Production of fructooligosaccharides by Bacillus subtilis natto CCT7712 and their antiproliferative potential

AIMS

Fructooligosaccharides (FOSs) known for their health properties and β-(2→6)-levan-type FOSs have shown prebiotic and immunomodulatory activities that overcome those of commercial β-(2→1)-FOSs, but costs do not favour their use. Moreover, FOSs can reach the bloodstream through the diet, and little is known about their direct effect on cells. The aim of this work was to produce high-content FOSs by Bacillus subtilis natto CCT7712 in a bioreactor using commercial sucrose and to evaluate their antiproliferative effects in OVCAR-3 cells.

METHODS AND RESULTS

FOS production reached 173·60 g l^-1 , 0·2 vvm aeration and uncontrolled pH. Levan-type FOSs, composed of β-(2 → 6) links and mainly GF₃ (6-nystose), were identified using RMN spectroscopy, FT-IR and ESI-MS. FOSs decreased the viability and proliferation of OVCAR-3 cells, and the effects were associated with an increased pro-inflammatory response by the induction of IL-8 and TNF-α, and the repression of ER-β genes. The metabolic profiles showed disruption of cellular homeostasis that can be associated with a decrease in proliferation.

CONCLUSIONS

The high production of levan-type FOSs from B. subtilis natto CCT7712 in a bioreactor was achieved, and they showed antiproliferative potential in OVCAR-3 cells.

SIGNIFICANCE AND IMPACT OF THE STUDY

FOS could be a good target for future therapeutic studies and commercial use.

Efficacy and safety of Everolimus and Exemestane in hormone-receptor positive (HR+) human-epidermal-growth-factor negative (HER2-) advanced breast cancer patients: New insights beyond clinical trials. The EVA study

BACKGROUND

The BOLERO-2 trial reported efficacy and safety of Everolimus (EVE) and Exemestane (EXE) combination in HR+ advanced breast cancer (ABC) patients. The BALLET trial further evaluated the safety of EVE-EXE in HR+ ABC patients, without reporting efficacy data. Aim of the EVA real-life study was to collect data of efficacy and safety of EVE-EXE combination in the clinical setting, as well as exploring efficacy according to EVE Dose-Intensity (DI) and to previous treatment with Fulvestrant.

PATIENTS AND METHODS

This study aimed to describe the outcome of ABC pts treated with EVE-EXE combination in terms of median duration of EVE treatment and ORR in a real-life setting.

RESULTS

From July 2013 to December 2015, the EVA study enrolled 404 pts. Median age was 61 years (33-83). Main metastatic sites were: bone (69.1%), soft tissue (34.7%) and viscera (33.2%). Median number of previous treatments was 2 (1-7). 43.3% of the pts had received Fulvestrant. Median exposure to EVE was 31.0 weeks (15.4-58.3) in the whole population. No difference was observed in terms of EVE exposure duration according to DI (p for trend = 0.27) or type of previous treatments (p = 0.33). ORR and Disease Control Rate (DCR) were observed in 31.6% and 60.7% of the patients, respectively, with the lowest ORRs confined in CHT pre-treated patients or in those who received the lowest DI of EVE. Grade 3-4 adverse events (AEs) were reported in 37.9% of the patients. Main AEs were: stomatitis (11.2%), non-infectious pneumonitis - NIP (3.8%), anaemia (3.8%) and fatigue (3.2%).

CONCLUSIONS

The EVA study provided new insights in the use of EVE-EVE combination in HR+ ABC pts many years after the publication of the pivotal trial. The combination is safe and the best response could be obtained in patients receiving the full dose of EVE and/or after hormone-therapy as Fulvestrant in ABC.

Abstract P4-22-17: Safety of the combination of everolimus plus exemestane in the Italian cohort of patients enrolled in the expanded access “BALLET” study

Background:The expanded access “BALLET” study has been designed toevaluate the safety of EVE plus EXE combination in hormone receptor-positive (HR+), human epidermal growth factor-receptor-2-negative (HER2-) metastatic Breast Cancer (mBC). The Italian population was predominantly enrolled in trial.

