Increasing Clinical Trial Participation of Black Women Diagnosed with Breast Cancer

Despite racial disparities in breast cancer mortality, Black women remain underrepresented in clinical trials. In this mixed methods research, 48 Black women were engaged via focus group discussions and in-depth interviews to better understand the lived experience of women with breast cancer. The results of this qualitative study informed the development of a subsequent online survey to identify barriers, motivators, and other factors that influence decision-making by Black women diagnosed with breast cancer when considering clinical trial participation. Among the 257 Black survey participants, most (95%) were aware of clinical trials; of those, most viewed them as lifesaving (81%) and/or benefiting others (90%). Negative perceptions such as serious side effects (58%), not receiving real treatment (52%), or risk of potential harm (62%) were indicated. Barriers included financial expenses (49%), concerns that their condition could be made worse (29%), that they would receive a placebo (28%), or that treatment was unapproved (28%). Participants were more likely than their health care providers (HCPs) to initiate discussions of clinical trials (53% versus 33%), and 29% of participants indicated a need for more information about risks and benefits, even after having those conversations. The most trustworthy sources of information on clinical trials were HCPs (66%) and breast cancer support groups (64%). These results suggest that trusted communities are key for providing education on clinical trials. However, there is also a need for HCPs to proactively discuss clinical trials with patients to ensure that they are adequately informed about all aspects of participation.

Transcriptome Analysis Identifies Tumor Immune Microenvironment Signaling Networks Supporting Metastatic Castration-Resistant Prostate Cancer

Prostate cancer (PCa) is the second most common cause of cancer death in American men. Metastatic castration-resistant prostate cancer (mCRPC) is the most lethal form of PCa and preferentially metastasizes to the bones through incompletely understood molecular mechanisms. Herein, we processed RNA sequencing data from patients with mCRPC (n = 60) and identified 14 gene clusters (modules) highly correlated with mCRPC bone metastasis. We used a novel combination of weighted gene co-expression network analysis (WGCNA) and upstream regulator and gene ontology analyses of clinically annotated transcriptomes to identify the genes. The cyan module (M14) had the strongest positive correlation (0.81, p = 4 × 10-15) with mCRPC bone metastasis. It was associated with two significant biological pathways through KEGG enrichment analysis (parathyroid hormone synthesis, secretion, and action and protein digestion and absorption). In particular, we identified 10 hub genes (ALPL, PHEX, RUNX2, ENPP1, PHOSPHO1, PTH1R, COL11A1, COL24A1, COL22A1, and COL13A1) using cytoHubba of Cytoscape. We also found high gene expression for collagen formation, degradation, absorption, cell-signaling peptides, and bone regulation processes through Gene Ontology (GO) enrichment analysis.

Abstract 821: Targeting metastatic prostate cancer using planetary ball-milled (PBM) nanoparticles

Men are most likely to develop prostate cancer (PCa), which has a high morbidity and fatality rate. Chemotherapy, the most recommended therapeutic strategy to combat PCa, has shown adverse effects on patients and develops drug-resistant PCa resulting in overall restricted survival of the patients. Many studies have demonstrated that natural compound-mediated therapy can be an effective option for treating PCa. Among the natural compounds, Thymoquinone (TQ), a derivative of Nigella sativa, has shown anti-proliferative, antioxidant, and anti-cancer effects. However, issues remain regarding its bioavailability, safety, and effective delivery system to cancer cells in vivo. In this study, we developed TQ nanoparticles (NPs) alone or in combination with DTX-encapsulated planetary ball-milled nanoparticles (PBM-NPs), formulated with starch (natural polysaccharides) inner core and biodegradable co-polymers poly (ε-caprolactone)/poly (ethylene glycol), functionalized with a prostate-specific membrane antigen (PSMA) aptamer (A10) to target the metastatic niche in PCa metastasis pre-clinical (patient-derived xenograft (PDX) and intra-tibial metastatic (LNCaP, PC-3 cells were injected directly into the tibia of SCID mice.) models. To determine the minimum effective dose (MED), efficacy, and safety of PBM-NPs, mice were treated intravenously with dose levels of vehicle control (empty-PBM-NPs), DTX alone (5 mg/kg, weekly), TQ alone (10 mg/kg, weekly), and a combination of TQ and DTX (25-fold less than maximum tolerance dose) using PBM-NPs, respectively for five weeks. Blood serum chemistry for toxicity and immunohistochemistry were performed to characterize these metastatic models. Our results showed TQ+DTX PBM NPs suppressed p-EGFR, ERK1/2, ABCB1, and Caspase3-expression, which are regulated by the EGFR-dependent pathway. We detected OPG, RANKL, PTHrP, and ET-1 immunoreactivity in all xenografts in the bone. In conclusion, sustained-release of combination PBM NPs demonstrated more significant anti-tumor activity following their conjugation to a prostate cancer cell-specific ligand, the toxicity of the drug can be reduced, and effective concentrations of the drug can be maintained locally for prolonged periods and prevention of PCa bone metastasis.

Citation Format: Santosh K. Singh, James W. Lillard, Rajesh Singh. Targeting metastatic prostate cancer using planetary ball-milled (PBM) nanoparticles [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 821.

Racial disparities in Black men with prostate cancer: A literature review

Black men are disproportionately affected by prostate cancer (PCa), with earlier presentation, more aggressive disease, and higher mortality rates versus White men. Furthermore, Black men have less access to PCa treatment and experience longer delays between diagnosis and treatment. In this review, the authors discuss the factors contributing to racial disparities and present solutions to improve access to care and increase clinical trial participation among Black men with PCa. Racial disparities observed among Black men with PCa are multifaceted, evolving from institutional racism. Cultural factors include generalized mistrust of the health care system, poor physician-patient communication, lack of information on PCa and treatment options, fear of PCa diagnosis, and perceived societal stigma of the disease. In the United States, geographic trends in racial disparities have been observed. Economic factors, e.g., cost of care, recovery time, and cancer debt, play an important role in racial disparities observed in PCa treatment and outcomes. Racial diversity is often lacking in genomic and precision medicine studies. Black men are largely underrepresented in key phase 3 PCa trials and may be less willing to enroll in clinical trials due to lack of awareness, lack of diversity in clinical trial research teams, and bias of health care providers to recommend clinical research. The authors propose solutions to address these factors that include educating clinicians and institutions on the barriers Black men experience, increasing the diversity of health care providers and clinical research teams, and empowering Black men to be involved in their treatment, which are keys to creating equity for Black men with PCa. LAY SUMMARY: Prostate cancer negatively affects Black men more than men of other races. The history of segregation and mistreatment in the health care system may contribute to mistrust among Black men. Outcomes are worse for Black men because they are less likely to be screened or to receive treatment for prostate cancer. Black men also are unlikely to participate in clinical research, making it difficult for investigators to understand how Black men are affected by prostate cancer. Suggestions for addressing these differences include teaching physicians and nurses about the issues Black men experience getting treatment and improving how Black men get information on prostate cancer.

Abstract LB173: AACR President's initiative - 2020 by 2020: Democratizing precision cancer medicine and advancing health equity in the black belt

African Americans (AA) have higher incidence and mortality rates for several cancer types in comparison to their European American (EA) counterparts. Increasing participation in clinical research and patient registries, related to precision cancer medicine, will significantly improve cancer health equity. Many AA cancer patients are treated in community oncology clinics. Unfortunately, these health systems have limited access to Clinical Laboratory Improvement Amendments (CLIA) next generation sequence (NGS) germline and somatic DNA and RNA testing that are used to inform oncologists on the best treatment and/or clinical trial options for cancer patients. Indeed, AA CLIA NGS sample sets are poorly represented, which could presumably result in incomplete knowledge of genomic variants that could affect their treatment and overall outcomes. Hence, it is crucial to implement CLIA NGS efforts for all cancer patients. To address these disparities, Morehouse School of Medicine has formed the Comprehensive Approach to Reimagine health Equity Solutions (CARhES) consortium with Tuskegee University that has engaged community oncology practices in Alabama and Georgia - two of five Black Belt states. The CARhES consortium aims to implement precision cancer medicine to underserved and underrepresented communities that will improve the standard of cancer care by providing access to CLIA NGS testing, clinical trials, and personalized cancer care. Here we describe the first proof of concept of this approach with community oncology partners, i.e., Grady Health System, Wellstar Health System, Georgia Urology, Midtown Urology, and Maui Memorial Medical Center. At the time of consent, saliva, buccal, and tumor samples were collected from participants. Germline and somatic CLIA NGS was performed, and medical reports were returned to practitioners within 14 days. Prior to the COVID pandemic, the study enrolled over 880 patients with a 88% consent rate (n = 1000) in the first 11months of the program. At the start of the COVID pandemic, recruitment efforts were suspended for four months with a slow restart by June 2020. A decrease in the number of staff, office visits (67% reduction), and increase in COVID cases significantly limited recruitment efforts. During this slowdown, we established and improved eConsenting capabilities, which exist today. Community anxiety, due to the pandemic and SARS-CoV-19 vaccine efforts, resulted in a significant reduction in consent rates (88% to 60%). Nevertheless, this study began in April of 2019 and consented 1,750 participants in less than 2 years. Taken together, our study shows that a community-focused precision medicine approach requires meeting people where they are and providing them with access and understanding the benefit of clinical trial participation. The approximate 2,000 clinically annotated genomic AA datasets will greatly contribute to our understanding of cancer health disparities and among the first steps to democratize precision medicine.

This study was funded by the American Association for Cancer Research, The Pelotonia Foundation, the M2Gen Foundation, and the National Cancer Institute (U54CA118638).

Citation Format: Latrisha L. Horne, Gabriella M. Oprea-Ilies, Eddie R. Stanley, Carla M. Holloway, Margaret P. Hooker, Amina Isom, Derrick J. Beech, Ana Gaonkar, Shavette Harden, Jeffrey F. Hines, LaTonya Randolph, James K. Bennett, Daniel Canter, Darrell J. Carmen, Pooja Mishra, Giuseppe Del Priore, Roland Matthews, Brian M. Rivers, James W. Lillard. AACR President's initiative - 2020 by 2020: Democratizing precision cancer medicine and advancing health equity in the black belt [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 LB173.

