Retrospective study to estimate the prevalence and describe the clinicopathological characteristics, treatments received, and outcomes of HER2-low breast cancer

BACKGROUND

Approximately 80% of all breast cancers (BCs) are currently categorized as human epidermal growth factor receptor 2 (HER2)-negative [immunohistochemistry (IHC) 0, 1+, or 2+/in situ hybridization (ISH) negative]; approximately 60% of BCs traditionally categorized as HER2-negative express low levels of HER2. HER2-low (IHC 1+ or IHC 2+/ISH-) status became clinically actionable with approval of trastuzumab deruxtecan to treat unresectable/metastatic HER2-low BC. Greater understanding of patients with HER2-low disease is urgently needed.

PATIENTS AND METHODS

This global, multicenter, retrospective study (NCT04807595) included tissue samples from patients with confirmed HER2-negative unresectable/metastatic BC [any hormone receptor (HR) status] diagnosed from 2014 to 2017. Pathologists rescored HER2 IHC-stained slides as HER2-low (IHC 1+ or IHC 2+/ISH-) or HER2 IHC 0 after training on low-end expression scoring using Ventana 4B5 and other assays at local laboratories (13 sites; 10 countries) blinded to historical scores. HER2-low prevalence and concordance between historical scores and rescores were assessed. Demographics, clinicopathological characteristics, treatments, and outcomes were examined.

RESULTS

In rescored samples from 789 patients with HER2-negative unresectable/metastatic BC, the overall HER2-low prevalence was 67.2% (HR positive, 71.1%; HR negative, 52.8%). Concordance was moderate between historical and rescored HER2 statuses (81.3%; κ = 0.583); positive agreement was numerically higher for HER2-low (87.5%) than HER2 IHC 0 (69.9%). More than 30% of historical IHC 0 cases were rescored as HER2-low overall (all assays) and using Ventana 4B5. There were no notable differences between HER2-low and HER2 IHC 0 in patient characteristics, treatments received, or clinical outcomes.

CONCLUSIONS

Approximately two-thirds of patients with historically HER2-negative unresectable/metastatic BC may benefit from HER2-low-directed treatments. Our data suggest that HER2 reassessment in patients with historical IHC 0 scores may be considered to help optimize selection of patients for treatment. Further, accurate identification of patients with HER2-low BC may be achieved with standardized pathologist training.

Agaritine derived from Agaricus blazei Murrill induces apoptosis via mitochondrial membrane depolarization in hematological tumor cell lines

Objectives

Agaritine (AGT) is a hydrazine-containing compound derived from the mushroom Agaricus blazei Murill. We previously reported the antitumor effect of AGT on hematological tumor cell lines and suggested that AGT induces apoptosis in U937 cells via caspase activation. However, the antitumor mechanism of AGT has not been fully understood.

Methods

Four hematological tumor cell lines (K562, HL60, THP-1, H929) were used in this study. The cells were incubated in the presence of 50 μM AGT for 24 h and analyzed for cell viability, annexin V positivity, caspase-3/7 activity, mitochondrial membrane depolarization, cell cycle, DNA fragmentation, and the expression of mitochondrial membrane-associated proteins (Bax and cytochrome c).

Results

In HL60, K562, and H929 cells, AGT reduced cell viability and increased annexin V- and dead cell-positive rates; however, it did not affect THP-1 cells. In K562 and HL60 cells, caspase-3/7 activity, mitochondrial membrane depolarization, and expression of mitochondrial membrane proteins, Bax and cytochrome c, were all increased by AGT. Cell cycle analysis showed that only K562 exhibited an increase in the proportion of cells in G₂/M phase after the addition of AGT. DNA fragmentation was also observed after the addition of AGT.

Conclusions

These results indicate that AGT induces apoptosis in K562 and HL60 cells, like U937 reported previously, but showed no effect on THP-1 cells. It was suggested that AGT-induced apoptosis involves the expression of Bax and cytochrome c via mitochondrial membrane depolarization.

Thalidomide and its metabolite 5-hydroxythalidomide induce teratogenicity via the cereblon neosubstrate PLZF