Patients and methods: Patients has been included according to the inclusion and exclusion criteria provided previously in the BALLET study. The aim of our analysis was the safety everolimus and exemestane analysed in two sets of population: a subpopulation including only patients who never received chemotherapy in metastatic setting (416 patients – 36.1% of the safety population) and a subpopulation including only patients who received at least one chemotherapy in metastatic setting, whatever the line of treatment (735 patients – 63.9%).

Results:One thousand two hundred seventy nine (1279) Italian female patients were screened, 1153 (90.1% of the screened set) out of these were included in the analysis and 1151 (90.0% of the screened set) were included in the safety population. 1116 (97.0% of the safety population) prematurely discontinued the study drug and the main reasons reported were disease progression (39.1%), local reimbursement of everolimus (31.1%) and adverse event(s) (16.1%). The mean duration of study treatment exposure was 158.3±106.79 days (median 139.5) for exemestane and 153.9±108.48 days (median 135.0) for everolimus with a treatment compliance (higher than 90%) of 94.4% and 58.6% and (lower than 60%) of 0.1% and 15.1% for exemestane and everolimus, respectively. 92.5% of patients of the safety population (91.1% and . 93.3% patients without and with chemotherapy respectively) experienced at least one adverse event: gastrointestinal disorders” (67.3% vs. 64.6% in without and with chemo group); general disorders (48.6% vs. 48.3%); metabolism and nutrition disorders (35.6% vs. 37.4%) and skin and subcutaneous tissue disorders (32.2% vs. 27.5%). The incidence of everolimus related adverse events was higher (83.9%) when compared to those which occurred with exemestane. The most commonly reported adverse event was stomatitis (51.3% of patients) with 22.5% Grade 1; 18.2% Grade 2; 10.5% Grade 3; 0.2% Grade 4. The 49.7% of the patients experienced at least one stomatitis related to everolimus. No relevant difference was observed between the two groups of patients without and with chemo in metastatic setting.

Conclusions: The administration of chemotherapy before starting EVE plus EXE combination did not affect the safety profile of EXE/EVE in the treatment of mBC. The stomatitis is the most frequent and relevant adverse event to be clinically focused on.

Citation Format: Generali D, Bordonaro R, Febbraro A, Madoffa A, Romito S, Michelotti A, Savastano C, Mariani G, Tondini C, Piovano P, Iona MT, Bighin C, Roviello G, Ascione G, Goffredo F, Sartori D, Frassoldati A, Simoncini E. Safety of the combination of everolimus plus exemestane in the Italian cohort of patients enrolled in the expanded access “BALLET” study [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 P4-22-17.

(S)-Goniothalamin induces DNA damage, apoptosis, and decrease in BIRC5 messenger RNA levels in NCI-H460 cells

(R)-Goniothalamin (R-GNT) is a secondary metabolite isolated from the plants of the genus Goniothalamus. This molecule has attracted the attention of researchers because of its selective cytotoxicity against tumor cells and its ability to induce apoptosis. (S)-Goniothalamin (S-GNT) is a synthetic enantiomer of R-GNT, and its mechanism of action is largely unknown. In this study, we investigated the activity of S-GNT in a human non-small cell lung cancer NCI-H460 cells. We observed that the cells exposed to this compound exhibited cytotoxicity in a concentration-dependent manner. Based on the data obtained through the assessment of apoptosis induction in situ and the comet assay, we suggest that this cytotoxicity occurs due to the potential ability of this molecule to induce DNA damage with the consequent induction of cell death via apoptosis. A significant reduction in the messenger RNA levels of baculoviral inhibitor of apoptosis repeat-containing 5 (BIRC5) gene that encodes the survivin protein was found. This novel finding may explain the inhibition of cell proliferation and induction of apoptosis in tumor cells caused by this compound.