Abstract 2950: Coexpression networks of miRNAs and gene transcripts coinciding with lung adenocarcinoma progression and survival

Lung & bronchus cancer is the second most diagnosed cancer, causing the most cancer-related deaths in the United States. A lung and bronchus subtype, NSCLC (non-small cell lung cancer), accounts for over 75% of new lung cancer diagnoses of which lung adenocarcinoma (LUAD) is the most common. Here, we studied the role of microRNAs and the transcriptome expression profile in LUAD prognosis, progression, and overall patient survival. We analyzed RNA-sequence data from a cohort of LUAD patients from The Cancer Genome Atlas (TCGA). The correlations of microRNA gene expression to transcription networks identified by weighted gene co-expression network analysis (WGCNA) were further explored in an upstream regulator/signaling pathway analysis, gene ontology (GO) process enrichment, and differential expression analysis. Mature microRNA abundance was also integrated with the mRNA network via correlation analysis. Our analysis revealed 18 clusters (modules) of highly correlated gene transcripts. The turquoise and red modules were of particular interest, as they were correlated negatively with overall survival, positively with stage 1 status, and negatively to later pathologic stages (3-4). Additionally, high select miRNA correlation to the red module transcripts (e.g., C16Orf89, ADGRF5, CFAP221, and SELENBP1; all with module eigengene correlation rho ≥ 0.75), and to the turquoise module (e.g., DDX39B and LENG8; each with rho ≥ 0.85) suggests these are miRNA-mRNA coregulatory networks of which both the gene products and potentially upstream miRNAs may serve as promising mechanistic targets and prognostic markers for LUAD, meriting further study.

Citation Format: Corey D. Young, Eric B. Dammer, Ti'ara L. Griffen, Sha'kayla K. Nunez, Courtney Dill, Kaylin M. Carey, James W. Lillard. Coexpression networks of miRNAs and gene transcripts coinciding with lung adenocarcinoma progression and survival [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 2950.

Transcriptome analysis identifies networks and key drivers in tumor microenvironment for metastatic castration-resistant prostate cancer

Prostate cancer (PCa) is the second most cancer-related cause of death in men. The most lethal form of PCa is metastatic castration-resistant prostate cancer (CRPC) that has progressed to the bone. The molecular mechanism underlying PCa progression to bone has not been fully elucidated. Here, we identify gene networks and characterize the cell types that contribute to the heterogeneity and complexity of CRPC associated with bone metastasis. Networks were investigated by using a novel weighted gene network co-expression analysis (WGCNA) method and examining overrepresentation of upstream regulators and signaling pathways within co-expressed transcriptome modules across clinically annotated transcriptomes from mCRPC patients (N=60). Functional Enrichment analysis was used, including Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment, and protein-protein interaction analysis to identify biological functions of related hub genes overrepresented in our module of interest. WGCNA identified significant modules that are associated with CRPC bone metastasis. KEGG and GO analysis results revealed genes in these modules were mainly related to collagen formation, cell signaling peptides, and bone regulation processes. Genes positively correlated with bone metastasis exhibited the following biological pathways: PI3K-Akt signaling, ECM-receptor interaction, and protein digestion and absorption pathways. This study provides novel insights into the biological pathways associated with CRPC metastasis to the bone and its tumor immune microenvironment (TIME) niche. The modules associated with bone metastasis and overall survival represent both known and novel pathways.

Supported by NIH/NCI Grant: MSM/Tuskegee U/UAB Comp. Cancer Center Partnership Name & Number of Grant Award: NCI - U54CA118638

Identification of Gene Co-Expression Networks Associated with Consensus Molecular Subtype-1 of Colorectal Cancer

Simple Summary

Colorectal cancer (CRC) is a frequently lethal disease with heterogenous outcomes. Alterations in the Wnt signaling pathways have been shown to promote activation of signaling pathways such as MAPK and PI3K-Akt. Consensus molecular subtyping (CMS) provides a cohesive structure to classify the heterogeneity of CRC using gene expression analysis. CMS is categorized into four subtypes: CMS1, immune; CMS2, canonical; CMS3, metabolic; and CMS4, mesenchymal. Here, we identify co-expressed gene networks associated with CMS1. Our findings distinguish co-expressed gene networks that play a pivotal role in key features specific for CMS1, such as immune infiltration and activation. The co-expressed gene networks for CMS1 were significantly and positively correlated with the TNF, WNT, and ERK1 and ERK2 signaling pathways. This study highlights the relevance of CMS1 gene networks relating to oncogenic signaling cascades, cell activation, and positive regulation of immune responses, promoting CRC progressiveness.

Abstract

Colorectal cancer (CRC) is driven in part by dysregulated Wnt, Ras-Raf-MAPK, TGF-β, and PI3K-Akt signaling. The progression of CRC is also promoted by molecular alterations and heterogeneous—yet interconnected—gene mutations, chromosomal instability, transcriptomic subtypes, and immune signatures. Genomic alterations of CRC progression lead to changes in RNA expression, which support CRC metastasis. An RNA-based classification system used for CRC, known as consensus molecular subtyping (CMS), has four classes. CMS1 has the lowest survival after relapse of the four CRC CMS phenotypes. Here, we identify gene signatures and associated coding mRNAs that are co-expressed during CMS1 CRC progression. Using RNA-seq data from CRC primary tumor samples, acquired from The Cancer Genome Atlas (TCGA), we identified co-expression gene networks significantly correlated with CMS1 CRC progression. CXCL13, CXCR5, IL10, PIK3R5, PIK3AP1, CCL19, and other co-expressed genes were identified to be positively correlated with CMS1. The co-expressed eigengene networks for CMS1 were significantly and positively correlated with the TNF, WNT, and ERK1 and ERK2 signaling pathways, which together promote cell proliferation and survival. This network was also aligned with biological characteristics of CMS1 CRC, being positively correlated to right-sided tumors, microsatellite instability, chemokine-mediated signaling pathways, and immune responses. CMS1 also differentially expressed genes involved in PI3K-Akt signaling. Our findings reveal CRC gene networks related to oncogenic signaling cascades, cell activation, and positive regulation of immune responses distinguishing CMS1 from other CRC subtypes.

Multivariate transcriptome analysis identifies networks and key drivers of chronic lymphocytic leukemia relapse risk and patient survival

Background

Chronic lymphocytic leukemia (CLL) is an indolent heme malignancy characterized by the accumulation of CD5⁺ CD19⁺ B cells and episodes of relapse. The biological signaling that influence episodes of relapse in CLL are not fully described. Here, we identify gene networks associated with CLL relapse and survival risk.

Methods

Networks were investigated by using a novel weighted gene network co-expression analysis method and examining overrepresentation of upstream regulators and signaling pathways within co-expressed transcriptome modules across clinically annotated transcriptomes from CLL patients (N = 203). Gene Ontology analysis was used to identify biological functions overrepresented in each module. Differential Expression of modules and individual genes was assessed using an ANOVA (Binet Stage A and B relapsed patients) or T-test (SF3B1 mutations). The clinical relevance of biomarker candidates was evaluated using log-rank Kaplan Meier (survival and relapse interval) and ROC tests.

Results

Eight distinct modules (M2, M3, M4, M7, M9, M10, M11, M13) were significantly correlated with relapse and differentially expressed between relapsed and non-relapsed Binet Stage A CLL patients. The biological functions of modules positively correlated with relapse were carbohydrate and mRNA metabolism, whereas negatively correlated modules to relapse were protein translation associated. Additionally, M1, M3, M7, and M13 modules negatively correlated with overall survival. CLL biomarkers BTK, BCL2, and TP53 were co-expressed, while unmutated IGHV biomarker ZAP70 and cell survival-associated NOTCH1 were co-expressed in modules positively correlated with relapse and negatively correlated with survival days.

Conclusions

This study provides novel insights into CLL relapse biology and pathways associated with known and novel biomarkers for relapse and overall survival. The modules associated with relapse and overall survival represented both known and novel pathways associated with CLL pathogenesis and can be a resource for the CLL research community. The hub genes of these modules, e.g., ARHGAP27P2, C1S, CASC2, CLEC3B, CRY1, CXCR5, FUT5, MID1IP1, and URAHP, can be studied further as new therapeutic targets or clinical markers to predict CLL patient outcomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12920-021-01012-y.

Selective Targeting of the Hedgehog Signaling Pathway by PBM Nanoparticles in Docetaxel-Resistant Prostate Cancer

An abnormality in hedgehog (Hh) signaling has been implicated in the progression of prostate cancer (PCa) to a more aggressive and therapy-resistant disease. Our assessments of human PCa tissues have shown an overexpression of the Hh pathway molecules, glioma-associated oncogene homolog 1 (GLI-1), and sonic hedgehog (SHH). The effect of the natural compound thymoquinone (TQ) in controlling the expression of Hh signaling molecules in PCa was investigated in this study. We generated planetary ball-milled nanoparticles (PBM-NPs) made with a natural polysaccharide, containing TQ, and coated with an RNA aptamer, A10, which binds to prostate-specific membrane antigen (PSMA). We prepared docetaxel-resistant C4-2B-R and LNCaP-R cells with a high expression of Hh, showing the integration of drug resistance and Hh signaling. Compared to free TQ, A10-TQ-PBM-NPs were more effective in controlling the Hh pathway. Our findings reveal an effective treatment strategy to inhibit the Hh signaling pathway, thereby suppressing PCa progression.

Abstract 4388: Weighted gene co-expression network analysis identified cell cycle signaling pathway associated hub genes correlated with progression and prognosis of multiple myeloma

There is a gap in understanding the molecular mechanisms behind early relapse / multiple myeloma (MM) progression in the newly diagnosed patient on standard treatment for MM, i.e., lenalidomide, bortezomib, and dexamethasone (RVD). As a result, the relatively high percentage of patients that progress after early treatment with RVD is significant. Therefore, identification of clinically relevant clusters of co-expressed genes or representative biomarkers for MM progression, while on RVD, would help identify new molecular mechanisms and drug targets. The objective of this study is to use weighted gene co-expression network analysis (WGCNA) to identify gene-signaling networks associated with early relapse / MM progression. To this end, we performed a WGCNA to determine module-trait correlations. We next examined the overrepresentation of upstream regulators and signal pathway networks from MM patients in the MMRF CoMMpass dataset (n = 175, gene transcripts= 30,598). WGCNA constructed 48 modules based on the correlations between patients on RVD and death. We are using death as a biomarker for MM progression and two years as cut off for treatment. We identified two modules, Green (p < 4.6 x 10-8), and Pale Turquoise (p < 8.8 x 10-7), that significantly and positively correlated with overall survival of < 2 years following initial treatment with RVD. Further analysis identified HDAC8, PARPBP, HSPG2, MAGE, KIF, and FOXM1 as the top six hub genes having tight variations in positive correlations. The signatures for these cell cycle signaling pathway related hub genes were found to be largely associated with the biological process for proliferation. Future studies will use connectivity mapping to identify drug signatures that can target any of the identified hub genes. The selective targeting of these hub genes is expected to improve response to RVD in MM patients. This transcriptome study is the first using this approach to identify gene signaling networks associated with MM progression.

Citation Format: Olayinka O. Adebayo, Tiara Griffen, Corey Young, Eric Dammer, James W. Lillard. Weighted gene co-expression network analysis identified cell cycle signaling pathway associated hub genes correlated with progression and prognosis of multiple myeloma [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 4388.