Thalidomide causes teratogenic effects by inducing protein degradation via cereblon (CRBN)‐containing ubiquitin ligase and modification of its substrate specificity. Human P450 cytochromes convert thalidomide into two monohydroxylated metabolites that are considered to contribute to thalidomide effects, through mechanisms that remain unclear. Here, we report that promyelocytic leukaemia zinc finger (PLZF)/ZBTB16 is a CRBN target protein whose degradation is involved in thalidomide‐ and 5‐hydroxythalidomide‐induced teratogenicity. Using a human transcription factor protein array produced in a wheat cell‐free protein synthesis system, PLZF was identified as a thalidomide‐dependent CRBN substrate. PLZF is degraded by the ubiquitin ligase CRL4^CRBN in complex with thalidomide, its derivatives or 5‐hydroxythalidomide in a manner dependent on the conserved first and third zinc finger domains of PLZF. Surprisingly, thalidomide and 5‐hydroxythalidomide confer distinctly different substrate specificities to mouse and chicken CRBN, and both compounds cause teratogenic phenotypes in chicken embryos. Consistently, knockdown of Plzf induces short bone formation in chicken limbs. Most importantly, degradation of PLZF protein, but not of the known thalidomide‐dependent CRBN substrate SALL4, was induced by thalidomide or 5‐hydroxythalidomide treatment in chicken embryos. Furthermore, PLZF overexpression partially rescued the thalidomide‐induced phenotypes. Our findings implicate PLZF as an important thalidomide‐induced CRBN neosubstrate involved in thalidomide teratogenicity.

Current Contributions of Organofluorine Compounds to the Agrochemical Industry

Currently, more than 1,200 agrochemicals are listed and many of these are regularly used by farmers to generate the food supply to support the expanding global population. However, resistance to pesticides is an ever more frequently occurring phenomenon, and thus, a continuous supply of novel agrochemicals with high efficiency, selectivity, and low toxicity is required. Moreover, the demand for a more sustainable society, by reducing the risk chemicals pose to human health and by minimizing their environmental footprint, renders the development of novel agrochemicals an ever more challenging undertaking. In the last two decades, fluoro-chemicals have been associated with significant advances in the agrochemical development process. We herein analyze the contribution that organofluorine compounds make to the agrochemical industry. Our database covers 424 fluoro-agrochemicals and is subdivided into several categories including chemotypes, mode of action, heterocycles, and chirality. This in-depth analysis reveals the unique relationship between fluorine and agrochemicals.

Front Cover: Gas/Liquid‐Phase Micro‐Flow Trifluoromethylation using Fluoroform: Trifluoromethylation of Aldehydes, Ketones, Chalcones, and N ‐Sulfinylimines (ChemistryOpen 4/2019)

The Front Cover shows an image related to the perpetual motion machine of the second kind in the eighteenth century, and “alchemy”. More information can be found in the Communication by K. Hirano et al. on page 406 in Issue 4, 2019 (DOI: 10.1002/open.201800286).

Gas/Liquid-Phase Micro-Flow Trifluoromethylation using Fluoroform: Trifluoromethylation of Aldehydes, Ketones, Chalcones, and N-Sulfinylimines

A micro-flow nucleophilic trifluoromethylation of carbonyl compounds using gaseous fluoroform was developed. This method also allows the first micro-flow transformation of N-sulfinylimines into trifluoromethyl amines with excellent diastereoselectivity. To demonstrate the synthetic utility of this micro-flow synthesis, the formal micro-flow synthesis of Efavirenz is described.

Gas/Liquid-Phase Micro-Flow Trifluoromethylation using Fluoroform: Trifluoromethylation of Aldehydes, Ketones, Chalcones, and N-Sulfinylimines

Invited for this month's cover picture is the group of Norio Shibata at the Nagoya Institute of Technology (Japan). The cover picture shows an image related to the perpetual motion machine of the second kind in the eighteenth century, and "alchemy". Our biggest challenge on the path to the results presented in this paper was the creation of alchemy using fluorine chemistry. Read the full text of their Communication at 10.1002/open.201800286.

Demonstration of wavelength-scan-free action spectroscopy in pump/probe measurement with supercontinuum pump light

We devise and introduce the principle of wavelength-scan-free spectroscopy for the pump light in pump/probe measurement (action spectroscopy) using supercontinuum light; we demonstrate its implementation by measuring transmission spectra. We use the supercontinuum light noise as a code in order to discriminate wavelength. We extract the stimulation at the desired wavelength by correlating the noise at that wavelength observed separately and the observed total stimulation carried by the probe light. The wavelength-scan-free spectroscopy is enabled with a simultaneous procedure for multiple wavelengths.

Abstract P6-16-01: Health-related quality of life in MONARCH 3: Abemaciclib plus an aromatase inhibitor as initial therapy in women with HR+, HER2- advanced breast cancer

Background: In the MONARCH 3 trial, abemaciclib plus an aromatase inhibitor (AI) significantly improved progression free survival and overall response rate with a generally tolerable safety profile compared to placebo plus AI. Here we report patient-reported outcomes (PRO) including health-related quality of life (Qol), functioning, and symptoms.

