Nørøxe DS, Yde CW, Østrup O, Michaelsen SR, Schmidt AY, Kinalis S, Torp MH, Skjøth‐Rasmussen J, Brennum J, Hamerlik P, Poulsen HS, Nielsen FC, Lassen U. Genomic profiling of newly diagnosed glioblastoma patients and its potential for clinical utility - a prospective, translational study. Mol Oncol 2020; 14:2727-2743. [PMID: 32885540 PMCID: PMC7607169 DOI: 10.1002/1878-0261.12790] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [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: 04/17/2020] [Revised: 07/29/2020] [Accepted: 08/27/2020] [Indexed: 12/27/2022] Open
Abstract
Glioblastoma (GBM) is an incurable brain tumor for which new treatment strategies are urgently needed. Next-generation sequencing of GBM has most often been performed retrospectively and on archival tissue from both diagnostic and relapse surgeries with limited knowledge of clinical information, including treatment given. We sought to investigate the genomic composition prospectively in treatment-naïve patients, searched for possible targetable aberrations, and investigated for prognostic and/or predictive factors. A total of 108 newly diagnosed GBM patients were included. Clinical information, progression-free survival, and overall survival (OS) were noted. Tissues were analyzed by whole-exome sequencing, single nucleotide polymorphism (SNP) and transcriptome arrays, and RNA sequencing; assessed for mutations, fusions, tumor mutational burden (TMB), and chromosomal instability (CI); and classified into GBM subgroups. Each genomic report was discussed at a multidisciplinary tumor board meeting to evaluate for matching trials. From 111 consecutive patients, 97.3% accepted inclusion in this study. Eighty-six (77%) were treated with radiation therapy/temozolomide (TMZ) and adjuvant TMZ. One NTRK2 and three FGFR3-TACC3 fusions were identified. Copy number alterations in GRB2 and SMYD4 were significantly correlated with worse median OS together with known clinical variables like age, performance status, steroid dose, and O6-methyl-guanine-DNA-methyl-transferase status. Patients with CI-median or TMB-high had significantly worse median OS compared to CI-low/high or TMB-low/median. In conclusion, performing genomic profiling at diagnosis enables evaluation of genomic-driven therapy at the first progression. Furthermore, TMB-high or CI-median patients had worse median OS, which can support the possibility of offering experimental treatment already at the first line for this group.
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Affiliation(s)
- Dorte S. Nørøxe
- Department of Radiation BiologyRigshospitaletCopenhagenDenmark
- Department of OncologyRigshospitaletCopenhagenDenmark
| | | | - Olga Østrup
- Center for Genomic MedicineRigshospitaletCopenhagenDenmark
| | - Signe R. Michaelsen
- Department of Radiation BiologyRigshospitaletCopenhagenDenmark
- Biotech, Research and Innovation Centre (BRIC)University of CopenhagenCopenhagenDenmark
| | - Ane Y. Schmidt
- Center for Genomic MedicineRigshospitaletCopenhagenDenmark
| | - Savvas Kinalis
- Center for Genomic MedicineRigshospitaletCopenhagenDenmark
| | | | | | | | | | - Hans S. Poulsen
- Department of Radiation BiologyRigshospitaletCopenhagenDenmark
- Department of OncologyRigshospitaletCopenhagenDenmark
| | | | - Ulrik Lassen
- Department of OncologyRigshospitaletCopenhagenDenmark
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Michaelsen SR, Staberg M, Pedersen H, Jensen KE, Majewski W, Broholm H, Nedergaard MK, Meulengracht C, Urup T, Villingshøj M, Lukacova S, Skjøth-Rasmussen J, Brennum J, Kjær A, Lassen U, Stockhausen MT, Poulsen HS, Hamerlik P. VEGF-C sustains VEGFR2 activation under bevacizumab therapy and promotes glioblastoma maintenance. Neuro Oncol 2019; 20:1462-1474. [PMID: 29939339 PMCID: PMC6176801 DOI: 10.1093/neuonc/noy103] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [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] [Indexed: 12/24/2022] Open
Abstract
Background Glioblastoma ranks among the most lethal cancers, with current therapies offering only palliation. Paracrine vascular endothelial growth factor (VEGF) signaling has been targeted using anti-angiogenic agents, whereas autocrine VEGF/VEGF receptor 2 (VEGFR2) signaling is poorly understood. Bevacizumab resistance of VEGFR2-expressing glioblastoma cells prompted interrogation of autocrine VEGF-C/VEGFR2 signaling in glioblastoma. Methods Autocrine VEGF-C/VEGFR2 signaling was functionally investigated using RNA interference and exogenous ligands in patient-derived xenograft lines and primary glioblastoma cell cultures in vitro and in vivo. VEGF-C expression and interaction with VEGFR2 in a matched pre- and post-bevacizumab treatment cohort were analyzed by immunohistochemistry and proximity ligation assay. Results VEGF-C was expressed by patient-derived xenograft glioblastoma lines, primary cells, and matched surgical specimens before and after bevacizumab treatment. VEGF-C activated autocrine VEGFR2 signaling to promote cell survival, whereas targeting VEGF-C expression reprogrammed cellular transcription to attenuate survival and cell cycle progression. Supporting potential translational significance, targeting VEGF-C impaired tumor growth in vivo, with superiority to bevacizumab treatment. Conclusions Our results demonstrate VEGF-C serves as both a paracrine and an autocrine pro-survival cytokine in glioblastoma, promoting tumor cell survival and tumorigenesis. VEGF-C permits sustained VEGFR2 activation and tumor growth, where its inhibition appears superior to bevacizumab therapy in improving tumor control.