Abstract C113: Antibody microarray analysis of signaling networks regulated by the CCR9/CCL25 axis in African American and Caucasian American triple-negative breast cancer

Therapeutic outcome of breast cancer (BrCa) is impeded due to the intratumoral heterogeneity, as well as differences among cancer-bearing individuals. Triple-negative breast cancer (TNBC) is a highly aggressive subtype that disproportionally affects African-American (AA) women. However, the molecular basis of racial disparity in therapeutic response and clinical outcome of TNBC in AA compared to Caucasian American (CA) patients is still obscure. Our group was the first to show the involvement of CCR9 and its natural ligand, CCL25 in cancer progression and therapeutic response, including BrCa. In this study, using proteomic and bioinformatics approach we have quantified the race-specific differences in biologic pathways modulated by the CCR9/CCL25 in TNBC cells. The difference in signaling cascades following CCR9 activation by CCL25 in BrCa cell derived from AA and CA were determined using cancer signaling phospho-protein antibody microarray, which featured 269 antibodies. A heat map was generated to visualize differences in phosphorylation status among cell line derived from AA and CA patients, as well as differences between the cell lines after CCL25 treatment. Graphics of biologic functions and oncogenic signaling networks, which were altered by CCR9/CCL25 axis, were produced using GeneMANIA and Ingenuity Pathway Analysis (IPA) software. Cells derived from AA (MDA-MB-468), show activation/phosphorylation of GSK3α, Elk-1, p70S6K, BCL-2, MEK2, NFkB and STAT3 involved in cell survival and migration. However, cells derived from CA (MDA-MB-231) show activation/phosphorylation of VEGFR2, CTNNB1, FAK, and SHC, suggesting involvement of distinct pathway supporting cell survival following CCR9 activation. Hence, our data suggest that CCR9/CCL25 contributes to the race-specific difference in signaling pathways and these race-specific differences in the biology of TNBC could be the reasons for the disparity in disease and therapeutic outcome.

Citation Format: Jeronay King Thomas, Neeraj Kapur, Hina Mir, Dominique N. Gales, James W. Lillard Jr., Shailesh Singh. Antibody microarray analysis of signaling networks regulated by the CCR9/CCL25 axis in African American and Caucasian American triple-negative breast cancer [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr C113.

WGCNA identification of CXCL13 and associated genes involved in the Tumor Immune Microenvironment (TIME) of lung adenocarcinoma

Lung cancer is the second most commonly diagnosed cancer, causing the most cancer-related deaths in the United States. Non-small cell lung cancer (NSCLC) accounts for over 75% of lung cancer cases of which lung adenocarcinoma (LUAD) is the most common. Chemokines and their receptors have been shown to be highly expressed in a number of cancers, presumably leading to abnormal signaling. Elevated levels of CXCL13, and its receptor, CXCR5, have been correlated with the overall features of mortality, but the exact mechanisms in which these factors act to promote NSCLC progression are not fully understood. Here, we studied the role of CXCL13, CXCR5, and associated genes expressed in NSCLC tumor immune microenvironment (TIME). The software package WGCNA was used to establish clusters of highly correlated genes related to clinical characteristics. A total of 23,329 transcripts were used to identify 37 modules (gene co-expression networks). The light-cyan module, consisting of 491 genes contained both CXCR5 and CXCL13. The light-cyan module is a hub gene heavy module with the top 300 transcripts exceeding our hub gene threshold (kMe > 0.6). The light-cyan module transcripts where negatively correlated with age. The top biological processes associated with the light-cyan module include immune system processes, regulation of lymphocyte activation, regulation of immune response and cellular defense response. Collectively, the gene clusters identified along with their clinical correlates provide a novel insight into the complex biology of NSCLC and its TIME.

Multivariate Gene Expression Analysis Identifies Novel Signatures and Therapeutic Targets for CLL Relapse

Chronic Lymphocytic Leukemia (CLL) is a hematological malignancy of immature B cells that is characterized by episodes of relapse. CLL relapse is supported by pro-survival factors, such as chemokines, secreted CLL cells of the CLL microenvironment. The CXCL13-CXCR5 axis has been previously shown to contribute to the progression of several malignancies and possibly CLL relapse. CXCR5 is highly expressed by CLL cells and CXCL13 serum levels were found to be significantly higher in CLL patients versus healthy donors. There is a gap in the understanding of the molecular mechanisms following CXCL13-CXCR5 interactions during CLL. The presence of CXCR5, CXCL13, and associated genes were investigated by using a novel weighted gene co-expression network analysis (WGCNA) method as well as examining overrepresentation of upstream regulators and biological functions found in the transcriptomes (24,658 genes) of CLL patients (n = 203). The WGCNA-designated yellow (p = 0.003), brown (p = 0.05), purple (p < 0.001), black (p = 0.006), and salmon (p = 0.001) modules were significantly correlated with relapse. The fourth-largest, yellow co-expression module contained CXCR5 and 1,315 other genes. The biological processes associated with this module included lipid metabolism, protein catabolism, positive regulation of cell cycle arrest, and cell cycle checkpoint signal transduction. Systems pharmacology analysis revealed drugs targeting ATPases, proteasomes, and microtubules, could disrupt CLL relapse signatures, found in the yellow module. Taken together, the relapse associated gene networks have provided new insights on the complex biology of CLL and identified new targets for the treatment CLL relpase.

CX3CR1/CX3CL1 axis in breast cancer pathology and its therapeutic use

Recent reports from the breast cancer (BrCa) suggests that >90% of patients diagnosed at an early stage are successfully treated with surgery, chemotherapy, and radiation or combination. However, chemoresistance, recurrence and metastasis have been noticed in advanced BrCa patients and still remains a challenge. Chemokine receptor-ligand interaction has been noticed to play a significant role in homing to cancer cells to distant sites. Fractalkine (CX3CL1), a structurally distinct chemokine, and its receptor (CX3CR1), are expressed in majority of the cancer including BrCa. Thus, therapeutic strategies that inhibit tumor immune microenvironment of BrCa cells can improve the quality life of patients. In this study, we analyzed the expression and role of the CX3CR1/CX3CL1 axis interface in the progression and invasiveness of BrCa. In vitro investigation of BrCa cell lines MCF-7 and MDA-MB-231 showed higher expression of CX3CR1 analyzed through flow cytometry, RT-PCR, western blot, and immunofluorescence techniques. This was corroborated by our clinical tissue microarray results that showed significantly (p < 0.001) higher expression of CX3CR1 and CX3CL1 in cancerous tissues compared to normal tissues. Furthermore, treatment of BrCa cells with small molecule antagonist JMS-17-2 abrogated the proliferation and metastasis of cancer cells delineating the role CX3CR1-CX3CL1 chemotaxis mediated metastasis of BrCa. This data demonstrates, both biological and clinical significance of CX3CR1 and CX3CL1 expression that may contribute to BrCa metastasis. Inhibition of CX3CR1/CX3CL1 interaction thus could be a promising avenue for researchers to target or treat BrCa.

CXCL13-CXCR5 signaling and its co-expression network are associated with colorectal cancer cell growth and poor prognosis

The heterogeneity of colorectal cancer (CRC) and its microenvironment has molecular traits of immune cells, and is driven by dysregulated WNT, RAS-RAF-MAPK, TGF-β, and PI3K-AKT pathways. CXCL13-CXCR5 signaling has been shown to induce PI3K- and Ras-dependent activation of MAPK/ERK1-2 to promote cancer cell survival, invasion, and growth. The hypothesis tested in this study is CXCL13-CXCR5 signaling and co-expression networks mediate CRC progression, cell growth, and survival. RNAseq data from CRC cases, along with matched controls, were acquired from The Cancer Genome Atlas (TCGA). Weighted gene co-expression network analysis (WGCNA) elucidated gene networks that significantly correlated with CRC poor prognosis. CXCL13, CXCR5, and other co-expressed genes were identified in the WGCNA designated brown module (M3). The canonical pathways and their upstream regulators of this module were analyzed using Ingenuity Pathway Analysis (IPA). M3 hub genes XCL1, CCL19, PIK3AP1, FLT3, and WNT1 were significantly and positively correlated with PI3K, WNT, ERK1 and ERK2 activation, which promotes cell proliferation and survival. Next, we measured the CRC cell line growth effected by CXCL13 using a XTT assay. In confirmation, CXCL13 treatment of CRC cell lines significantly increased CRC cell line proliferation, but had no direct influence on cell survival. Our findings strongly support CXCL13-CXCR5 signaling and its co-expression networks activates important pathways associated with CRC progression and tumor growth.

Co-expression network analysis identified cell cycle signaling hub genes associated with progression and prognosis of multiple myeloma

There is a gap in understanding the molecular mechanisms behind early multiple myeloma (MM) progression in the newly diagnosed patient on standard treatment, i.e., lenalidomide, bortezomib, and dexamethasone (RVD). As a result, the relatively high percentage of patients that progress after early treatment with RVD is significant. Therefore, identification of clinically relevant clusters of co-expressed genes or related biomarkers for MM progression, while on RVD, would help identify new molecular mechanisms and drug targets. The objective of this study is to use weighted gene co-expression network analysis (WGCNA) to identify gene-signaling networks associated with early MM progression. Therefore, we performed a novel WGCNA to determine module-trait correlations. We next examined the overrepresentation of upregulators and signal pathway networks from MM patients in the MMRF CoMMpass dataset (n = 175). WGCNA constructed 45 modules based on the correlations between patients on RVD and death using 30,598 gene transcripts. We are using death as a biomarker for MM progression and two years as cut off for treatment. One of the highest modules identified; Pink module has HDAC8, HSPG2, LILRB4, CDC and FOXM1 genes and other 595 genes that are co-expressed together, that are significantly and positively correlated (p < 3.6 × 10-8, R2 =0.38) with overall survival of < 2 years following initial treatment with RVD. These genes are associated with cell cycle signaling, and Jak-Stat signaling pathways and their biological process is largely significant for proliferation and tumorigenesis. In future, connectivity mapping will be used to identify drug signatures that can target any of the hub genes. This study is expected to improve MM’s relapse.

Role of natural compounds in preventing and treating breast cancer

Breast cancer (BrCa) is the most commonly diagnosed cancer and the second leading cause of cancer-related death in women. Alarming increases in the cases quests for more effective treatment of BrCa. As most chemotherapeutic drugs are associated with drug resistance, cancer relapse, and side effects, scientists are turning to agents with more efficacy, such as natural compounds for treatment and prevention of BrCa. Selected natural compounds, substances derived from living organisms, promote apoptosis and inhibit metastasis, preventing cancer growth. As a result, these compounds have the potential to suppress BrCa progression, thus increasing patient survival rates and decreasing the number of BrCa-related deaths. In this review, we summarize natural compounds that have displayed, anti-cancer effects on BrCa cells in various studies. These natural compounds inhibit the development of BrCa, suppress the growth of cancer cells, and promote cell death. We conclude that natural compounds are efficient, effective and promising agents for treating BrCa other than therapeutic methods.