Methods: MONARCH 3 was a double-blind, randomized phase III study of abemaciclib or placebo plus an AI in 493 post-menopausal women with hormone receptor-positive (HR+), human epidermal growth factor receptor 2-negative (HER2-) advanced breast cancer with no prior systemic therapy in the advanced setting. Two European Organization for Research and Treatment of Cancer (EORTC) questionnaires were included: Quality of Life Questionnaire (QLQ)-Core 30 (C30) and the EORTC QLQ-Breast 23 (BR23) that were assessed at baseline, every 2 cycles through cycle 19, then every 3 cycles until treatment discontinuation, and at short-term follow up. Higher scores on functional and health status/QoL outcomes indicate higher/better levels of functioning or health; conversely higher scores on symptom outcomes indicate higher/worse levels of symptom burden. Between-arm comparisons of change from baseline were conducted using mixed model methods. Statistical significance was set at 0.05 and clinical meaningfulness was set at ≥10 points on a 0-100 scale1.

Results: PRO completion rates were >91% through cycle 19; duration of treatment was longer for abemaciclib plus AI patients (median number of cycles 19 vs.15). Compared to the placebo arm, diarrhea PRO scores in the abemaciclib arm showed a clinically (18.68 points) and statistically significant (p<0.001) increase/worsening. By-cycle analysis showed group mean diarrhea scores returned to near-baseline levels post-therapy. Other symptom PROs showed statistically significant (<0.05) but not clinically meaningful differences; fatigue (4.96; p=0.004), systemic therapy side effects (4.48, p<0.001), appetite loss (4.03; p=0.034), and nausea/vomiting (2.77; p=0.013). These results were consistent with the investigator-reported treatment emergent adverse events (TEAEs). Several non-symptom results were also statistically significant but not clinically meaningful including global health/health status (-4.36; p=0.003), role function (-4.25; p=0.025), social function (-3.41, p=0.047), and body image (-5.11, p=0.009). No statistically significant between-treatment differences were observed for physical, emotional, and cognitive functioning or for symptoms of pain, dyspnea, insomnia, constipation, or financial difficulties.

Conclusions: The addition of abemaciclib to an AI resulted in clinically and statistically significant changes in diarrhea without clinically meaningful differences in other symptom scores. Increased GI-related symptoms were consistent with the manageable, reversible AE profile; the highest symptom burden was reported during early visits. No clinically meaningful differences in global health status or functional scores were observed.

ClinicalTrials.gov: NCT02246621

Reference:

1. Osoba D et al. J Clin Oncol 2002;20(14):3106-13.

Citation Format: Goetz MP, Johnston S, Martin M, Tokunaga E, Park IH, Huober J, Toi M, Price GL, Boye M, Li L, Forrester T, Gainford C, Gable J, Carter GC, Sood A, DiLeo A. Health-related quality of life in MONARCH 3: Abemaciclib plus an aromatase inhibitor as initial therapy in women with HR+, HER2- advanced breast cancer [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 P6-16-01.

Abstract P4-08-24: Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in postmenopausal breast cancer patients

Background: Several studies have shown the association between high neutrophil-to-lymphocyte ratio (NLR) and poor prognosis in various cancer types, including breast cancer. On the other hand, menopausal status, which is an important consideration in breast cancer treatment, has been shown to be associated with changes in NLR levels. The purpose of the present study was to clarify the prognostic significance of preoperative NLR, especially in postmenopausal breast cancer patients.

Patients and methods: Between October 2003 and December 2014, 1868 women underwent surgery without neoadjuvant systemic therapy for primary breast cancer in our department. The optimal cutoff value of preoperative NLR was determined using receiver operating characteristic curve analysis. The patients were divided into two groups based on the NLR cutoff value of 3.34: High NLR (NLR value ≥ 3.34) and Low NLR (NLR value < 3.34). Correlations between clinicopathological characteristics and preoperative NLR were analyzed, and relapse-free survival (RFS) and overall survival (OS) were estimated.

Results: Among the 1868 patients, 286 (15.3%) and 1582 (84.7%) patients were classified into High NLR and Low NLR, respectively. Although the patients in High NLR was younger (p=0.0023), there were no significant correlations between NLR and all other prognostic factors, such as tumor size, lymph node status, and histological grade. High NLR was associated with tendency to shorter RFS (p=0.0583) and shorter OS (p=0.0303). In postmenopausal patients (n=1177), significant correlations were observed between High NLR and shorter RFS and OS (p=0.0002 and p=0.0011). However, NLR was not correlated with RFS and OS in premenopausal patients (n=691). Although the postmenopausal patients with relapsed cancer had higher NLR levels than those without relapse (p=0.0252), NLR levels were not correlated with relapse occurrence in premenopausal patients. Both univariate (p=0.0009) and multivariate (p=0.0015) analyses revealed that High NLR as well as larger tumor size, lymph node metastases, and higher histological grade was significantly associated with relapse in postmenopausal patients. Moreover, in postmenopausal patients, subgroup analysis according to cancer subtype revealed that High NLR was correlated with shorter RFS only in patients with hormone receptor (HR)-positive/human epidermal growth factor receptor 2 (HER2)-negative breast cancer (p=0.0009), in those without adjuvant chemotherapy (p=0.0034) but not in those with adjuvant chemotherapy.

