Design and fabrication of a coupled high-Q photonic nanocavity system with large coupling coefficients

In a previous work, we demonstrated a coupled cavity system where photons in one storage cavity can be transferred to another storage cavity at an arbitrary time by applying a voltage pulse to a third cavity placed in a p-i-n junction. In this work, we demonstrate methods to improve the transfer efficiency and photon lifetimes of such a coupled system. Firstly, we designed a photonic-crystal structure that achieves a large coupling coefficient without reducing the radiation quality factor compared to the previously proposed structure: The photonic-crystal design was changed to a more symmetric configuration to suppress radiation losses and then optimized using an automatic structure tuning method based on the Covariance Matrix Adaptive Evolutional Strategy (CMAES). Here we added two improvements to achieve an evolution toward the desired direction in the two-dimensional target parameter space (spanned by the coupling coefficient and the inverse radiation loss). Secondly, to improve the experimental cavity quality factors, we developed a fabrication process that reduces the surface contamination associated with the fabrication of the p-i-n junction: We covered the photonic structure with a SiO2 mask to avoid the contamination and the electrode material was changed from Al to Au/Cr to enable cleaning by a weak acid. Owing to these improvements of the cavity design and the fabrication process, the obtained system provides coupling strengths that are about three times stronger and photon lifetimes that are about two times longer, compared to the previously reported system.

Mineral trioxide aggregate suppresses pro-inflammatory cytokine expression via the calcineurin/nuclear factor of activated T cells/early growth response 2 pathway in lipopolysaccharide-stimulated macrophages

AIM

To elucidate mechanisms by which mineral trioxide aggregate (MTA) suppresses pro-inflammatory cytokine mRNA expression in lipopolysaccharide (LPS)-stimulated RAW264.7 macrophages.

METHODOLOGY

Mineral trioxide aggregate extracts were prepared by immersing set ProRoot MTA in culture medium. RAW264.7 cells were cultured in the presence of LPS and MTA extracts. mRNA expression levels of interleukin (IL)-1α, IL-6, early growth response 2 (Egr2), suppressor of cytokine signalling 3 (Socs3) and IL-10 were quantified with reverse transcription-quantitative polymerase chain reaction. Phosphorylation of nuclear factor-kappa B (NF-κB) p65 in RAW264.7 cells was analysed by Western blotting. Intracellular calcium imaging was performed with Fluo-4 AM. The activity of nuclear factor of activated T cells (NFAT) was determined by luciferase assays. Enforced expression and silencing of Egr2 in RAW264.7 cells were carried out using an expression vector and specific RNAi, respectively. In vivo kinetics of Egr2⁺ cells in MTA-treated rat molar pulp tissues were examined using immunohistochemistry. Data were analysed by one-way analysis of variance, followed by the Tukey-Kramer test (P < 0.05).

RESULTS

Exposure to MTA extracts resulted in reduced mRNA expression levels of IL-1α and IL-6, as well as reduced expression of phosphorylated NF-κB, in LPS-stimulated RAW264.7 cells. Exposure to MTA extracts induced Ca²⁺ influx, which was blocked by NPS2143, an antagonist of calcium-sensing receptor (CaSR); Ca²⁺ influx then triggered activation of calcineurin/NFAT signalling and enhanced mRNA expression of Egr2. Enforced expression of Egr2 in RAW264.7 cells promoted the expression of both IL-10 and Socs3. In vivo application of MTA onto rat molar pulp tissue resulted in the appearance of Egr2-expressing cells that coexpressed CD163, a typical M2 macrophage marker.

CONCLUSIONS

Mineral trioxide aggregate extracts induced downregulation of IL-1α and IL-6 in LPS-stimulated RAW264.7 cells via CaSR-induced activation of calcineurin/NFAT/Egr2 signalling and subsequent upregulation of IL-10 and Socs3.

Design of photonic-crystal surface-emitting lasers with enhanced in-plane optical feedback for high-speed operation

Photonic-crystal surface-emitting lasers (PCSELs) use the two-dimensional (2D) resonance at the band-edge of a photonic crystal for lasing, and they feature various outstanding functionalities such as high-brightness lasing, arbitrary shaping of beam patterns and on-chip 2D beam steering. In this paper, to investigate the applicability of PCSELs for high-speed operation, we design PCSELs with enhanced in-plane optical feedback, which enable single-mode lasing inside a circular region the diameter of which is less than 10 µm. To realize a strong in-plane confinement of the lasing mode, we increase the one-dimensional coupling coefficients between counter-propagating waves through the careful design of the lattice points. We also introduce an in-plane heterostructure composed of two photonic crystals with different photonic bandgaps and utilize reflection at the boundary of the two photonic crystals in addition to the optical feedback at the band-edge of each photonic crystal. By using three-dimensional finite-difference time-domain method (3D-FDTD), we confirm that the proposed hetero-PCSELs can achieve single-mode lasing operation inside a 9-µm-diameter and possibly realize a 3-dB modulation bandwidth larger than 40 GHz.