Transcriptome Network Analysis Identifies CXCL13-CXCR5 Signaling Modules in the Prostate Tumor Immune Microenvironment

The tumor immune microenvironment (TIME) consists of multiple cell types that contribute to the heterogeneity and complexity of prostate cancer (PCa). In this study, we sought to understand the gene-expression signature of patients with primary prostate tumors by investigating the co-expression profiles of patient samples and their corresponding clinical outcomes, in particular “disease-free months” and “disease reoccurrence”. We tested the hypothesis that the CXCL13-CXCR5 axis is co-expressed with factors supporting TIME and PCa progression. Gene expression counts, with clinical attributes from PCa patients, were acquired from TCGA. Profiles of PCa patients were used to identify key drivers that influence or regulate CXCL13-CXCR5 signaling. Weighted gene co-expression network analysis (WGCNA) was applied to identify co-expression patterns among CXCL13-CXCR5, associated genes, and key genetic drivers within the CXCL13-CXCR5 signaling pathway. The processing of downloaded data files began with quality checks using NOISeq, followed by WGCNA. Our results confirmed the quality of the TCGA transcriptome data, identified 12 co-expression networks, and demonstrated that CXCL13, CXCR5 and associated genes are members of signaling networks (modules) associated with G protein coupled receptor (GPCR) responsiveness, invasion/migration, immune checkpoint, and innate immunity. We also identified top canonical pathways and upstream regulators associated with CXCL13-CXCR5 expression and function.

Abstract 1975: Multivariate exome analysis identifies CXCR5-CXCL13 signaling as a key driver in early breast cancer development and prognosis

Breast cancer (BrCa) is the most frequently diagnosed cancer and the second leading cause of cancer-related death among women worldwide despite new developments in prevention and treatment. More recently, rapid increases in BrCa incidence have been reported in countries of the Asia-Pacific region. Age of diagnosis in Asian BrCa patients is much younger than age of diagnosis in western countries, such as the United States, and Asian early BrCa patients tend to be pre-menopausal, whereas only 15-30% of western BrCas are pre-menopausal. The mechanisms responsible for early BrCa remain unknown. Furthermore, it remains controversial whether early breast cancer has unique tumor biology. The goal of this study was to characterize the molecular phenotype of early BrCa in the context of CXCL13, CXCR5 and associated gene expression. We hypothesized that CXCR5-CXCL13 signaling contributes to the aggressive phenotype of early BrCa. A bioinformatic approach was used to aid in characterizing this condition. Our patient cohort data (50 females of Korean descent, age ≤ 35 years) was obtained from The International Cancer Genome Consortium (ICGC). DESeq analysis was used to identify genes differentially expressed among normal tissue and primary tumor groups. Weighted Gene Network Co-expression (WGCNA) analysis was carried-out to identify gene networks associated with factors influencing BrCa prognosis. Finally, canonical pathway, upstream regulator, and gene interaction analysis was conducted using Ingenuity Pathway Analysis. Our data show CXCL13, CXCR5, and associated genes (LTA, LTB, IL10, IL27RA, TNFRSF13B, TNFRSF17, and TNFRSF9), which have been previously shown to drive tertiary lymphoid structure (TLS) formation, were significantly associated with the molecular phenotype of early BrCa in our patient cohort. Taken together, our findings suggest TLSs contribute to the tumor immune microenvironment and contribute to early BrCa progression.

Citation Format: Courtney D. Dill, Tiara Griffen, Corey Young, Kaylin Carey, James W. Lillard. Multivariate exome analysis identifies CXCR5-CXCL13 signaling as a key driver in early breast cancer development and prognosis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 1975.

Abstract LB-132: The role of CXCL13, its sole receptor CXCR5, and associated genes in multiple myeloma progression

Multiple myeloma (MM) is characterized by the neoplastic proliferation of plasma cells producing monoclonal immunoglobulin in blood, bone marrow, and urine. In 2018, it was estimated that approximately 30,770 new cases would be diagnosed (16,400 in men and 14,370 in women) and about 12,770 deaths were expected to occur (6,830 in men and 5,940 in women). MM is a heterogenous disease; thus, characterizing their molecular phenotypes, plays a significant role in prognosis and effective treatment of MM and relapse cases. Certain chemokine and it sole receptor (CXCL13 and CXCR5) has been shown to contribute to the progression and metastasis of several types of cancers. CXCL13 and CXCR5 are expressed by cells in the microenvironment of bone marrow and function in malignancy cell homing, adhesion, signal transduction, and calcium flux, all of which promote MM progression. To identify the potential function of relevant somatic mutations and gene expression in MM causing clonal evolution and lethality, we analyzed RNA-sequence data from matched normal, primary and relapsed MM cases. Patient control mRNA samples, matched primary tumor and relapse samples were acquired from dbGap (database of Genotypes and Phenotypes) to evaluate the mRNA expression of CXCL13-CXCR5 and associated genes in MM progression. A bioinformatics strategy was used to integrate published genomic data from these MM patients (n=240) and teased out genes associated with CXCL13-CXCR5 signaling. DESeq analysis was used to determine differentially expressed genes between normal tissues, primary tumor and relapse groups. Our preliminary analysis done with Weighted Gene Co-expression Network Analysis (WGCNA) identified clusters of genes; transcription factors (NF-κB and JUN) known to be induced by the CXCL13-CXCR5 axis, and plasma cell signaling pathways. Moreover, Ingenuity pathway analysis (IPA) was performed to analyze upstream regulators, gene interaction networks and canonical pathways, which identified biological processes associated with the differentially expressed genes. We suggested that, the doubling effect of the activation of transcription factors (NF-κB and JUN) by plasma cell signaling and CXCR5-CXCL13 signaling are most likely responsible for the pathogenesis and plasma clonality of MM. This study provided a better understanding of the heterogeneous nature of MM and the role of the CXCL13-CXCR5 axis plays in MM. Therefore, CXCL13-CXCR5 and associated genes serves as a potential clinical application and a new therapeutic target for MM.

Note: This abstract was not presented at the meeting.

Citation Format: Olayinka O. Adebayo, Tiara Griffin, Corey Young, Courtney D. Dill, Sha'Kayla Nunez, Kaylin Carey, James W. Lillard. The role of CXCL13, its sole receptor CXCR5, and associated genes in multiple myeloma progression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-132.

Abstract 4412: Piperine enhances the efficacy of 5 FU against liver cancer

Liver cancer is one of the most devastating malignancies. Hepatocellular carcinoma (HCC) accounts for >90% of primary liver malignancies and is the third-leading cause of cancer-related deaths worldwide. Systemic chemotherapy is one of the most important treatment modalities for advanced HCC. Unfortunately, long-term treatment acquired resistance in HCC due to the activation of drug efflux pumps. A natural compound in combination with chemotherapeutic drugs is a potential approach to combat the side effects. In this study, we have demonstrated whether piperine (natural compound) could increase the effect of 5-FU in HCC cells. The cell viability (MTT) assay was performed to determine the optimal IC50 values of Piperine, 5-FU alone and in combination. Immunofluorescence study confirmed the effectiveness of combined drug; dead nuclei were found more within the cells treated by the combination compared to piperine or 5-FU alone. The combined drug treatment was most effective in inhibiting proliferation and inducing apoptosis; accordingly, it showed noticeable increases in pro-apoptotic (BAK, BID), PARP and decreases in anti-apoptotic genes (BCL-XL) gene in a western blot and RT-PCR analysis. Further, in SK-HEP-1 cells, the combination upregulated the expression of cell cycle inhibitors (p21WAF1/CIP1, p27KIP), which, in turn, inhibited the expression of CDK2/ Cyclin D1 complex. Therefore, it blocks the transition of cells into G0/G1 to S phase. Taken together, we observed that the combination of 5-FU and Piperine resulted in a significant cytotoxicity and apoptosis as compared to alone. Our results suggest that piperine can be a potential agent in enhancing the efficacy of 5-FU in liver cancer treatment. These finding highlights the promising role of natural bioactive compounds and provides the rationale for further transitional researches.

Citation Format: David Anwanwan, Santosh Kumar Singh, James W. Lillard, Manoj K. Mishra, Rajesh Singh. Piperine enhances the efficacy of 5 FU against liver cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 4412.

Multivariate Transcriptome Analysis of CXCR5-CXCL13 signaling in Unmutated and Mutated CLL

Chronic Lymphocytic Leukemia (CLL) is characterized by the appearance of mature-appearing B cells in the blood, bone marrow, and lymph nodes, but the molecular pathogenesis of CLL is incompletely known. Chemokines and their receptors contribute to the progression of several malignancies. CXCR5 and CXCL13 are produced by cells in the CLL microenvironments, which promote disease progression. There is a gap in understanding the molecular mechanisms involved in CXCL13-CXCR5 interactions during CLL. Together, this provided the rationale to test the hypothesis CXCR5-CXCL13 signaling contributes to the growth, metastasis, and survival of CLL. The role of CXCR5, CXCL13, and associated genes was investigated by conducting Weighted Gene Network Co-expression (WGCNA) and upstream regulator, canonical pathway, and gene interaction analyses of International Cancer Genome Consortium (ICGC) transcriptomes with quantitative and qualitative clinical traits identified in CLL patients (n=203). The WGCNA-designated blue module, co-expression network, contained CXCL13 and 2088 other genes, which significantly correlated (R2=0.31, p= 3e–05) with IGHV-unmutated CLL status. This network included CXCL13-CXCR5 driven genes, e.g., SYK, ATM, JAK1, STAT1, LTB, LTB4R, MAPK, PLC, PIK3, and WNT genes, which mediate survival, stemness, and metastasis of CLL. CXCR5 was found in the WCGNA grey module, which included other CLL-driver genes, e.g., IGHV, MYC, and ZAP-70. This module was significantly associated with stage A, relapse, and IGHV-mutatedCLL cases. Among the top canonical pathways of the grey module were BCR- and PIK3/Akt-signaling. Taken together, our data suggest clinical significance of the CXCL13-CXCR5 pathway in CLL progression.