Conclusion: Elevated preoperative NLR is an independent predictor of poor prognosis in postmenopausal but not premenopausal patients with breast cancer. In postmenopausal patients, adjuvant chemotherapy may improve prognosis in patients with HR-positive/HER2-negative breast cancer, especially in those with elevated preoperative NLR.

Citation Format: Ijichi H, Tajiri W, Masuda T, Koga C, Tanaka J, Nakamura Y, Okamoto M, Tokunaga E. Prognostic significance of preoperative neutrophil-to-lymphocyte ratio in postmenopausal breast cancer patients [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 P4-08-24.

Abstract P5-07-07: The immune microenvironment of ductal carcinoma in situ of the breast

Background: The importance of tumor-infiltrating lymphocytes (TIL) in invasive breast carcinoma for tumor development and therapeutic response is widely accepted. However, the immune microenvironment of breast ductal carcinoma in situ (DCIS) has not been fully elucidated. Evasion of immune surveillance is a necessary step in tumor evolution. In DCIS, the tumor cells are relatively protected from the immune system due to an myoepithelial cell layer and basement membrane, and intraductal immune cells are rarely detected. In contrast, in invasive disease, cancer cells and immune cells are often intermingled. Thus, understanding the immune microenviroment of in situ to invasive carcinoma transition might be particularly important to identify novel targets for early stage of tumor invasion.

Aims: The aim of this study is to evaluate the clinical importance of TILs in DCIS.

Methods: TILs were assessed in 133 DCIS samples with or without microinvasive disease according to the proposed method from the International Immuno-Oncology Working Group on Breast Cancer. In addition, the relationship between TILs in DCIS and clinicopathological features was evaluated.

Results: TILs are present in most DCIS in varying levels. The median proportion of TILs in DCIS was 14%. Only a minority of DCIS showed >50% TILs, which represented only 12.8% of all cases. High TILs in DCIS was significantly associated with comedo necrosis (p<0.0001), high nuclear grade (p=0.0030), ER negativity (p<0.0001), PR negativity (p<0.0001), HER2 positivity (p=0.0030). Triple negative DCIS and HER2 positive DCIS had significantly higher level of TILs (p=0.0008). No correlation was demonstrated between TILs and recurrence risk.

Conclusions: High TILs in DCIS was significantly associated with adverse histopathologic features. Further characterization of immune environment of DCIS may be essential for immunotherapy and breast cancer prevention.

Citation Format: Yamashita N, Hisamatsu Y, Shigechi T, Tokunaga E, Saeki H, Oki E, Maehara Y. The immune microenvironment of ductal carcinoma in situ of the breast [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 P5-07-07.

Defluorosilylation of fluoroarenes and fluoroalkanes

Direct activation of carbon–fluorine bonds (C–F) to introduce the silyl or boryl groups and generate valuable carbon–silicon (C–Si) or carbon–boron (C–B) bonds is important in the development of synthetically useful reactions, owing to the unique opportunities for further derivatization to achieve more complex molecules. Despite considerable progress of C–F bond activation to construct carbon–carbon (C–C) and carbon–heteroatom (C–X) bond formation, the defluorosilylation via C–F cleavage has been rarely demonstrated. Here, we report an ipso-silylation of aryl fluorides via cleavage of unactivated C–F bonds by a Ni catalyst under mild conditions and without the addition of any external ligand. Alkyl fluorides are also directly converted into the corresponding alkyl silanes under similar conditions, even in the absence of the Ni catalyst. Applications of this protocol in late-stage defluorosilylation of potentially bioactive pharmaceuticals and in further derivatizations are also carried out.

Transformation of strong C-F bonds into C-Si bonds is an extremely useful strategy for further derivatization of organic molecules. Here, the authors report a nickel-catalyzed strategy to convert aryl fluorides into sylylated arenes while defluorosilylation of alkyl fluorides is achieved under metal-free conditions.

Super-Sensitive Protonation Behavior of Trifluoroethoxy-Substituted Phthalocyanines and Their Application to Solvent Discrimination

The super-sensitive protonation behavior of trifluoroethoxy-substituted phthalocyanines (TFEO-Pcs) was carefully studied using UV-vis and fluorescence spectroscopy, as well as computational calculations. The practical utility of TFEO-Pcs in sensor technology was demonstrated by identifying chloroform samples from different commercial sources.