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Affiliation(s)
- Signe R Michaelsen
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Mikkel Staberg
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
| | | | | | - Wiktor Majewski
- Center for Genomic Medicine, Copenhagen University Hospital, Copenhagen, Denmark
| | - Helle Broholm
- Department of Neuropathology, Center of Diagnostic Investigation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette K Nedergaard
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Thomas Urup
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Mette Villingshøj
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Slávka Lukacova
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | | | - Jannick Brennum
- Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Andreas Kjær
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrik Lassen
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | | | - Hans S Poulsen
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark.,Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Petra Hamerlik
- Department of Radiation Biology, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
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Affiliation(s)
| | - Hans S Poulsen
- Copenhagen University Hospital, Copenhagen, Denmark.,Danish Cancer Society, Copenhagen, Denmark
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Kristensen LS, Michaelsen SR, Dyrbye H, Aslan D, Grunnet K, Christensen IJ, Poulsen HS, Grønbæk K, Broholm H. Assessment of Quantitative and Allelic MGMT Methylation Patterns as a Prognostic Marker in Glioblastoma. J Neuropathol Exp Neurol 2016; 75:246-55. [PMID: 26883115 PMCID: PMC4777218 DOI: 10.1093/jnen/nlv024] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [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] [Indexed: 11/18/2022] Open
Abstract
Methylation of the O6-methylguanine-DNA methyltransferase (MGMT) gene is a predictive and prognostic marker in newly diagnosed glioblastoma patients treated with temozolomide but how MGMT methylation should be assessed to ensure optimal detection accuracy is debated. We developed a novel quantitative methylation-specific PCR (qMSP) MGMT assay capable of providing allelic methylation data and analyzed 151 glioblastomas from patients receiving standard of care treatment (Stupp protocol). The samples were also analyzed by immunohistochemistry (IHC), standard bisulfite pyrosequencing, and genotyped for the rs1690252 MGMT promoter single nucleotide polymorphism. Monoallelic methylation was observed more frequently than biallelic methylation, and some cases with monoallelic methylation expressed the MGMT protein whereas others did not. The presence of MGMT methylation was associated with better overall survival (p = 0.006; qMSP and p = 0.002; standard pyrosequencing), and the presence of the protein was associated with worse overall survival (p = 0.009). Combined analyses of qMSP and standard pyrosequencing or IHC identified additional patients who benefited from temozolomide treatment. Finally, low methylation levels were also associated with better overall survival (p = 0.061; qMSP and p = 0.02; standard pyrosequencing). These data support the use of both MGMT methylation and MGMT IHC but not allelic methylation data as prognostic markers in patients with temozolomide-treated glioblastoma.
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Affiliation(s)
- Lasse S Kristensen
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB).
| | - Signe R Michaelsen
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Henrik Dyrbye
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Derya Aslan
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Kirsten Grunnet
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Ib J Christensen
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Hans S Poulsen
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Kirsten Grønbæk
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
| | - Helle Broholm
- From the Department of Hematology (LSK, DA, KG); Department of Radiation Biology (SRM, KG, IJC, HSP); and Department of Pathology, Rigshospitalet, Copenhagen Ø, Denmark (HD, HB)
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Toft A, Urup T, Christensen IJ, Michaelsen SR, Lukram BS, Grunnet K, Kosteljanetz M, Larsen VA, Lassen U, Broholm H, Poulsen HS. Abstract B3: Prognostic and predictive biomarkers in recurrent WHO grade 3 malignant glioma patients treated with bevacizumab and irinotecan. Mol Cancer Ther 2015. [DOI: 10.1158/1535-7163.targ-15-b3] [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: 11/16/2022]
Abstract
Abstract
BACKGROUND Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), has demonstrated activity in the treatment of recurrent malignant glioma. High response rates have been observed, but particularly in WHO grade 3 gliomas, efforts to identify predictors of clinical response have been limited. Predictive markers and prognostic models are required in order to individualize treatment for this patient population. The primary endpoint of this study was to identify predictive biomarkers associated with response to bevacizumab therapy. The secondary endpoint was to identify prognostic factors associated with progression-free survival (PFS) and overall survival (OS).