Clinicopathological and Prognostic Significance of CCR5/CCL5 axis in Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is one of the world’s most devastating malignancy which accounts for more than 90% liver cancer. The poor diagnosis of HCC lead’s scientists to search for novel treatment options to improve patient survival rates. There is accumulating evidence that chemokines and chemokine receptors (CCRs) contribute to tumor development and progression, as well as metastasis. Chemokine CCL5 (RANTES) has been reported to facilitate tumor progression and metastasis in various cancers, including liver cancer. However, the function of CCR5/CCL5 interaction in HCC proliferation and migration is poorly understood. Hence, the present study was undertaken to investigate the expression and role of the CCR5/CCL5 axis interface in the progression and invasiveness of HCC. In vitro study of liver cancer cell lines SNU387, PLC/PRF 5, and SK-HEP-1 showed higher expression of CCR5. Flow cytometry, RT-PCR, western blot, immunofluorescence techniques were used to quantify the expression of chemokine CCR5 and CCL5 in liver cancer cells. To determine the clinical significance of CCR5 expressed by HCC cell lines, a microarray of liver cancer tissues stained for CCR5 and CCL5 were analyzed. Our results show significantly (p< 0.001) higher expression of CCR5 and CCL5 in cancerous tissues compared to normal liver tissues. Furthermore, in order to delineate the role of CCR5/CCL5 interaction in HCC cell proliferation and migration, we pre-treated the HCC cell lines with the Maraviroc (CCR5 antagonist) in presence of CCL5. This data demonstrates both biological and clinical significance of CCR5 and CCL5 expression that may contribute to HCC metastasis, thus inhibition of its axis could be a promising avenue to treat liver cancer.

Multivariate analysis of genes expressed in the colorectal tumor immune microenvironment driven by CXCL13

Colorectal cancer (CRC) is a heterogenous disease having numerous molecular phenotypes. Key tumor progression markers such as microsatellite instability, BRAF, and KRAS mutation status have been widely studied. Less is known regarding the influence of chemokines and chemokine receptors in CRC. CXCL13 and CXCR5 have been shown to be associated with poor prognosis of advanced CRC. The central hypothesis tested in this study was CXCR5-CXCL13 signaling mediates gene expressions associated with CRC progression. RNAseq patient control and matched primary tumor samples were acquired from The Cancer Genome Atlas (TCGA). DESeq analysis identified differentially expressed genes between normal tissue and primary tumor groups. Weighted Gene Co-expression Network Analysis (WGCNA) elucidated gene networks that correlated with factors influencing CRC prognosis. Canonical pathway, upstream regulator, and protein-protein interaction analyses were performed using Ingenuity Pathway Analysis (IPA). CXCL13 was identified in the WGCNA-designated green module, which also contained XCL1, TNFRSF17, FCRN1, CCL19, IL-17A and IFNG. These genes are associated with immunoregulatory signals found in lymphoid and non-lymphoid cells, BCR-signaling and poor prognosis of CRC. Genes associated with energy metabolism, apoptosis, hypoxia and angiogenesis, including GNG4, PRKCG, WNT11, and KNG1, were found in the WCGNA-designated yellow module. These factors are involved in Wnt/CTNNNB1 and PI3K/AKT signaling, which have previously shown to be driven by CXCR5-CXCL13 interactions. Taken together, our data suggest a role of the CXCL13-CXCR5 axis in shaping the tumor immune microenvironment of CRC.

Weighted Gene Co-expression Network Analysis of CXCL13, CXCR5, and associated genes in multiple myeloma

Multiple myeloma (MM) is characterized by the neoplastic proliferation of plasma cells. In 2018, there were approximately 30,770 new cases diagnosed and about 12,770 dead. Characterizing its molecular phenotypes is important for effective treatment of MM and predicting relapse. CXCL13-CXCR5 interactions are involved in malignancy cell homing, adhesion, signal transduction, and calcium flux, all of which promote MM progression. Here, we analyzed RNA-sequence data from matched normal, primary and relapsed MM cases. Patient control mRNA samples matched primary tumor and relapse samples were acquired from the database of Genotypes and Phenotypes to evaluate the mRNA expression patterns of CXCL13, CXCR5 and associated genes in MM. Bioinformatics tools were to integrate published genomic data from MM patients (n=480) and identify genes associated with CXCL13-CXCR5 signaling. DESeq analysis was used to determine differentially expressed genes between normal tissues, primary tumor, and relapse groups. Weighted gene co-expression network analysis identified clusters of genes significantly associated with the molecular phenotypes of MM. Notably, gene expression is driven by NFAT and JUN, known to be activated by the CXCL13-CXCR5 axis, and plasma cell signaling pathways significantly correlated with select MM molecular phenotypes and patient survival. Ingenuity pathway analysis was performed to analyze upstream regulators, gene interaction and canonical pathways. Taken together, our data show CXCR5-CXCL13 signaling networks are significantly expressed and associated with MM pathogenesis and plasma clonality. This study provides a better understanding of the heterogeneous nature of MM and the role of CXCL13-CXCR5 axis in MM.

Weighted Gene Correlation Network Analysis of Ovarian Cancer Driven by CXCL13- CXCR5 Interactions

Ovarian Cancer (OvCa) is a disease that affects postmenopausal women, with high-grade serous ovarian carcinoma being the most common and lethal type. Many patients are asymptomatic in the early stages of OvCa, thus going undetected, leading to higher patient mortality rates. Identifying biomarkers involved in ovarian cancer progression could enhance current therapeutic outcomes. Our laboratory was the first to show that CXCL13- CXCR5 signaling mediates prostate, breast and lung cancer cell growth, migration, invasion, and survival. We provided evidence that these chemokines are highly elevated in OvCa cell lines and clinical samples. These previous findings provided the rationale to support the hypothesis CXCL13-CXCR5 signaling promotes OvCa progression, metastasis and survival. In this study, we analyzed transcriptome data to determine possible molecular mechanisms and CXCL13-CXCR5 signaling pathways controlling OvCa progression. Weighted Gene Network Co-expression (WGCNA) analysis and Ingenuity Pathway Analysis were used to identify gene coexpression networks correlated with aggressive OvCa clinical phenotypes. CXCR5 was found to be co-expressed with several genes such as RB1, PIK3C3, GNAI1, LTB TNFRSF11B which are known to facilitate OvCa progression and tertiary lymphoid structure formation. Upon further analysis, we found that these gene expressions closely correlated with age at diagnosis and patient relapse. Our study suggests an important role of CXCL13-CXCR5 signaling and reveals an important set of co-expressed epigengenes involved in OvCa relapse.

Prostate cancer cells hyper-activate CXCR6 signaling by cleaving CXCL16 to overcome effect of docetaxel

Molecular reprogramming in response to chemotherapeutics leads to poor therapeutic outcomes for prostate cancer (PCa). In this study, we demonstrated that CXCR6-CXCL16 axis promotes DTX resistance and acts as a counter-defense mechanism. After CXCR6 activation, cell death in response to DTX was inhibited, and blocking of CXCR6 potentiated DTX cytotoxicity. Moreover, in response to DTX, PCa cells expressed higher CXCR6, CXCL16, and ADAM-10. Furthermore, ADAM-10-mediated release of CXCL16 hyper-activated CXCR6 signaling in response to DTX. Activation of CXCR6 resulted in increased GSK-3β, NF-κB, ERK1/2 phosphorylation, and survivin expression, which reduce DTX response. Finally, treatment of PCa cells with anti-CXCR6 monoclonal antibody synergistically or additively induced cell death with ∼1.5-4.5 fold reduction in the effective concentration of DTX. In sum, our data imply that co-targeting of CXCR6 would lead to therapeutic enhancement of DTX, leading to better clinical outcomes for PCa patients.

Higher CXCL16 exodomain is associated with aggressive ovarian cancer and promotes the disease by CXCR6 activation and MMP modulation

Ovarian cancer (OvCa) is the leading cause of death from gynecological malignancies. Five-year survival rate of OvCa ranges from 30–92%, depending on the spread of disease at diagnosis. Role of chemokines is well appreciated in cancer, including OvCa. However, their precise role is understudied. Here, we show clinical and biological significance of CXCR6-CXCL16 and ADAM10 in OvCa. Expression of CXCR6 and N-terminal CXCL16 was significantly higher in serous carcinoma tissues compared to endometrioid. OvCa cells (SKOV-3 and OVCAR-3) also showed higher expression of CXCR6 than normal ovarian epithelial cells (IOSE-7576) while CXCL16 was higher in SKOV-3 than IOSE-7576. Furthermore, N-terminal CXCL16 was higher in conditioned media of OvCa cells than IOSE-7576. Compared to OVCAR-3, SKOV-3 cells, which had higher CXCL16, expressed significantly higher transcripts of ADAM10, a protease that cleaves CXCL16. OVCAR-3 cells showed higher CXCR6 specific migration whereas SKOV-3 cells showed more invasion. Difference in invasive potential of these cells was due to modulation of different MMPs after CXCL16 stimulation. Higher CXCR6 expression in serous papillary carcinoma tissues suggests its association with aggressive OvCa. Increased migration-invasion towards CXCL16 implies its role in metastatic spread. Therefore, CXCR6-CXCL16 axis could be used to differentiate between aggressive versus non-aggressive disease and as a target for better prognosis.

Abstract A42: Identifying relationships between high expression levels of the HSPA9 gene, putative HSPA9 alterations, and patient survivability in invasive breast carcinomas

Metastasis is the primary cause for the lethality of breast cancer, and is responsible for approximately 90% of breast cancer-related deaths. Tumor cell resistance to cancer treatment continues to stymie efforts to effectively treat breast cancer, which we know to be primarily mediated by a highly conserved molecular chaperone in the heat shock protein 70 family known as mortalin. Mortalin is encoded by the gene HSPA9B localized on chromosome 5q31.1.1, and is low or undetectable in normal unstressed cells while highly expressed in many carcinomas. Breast cancer cell invasion and metastasis are closely related to adverse clinical outcomes and a worsened prognosis for patients. Previous studies have shown that breast cancer patients with high mortalin expression had decreased DFS and OS rates compared to those with low mortalin expression in early- or late-stage breast cancer. Conversely, low expression of mortalin decreases tumor cell progression and inhibits the epithelial-mesenchymal transition. Gene amplification is one of the major pathways by which proto-oncogenes are activated during tumorigenesis, and missense mutations in the gene of interest could potentially render a nonfunctional mortalin product. We examined three different publicly available datasets from the Genome Data Commons for possible relationships between alterations in the HSPA9 gene and BRCA patient survival rates. On a mutation-specific level, we compared the survival rates of the cases with a high frequency of HSPA9 alterations versus the cases without HSPA9 alterations. Our bioinformatics analysis of the BRCA datasets showed fourteen alterations in the HSPA9 gene that correlated to prognosis and survival rate in patients with breast cancer. Amplifications in the HSPA9 gene lead to lower survivability rates for the patient samples, while missense mutations in HSPA9 led to higher survivability rates. Also of interest, missense mutations were far more numerous than any other HSPA9 alteration type. Different alterations in the HSPA9 gene result in different mortalin protein products, ultimately leading to differences in prognosis for patients with invasive breast carcinomas. Our study supports that much of the clinically observable plasticity and heterogeneity occurs within, rather than across, the major biologic subtypes of breast cancer suggested by the variance in HSPA9 alteration types. Furthermore, the study supports that mortalin expression has a significant effect on breast cancer status and lends credence to mortalin as a survival predictor, particularly in BRCA patients.