Fluorescence anisotropy in indole under two-photon excitation in the spectral range 385-510 nm

This paper presents the detailed study of two-photon excited fluorescence in indole dissolved in propylene glycol produced by two-photon absorption from the molecular ground state to several high lying excited states. The experimental method involved excitation with linearly and circularly polarized femtosecond pulses and time-resolved detection of the polarized fluorescence decay. The fluorescence intensity, anisotropy, excited state lifetime, and rotation diffusion time as function of the excitation light wavelength in the spectral range 385-510 nm were determined in experiment. The theoretical fit of the experimental results obtained demonstrated the contributions of six highly excited molecular states of different symmetry to the two-photon absorption intensity and fluorescence anisotropy. An intense two-photon absorption peak was observed experimentally in the spectral range 385-480 nm and explained as contributions from four high lying electronic excited states. The temporal dependence of fluorescence intensity in indole was satisfactory characterized by a single excited state lifetime τf and a single rotational diffusion time τrot. As shown, the excited state lifetime τf depends on the excitation light wavelength, which was explained by taking into account nonradiative relaxation transitions in the molecular vibronic excited states. The rotation diffusion time τrot was found to be equal to τrot = 0.9 ± 0.5 ns and practically independent of the excitation wavelength. The determined molecular anisotropy changed substantially in the spectral area 385-480 nm taking positive and negative values, and the anisotropies referring to linearly and circularly polarized excitation light changed almost in opposite phases with each other. The experimental results obtained were interpreted using ab initio molecular structure computations and a model based on the Frank-Condon approximation and taking into account vibronic absorption bands.

Direct nucleophilic trifluoromethylation of carbonyl compounds by potent greenhouse gas, fluoroform: Improving the reactivity of anionoid trifluoromethyl species in glymes

A simple protocol to overcome the problematic trifluoromethylation of carbonyl compounds by the potent greenhouse gas "HFC-23, fluoroform" with a potassium base is described. Simply the use of glymes as a solvent or an additive dramatically improves the yields of this transformation. Experimental results and DFT calculations suggest that the beneficial effect deals with glyme coordination to the K+ to produce [K(polyether)n]+ whose diminished Lewis acidity renders the reactive anionoid CF3 counterion species more 'naked', thereby slowing down its undesirable decomposition to CF2 and F- and simultaneously increasing its reactivity towards the organic substrate.

An eccentric rod-like linear connection of two heterocycles: synthesis of pyridine trans-tetrafluoro-λ6-sulfanyl triazoles

The trans-tetrafluoro-λ6-sulfane (SF4) group has been utilized as a unique three-dimensional building block for the linear connection of two independent N-heterocycles, pyridines and triazoles. The linearly connected heterocyclic compounds were synthesized by thermal Huisgen 1,3-dipolar cycloaddition between previously unknown pyridine SF4-alkynes and readily available azides, providing a series of rod-like SF4-connected N-heterocycles in good to excellent yields. X-ray crystallographic analysis of the target products revealed the trans-geometry of the SF4 group, which linearly connects two independent N-heterocycles. This research will open the field of chemistry of SF4-connected heterocyclic compounds.

Access to benzo-fused nine-membered heterocyclic alkenes with a trifluoromethyl carbinol moiety via a double decarboxylative formal ring-expansion process under palladium catalysis

Direct access to pharmaceutically attractive benzo-fused nine-membered heterocyclic alkenes 3 with a trifluoromethyl carbinol moiety was achieved via a palladium-catalyzed double-decarboxylative formal ring-expansion process from six-membered trifluoromethyl benzo[d][1,3]oxazinones 1 to nine-membered trifluoromethyl benzo[c][1,5]oxazonines 3 in the presence of vinylethylene carbonates 2. Generation of a Pd-π-allyl zwitterionic intermediate was proposed in the catalytic cycle. The trifluoromethyl group in the benzoxazinanones 1 plays an important role throughout the transformation. Diastereoselective chemical transformations of products 3 were also demonstrated.

Trifluoroethoxy-Coated Subphthalocyanines Attract Small Arenes in Their π-Concave Cavity

Invited for this month's cover is the group of Prof. Norio Shibata based at the Nagoya Institute of Technology, Japan. The cover picture shows the crystal structures of trifluoroethoxy-substituted subphthalocyanines which form crystalline clathrates with one small aromatic molecule, such as toluene or benzene, in their concave cavity. Twelve trifluoroethoxy substituents flexibly surround the small molecule to hold it on the 14π-electron conjugated surface of the subphthalocyanines. Read the full text of the article at 10.1002/cplu.201700508.

Trifluoroethoxy-Coated Subphthalocyanines Attract Small Arenes in Their π-Concave Cavity

X-ray crystallographic analyses of a series of trifluoroethoxy-substituted subphthalocyanines disclosed that a molecule of toluene is clasped at the center of the molecular concave cavity. Twelve trifluoroethoxy substituents, which flexibly surround the toluene molecule to hold it on the 14 π-electron-conjugated surface of the subphthalocyanines, can also catch a molecule of benzene. In contrast, a nonsubstituted subphthalocyanine does not show the same phenomena, and two subphthalocyanine units are required to maintain a small aromatic compound in their concave cavity. DFT calculations of the complexes were conducted to better understand the arene clathrates. Trifluoroethoxy-substituted subphthalocyanines can be used to prepare arene clathrates as a result of their concave space. This is a unique approach to obtaining X-ray crystal structures of small noncrystalline aromatic compounds.