METHODS A total of 62 consecutive, recurrent grade 3 glioma patients were retrospectively evaluated. Eligible patients from our center had a WHO performance status of 0-2 and were administered bevacizumab and irinotecan between December 2005 and November 2014 according to a previously published clinical protocol. Baseline factors screened for potential prognostic and predictive value included: Age, gender, PS, WHO grade 3 diagnosis, tumor size and location, multifocal disease, extent of resection, number of prior chemotherapy regiments, response to prior chemotherapy, first-line treatment, number of previous recurrences, neurological deficit, corticosteroid use, necrosis, vascular proliferation, neutrophil-to-lymphocyte ratio, and expression of p53, EGFR, MIB-1, MGMT, IDH1 and ATRX. Candidate factors with p-values below 5% were considered for multivariate analysis. Prognostic models were generated by logistic regression and Cox regression, modelling response and survival endpoints.
RESULTS Twenty-two patients (35.5%) demonstrated a response according to the RANO criteria. Responders had significantly prolonged OS (p = 0.007) and trended toward longer PFS (p = 0.067) as compared to non-responders (OS: 12.4 vs 4.3 months, PFS: 5.6 vs 3.2 months). Presence of necrosis (OR: 0.17, CI: 0.04-0.68, p = 0.012) and a WHO performance status (PS) of more than 1 (OR: 0.04, CI: 0.002-0.89, p = 0.042) were more common in non-responders than responders. Female gender (HR: 0.48, CI: 0.28-0.82, p = 0.008) and a PS of 0-1 (HR: 0.20, CI: 0.10-0.41, p < 0.0001) were identified as positive prognostic factors for PFS. Immunohistochemical p53 negativity (HR: 0.47, CI: 0.26-0.87, p = 0.016) and low PS (HR: 0.17, CI: 0.07-0.39, p < 0.0001) correlated with extended OS and these factors were included in a prognostic model.
CONCLUSIONS A favorable baseline PS and absence of necrosis were positively associated with response to bevacizumab treatment in recurrent grade 3 glioma patients. Low PS, female gender and p53 negativity are prognostic of improved outcome in this patient group.
Citation Format: Anders Toft, Thomas Urup, Ib J. Christensen, Signe R. Michaelsen, Babloo S. Lukram, Kirsten Grunnet, Michael Kosteljanetz, Vibeke A. Larsen, Ulrik Lassen, Helle Broholm, Hans S. Poulsen. Prognostic and predictive biomarkers in recurrent WHO grade 3 malignant glioma patients treated with bevacizumab and irinotecan. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr B3.
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Affiliation(s)
- Anders Toft
- 1Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Thomas Urup
- 1Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Ib J. Christensen
- 2Department of Gastroenterology, Hvidovre Hospital, Hvidovre, Denmark
| | - Signe R. Michaelsen
- 1Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Babloo S. Lukram
- 3Department of Pathology, Center of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Kirsten Grunnet
- 1Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Michael Kosteljanetz
- 4Department of Neurosurgery, Neuroscience Centre, Rigshospitalet, Copenhagen, Denmark
| | - Vibeke A. Larsen
- 5Department of Radiology, Center of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Ulrik Lassen
- 1Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Helle Broholm
- 3Department of Pathology, Center of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark
| | - Hans S. Poulsen
- 1Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
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Persson M, Nedergaard MK, Brandt-Larsen M, Skovgaard D, Jørgensen JT, Michaelsen SR, Madsen J, Lassen U, Poulsen HS, Kjaer A. Urokinase-Type Plasminogen Activator Receptor as a Potential PET Biomarker in Glioblastoma. J Nucl Med 2015; 57:272-8. [PMID: 26429955 DOI: 10.2967/jnumed.115.161703] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Accepted: 08/26/2015] [Indexed: 01/01/2023] Open
Abstract
UNLABELLED Glioblastoma is one of the most malignant types of human cancer, and the prognosis is poor. The development and validation of novel molecular imaging biomarkers has the potential to improve tumor detection, grading, risk stratification, and treatment monitoring of gliomas. The aim of this study was to explore the potential of PET imaging of the urokinase-type plasminogen activator receptor (uPAR) in glioblastoma. METHODS The uPAR messenger RNA expression of tumors from 19 glioblastoma patients was analyzed, and a cell culture derived from one of these patients was used to establish an orthotopic xenograft model of glioblastoma. Tumor growth was monitored using bioluminescence imaging. Five to six weeks after inoculation, all mice were scanned with small-animal PET/CT using two new uPAR PET ligands ((64)Cu-NOTA-AE105 and (68)Ga-NOTA-AE105) and, for comparison, O-(2-(18)F-fluoroethyl)-l-tyrosine ((18)F-FET). One MRI scan was obtained for each mouse to confirm tumor location. The uPAR specificity of (64)Cu-NOTA-AE105 was confirmed by alignment of hematoxylin- and eosin-stained and uPAR immunohistochemistry-stained slides of the brain with the activity distribution as determined using autoradiography. RESULTS uPAR expression was found in all 19 glioblastoma patient tumors, and high expression of uPAR correlated with decreased overall survival (P = 0.04). Radiolabeling of NOTA-AE105 with (64)Cu and (68)Ga was straightforward, resulting in a specific activity of approximately 20 GBq/μmol and a radiochemical purity of more than 98% for (64)Cu-NOTA-AE105 and more than 97% for (68)Ga-NOTA-AE105. High image contrast resulting in clear tumor delineation was found for both (68)Ga-NOTA-AE105 and (64)Cu-NOTA-AE105. Absolute uptake in tumor was higher for (18)F-FET (3.5 ± 0.8 percentage injected dose [%ID]/g) than for (64)Cu-NOTA-AE105 (1.2 ± 0.4 %ID/g) or (68)Ga-NOTA-AE105 (0.4 ± 0.1 %ID/g). A similar pattern was observed in background brain tissue, where uptake was 1.9 ± 0.1 %ID/g for (18)F-fluorothymidine, compared with 0.05 ± 0.01 %ID/g for (68)Ga-NOTA-AE105 and 0.11 ± 0.02 %ID/g for (64)Cu-NOTA-AE105. The result was a significantly higher tumor-to-background ratio for both (68)Ga-NOTA-AE105 (7.6 ± 2.1, P < 0.05) and (64)Cu-NOTA-AE105 (10.6 ± 2.3, P < 0.01) than for (18)F-FET PET (1.8 ± 0.3). Autoradiography of brain slides confirmed that the accumulation of (64)Cu-NOTA-AE105 corresponded well with uPAR-positive cancer cells. CONCLUSION On the basis of our translational study, uPAR PET may be a highly promising imaging biomarker for glioblastoma. Further clinical exploration of uPAR PET in glioblastoma is therefore justified.