Note: This abstract was not presented at the conference.

Citation Format: Kofi K. Khamit-Kush, James W. Lillard, Jr., Vincent C. Bond, Ming Huang, William Roth. Identifying relationships between high expression levels of the HSPA9 gene, putative HSPA9 alterations, and patient survivability in invasive breast carcinomas [abstract]. In: Proceedings of the AACR Special Conference: Advances in Breast Cancer Research; 2017 Oct 7-10; Hollywood, CA. Philadelphia (PA): AACR; Mol Cancer Res 2018;16(8_Suppl):Abstract nr A42.

Abstract 2590: Race-specific differential expression of CCL25 and CCR9 in triple-negative breast cancer

Breast cancer (BrCa) is the second leading cause of cancer-related deaths among women. Therapeutic intervention of the disease is impeded due to the heterogeneity contributed by inter- and intra-tumoral diversity, as well as difference among cancer-bearing individuals. Triple-negative breast cancer (TNBC) is a hormone-independent and highly aggressive subtype that disproportionally affects African-American (AA) women. However, the molecular basis of racial disparity in therapeutic response and clinical outcome in AA and Caucasian (CA) patients is still obscure. Our group was the first to show the involvement of CCR9 and its natural ligand, CCL25 in cancer progression and therapeutic response, including breast cancer. In this study, we have shown the association of CCR9 and CCL25 with TNBC. Both CCR9 and CCL25 are highly expressed in TNBC cells (MDA-MB-468 and MDA-MB-231) compared to other BrCa subtypes (MCF-7, MDA-MB-361, SKBr-3). Expression of this receptor-ligand pair was significantly elevated in TNBC cells derived from AA compared to those derived from CA patients. RNA-Seq based transcriptome data obtained from The Cancer Genome Atlas (TCGA) confirmed these results. Further, phospho-proteomic profiling of cancer signaling molecules showed race specific hyper-activation of GSK-3α, GSK-3β and NF-κB in AA derived cells. These molecules are known to provide the survival advantage to cancer cells. These findings, therefore, highlight significance of CCR9 and its association with the disparity in observed in TNBC. Hence, CCR9 targeted approach to address the disparity in the therapeutic outcome of TNBC seems to be promising.

Citation Format: Jeronay King, Neeraj Kapur, Hina Mir, Dominique N. Gales, James W. Lillard, Shailesh Singh. Race-specific differential expression of CCL25 and CCR9 in triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 2590.

Abstract B50: The role of CXCL13-CXCR5 signaling in triple-negative breast cancer progression

Triple-negative breast cancer (TNBC) is an aggressive cancer with poor prognosis and is difficult to treat. There is a major health disparity associated with TNBC; the number of fatalities associated with this disease is significantly higher in African American women compared to their Caucasian counterparts. The mechanisms behind these differences have not been entirely elucidated. There are no targeted therapies for TNBC; instead, standard therapy for this disease includes a combination of chemotherapeutic drugs: doxorubicin (DOX), paclitaxel (TAX), and/or cyclophosphamide (CTX). Even more troubling, the efficacy of standard TNBC therapies is marginal and patients eventually become resistant to this intervention. TNBC patients suffer from chemoresistance and metastasis and ultimately succumb to this disease. Understanding TNBC and its health disparity requires a better understanding of the race-specific differences in breast tumor biology, molecules leading to breast inflammation, and the mechanisms associated with TNBC chemoresistance. Chemokines and their receptors play a significant role in TNBC. Our laboratory was the first to show that CXCL13-CXCR5 signaling mediates prostate cancer cell growth, migration, invasion, and survival (1-3). We also demonstrated that CXCL13-CXCR5 signaling induces cancer progression signaling pathways PI3K, AKT, ERK, and Jun (1;4). These preliminary and published findings provide the rationale or scientific premise in support of our hypothesis that CXCL13-CXCR5 signaling promotes TNBC progression migration, invasion, proliferation, and chemoresistance. To determine whether CXCL13-CXCR5 signaling induces TNBC, the expression profile of CXCL13 and CXCR5 RNA, associated miRNAs, and cancer progression genes (epithelial mesenchymal transition [EMT] markers) will be correlated with disease-free and overall survival of TNBC patients in silico using RNA-seq datasets from the Sequence Read Archive (SRA). Fastq data set files were downloaded from SRA, checked for quality control, aligned, and normalized using open-source platforms. Hierarchical clustering, gene set enrichment analysis, disease progression analysis, and statistics were conducted using Partek Genomic Suite. Pathway enrichment analysis was conducted using Ingenuity Pathway Studios. Overall, CXCL13-CXCR5 signaling is implicated in TNBC progression, migration, and invasion.

Citation Format: Courtney D. Dill, Adaugo Okoro, Dongquan Chen, James W. Lillard, Jr.. The role of CXCL13-CXCR5 signaling in triple-negative breast cancer progression [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B50.

Abstract 5080: ADAM10 promotes breast cancer via CXCL16 constitutive cleavage and CXCR6 signaling

Despite the survival of breast cancer (BrCa) patients, there is still demand to better understand metastasis as the obvious mark for most aggressive breast cancers. Recent evidence highlighted the possible involvement of chemokines and their cognate receptors in BrCa progression and metastasis. Expression and functional role of CXCR6 and CXCL16 have been investigated in different types of cancer. ADAM10 is also known to regulate the metastatic process by the proteolytic shedding of CXCL16 creating a soluble form of CXCL16. High levels of soluble CXCL16 could support tumor progression by promoting migration and invasion of CXCR6 expressing BrCa cells. Here, we demonstrate the significance of CXCR6-CXCL16 axis in BrCa progression. In addition to increased CXCR6 expression, our tissue microarray analysis (TMA) showed increased expression of CXCL16 and ADAM10 in BrCa tissues. BrCa cell lines (MCF-7 and MBA-231) also showed higher expression of ADAM10 as compared to the normal epithelial cells (MCF-10A). Further, these BrCa cells showed increased migration and invasion towards CXCL16 gradient that is due to high expression of CXCR6 and ADAM10. Hence, our findings suggest the clinical and biological significance of ADAM10 and soluble CXCL16 in BrCa progression. We also highlight the potential of ADAM10 and soluble CXCL16 as prognostic markers and new therapeutic target for BrCa.

Citation Format: Dominique N. Gales, Hina Mir, Neeraj Kapur, James W. Lillard, Shailesh Singh. ADAM10 promotes breast cancer via CXCL16 constitutive cleavage and CXCR6 signaling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5080.

Abstract 4665: Neurotensin receptor-based targeted delivery of thymoquinone for non-small cell lung cancer

Non-small cell lung cancer (NSCLC) is a very recalcitrant cancer, accounting for 80% to 85% of all lung cancer diagnoses. About 40% of NSCLC are adenocarcinomas. Thus, there is an urgent need to identify targeted therapies, specifically for NSCLC. Although, multiple signaling molecules have now been identified within the last decade, among them Neurotensin receptor 1 (NTSR1) have afforded an improved understanding of the underlying pathology and significant heterogeneity of NSCLC. NTSR1 belongs to the G-protein coupled receptors (GPCR) superfamily that has been shown numerous oncogenic effects in tumor initiation, progression, proliferation, apoptosis, and metastasis. In the present study, we used a novel method for targeted delivery of Thymoquinone (TQ), a constituent of Nigella sativa at the desired location. We described a proprietary planetary ball milling (PBM) approach that uses a natural polysaccharide (starch; FDA approved) to create a drug-polysaccharide nanoparticle as a core that is subsequently coated with poly (ϵ-caprolactone) / poly (ethylene glycol) copolymer and conjugated with anti-NTSR1-mAb, which allows binding to high-affinity NTSR1 receptors presents on NSCLC. Our tissue microarray data show higher expression of NTSR1 in lung cancer patients, which were negligible in normal cells. These studies were further confirmed by targeting NTSR1 in lung cancer cell lines NCI-H1563, NCI-H1975 and MRC-5 using our novel anti-NTSR1 conjugated, and TQ encapsulated PBM nanoparticle and further, validated using flow cytometry, immunofluorescence, qRT-PCR and western blot techniques. Our result showed the PBM nanoparticles encapsulated with TQ rapidly internalized and depolymerized the microtubule network by inducing apoptosis. The up-regulation of pro-apoptotic (BAX, BID) and down-regulation of anti-apoptotic (BCL-2, MCL-1) makers to confirm the targeted delivery of PBM-NPs to the tumor cells. This study strongly suggests anti-NTSR1-mAb conjugated PBM-NPs has its application to drugs targeting for the treatment of NSCLC. In summary, this study combines innovative ideas with an innovative technology to create new therapeutics and a new strategy to improve the treatment of NSCLC and has the potential to create a new class of targeted treatments for advanced lung cancer.

Citation Format: Santosh Kumar Singh, James W. Lillard, Rajesh Singh. Neurotensin receptor-based targeted delivery of thymoquinone for non-small cell lung cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4665.

Abstract 1924: Role of CXCL16 and ADAM10 in ovarian cancer pathogenesis

Ovarian cancer is the leading cause of death from gynecological malignancies. The five-year survival rate of ovarian cancer ranges from 30 to 92%, depending on the severity of the disease. Our laboratory has shown the role of chemokines and chemokines receptors in cancer, including ovarian cancer. In this study, we have shown higher expression of CXCR6, which is the only receptor of chemokine CXCL16, in ovarian cancer cell lines and clinical samples. We have tested the biological significance of CXCR6 and soluble CXCL16 (sCXCL16) using ovarian cancer cell lines in vitro. We show higher migratory and invasive potential of high CXCR6 expressing ovarian cancer cell lines in the response of sCXCL16. Migratory and invasive potential in response to sCXCL16 was significantly inhibited when CXCR6 and CXCL16 interaction was blocked using anti-CXCR6 monoclonal antibody. ADAM10 basal mRNA level was higher in cells with high migratory and invasive potential. Similar to cell lines, higher expression of CXCR6 and CXCL16, as well as ADAM10, was observed in tissue, which showed a positive correlation with tumor stage. These results suggest the clinical and biological significance of CXCR6-CXCL16 axis in the pathogenesis of ovarian cancer. Therefore, therapeutics directed to the CXCR6-CXCL16 axis may provide better therapeutic outcome and overall survival.

Citation Format: Hina Mir, Neeraj Kapur, James W. Lillard, Shailesh Singh. Role of CXCL16 and ADAM10 in ovarian cancer pathogenesis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1924.