Abstract P2-09-33: Not presented

This abstract was not presented at the symposium.

Synthesis of fluoro-functionalized diaryl-λ3-iodonium salts and their cytotoxicity against human lymphoma U937 cells

Conscious of the potential bioactivity of fluorine, an investigation was conducted using various fluorine-containing diaryliodonium salts in order to study and compare their biological activity against human lymphoma U937 cells. Most of the compounds tested are well-known reagents for fluoro-functionalized arylation reactions in synthetic organic chemistry, but their biological properties are not fully understood. Herein, after initially investigating 18 fluoro-functionalized reagents, we discovered that the ortho-fluoro-functionalized diaryliodonium salt reagents showed remarkable cytotoxicity in vitro. These results led us to synthesize more compounds, previously unknown sterically demanding diaryliodonium salts having a pentafluorosulfanyl (SF₅) functional group at the ortho-position, that is, unsymmetrical ortho-SF₅ phenylaryl-λ³-iodonium salts. Newly synthesized mesityl(2-(pentafluoro-λ⁶-sulfanyl)phenyl)iodonium exhibited the greatest potency in vitro against U937 cells. Evaluation of the cytotoxicity of selected phenylaryl-λ³-iodonium salts against AGLCL (a normal human B cell line) was also examined.

Anionic Triflyldiazomethane: Generation and Its Application for Synthesis of Pyrazole-3-triflones via [3 + 2] Cycloaddition Reaction

The synthesis of pyrazole triflones containing a triflyl group at the 3-position is disclosed. Treatment of 2-diazo-1-phenyl-2-((trifluoromethyl)sulfonyl)ethan-1-one with nitroalkenes under basic conditions gave pharmaceutically attractive pyrazole 3-triflones in good to high yields. The generation of anionic triflyldiazomethane species followed by the [3 + 2] cycloaddition reaction with nitroalkenes is proposed for this transformation. 3-(Difluoromethanesulfonyl)pyrazoles were also synthesized by using a previously unknown anionic (difluoromethanesulfonyl)diazomethane species under a similar strategy.

Synthesis of Aryl Triflones through the Trifluoromethanesulfonylation of Benzynes

The direct synthesis of aryl triflones, that is, trifluoromethanesulfonyl arenes, was achieved through the trifluoromethanesulfonylation of benzynes. The trifluoromethanesulfonyl group, one of the fluorinated functional groups, is a highly electron-negative and mild lipophilic substituent. Aryl triflones have high potential in the synthesis of bioactive compounds and specialty materials. The treatment of 2-(trimethylsilyl)aryl trifluoromethanesulfonates with cesium fluoride in the presence of 15-crown-5 generated benzynes, which reacted with sodium trifluoromethanesulfinate followed by protonation with tBuOH under heating conditions, provided aryl triflones in moderated to good yields. Both symmetrical and unsymmetrical triflones were nicely accessed under the same reaction conditions. Interestingly, the trifluoromethanesulfonylation of unsymmetrical benzyne precursors proceeded smoothly to furnish corresponding aryl triflones in good yields with good to high regioselectivities. The balance of polarization of electric charge as well as steric hindrance of the benzyne intermediates are central factors to control the outcome of regioselectivity.

Structural basis of thalidomide enantiomer binding to cereblon

Thalidomide possesses two optical isomers which have been reported to exhibit different pharmacological and toxicological activities. However, the precise mechanism by which the two isomers exert their different activities remains poorly understood. Here, we present structural and biochemical studies of (S)- and (R)-enantiomers bound to the primary target of thalidomide, cereblon (CRBN). Our biochemical studies employed deuterium-substituted thalidomides to suppress optical isomer conversion, and established that the (S)-enantiomer exhibited ~10-fold stronger binding to CRBN and inhibition of self-ubiquitylation compared to the (R)-enantiomer. The crystal structures of the thalidomide-binding domain of CRBN bound to each enantiomer show that both enantiomers bind the tri-Trp pocket, although the bound form of the (S)-enantiomer exhibited a more relaxed glutarimide ring conformation. The (S)-enantiomer induced greater teratogenic effects on fins of zebrafish compared to the (R)-enantiomer. This study has established a mechanism by which thalidomide exerts its effects in a stereospecific manner at the atomic level.

The CF3-DAST-induced deacylative trifluoromethylthiolation of cyclic 1,3-diketones/lactams/lactones and its extension to deacylative pentafluorophenylthiolation

CF₃-DAST-induced deacylative trifluoromethylthiolation of cyclic 1,3-diketones lactams, and lactones that provides cyclic trifluoromethylthioketones, lactams and lactones is reported.