Effects of β-glucan extracted from Agaricus blazei on the expression of ERCC5, CASP9, and CYP1A1 genes and metabolic profile in HepG2 cells

The polysaccharide β-glucan has biological properties that stimulate the immune system and can prevent chronic pathologies, including cancer. It has been shown to prevent damage to DNA caused by the chemical and physical agents to which humans are exposed. However, the mechanism of β-glucan remains poorly understood. The objective of the present study was to verify the protective effect of β-glucan on the expression of the genes ERCC5 (involved in excision repair of DNA damage), CASP9 (involved in apoptosis), and CYP1A1 (involved in the metabolism of xenobiotics) using real-time polymerase chain reaction and perform metabolic profile measurements on the HepG2 cells. Cells were exposed to only benzo[a]pyrene (B[a]P), β-glucan, or a combination of B[a]P with β-glucan. The results demonstrated that 50 µg/mL β-glucan significantly repressed the expression of the ERCC5 gene when compared with the untreated control cells in these conditions. No change was found in the CASP9 transcript level. However, the CYP1A1 gene expression was also induced by HepG2 cells exposed to B[a]P only or in association with β-glucan, showing its effective protector against damage caused by B[a]P, while HepG2 cells exposed to only β-glucan did not show CYP1A1 modulation. The metabolic profiles showed moderate bioenergetic metabolism with an increase in the metabolites involved in bioenergetic metabolism (alanine, glutamate, creatine and phosphocholine) in cells treated with β-glucan and to a lesser extent treated with B[a]P. Thus, these results demonstrate that the chemopreventive activity of β-glucan may modulate bioenergetic metabolism and gene expression.

Brain metastases in breast cancer: Different survival by biological subtype and Ki67 expression

1069

Background: Ten to 15% of patients (pts) with breast cancer will be diagnosed with central nervous system (CNS) metastases, and autopsy series suggest that up to 30% of pts have evidence of CNS disease at the time of death. The idenfication of factors that may predispose to CNS metastasis may help lead to earlier detection and possibly to improvement in disease management. Methods: Breast cancer pts with CNS metastases were identified within a database of 1300 breast cancer diganoses from 1995 to 2007 at the Department of Oncology, Azienda ULSS 13 VE. Pathologic features of tumor samples were examined using standard immunohistochemical assays. Results: Fifty-one pts with CNS metastases were identified. Median age at primary breast cancer diagnosis was 49 years (range, 28–78); median time to CNS metastases was 45 months (range, 3–244). HER2 overexpression was found in tumors from 25 pts (49.0%); 23 pts had tumors lacking overexpression of HER2, estrogen receptors (ER), and progesterone receptors (PgR) (ie, “triple negative” disease). Overexpression of p53 (at least 20% tumor cells positive), Ki67 (at least 20%), and BCL2 (at least 30%) were detected in tumors from 16 pts (31.4%), 32 pts (62.7%), and 14 pts (27.5%), respectively. Median survival from CNS involvement was 3.67 months (95% CI 2.05–5.28), with 24.4% and 15.3% of patients estimated to be alive at 12 and 24 months, respectively (Kaplan-Meier product limit method). A Cox proportional hazards analysis found that Ki67 overexpression was the only factor independently associated with a significantly increased risk of death (2.7-fold increase, p=0.028), while triple negative status was associated with a 1.8-fold increase in the risk of death (P=0.08) (Table). Conclusions: In our series of breast cancer pts with CNS metastases, nearly all had either HER2 overexpression or triple-negative disease. Pts whose tumors had higher proliferative indices, assessed by Ki67, had the poorest prognosis.