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Affiliation(s)
- Morten Persson
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Mette K Nedergaard
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark Department of Radiation Biology, Finsen Center, Rigshospitalet, Copenhagen, Denmark; and
| | - Malene Brandt-Larsen
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Dorthe Skovgaard
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Jesper T Jørgensen
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Signe R Michaelsen
- Department of Radiation Biology, Finsen Center, Rigshospitalet, Copenhagen, Denmark; and
| | - Jacob Madsen
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Lassen
- Department of Oncology, Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Hans S Poulsen
- Department of Radiation Biology, Finsen Center, Rigshospitalet, Copenhagen, Denmark; and
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine, and PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
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Toft A, Urup T, Grunnet K, Christensen IJ, Michaelsen SR, Broholm H, Larsen VA, Kosteljanetz M, Lassen U, Poulsen HS. Abstract 5310: Prognostic and predictive biomarkers of clinical response to Bevacizumab in recurrent WHO grade 3 malignant glioma patients. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-5310] [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: Bevacizumab, a monoclonal antibody targeting vascular endothelial growth factor A (VEGF-A), has proven activity in treatment of recurrent high-grade glioma. High response rates have been demonstrated, but particularly in WHO grade 3 malignant gliomas, efforts to identify predictors of clinical response have been limited. Predictive biomarkers and prognostic models are required in order to individualize treatment for this patient population. The primary end-point of this study was identification of prognostic and potentially predictive clinical and paraclinical factors of response. The secondary end-point was to identify prognostic factors associated with progression-free survival (PFS) and overall survival (OS).
Materials and methods: A total of 64 recurrent grade 3 glioma patients treated with bevacizumab and irinotecan were retrospectively evaluated. Eligible patients from our center had a WHO performance status of 0-2 and were administered bevacizumab and irinotecan between December 2005 and November 2014 according to a previously published clinical protocol.
The possibly relevant prognostic baseline factors screened for included: Age, gender, WHO grade 3 diagnosis, tumor size and location, multifocal disease, extent of resection, number of prior chemotherapy regiments, response to prior chemotherapy, first-line treatment, number of previous recurrences, neurological deficit, corticosteroid use, performance status, necrosis, vascular proliferation, neutrophil-to-lymphocyte ratio, and expression of p53, EGFR, Mib-1, MGMT, IDH-1 and ATRX.
Candidate factors were subjected to univariate analysis and factors with P-values below 0.10 were considered for multivariate analysis. Prognostic models were generated by logistic regression and Cox regression, modeling response and survival end-points. P-values below 0.05 were considered statistically significant.
Results will be presented.