Highly C-selective difluoromethylation of β-ketoesters by using TMSCF2Br/lithium hydroxide/N,N,N-trimethylhexadecan-1-ammonium bromide

The first highly C-selective difluoromethylation of β-ketoesters was achieved by combining TMSCF₂Br/LiOH/(CH₃(CH₂)₁₅(CH₃)₃NBr).

Synthesis of pyridine trans-tetrafluoro-λ6-sulfane derivatives via radical addition

Pyridine-trans-SF₄-alkenes or -alkanes have been synthesized for the first time via the radical addition reactions of pyridine-trans-SF₄Cl to alkynes or alkenes in good to high yields.

Stereodivergent trifluoromethylation of N-sulfinylimines by fluoroform with either organic-superbase or organometallic-base

The first stereodivergent trifluoromethylation of N-sulfinylimines by fluoroform is reported.

Synthesis of Sulfur Perfluorophenyl Compounds Using a Pentafluorobenzenesulfonyl Hypervalent Iodonium Ylide

A novel pentafluorobenzenesulfonyl hypervalent iodonium ylide 3 was designed and synthesized as a useful tool for the preparation of sulfur pentafluorophenyl compounds containing a C₆F₅S or C₆F₅SO₂ unit. Electrophilic pentafluorophenylthiolation of enamines, formal [3+2] cycloaddition reaction of nitriles and alkynes, and intramolecular S_NAr cyclization were achieved using iodonium ylide 3. The fluoro-click reaction was also demonstrated using one of the products via an intermolecular S_NAr reaction with heterocentered nucleophiles.

Intramolecular Aminotrifluoromethanesulfinyloxylation of ω-Aminoalkenes by CF3SO2Na/Pd(OAc)2/PhI(OAc)2/ t BuOCl/PivOH System

The first example of palladium-catalyzed intramolecular aminotrifluoromethanesulfinyloxylation of unactivated ω-aminoalkenes has been achieved. Reaction conditions are rather unique with a complex consisting of CF3SO2Na/Pd(OAc)2/PhI(OAc)2/ t BuOCl/PivOH to provide 6-endo-cyclized type products with a piperidine skeleton. Yields are moderate, and SO2 is not extruded. This method also provides the first synthesis of 3-trifluoromethanesulfinyloxy piperidine derivatives.

Trifluoroethoxy-Coated Subphthalocyanine affects Trifluoromethylation of Alkenes and Alkynes even under Low-Energy Red-Light Irradiation

Photoredox chemical reactions induced by visible light have undergone a renaissance in recent years. Polypyridyl dyes such as Ir(ppy)3 and Ru(bpy)3 are key catalysts in this event, and blue- or white-light irradiation is required for the chemical transformations. However, it remains a challenge to achieve reactions under the lower energy of red light. We disclose, herein, that trifluoroethoxy-coated subphthalocyanine realizes the red-light-driven trifluoromethylation of alkenes and alkynes with trifluoromethyl iodide in good-to-high yields. Perfluoroalkylations were also achieved under red light. The reaction mechanism is discussed with the support of UV/Vis spectroscopy and cyclic voltammetry of trifluoroethoxy-coated subphthalocyanine. Light irradiation/dark study also supports the proposed mechanism.

Abstract P6-01-17: Epithelial paradox; clinical significance of co-expression of E-cadherin and vimentin in the invasion and the metastasis of breast cancer

Background: E-cadherin and vimentin are now regarded as major and conventional canonical markers of epithelial-mesenchymal transition (EMT). It is commonly assumed E-cadherin is uniformly lost during the process of EMT. We previously reported that the elevated expression of vimentin contributes to the aggressive phenotype in invasive breast cancer. On the other hand, the role of E-cadherin in breast cancer biology might be unclear and more complex. Although, cell cohesion during breast cancer invasion is often overlooked, accumulating evidences indicate breast tumor cells are typically cohesive and often display membrane-localized E-cadherin in both the primary tumor and distant metastases, termed collective invasion. Multiple mechanisms have emerged to address how epithelial breast tumors invade.

Aims: The aim of this study is to reveal the clinical importance of the expression pattern of E-cadherin and vimentin in breast cancer.

Methods: The E-cadherin and vimentin protein expression were evaluated by immunohistochemistry (IHC) in 177 invasive breast cancer samples. Among these, E-cadherin and vimentin expression were evaluated in the set of primary breast cancer and metastatic lymph nodes in 65 cases. In addition, E-cadherin and vimentin expression were analyzed by immunofluorescent staining and evaluated using confocal laser scanning microscopy to see E-cadherin and vimentin localization in the breast cancer cells.