[Table: see text]

[Table: see text]

Efficacy of docetaxel in metastatic, castration-resistant prostate cancer (mCRPC): Comparison with therapeutic standards in other solid tumors

5167

Background: Difference of opinion exists between urologists and oncologists as to what constitutes a beneficial survival advantage from a drug. Therefore, the aim of this analysis was to consider the efficacy of docetaxel (DOC) in the treatment of mCRPC as compared with the efficacy results previously observed in breast cancer (BC), non-small cell lung cancer (NSCLC), and colorectal cancer (CRC). Methods: A systematic review (Review Manager 5, Cochrane Collaboration, 2008) of the phase III studies which defined the new standard approaches in the 1st-line cytotoxic chemotherapy of metastatic disease for the above mentioned neoplasms was conducted. The relative efficacy of taxane combinations (TAX) in BC, cisplatin-based doublets (DDP) in NSCLC, 5FU/LV-oxaliplatin (FOLFOX) in CRC and DOC-based combinations in mCRPC were calculated. Efficacy parameters for the present analysis were: a) odds ratio for death (fixed method) and: b) NNT[odds ratio], e.g. the number of patients you need to treat to prevent one additional death, as compared with the control group; the NNT (odds ratio) is (1-(pc*(1-OR))/((1-pc)*pc*(1-OR)), where pc is the proportion of death events in the control arm and OR is the odds ratio for death. Results: BC (4 studies, 1313 patients), TAX vs non TAX: OR 0.84 (95% CL 0.66 1.07), NNT (odds ratio) at 5 years = 28. NSCLC (9 studies, 4671 patients), DDP vs non DDP: OR 0.83 (95% CL 0.74 0.94), NNT (odds ratio) at 1 year = 23. CRC (3 studies, 1256 patients), FOLFOX vs non FOLFOX: OR 0.72 (95% CL 0.54 0.98), NNT (odds ratio) at 5 years = 22. mCRPC (2 studies, 1439 patients), DOC vs non DOC: OR 0.78 (95%CL 0.63 0.96), NNT (odds ratio) at 3 years = 16. Conclusions: TAX in BC, DDP in NSCLC and FOLFOX in CRC are the 1st choice cytotoxic approach to metastatic disease, with relative reductions in the risk of death (RRR) of 16%, 17% and 28%, respectively; thus, you will need to treat 28, 23 and 22 patients to prevent one additional death, in the order. DOC had a similar RRR (22%) and the most favourable (16 patients) NNT (odds ratio) in this analysis. Both the quality of evidence and the small number of patients to treat with DOC to avoid one additional death did recommend this chemotherapy in 1st-line mCRPC.

[Table: see text]

Topoisomerase-2alpha (T-2a), Ki67, Her-2 and response to neoadjuvant anthracycline-containing chemotherapy in breast cancer. A prospective, correlation study

21094

Background: T-2a creates a reversible double-strand DNA break allowing DNA doubling. Anthracyclines (A) stabilize the DNA double-strand breaks, and T-2a is probably the primary molecular target of A. Due to the close location of T-2a and Her-2 genes on chromosome 17, T-2a gene aberrations are mainly associated with Her-2 gene amplification; while a correlation exists between Her-2 amplification and protein overexpression this is not true for T-2a. A linear correlation between T-2a and Ki67 labeling indices was found, suggesting that both essentially reflect cellular proliferation. The correlation between T-2a overexpression and both Her-2 and Ki67 was investigated in a series of consecutive patients undergone neoadjuvant A-containing chemotherapy for locally-advanced breast cancer. Material and Methods: T-2a expression was measured by means of monoclonal antibody Ki-S1; thresholds (ts) for immunopositivity were tested at 10%, 15% and 20%, respectively. Both the anti-c-erb-B2 primary antibody (clone CB11) and the Dako test were employed to recognize c-erb-B2 protein. Ki67 was measured using the MIB-1 antibody, with ts for positivity at 10%. Patients were required to have a cT>2cm breast cancer. The neoadjuvant chemotherapy included Adriamycin 60mg/m2 or Epirubicin 75mg/m2, in combination with Paclitaxel (175 mg/m2), every 3 weeks for 4 cycles. Bivariate correlations were performed according to Pearson. Results: 38 patients were enrolled until August, 2006. A significant correlation between T-2a and Ki67 was found (r=.598; P<.000); the T-2a positivity rate within Ki67 positive patients was of 90% (10% ts), 86% (15% ts), and 67% (20% ts). No correlation appeared between T-2a and Her-2 labeling indices (r=.150; P=.391); the T-2a positivity rate within Dako +++ patients was 75% (for both 10% and 15% ts) and 50% (for 20% ts). The overall response rate by T-2a overexpression was 61% (10% ts), 70% (15% ts), and 72% (20% ts). Conclusions: We provide a further evidence of the correlation between T-2a and Ki67. We can also generate the hypothesis that a 20% ts for T-2a correlate with a better prediction of response to A-containing chemotherapy; at the same ts, no correlation with Her-2 status was found.