Self-Supporting Hybrid Supercapacitor Electrodes Based on Carbon Nanotube and Activated Carbons

Self-supporting AC (activated carbon)-FWCNT (few-wall carbon nanotubes) hybrid electrodes were fabricated by mixing of ACs with high specific surface area (SSA) and sub-millimeter-long FWCNTs. In order to fabricate the hybrid electrodes, AC and FWCNT were mixed in a weight ratio of 9:1, dispersed by bath-sonication and vacuum-filtrated on a membrane filter. The addition of FWCNTs gives conductivity and mechanical strength, and replace metallic current collectors in thick (0.1 mm) electrodes. For making an electrode, three different ACs that derived from walnut shell (WS), that from apricot stones (AS), and that commercially used for capacitors (YP-80F, Kuraray Chemical Co., Osaka Japan), were used with FWCNT in weight ratio of AC:FWCNT = 9:1. An electrode based only on FWCNT was also prepared as a reference for comparison. Electrochemical properties of the obtained electrodes were investigated by the cyclic voltammetry method (CV). Electrochemical characteristics were measured using the three-electrode cell contained of YP80F-FWCNT, AS-FWCNT, WS-FWCNT as a working electrode, a YP-80F-FWCNT counter electrode and a Ag/AgCl reference electrode with an electrolyte of 1 M Na2SO4 aqueous solution. Also, the morphological properties of obtained electrodes were studied using scanning electron microscope (SEM), the SSA was investigated by the Brunauer-Emmett-Teller analysis. SSA, conductivity, and resistivity of AS-FWCNT and WS-FWCNT electrodes were summarized. Both the AS-FWCNT and WS-FWCNT hybrid electrodes showed specific capacitances of about 140 F/g at 1 mV/s and about 100 F/g at 100 mV/s, which are similar or even better than the AC-CNT hybrid electrode made of commercialized AC (YP-80F).

Abstract P6-09-25: Circulating tumor cell clusters-associated gene plakoglobin is a novel prognostic predictor in patients with breast cancer

Background: Accumulating evidence shows that circulating tumor cells (CTC) are linked to metastatic relapse and are regarded as a prognostic marker for human cancer. It was reported that CTC clusters (CTCc) have more metastatic potential than single CTC. Lately, studies also show that the high expression of plakoglobin, a cell adhesion protein, within the primary tumor are positively associated with CTCc in breast cancer patients. In addition, it is thought that insufficient expression of plakoglobin could promote epithelial-mesenchymal transition (EMT). In this study, we investigated the correlation between plakoglobin expression and survival of breast cancer.

Materials and Methods:A total of 126 patients with resectable early-stage breast cancer were treated with neoadjuvant chemotherapy (NAC). All patients received a standardized protocol of NAC consisting of four courses of FEC100 (500 mg/m2 fluorouracil, 100 mg/m2 epirubicin, and 500 mg/m2 cyclophosphamide) every 3 weeks, followed by 12 courses of 80 mg/m2 paclitaxel administered weekly. The expression of plakoglobin were identified by immunohistochemical staining properties in cell membrane. Staining with plakoglobin (clone 4C12) was scored according to the percentage of cells that stained positively: low, 0-25%; medium, 26-75%; high, &gt;75%. We investigated the correlation between the plakoglobin expression in primary tumor specimen and clinical outcomes including overall-survival (OS), disease-free-survival (DFS), distant-metastasis-free-survival (DMFS), the efficacy of NAC. And we examined the relation between the expression of plakoglobin and E-cadherin, EMT marker.

Results: The patient with high plakoglobin expression had significantly worse OS (p=0.021, log-rank) and DFS (p=0.015, log-rank), DMFS (p=0.040, log-rank). And the plakoglobin expression had no correlation with pathological complete response (pCR) rate (p=0.596). Also, there was not a statistically significant relationship between the plakoglobin expression and other clinicopathological parameters including tumor size (p=0.708), lymph node status (p=0.479), subtype (p=0.413), nuclear grade (p=0.642), Ki67 (p=0.202), tumor infiltrating lymphocytes (p=0.828). On univariate analysis with respect to distal metastasis, high plakoglobin expression showed worse prognosis than low plakoglobin expression (p=0.013, hazard ratio=4.221). And multivariate analysis found the same result (p=0.015, hazard ratio=4.070). In addition, there was a significant relationship between the expression of plakoglobin and E-cadherin (p=0.023).

Conclusions: Plakoglobin expression is an independent prognostic factor in the patients with breast cancer; particularly for DMFS, and this mechanism related to EMT.Background: Accumulating evidence shows that circulating tumor cells (CTC) are linked to metastatic relapse and are regarded as a prognostic marker for human cancer. It was reported that CTC clusters (CTCc) have more metastatic potential than single CTC. Lately, studies also show that the high expression of plakoglobin, a cell adhesion protein, within the primary tumor are positively associated with CTCc in breast cancer patients. In addition, it is thought that insufficient expression of plakoglobin could promote epithelial-mesenchymal transition (EMT). In this study, we investigated the correlation between plakoglobin expression and survival of breast cancer.