Abstract B56: Regulation of CXCR5-CXCL13 signaling in prostate cancer etiologic disparities

The prevalence of prostate cancer (PCa) has been a worldwide burden. Cancer of the prostate is the most prevalent form of cancer in men and the second leading cause of death due to cancer in men in the United States and Europe. There is a major health disparity associated with PCa; the number of fatalities associated with this disease is more significant in African-American (AA) men than in European American (EA) men. Disease progression occurs despite hormone ablation therapy, which leads to a condition called castration-resistant prostate cancer (CRPC). Further complicating the matter, CRPC is a disease that affects a variety of patients differently, which can be problematic for physicians to provide standardized treatments with similar outcomes. AAs with CRPC can experience significantly lower rates of overall survival, faster rates of tumor progression, and poor responses to chemotherapy compared to EAs with this disease.

We previously showed that CXCL13:CXCR5 axis plays a role in PCa pathobiology and is also associated with PCa aggressiveness; CXCR5 signaling mediates PCa cell growth, migration, invasion, and docetaxel resistance. To further understand the implication of CXCR5-CXCL13 in CRPC, we characterize the reason behind the health disparities seen across groups of PCa patients by evaluating the difference in regulatory molecules (miRNAs) on CXCL13-CXCR5 signaling.

We found the expression profile of CXCL13 and CXCR5 RNA to be associated with miRNAs (miR-140-3p.1, miR-24-3p, miR-200c, miR-221-3p/22-3p, miR-192-5p/215-5p, miR-214-5p). Using RNA-seq datasets from the Gene Expression Omnibus (GEO) and the Sequence Read Archive (SRA), CXCL13 and CXCR5 RNA as well as associated miRNAs (miR-140-3p.1, miR-24-3p, miR-221-3p/22-3p, miR-192-5p/215-5p, and miR-214-5p) were defined by etiologic disparities among PCa patients; this correlation is different among AA men compared to EA men.

Understanding PCa and specifically CRPC disparities requires a better understanding of the race-specific differences in prostate tumor biology, molecules leading to prostate inflammation, and the mechanisms associated with CRPC therapeutic resistance and its aggressive phenotype.

Citation Format: Adaugo Queen Ohandjo, Courtney Dill, Chen Dongquan, James W. Lillard, Jr.. Regulation of CXCR5-CXCL13 signaling in prostate cancer etiologic disparities [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr B56.

Abstract 4803: CXCR6-directed therapeutic approach potentiates efficacy of docetaxel in prostate cancer

Development of chemo-resistance negatively impacts therapeutic outcome of advanced prostate cancer (PCa). Molecular mechanism used by cancer cells to overcome therapeutic effect is still undefined. Here, we demonstrate the influence of CXCR6/CXCL16 mediated molecular signals on the efficacy of docetaxel (DTX). Out data showed poor DTX efficacy on PCa cells (LNCaP, PC3, and DU145) after stimulating CXCR6 with soluble CXCL16, while significant improvement in cytotoxic effect of DTX was observed after CXCR6 blockade using anti-CXCR6 monoclonal antibody. Interestingly, CXCR6, CXCL16, and ADAM-10, a metalloproteinase involved in CXCL16 cleavage from PCa cell membranes, were significantly elevated in response to DTX treatment. This was further confirmed on xenograft tumor by immunohistochemistry. Further, phospho-proteomic profiling and western blot analysis showed activation of pro-survival molecules: GSK-3β, NFκB, ERK/1/2, and survivin following soluble CXCL16 treatment. Activation of CXCR6-CXCL16 axis also inhibited expression of the epithelial marker (E-cadherin) while increased expression of mesenchymal markers (β-catenin, α-SMA, vimentin, snail), which highlights the role of CXCR6 in promoting mesenchymal phenotype that is known to have a significant impact on cancer progression and therapeutic outcome. Thus, our study shows that CXCR6-CXCL16 signaling instigates chemotherapeutic resistance by increasing pro-survival signaling and promoting mesenchymal phenotype. Hence, combining CXCR6 blockade with DTX would be a better treatment option for advanced, drug-resistant PCa.

Citation Format: Neeraj Kapur, Hina Mir, Guru Sonpavde, James W. Lillard, Shailesh Singh. CXCR6-directed therapeutic approach potentiates efficacy of docetaxel in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 4803.

Thymoquinone enhanced the tumoricidal activity of NK Cells against Lung Cancer

Among different immune cell populations, NK cells are an important component in unleashing the therapeutic activity of immune cells. Therefore, in order to enhance the tumoricidal activity of NK cells, identification of new small-molecule natural products is prominent. In this study, we used a natural compound Thymoquinone (TQ), a constituent of Nigella sativa to enhance the tumoricidal activity of NK cell. We expanded human NK cell (NK-92MI) population derived from human peripheral blood mononuclear cells (PBMCs). Next, expanded NK cells were co-cultured with A549, which is a non-small cell lung cancer cell lung cancer (NSCLC) cell, with or without TQ and after 24h of co-cultured, harvested supernatants were analyzed for IFN-g secretions by ELISA method. This study was further validated using flow cytometry; immunofluorescence, qRT-PCR and western blot techniques. Our result showed TQ increased IFN-γ secretion by NK cells and enhanced NK cell-mediated killing of NSCLC cells. The up-regulation of pro-apoptotic (BAX, BID) and down-regulation of anti-apoptotic (BCL-2, MCL-1) makers confirmed that TQ enhanced the NK cell tumoricidal activity, which is a simple, economic and reliable method to create a new strategy to improve the treatment of NSCLC and has the potential to create a modern class of treatments for advanced lung cancer.

Reversal of drug resistance by planetary ball milled (PBM) nanoparticle loaded with resveratrol and docetaxel in prostate cancer

The folate receptor (FR) is a valued target that is highly expressed in various cancers, which will expedite the development of ligand-receptor binding based cancer therapeutics. In the present investigation, through tissue microarray analysis, we report higher levels of folate receptor expression in prostate cancer (PCa) tissue derived from patients, which were minimal in normal tissue. For folate-receptor based targeted therapy of PCa, we generated novel planetary ball milled (PBM) nanoparticles (NPs) encapsulated with resveratrol (RES), and in combination with docetaxel (DTX) and conjugated with folic acid (FA) on the surface. The cytotoxic effect of FA-conjugated DTX-nanoparticles was found effectual that reduced the concentration of free drug (DTX) to 28 times. Flow cytometry analysis showed a significant increase in the number of apoptotic cells by 30.92% and 65.9% in the FA-conjugated RES and in combination with DTX nanoparticle formulation respectively. However, only 8.9% apoptotic cells were found with control (empty NP). The expressions of NF-kB p65, COX-2, pro (BAX, BAK) and anti-apoptotic (BCL-2, BCL-XL) genes were significantly reduced after treatment with FA-RES + DTX-NP. In addition, the FA-conjugated DTX formulation exhibited additional cytotoxic effects with the down-regulation of survivin and an increased expression of Cleaved Caspase-3 in PCa cells. Further, we observed that treating DTX resistant PCa cells with FA-RES + DTX-NP exhibited a reversal of the ABC-transporter markers thereby limiting the multidrug resistance phenotype of the cancer cells. Our results strongly suggested that FA conjugated nanoparticle drugs acted as effective inhibitors of drug efflux that effectually enhances the intracellular concentration of the drug to exhibit their cytotoxic effect.

Drug delivery approaches for breast cancer

Breast cancer is one of the most common cancers affecting women worldwide. The controlled release of drugs to the precise site of the disease using a nanocarrier vehicle increases the therapeutic efficiency of the drugs. Nanotechnology-based approaches used to endorse clinical improvement from a disease also help to understand the interaction of malignant cells with their microenvironment. Receptor-based targeting is another approach for drug delivery which is undergoing clinical trials. Nanoparticles (NPs) delivery has been proven to promise high loading capacity, less toxicity, and stability of the drugs or biomolecules compared to traditional chemotherapeutic drugs. The goal of this review is to present the current problems of breast cancer therapy and discuss the NP-based targeting to overcome the hurdles of conventional drug therapy approach.

Resveratrol induces cell cycle arrest and apoptosis with docetaxel in prostate cancer cells via a p53/ p21WAF1/CIP1 and p27KIP1 pathway

Resveratrol (RES) is the most effective natural products used for the treatment of a variety of cancers. In this study, we tested the effect of RES in enhancing the efficacy of docetaxel (DTX) treatment in prostate cancer (PCa) cells. The C4-2B and DU-145 cell lines were treated with RES, DTX and combination followed by evaluating the apoptosis and cell cycle progression. The combined drug treatment up-regulates the pro-apoptotic genes (BAX, BID, and BAK), cleaved PARP and down regulates the anti-apoptotic genes (MCL-1, BCL-2, BCL-XL) promoting apoptosis. In C4-2B cells the combination up regulated the expression of p53, and cell cycle inhibitors (p21^WAF1/CIP1, p27^KIP), which, in turn, inhibited the expression of CDK4, cyclin D1, cyclin E1 and induced hypo-phosphorylation of Rb thus blocking the transition of cells in the G₀/G₁ to S phase. In contrast, the synergistic effect was not profound in DU145 due to its lesser sensitivity to DTX. The suppression of cyclin B1 and CDK1 expression in both cell lines inhibits the further progression of cells in G₂/M phase. The current study demonstrates that combination treatment blocks the cell cycle arrest by modulation of key regulators and promotes apoptosis via p53 dependent and independent mechanism in PCa.

Hypoxia-inducible factor-1 mediated CX3CR1 expression correlates with progression and metastasis in ovarian cancer

Chemokines mediate the important roles in organ-specific homing of various cancer cells, including ovarian cancer (OvCa) to distant organs that may favor or inhibit cancer progression and metastasis. Hypoxia, a common phenomenon in solid tumors, is associated with a malignant cancer phenotype. Here, we provided the evidence that hypoxia up-regulate CX3CR1 expression and lead to an increased chemotactic response to CX3CL1 in OvCa cells. Hypoxia- induced genes are widely involved in metastasis-associated functions; and also undergo epithelial-to-mesenchymal transition (EMT). In the present study, we found that CX3CR1 expression was significantly increased in OvCa cells (OVCAR-3, SW626 and TOV-112D) following exposure to hypoxia. Flow cytometry, RT-PCR, western blot, Immunohistochemistry and immunofluorescence techniques were used to quantify the expression of chemokine CX3CR1and CX3CL1 in OvCa. Moreover, a significant higher expression of CX3CR1 under hypoxia compared to the normoxic condition in OvCa. Furthermore, we demonstrated that OvCa cells display a marked increase in hypoxia-induced CX3CR1-dependent PI3K/Akt/mTOR and MAPK signaling molecules as well as EMT markers and matrix metalloproteinase (MMPs) which are involved in cancer progression and metastasis of OvCa cells in hypoxic condition. These data demonstrate hypoxia pathway regulate the expression of CX3CR1 that may contribute to progression and metastasis of OvCa.