No significant financial relationships to disclose.

Primary breast lymphoma

Breast involvement by non-Hodgkin lymphoma is uncommon. Differences between primary and secondary breast lymphoma have been well-defined. However, histopathological features, therapeutic approach and outcome are still debated. We report the clinical and pathological features of 5 cases of malignant lymphoma primarily involving the breast. The literature is extensively reviewed paying particular attention to pathological features, therapeutic approach and survival analysis. All patients were women; the median age was 63.2 yr. The clinical course was indistinguishable from that of breast carcinoma. High-grade lymphoma was found in 4 cases; T cell lineage antigens were expressed in one case. All patients were in stage I or II. Treatment consisted of chemotherapy and/or radiotherapy. The follow-up period ranged from 20 to 54 months (mean, 33.2). All patients are still in complete clinical remission. Analysis of the literature showed that about 80% of cases are high grade lymphoma. In this group, stage I at presentation statistically gives the best survival rate; surgery does not appear to have a role in high-grade lymphoma treatment.

Idiopathic myelofibrosis with neutrophil myeloperoxidase deficiency: a case report

We describe a case of idiopathic myelofibrosis with total neutrophil myeloperoxidase deficiency. The combination of this enzymatic defect with myelofibrotic changes in the nuclear shape of neutrophils confers a peculiar appearance on leukograms produced by a Technicon H*1. The clinical course of the disease was shortened by recurrent infections that may be ascribed, at least in part, to reduced leukocyte microbicidal ability.

Specificity of HOX protein function depends on DNA-protein and protein-protein interactions, both mediated by the homeo domain

Transcription of human HOX gene promoters in cultured cells is positively and negatively regulated by HOX proteins interacting with specific target sequences. The human HOXD9 protein activates transcription of the HOXD9 promoter by interacting with the HCR sequence and is antagonized by the HOXD8 protein. HOXD8 is not intrinsically a repressor, since it can activate transcription on different targets. Complete or partial HOXD8/HOXD9 homeo domain swapping indicates that the ability to recognize, and activate transcription from, the HCR target in vivo depends on the amino terminus and helix 1 of the homeo domain. The inhibitory activity of HOXD8 is not affected by deletion of the homeo domain helix 2/3 region, whereas it requires the amino terminus/helix 1 region and an additional, effector domain located at the protein amino-terminal end. This activity is therefore DNA-binding independent, and possibly mediated by protein-protein interactions. Affinity chromatography experiments show that the homeo domain amino terminus/helix 1 region is able to mediate direct interactions between HOX proteins in solution. These data indicate that specificity of HOX protein function in vivo depends on both DNA-protein and protein-protein interactions, mediated by the same sub region of the homeo domain.

Serum neopterin levels in haematological malignancies

BACKGROUND

Neopterin is an intermediate in the pathway of pteridines released in vitro from non proliferating activated cells such as macrophages stimulated with interferons. Increased urinary excretion of neopterin has been described in conditions of cell-mediated immune activation and in neoplastic diseases, including haemopoietic tumours.

METHODS

We studied by radioimmunoassay serum neopterin levels of 91 patients with haematological malignancies differing in diagnosis, stage, treatment, and disease duration.