Citation Format: Anders Toft, Thomas Urup, Kirsten Grunnet, Ib J. Christensen, Signe R. Michaelsen, Helle Broholm, Vibeke A. Larsen, Michael Kosteljanetz, Ulrik Lassen, Hans S. Poulsen. Prognostic and predictive biomarkers of clinical response to Bevacizumab in recurrent WHO grade 3 malignant glioma patients. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 5310. doi:10.1158/1538-7445.AM2015-5310
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Affiliation(s)
- Anders Toft
- 1The Finsen Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Urup
- 2The Finsen Center, Copenhagen University Hospital, and Department of Clinical Oncology, The Finsen Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Kirsten Grunnet
- 2The Finsen Center, Copenhagen University Hospital, and Department of Clinical Oncology, The Finsen Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ib J. Christensen
- 3Finsen Laboratory, The Finsen Center, Rigshospitalet, and Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark
| | | | - Helle Broholm
- 4Department of Pathology, Center of Diagnostic Investigation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Vibeke A. Larsen
- 5Department of Diagnostic Radialogy, Center of Diagnostic Investigation, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Kosteljanetz
- 6Department of Neurosurgery, Neuroscience Centre, Copenhagen University Hospital, Copenhagen, Denmark
| | - Ulrik Lassen
- 2The Finsen Center, Copenhagen University Hospital, and Department of Clinical Oncology, The Finsen Center, Copenhagen University Hospital, Copenhagen, Denmark
| | - Hans S. Poulsen
- 2The Finsen Center, Copenhagen University Hospital, and Department of Clinical Oncology, The Finsen Center, Copenhagen University Hospital, Copenhagen, Denmark
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Michaelsen SR, Nedergaard MK, Urup T, Villingshoej M, Kjaer A, Perryman L, Erler JT, Lassen U, Poulsen HS. Abstract 4170: The role of VEGF-C for cell viability, tumor growth and bevacizumab resistance in glioblastoma multiforme. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-4170] [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
Although treatment with the VEGF-A targeting antibody Bevacizumab has resulted in substantial response rates in patients with the brain tumor Glioblastoma Multiforme, patients invariable progress. The VEGF-A receptor VEGFR2, has in addition to be expressed on endothelial cells, recently been shown also to be expressed by GBM tumor cells. Autocrine VEGF-A/VEGFR2 signaling has been identified in GBM cells, but contradicting results exist for the effects of inhibiting VEGF-A and VEGFR2 respectively; indicating that VEGFR2 in GBM at least partly is activated by other factors than VEGF-A. Study aim was to search for other factors responsible for VEGFR2 activation in GBM cells and to examine their role for GBM growth and response to Bevacizumab.
To study VEGFR2 regulation we examined a VEGFR2-positive and a VEGFR2-negative GBM cell culture, which both expressed VEGF-A. In line with others, we found that VEGFR2 phosphorylation could be stimulated by recombinant VEGF-A, and found that inhibition of receptor phosphorylation by SU1498 resulted in significantly reduced proliferation of the VEGFR2-positive cells, while inhibition of the VEGF-A expressed by the cells using Bevacizumab only had minimal effect on proliferation. Examinations revealed that the VEGFR2-positive cells also were positive for the VEGF variant VEGF-C. Addition of recombinant VEGF-C protein to the VEGFR2-positive cells could stimulate VEGFR2 phosphorylation, while inhibition of VEGF-C using siRNA constructs resulted in reduced in vitro growth of VEGFR2-positive cells. Further, when injected into the brains of mice, VEGF-C-siRNA transfected cells resulted in reduced tumor growth and increased survival compared to control cells. Moreover, measurement of the VEGF-C mRNA level in 19 GBM patient tumors showed that all tumors were positive for VEGF-C expression, although the level was varying. To examine if VEGF-C expression represents a possible mechanism behind insensitivity towards Bevacizumab therapy, we are currently investigating the expression of VEGF-C in paired samples from GBM patients taken before and after Bevacizumab therapy and in xenograft tumors from mice receiving this treatment.
In conclusion, our current results show that VEGF-C is of importance for GBM cell viability and tumor growth presumable due to its ability to stimulate autocrine activation of VEGFR2. VEGF-C expression therefore could respresent a possible mechanism behind Bevacizumab resistance. An update on this will be presented.
Citation Format: Signe R. Michaelsen, Mette K. Nedergaard, Thomas Urup, Mette Villingshoej, Andreas Kjaer, Lara Perryman, Janine T. Erler, Ulrik Lassen, Hans S. Poulsen. The role of VEGF-C for cell viability, tumor growth and bevacizumab resistance in glioblastoma multiforme. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4170. doi:10.1158/1538-7445.AM2015-4170
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Affiliation(s)
| | - Mette K. Nedergaard
- 2Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Thomas Urup
- 1Department of Radiation Biology, Rigshospitalet, Copenhagen, Denmark
| | | | - Andreas Kjaer
- 2Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Lara Perryman
- 3Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Janine T. Erler
- 3Biotech Research and Innovation Center (BRIC), University of Copenhagen, Copenhagen, Denmark
| | - Ulrik Lassen
- 1Department of Radiation Biology, Rigshospitalet, Copenhagen, Denmark
| | - Hans S. Poulsen
- 1Department of Radiation Biology, Rigshospitalet, Copenhagen, Denmark
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Christensen CL, Kwiatkowski N, Abraham BJ, Carretero J, Al-Shahrour F, Zhang T, Chipumuro E, Herter-Sprie GS, Akbay EA, Altabef A, Zhang J, Shimamura T, Capelletti M, Reibel JB, Cavanaugh JD, Gao P, Liu Y, Michaelsen SR, Poulsen HS, Aref AR, Barbie DA, Bradner JE, George RE, Gray NS, Young RA, Wong KK. Targeting transcriptional addictions in small cell lung cancer with a covalent CDK7 inhibitor. Cancer Cell 2014; 26:909-922. [PMID: 25490451 PMCID: PMC4261156 DOI: 10.1016/j.ccell.2014.10.019] [Citation(s) in RCA: 340] [Impact Index Per Article: 34.0] [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] [Received: 06/25/2014] [Revised: 10/03/2014] [Accepted: 10/28/2014] [Indexed: 01/24/2023]
Abstract
Small cell lung cancer (SCLC) is an aggressive disease with high mortality, and the identification of effective pharmacological strategies to target SCLC biology represents an urgent need. Using a high-throughput cellular screen of a diverse chemical library, we observe that SCLC is sensitive to transcription-targeting drugs, in particular to THZ1, a recently identified covalent inhibitor of cyclin-dependent kinase 7. We find that expression of super-enhancer-associated transcription factor genes, including MYC family proto-oncogenes and neuroendocrine lineage-specific factors, is highly vulnerability to THZ1 treatment. We propose that downregulation of these transcription factors contributes, in part, to SCLC sensitivity to transcriptional inhibitors and that THZ1 represents a prototype drug for tailored SCLC therapy.