Calibrated flux measurements reveal a nanostructure-stimulated transcytotic pathway

Transport of therapeutic agents across epithelial barriers is an important element in drug delivery. Transepithelial flux is widely used as a measure of transit across an epithelium, however it is most typically employed as a relative as opposed to absolute measure of molecular movement. Here, we have used the calcium switch approach to measure the maximum rate of paracellular flux through unencumbered intercellular junctions as a method to calibrate the flux rates for a series of tracers ranging in 0.6-900kDa in size across barriers composed of human colon epithelial (Caco-2) cells. We then examined the effects of nanostructured films (NSFs) on transepithelial transport. Two different NSF patterns were used, Defined Nanostructure (DN) 2 imprinted on polypropylene (PP) and DN3 imprinted on polyether ether ketone (PEEK). NSFs made direct contact with cells and decreased their barrier function, as measured by transepithelial resistance (TER), however cell viability was not affected. When NSF-induced transepithelial transport of Fab fragment (55kDa) and IgG (160kDa) was measured, it was unexpectedly found to be significantly greater than the maximum paracellular rate as predicted using cells cultured in low calcium. These data suggested that NSFs stimulate an active transport pathway, most likely transcytosis, in addition to increasing paracellular flux. Transport of IgG via transcytosis was confirmed by immunofluorescence confocal microscopy, since NSFs induced a significant level of IgG endocytosis by Caco-2 cells. Thus, NSF-induced IgG flux was attributable to both transcytosis and the paracellular route. These data provide the first demonstration that transcytosis can be stimulated by NSFs and that this was concurrent with increased paracellular permeability. Moreover, NSFs with distinct architecture paired with specific substrates have the potential to provide an effective means to regulate transepithelial transport in order to optimize drug delivery.

Combinatorial effect of curcumin with docetaxel modulates apoptotic and cell survival molecules in prostate cancer

Docetaxel is the most commonly used chemotherapeutic agent to target androgen signaling in metastatic prostate cancer (PCa); however, prolonged treatment with docetaxel results in drug-resistant cancer cells. Combination therapies have the potential of increasing the effectiveness of drug treatment as well as decreasing the side effects. Curcumin is a nontoxic organic compound with multifaceted chemopreventive potential. In this study, we evaluated whether curcumin can reinforce the effect of docetaxel on PCa cells. The PCa cell lines DU145 and PC3 were treated with curcumin and docetaxel alone or in combination. After completion of the treatment cell proliferation and the expression of pro-survival and anti-apoptotic markers and the signaling molecules were analyzed. The combined treatment of curcumin and docetaxel inhibited the proliferation and induced apoptosis significantly higher than the curcumin and docetaxel-treated group alone. Interestingly, the combined treatment with curcumin and docetaxel modulates the expression of RTKs, PI3K, phospho-AKT, NF-kappa B, p53, and COX-2. These results suggest that curcumin can be a potential therapeutic contender in enhancing the efficacy of docetaxel in PCa treatment.

Molecular basis for prostate cancer racial disparities

Prostate cancer (PCa) remains the most common cancer in American men. African-American (AA) men continue to have higher PCa prevalence and mortality rates compared to men in other populations. In addition to socioeconomic factors and lifestyle differences, molecular alterations contribute to this discrepancy. We summarize molecular genetics research results interrelated with the biology of PCa racial disparity. Androgen and androgen receptor (AR) pathways have long been associated with prostate growth. Racial differences have also been found among variants of genes of the enzymes involved in androgen biosynthesis and metabolism. Growth factors and their receptors are a potential cause of the disparity in PCa. Recent molecular and biotechnological approaches in the field of proteomics and genomics will greatly aid the advancement of translational research on racial disparity in PCa, which may help, in finding new prognostic markers and novel therapeutic approaches for the treatment of PCa in AA.

Andrographolide inhibits prostate cancer by targeting cell cycle regulators, CXCR3 and CXCR7 chemokine receptors

Despite state of the art cancer diagnostics and therapies offered in clinic, prostate cancer (PCa) remains the second leading cause of cancer-related deaths. Hence, more robust therapeutic/preventive regimes are required to combat this lethal disease. In the current study, we have tested the efficacy of Andrographolide (AG), a bioactive diterpenoid isolated from Andrographis paniculata, against PCa. This natural agent selectively affects PCa cell viability in a dose and time-dependent manner, without affecting primary prostate epithelial cells. Furthermore, AG showed differential effect on cell cycle phases in LNCaP, C4-2b and PC3 cells compared to retinoblastoma protein (RB(-/-)) and CDKN2A lacking DU-145 cells. G2/M transition was blocked in LNCaP, C4-2b and PC3 after AG treatment whereas DU-145 cells failed to transit G1/S phase. This difference was primarily due to differential activation of cell cycle regulators in these cell lines. Levels of cyclin A2 after AG treatment increased in all PCa cells line. Cyclin B1 levels increased in LNCaP and PC3, decreased in C4-2b and showed no difference in DU-145 cells after AG treatment. AG decreased cyclin E2 levels only in PC3 and DU-145 cells. It also altered Rb, H3, Wee1 and CDC2 phosphorylation in PCa cells. Intriguingly, AG reduced cell viability and the ability of PCa cells to migrate via modulating CXCL11 and CXCR3 and CXCR7 expression. The significant impact of AG on cellular and molecular processes involved in PCa progression suggests its potential use as a therapeutic and/or preventive agent for PCa.

Abstract 1701: CCR6 associates with colon cancer metastasis

Despite established benefits of screening, colon cancer remains a leading cause of cancer death in the U.S. Majority of colon cancer deaths result from metastasis. Effective treatments are not available for advanced disease because molecular mechanisms of initiation and progression of this disease are yet to be defined. Chemokine-chemokine receptor interaction plays an important role in cancer progression. In this study, using colon cancer tissue microarray, we have shown that expression of CCR6 was significantly higher in advanced colon cancer (p<0.0001) with distant and regional lymph node metastasis as compared to non-metastatic and adjacent normal tissues. Expression of CCR6 was further confirmed in cell lines derived from Dukes's type C and type D colon cancer patients using flow cytometric analysis. Like tissues, CCR6 expression was significantly (p<0.0001) higher in colon cancer cell lines compared to normal colon epithelial cells. Furthermore, colon cancer cells showed higher migratory potential toward chemotactic gradient of its only known natural ligand, CCL20. Cell proliferation was also inhibited in presence of CCL20. Significant decrease in E-cadherin, increased expression of vimentin, β-catenin, N-cadherin, α-SMA, SNAIL and ZEB1 was observed following CCL20 treatment. These results suggest the importance of CCR6-CCL20 axis in the etiopathogenesis of colon cancer and highlight its potential as therapeutic target.

Citation Format: Neeraj Kapur, Hina Mir, Clarence E. Clark, Uma Krishnamurti, Derrick J. Beech, James W. Lillard, Shailesh Singh. CCR6 associates with colon cancer metastasis. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 1701.

Abstract 3841: Curcumin enhances the efficacy of docetaxel- induced apoptosis of prostate cancer cell

Despite the different prostate cancer (PCa) treatment therapies it continues to be one of the leading causes of death in men. Docetaxel is a well-established chemotherapeutic agent used to target metastatic PCa, however long-term treatment with docetaxel results in drug resistant and toxicity in PCa cells. Combining agents is common to improve outcomes, but the combination should not significantly increase toxicity. Curcumin is a non-toxic natural compound with multifaceted chemo preventive potential. In current study we evaluated whether curcumin can reinforce the effect of docetaxel on PCa cell lines (RWPE-1, C4-2b, DU145 and PC3). PCa cell lines were treated with curcumin or docetaxel alone or in combination followed by cell viability (MTT assay) and apoptosis assay (TUNEL assay and flow-cytometric analysis of annexin V/propidium iodide-stained cells). The expressions of pro- and anti-apoptotic markers were quantitated with real-time PCR and western blot assay. Our results indicate that curcumin combined with docetaxel led to lower cell viability than treatment with docetaxel or curcumin alone. Annexin V staining followed by flow cytometric analysis demonstrated that curcumin treatment enhanced the docetaxel-induced apoptosis of PCa cells, which was further confirmed by TUNEL assay. The down-regulation of the anti-apoptotic proteins (Bcl2, Mcl-1) and upregulation of pro-apoptotic proteins (Bax, Bid etc.) further confirm that we can considerably reduce docetaxel dose using synergistic combination therapy with curcumin. Thus, our results strongly suggest that we can reduce dose levels of docetaxel and compensate it with non-toxic curcumin and it could be a potential therapeutic contender in enhancing the efficacy of docetaxel in PCa treatment.

Citation Format: Saswati Banerjee, Santosh K. Singh, James W. Lillard, Rajesh Singh. Curcumin enhances the efficacy of docetaxel- induced apoptosis of prostate cancer cell. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 3841.

Abstract 5254: Andrographolide prevents prostate cancer by targeting CXCR3/CXCR7 and regulators of cell cycle

Despite state of the art cancer diagnostics and therapies offered in clinics, prostate cancer (PCa) remains the second leading cause of cancer-related deaths in men. Hence, more robust therapeutic/preventive regimes are required to combat this lethal disease. In the current study, we have tested the efficacy of andrographolide (AG), a bioactive diterpenoid isolated from Andrographis paniculata, against PCa. This natural agent selectively affects PCa cell viability in a dose and time-dependent manner, without affecting primary prostate epithelial cells. Furthermore, AG showed differential effect on phases of cell cycle in LNCaP, C4-2b and PC3 cell lines compared to retinoblastoma protein (RB-/-) lacking DU-145 cells. This agent blocked the G2/M transition in LNCaP, C4-2b and PC3 whereas DU-145 cells failed to transit G1/S phase. This difference was primarily due to switching of the activation states of cell cycle regulators in these cell lines. AG induced its effect mainly via cyclin A2 and B1 in LNCaP, C4-2b and PC3 cell lines; whereas, cyclin E related regulation was affected in DU-145 cells. Phosphorylation status of Wee1, a nuclear kinase belonging to the Ser/Thr family and CDC2 was also affected by AG. Intriguingly, AG affected cell viability and the ability of PCa cells to migrate via modulating CXCL11 and CXCR3 and CXCR7 expression. The significant impact of AG on cellular and molecular processes involved in PCa progression suggest this agent has potential to be used as a therapeutic and/or preventive modality.

Citation Format: Hina Mir, Neeraj Kapur, Rajesh Singh, Guru Sonpavde, James W. Lillard, Shailesh Singh. Andrographolide prevents prostate cancer by targeting CXCR3/CXCR7 and regulators of cell cycle. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 5254.