Results: The positive vimentin expression was highly correlated with poor disease-free survival (DFS) and overall survival (OS) (p=0.019 and p=0.0044), however, the E-cadherin expression alone did not correlate with prognosis. Interestingly, both E-cadherin and vimentin positive tumors had the worst DFS and OS among all breast cancer (p=0.03 and p=0.0089). Vimentin expression was highly correlated between primary tumors and metastatic lymph nodes. However, E-cadherin expression levels were significantly elevated in metastatic lymph nodes (p=0.0017). Co-expression of E-cadherin and vimentin in the metastatic lymph nodes also showed worst DFS and OS (p=0.12 and p=0.027).Immunofluorescent analysis revealed that E-cadherin and vimentin were co-localized within the same tumor cells in many of the E-cadherin high/vimentin positive tumors.

Conclusions: Co-expression of E-cadherin and vimentin seems to be associated with the most aggressive phenotype and poorest prognosis in breast cancer. Moreover, co-localization of E-cadherin and vimentin within the same breast cancer cells suggests the significance of the expressions of both proteins in breast cancer invasion and metastasis.

Citation Format: Yamashita N, Tokunaga E, Inoue Y, Tanaka K, Saeki H, Oki E, Maehara Y. Epithelial paradox; clinical significance of co-expression of E-cadherin and vimentin in the invasion and the metastasis of breast cancer [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 P6-01-17.

Abstract P1-08-13: The clinical importance of nuclear wild-type p53-induced phosphatase 1(Wip1) expression in breast cancer patients

Backgrounds; The wild-type p53-induced phosphatase 1(Wip1) is a member of the serine/threonine protein phosphatases, and plays an important role in the nucleus as one of the key components in the DNA damage response network. Wip1 is encoded by the protein phosphatase magnesium dependent 1 delta (PPM1D), sited on locus 17q23. PPM1D gene amplification and/or Wip1 expression have been observed in numerous tumors, including breast cancer. PPM1D is referred to as oncogene, as Wip1 inhibits phosphorylation of p53 and work as a negative regulator in cell death. Inhibition of Wip1 may have an important therapeutic role in suppressing tumor growth and evolution.

Aims; We evaluated the expression of Wip1 mRNA, Wip1 protein and PPM1D DNA copy number to clarify the relationship between Wip1 expression and the clinicopathological features and prognosis to determine the biological significance of Wip1.

Materials and Methods; Breast cancer cell lines (MCF7, T47D, MDA-MB231, HCC1937, HS578T, BT20 and SKBr3) were used for Wip1 expression analysis and copy number analysis. The specimens were obtained from Japanese breast cancer patients who underwent surgery without neoadjuvant chemotherapy or endocrine therapy in our department. Wip1 mRNA expression was evaluated in 140 cases by quantitative RT-PCR and Wip1 protein expression was evaluated in 192 cases by immunohistochemistry (IHC). The PPM1D DNA copy number was analyzed by genomic PCR in 33 breast cancer cases and by SNP-CGH array (Illumina, Human Omni 2.5-8) in 12 cases. The effects on the cell growth of the Wip1 inhibitor (GSK2830371) were analyzed by the viability assay in MCF7.

Results; Wip1 mRNA expression was significantly higher in MCF7, luminal type cell line. There was no significant correlation between Wip1 mRNA expression and prognosis. In IHC, positive nuclear Wip1 protein expression was detected in 21 cases (10.9%). There was no significant correlation between Wip1 mRNA expression and Wip1 protein expression. There was no significant association between the Wip1 protein expression levels and the clinicopathological factors and the prognosis. PPM1D DNA copy number significantly correlated with Wip1 protein expression (p=0.0035). Copy number gain at 17q23 was detected in 6 cases by SNP-CGH array, and all of these six cases showed positive nuclear Wip1 expression. PPM1D copy number gain was not observed in Wip1 negative cases. In the cell viability assay, the MCF7 cell growth was suppressed by Wip1 inhibitor administration.

Conclusions;Wip1 protein expression in nucleus is important as oncogene, and its expression may be regulated by PPM1D copy number gain. Wip1 is considered to be the new therapeutic target for breast cancer patients.

Citation Format: Inoue Y, Yamashita N, Tokunaga E, Kitao H, Tanaka K, Saeki H, Oki E, Maehara Y. The clinical importance of nuclear wild-type p53-induced phosphatase 1(Wip1) expression in breast cancer patients [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 P1-08-13.

IF5 affects the final stage of the Cl–F exchange fluorination in the synthesis of pentafluoro-λ6-sulfanyl-pyridines, pyrimidines and benzenes with electron-withdrawing substituents

SF₅-(hetero)arenes having electron-deficient groups were efficiently synthesized by oxidative chlorotetrafluorination followed by a S_Ni-type Cl–F exchange reaction using IF₅.