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Affiliation(s)
- Camilla L Christensen
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Nicholas Kwiatkowski
- Whitehead Institute for Biomedical Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Brian J Abraham
- Whitehead Institute for Biomedical Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA
| | - Julian Carretero
- Departament de Fisiologia, Facultat de Farmacia, Universitat de Valencia, Valencia 46010, Spain
| | - Fatima Al-Shahrour
- Translational Bioinformatics Unit, Clinical Research Programme, Spanish National Cancer Research Centre, 28029 Madrid, Spain
| | - Tinghu Zhang
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02115, USA
| | - Edmond Chipumuro
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute and Children's Hospital, Boston, MA 02115, USA
| | - Grit S Herter-Sprie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Esra A Akbay
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Abigail Altabef
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Jianming Zhang
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02115, USA
| | - Takeshi Shimamura
- Department of Molecular Pharmacology and Therapeutics, Oncology Research Institute, Loyola University Chicago, Stritch School of Medicine, Maywood, IL 60153, USA
| | - Marzia Capelletti
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Jakob B Reibel
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Jillian D Cavanaugh
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Peng Gao
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Yan Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Signe R Michaelsen
- Department of Radiation Biology, The Finsen Center, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Hans S Poulsen
- Department of Radiation Biology, The Finsen Center, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Amir R Aref
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - David A Barbie
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - James E Bradner
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA
| | - Rani E George
- Department of Pediatric Hematology/Oncology, Dana-Farber Cancer Institute and Children's Hospital, Boston, MA 02115, USA
| | - Nathanael S Gray
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02115, USA
| | - Richard A Young
- Whitehead Institute for Biomedical Research, Massachusetts Institute of Technology, Cambridge, MA 02142, USA; Department of Biology, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
| | - Kwok-Kin Wong
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA 02115, USA; Belfer Institute for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA 02115, USA.
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Nedergaard MK, Kristoffersen K, Michaelsen SR, Madsen J, Poulsen HS, Stockhausen MT, Lassen U, Kjaer A. The use of longitudinal 18F-FET MicroPET imaging to evaluate response to irinotecan in orthotopic human glioblastoma multiforme xenografts. PLoS One 2014; 9:e100009. [PMID: 24918622 PMCID: PMC4053391 DOI: 10.1371/journal.pone.0100009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 05/21/2014] [Indexed: 11/26/2022] Open
Abstract
Objectives Brain tumor imaging is challenging. Although 18F-FET PET is widely used in the clinic, the value of 18F-FET MicroPET to evaluate brain tumors in xenograft has not been assessed to date. The aim of this study therefore was to evaluate the performance of in vivo18F-FET MicroPET in detecting a treatment response in xenografts. In addition, the correlations between the 18F-FET tumor accumulation and the gene expression of Ki67 and the amino acid transporters LAT1 and LAT2 were investigated. Furthermore, Ki67, LAT1 and LAT2 gene expression in xenograft and archival patient tumors was compared. Methods Human GBM cells were injected orthotopically in nude mice and 18F-FET uptake was followed by weekly MicroPET/CT. When tumor take was observed, mice were treated with CPT-11 or saline weekly. After two weeks of treatment the brain tumors were isolated and quantitative polymerase chain reaction were performed on the xenograft tumors and in parallel on archival patient tumor specimens. Results The relative tumor-to-brain (T/B) ratio of SUVmax was significantly lower after one week (123±6%, n = 7 vs. 147±6%, n = 7; p = 0.018) and after two weeks (142±8%, n = 5 vs. 204±27%, n = 4; p = 0.047) in the CPT-11 group compared with the control group. Strong negative correlations between SUVmax T/B ratio and LAT1 (r = −0.62, p = 0.04) and LAT2 (r = −0.67, p = 0.02) were observed. In addition, a strong positive correlation between LAT1 and Ki67 was detected in xenografts. Furthermore, a 1.6 fold higher expression of LAT1 and a 23 fold higher expression of LAT2 were observed in patient specimens compared to xenografts. Conclusions 18F-FET MicroPET can be used to detect a treatment response to CPT-11 in GBM xenografts. The strong negative correlation between SUVmax T/B ratio and LAT1/LAT2 indicates an export transport function. We suggest that 18F-FET PET may be used for detection of early treatment response in patients.