RESULTS

Mean patient neopterin (13.5 nmol/L) was increased compared to 69 healthy controls (5.4 nmol/L, P < 0.001), and individual levels were related to patient survival (P = 0.006). No relevant differences were found among the various disorders, whilst advanced stages and active diseases had higher levels than initial stages and non-active diseases. Furthermore, off-therapy patients in stable remission did not differ from normals. Among subjects on therapy, patients on alpha-interferon had a higher percentage of (dose-related) neopterin elevation, in spite of a steady disease.

CONCLUSIONS

We suggest that serum neopterin dosage has prognostic value in staging and follow-up, and may provide a useful tool for monitoring the therapy (particularly with biological response modifiers) of haematological neoplasias.

Multidrug resistance in lung allograft recipients: possible correlation with the development of acute and chronic rejection

The expression of drug resistance antigens in mononuclear inflammatory cells was studied in transbronchial lung biopsy specimens of lung allograft recipients who experienced steroid-sensitive and steroid-resistant bouts of acute rejection and bronchiolitis obliterans. Immunostains for C494 and C219 epitopes of p-glycoprotein and human metallothionein revealed that (1) mononuclear cells expressing these antigens are present in the lung allograft during rejection, (2) that steroid-resistant acute rejection is associated with increased percentages of C494 and metallothionein-positive cells as compared to steroid-sensitive cases, (3) that bronchiolitis obliterans was associated with a higher percentage of cells with drug-resistant antigen expression, and (4) that steroid-resistant bronchiolitis obliterans is associated with the highest percentage of C494 and metallothionein-positive cells in the five clinical situations studied. P-glycoprotein and metallothionein expression may be a marker of aggressive or persistent cases of acute rejection and bronchiolitis obliterans.

Isolation and characterization of variant cDNAs encoding mouse tyrosinase

Two different cDNA clones encoding mouse tyrosinase (monophenol oxygenase, E.C. 1.14.18.1) were isolated from B16 melanoma cells, and their primary structure was determined. One of the cDNAs consists of 3309 nucleotides with an open reading frame coding for a peptide of 533 amino acids. The other cDNA is approximately 1600 nucleotides long, with a shorter 3'-untranslated region and a deduced in-frame deletion of 77 amino acid residues with respect to the former clone. Neither of these clones is structurally identical to other described mouse tyrosinase cDNAs (1-3). RNA blotting analysis demonstrates that multiple tyrosinase mRNA species are not only present in B16 melanoma, but also in normal skin melanocytes.

Oxidation and metabolic effects of fructose or glucose ingested before exercise

The aim of this study was to compare the effects of fructose (F) and glucose (G) intake before exercise on oxidation of the ingested substrate, glycogen utilization, work output, and metabolic changes. Ten trained subjects ingested F or G (1 g/kg), both of which were naturally enriched in 13C. After 1 h of rest, they exercised on an ergometer at 61% of their maximal oxygen uptake (VO2 max) for 45 min, which was immediately followed by 15 min at their maximal voluntary output. During the resting hour, blood insulin and glucose were lower (p less than 0.05) and respiratory quotient and blood lactate higher (p less than 0.01) after F. During exercise, the differences disappeared, apart from a transient but moderate (4.3 mmol/l) hypoglycemia after G compared to F. No difference between F and G was observed for uric acid, glycerol, FFA, and glucagon. Glycogen decrements in the vastus lateralis muscle were 67 +/- 9 (F) and 97 +/- 15 (G) mmol/kg, values not significantly different from each other (P greater than 0.05). The maximal voluntary work produced during the last 15 min did not differ between treatments. During the 2 h after sugar ingestion, 30 +/- 3 g of F and 26 +/- 3 g of G were oxidized to 13CO2. These findings indicate that fructose ingested before exercise was utilized at least as well as glucose, allowed a more stable glycemia, and did not modify performance.