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Affiliation(s)
- Mette K. Nedergaard
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - Karina Kristoffersen
- Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Signe R. Michaelsen
- Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Jacob Madsen
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
| | - Hans S. Poulsen
- Department of Radiation Biology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | | | - Ulrik Lassen
- Phase 1 Unit, Department of Oncology, The Finsen Center, Rigshospitalet, Copenhagen, Denmark
| | - Andreas Kjaer
- Department of Clinical Physiology, Nuclear Medicine & PET and Cluster for Molecular Imaging, Rigshospitalet and University of Copenhagen, Copenhagen, Denmark
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Christensen CL, Shimamura T, Akbay EA, Michaelsen SR, Poulsen HS, Wong KK. Abstract 3126: Insulinoma-associated 1 is a key transcriptional regulator of growth and survival-promoting pathways in small cell lung cancer. Cancer Res 2013. [DOI: 10.1158/1538-7445.am2013-3126] [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
Insulinoma-associated 1 (INSM1) is neuroendocrine (NE) transcription factor which temporal and spatial expression pattern is restricted to regions undergoing NE differentiation during embryogenesis. INSM1 is however re-expressed at high levels in small-cell lung cancer (SCLC) together with an array of other NE markers. The NE signature of SCLC is a central diagnostic tool for the disease but recent data pinpoints that this distinct signature might play a role in SCLC pathogenesis.
The functional role of INSM1 in SCLC was here investigated by shRNA-mediated silencing of INSM1 in a panel of SCLC cell lines. Upon silencing of INSM1, significant reduction in cell viability was observed as measured by MTT assay. This reduction in cell viability was concomitant with decreased cell proliferation and increased apoptosis as measured by BrdU incorporation and cleaved caspase 3/7 levels, respectively. Accordingly with phenotypic growth changes it was demonstrated that INSM1 silencing caused reduced phosphorylation of members of the growth- and survival-promoting PI3K/Akt, MAPK and JAK-STAT signaling pathways and reduced levels of the inhibitors of apoptosis proteins (IAPs) members c-IAP1, XIAP and survivin. Importantly, it was shown that INSM1 is an upstream regulator of signatures previously shown to play a role in SCLC tumorigenesis, including achate-scute homolog 1 (ASCL1) and Sonic Hedgehog (SHh) pathway. Upon silencing of INSM1, a decrease in mRNA and protein levels of ASCL1 and downstream targets aldehyde dehydrogenase 1 (ALDH1) and delta-like ligand 3 (DLL3) was observed. Furthermore, mRNA levels of the SHh positive mediators Gli2, Gli3 and Smoothened was downregulated while the SHh inhibitor Patched was upregulated upon INSM1 silencing. Futhermore, overexpression of the Notch1 intracellular domain in SCLC cells resulted in a significant reduction in INSM1 expression and cell viability. This suggest that a master inhibitor of the NE signature, Notch1 signaling, could be an inhibitor of INSM1-driven tumorigenesis.
In conclusion, INSM1 is a potential key driver of growth- and survival-promoting pathways in SCLC and warrants further investigation of INSM1 as a therapeutic target.
Citation Format: Camilla L. Christensen, Takeshi Shimamura, Esra A. Akbay, Signe R. Michaelsen, Hans S. Poulsen, Kwok-kin Wong. Insulinoma-associated 1 is a key transcriptional regulator of growth and survival-promoting pathways in small cell lung cancer. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3126. doi:10.1158/1538-7445.AM2013-3126
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Affiliation(s)
| | - Takeshi Shimamura
- 2Loyola University Chicago Stritch School of Medicine, Oncology Institute, Chicago, IL
| | - Esra A. Akbay
- 1Dana-Farber Cancer Institute, Medical Oncology, Boston, MA
| | | | | | - Kwok-kin Wong
- 1Dana-Farber Cancer Institute, Medical Oncology, Boston, MA
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Michaelsen SR, Christensen CL, Sehested M, Cramer F, Poulsen TT, Patterson AV, Poulsen HS. Single agent- and combination treatment with two targeted suicide gene therapy systems is effective in chemoresistant small cell lung cancer cells. J Gene Med 2012; 14:445-58. [PMID: 22576955 DOI: 10.1002/jgm.2630] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Transcriptional targeted suicide gene (SG) therapy driven by the insulinoma-associated 1 (INSM1) promoter makes it possible to target suicide toxin production and cytotoxicity exclusively to small cell lung cancer (SCLC) cells and tumors. It remains to be determined whether acquired chemoresistance, as observed in the majority of SCLC patients, desensitizes SCLC cells to INSM1 promoter-driven SG therapy. METHODS A panel of SCLC cell lines resistant to clinically relevant chemotherapeutics was characterized regarding the expression of proteins involved in response to chemotherapy and regarding INSM1 promoter activity. Sensitivity towards INSM1 promoter-driven SG therapy was tested using different systems: Yeast cytosine deaminase-uracil phosphoribosyl transferase (YCD-YUPRT) in combination with the prodrug 5-fluorocytosine (5-FC) or Escherichia coli nitroreductase (NTR) together with the bromomustard prodrug SN27686. RESULTS The chemoresistant cell lines displayed heterogeneous expression profiles of molecules involved in multidrug resistance, apoptosis and survival pathways. Despite this, the INSM1 promoter activity was found to be unchanged or increased in SCLC chemoresistant cells and xenografts compared to chemosensitive variants. INSM1 promoter-driven SG therapy with YCD-YUPRT/5-FC or NTR/SN27686, was found to induce high levels of cytotoxicity in both chemosensitive and chemoresistant SCLC cells. Moreover, the combination of INSM1 promoter-driven YCD-YUPRT/5-FC therapy and chemotherapy, as well as the combination of INSM1 promoter-driven YCD-YUPRT/5-FC and NTR/SN27686 therapy, was observed to be superior to single agent therapy in chemoresistant SCLC cells. CONCLUSIONS Collectively, the present study demonstrates that targeted SG therapy is a potent therapeutic approach for chemoresistant SCLC patients, with the highest efficacy achieved when applied as combination SG therapy or in combination with standard chemotherapy.
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Affiliation(s)
- Signe R Michaelsen
- Department of Radiation Biology, The Finsen Center, National University Hospital, Copenhagen, Denmark
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Michaelsen SR, Christensen CL, Sehested M, Cramer F, Poulsen TT, Poulsen HS. Abstract 832: Suicide gene therapy is effective for treating chemo-resistant small cell lung cancer cells. Cancer Res 2012. [DOI: 10.1158/1538-7445.am2012-832] [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: Resistance arises in patients with small cell lung cancer (SCLC) following treatment with chemotherapeutic agents. Suicide gene (SG) therapy is a novel treatment strategy for cancer in which the introduced therapeutic gene encodes an enzyme capable of transforming a non-toxic prodrug into a cell poison. By coupling the SCLC specific promoter Insulinoma-associated 1 (INSM1) to the SG, it is possible to target SG expression and resulting cytotoxicity exclusive to SCLC cells. The aim of this project was to investigate the influence of chemo-resistance on transcriptional targeted SG therapy. Results: As an in vitro model of chemo-resistance we used a number of SCLC cell lines resistant to different chemotherapeutic agents used in first-line treatment of SCLC patients. Protein expression analysis showed the cells lines to vary in expression of a several proteins correlated to development of resistance. Despite of this the INSM1 promoter activity was found to be equally or increased in chemo-resistant compared to chemo-sensitive cells as measured by luciferase reporter assays and determination of INSM1 mRNA levels by RT-PCR. Additionally, in tumor xenografts stably expressing EGFP from the INSM1 promoter it was apparent that the INSM1 promoter activity is very strong and stable in vivo. Cytotoxic effects of two different SG systems driven by the INSM1 promoter were tested in the chemo-resistant cell lines by MTT assays. One consisted of the fusion SG of yeast-cytosine-deaminase (YCD) and yeast-uracil-phosphoribosyl-transferase (YUPRT) and the prodrug 5-fluorocytosin (5-FC). The other system consisted of the Nitroreductase (NTR) gene and SN27686 prodrug. While equal sensitivity was found in chemo-sensitive and -resistant cells towards YCD-YUPRT/5-FC therapy, the NTR/SN276868 system showed reduced cytotoxicity in cells resistant to alkylating agents. Importantly, equal cytotoxicity could be obtained in these chemo-resistant cells upon NTR/SN27686 therapy by exposing cells to higher prodrug doses, still not inducing off-target toxicity in NTR-negative cells. Finally, the combination of YCD-YUPRT/5-FC SG therapy with standard chemotherapy and with NTR/SN27686 SG therapy, respectively, were tested and evaluated by MTT assay. In contrast to chemo-sensitive cells, where the combination therapy had no additive effect, significantly additive cytotoxicity was achieved in chemo-resistant SCLC cells exposed to combination therapy compared to single agent therapy. Conclusion: The results demonstrate that targeted SG therapy is equally effective in chemo-resistant and -sensitive SCLC cells and that additional effect can be achieved in chemo-resistant SCLC cells when SG therapy is given in combination with chemotherapy or another SG therapy system. INSM1-driven SG therapy therefore seems potent to be effective in the treatment of SCLC patients with chemo-resistant tumors.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 832. doi:1538-7445.AM2012-832
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Affiliation(s)
- Signe R. Michaelsen
- 1Department of Radiation Biology, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | | | - Maxwell Sehested
- 2Department of Pathology, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Frederik Cramer
- 1Department of Radiation Biology, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Thomas T. Poulsen
- 1Department of Radiation Biology, Copenhagen University Hospital, Copenhagen Ø, Denmark
| | - Hans S. Poulsen
- 1Department of Radiation Biology, Copenhagen University Hospital, Copenhagen Ø, Denmark
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