Materials and Methods:A total of 126 patients with resectable early-stage breast cancer were treated with neoadjuvant chemotherapy (NAC). All patients received a standardized protocol of NAC consisting of four courses of FEC100 (500 mg/m2 fluorouracil, 100 mg/m2 epirubicin, and 500 mg/m2 cyclophosphamide) every 3 weeks, followed by 12 courses of 80 mg/m2 paclitaxel administered weekly. The expression of plakoglobin were identified by immunohistochemical staining properties in cell membrane. Staining with plakoglobin (clone 4C12) was scored according to the percentage of cells that stained positively: low, 0-25%; medium, 26-75%; high, &gt;75%. We investigated the correlation between the plakoglobin expression in primary tumor specimen and clinical outcomes including overall-survival (OS), disease-free-survival (DFS), distant-metastasis-free-survival (DMFS), the efficacy of NAC. And we examined the relation between the expression of plakoglobin and E-cadherin, EMT marker.

Results: The patient with high plakoglobin expression had significantly worse OS (p=0.021, log-rank) and DFS (p=0.015, log-rank), DMFS (p=0.040, log-rank). And the plakoglobin expression had no correlation with pathological complete response (pCR) rate (p=0.596). Also, there was not a statistically significant relationship between the plakoglobin expression and other clinicopathological parameters including tumor size (p=0.708), lymph node status (p=0.479), subtype (p=0.413), nuclear grade (p=0.642), Ki67 (p=0.202), tumor infiltrating lymphocytes (p=0.828). On univariate analysis with respect to distal metastasis, high plakoglobin expression showed worse prognosis than low plakoglobin expression (p=0.013, hazard ratio=4.221). And multivariate analysis found the same result (p=0.015, hazard ratio=4.070). In addition, there was a significant relationship between the expression of plakoglobin and E-cadherin (p=0.023).

Conclusions: Plakoglobin expression is an independent prognostic factor in the patients with breast cancer; particularly for DMFS, and this mechanism related to EMT.

Citation Format: Goto W, Kashiwagi S, Asano Y, Takada K, Takashima T, Morisaki T, Noda S, Onoda N, Ohsawa M, Hirakawa K, Ohira M. Circulating tumor cell clusters-associated gene plakoglobin is a novel prognostic predictor in patients with breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P6-09-25.

Abstract P3-04-20: Predicting therapeutic effect by on tumor invasion lymphocytes (TILs) in endocrine therapy for stage IV breast cancer

Background: Breast cancer with distant metastasis at first presentation (stage IV disease) is often encountered in the outpatient department. With recent advances in multimodal therapies for breast cancer, long-term survival can now be expected even in stage IV breast cancer with distant metastasis. However, a goal in treating metastatic disease is prolongation of survival while maintaining good quality of life (QOL). Endocrine therapy is suitable for this purpose.The tumor immune environment not only modulates the effects of immunotherapy, but also the effects of other anticancer drugs and treatment outcomes. These immune responses can be evaluated with tumor-infiltrating lymphocytes (TILs), which has frequently been verified clinically. In the present study, we hypothesized that TILs would be useful as predictive marker of the therapeutic effect in endocrine therapy as well. In this study, the prediction of the therapeutic effect by TILs in endocrine therapy for stage IV breast cancer was clinically verified.

Materials and Methods:Data from 40 patients who underwent endocrine therapy as the initial drug therapy for stage IV breast cancer were used. The correlation between TILs evaluated according to the standard method, and prognosis, including the efficacy of endocrine therapy, was investigated retrospectively. Patients with 350% lymphocytic infiltration were considered to have lymphocyte-predominant breast cancer (LPBC).

Results:Among all 40 patients, TIL levels were high in 13 (32.5%) and low in 27 (67.5%) patients. Nine patients (22.5%) had LPBC, and 31 patients (77.5%) had non-LPBC. Investigation of the clinical pathological features of patients showed no significant differences between the high TIL and low TIL groups. There were also no significant differences between LPBC and non-LPBC patients. An analysis of outcomes comparing the high TIL and low TIL groups showed no prolongation in progression-free survival (PFS) (p=0.171, log-rank), time to treatment failure (TTF)(p=0.054), or overall survival (OS) (p=0.641). LPBC patients had significant prolongations of PFS (p=0.005), TTF (p=0.001), and OS (p=0.027) compared to non-LPBC patients. On receiver operating characteristic (ROC) curve analyses, results were better with LPBC (AUC: 0.700) than with TILs (AUC: 0.606).

Conclusion: The present findings suggest that a high level of lymphocytic infiltration in the tumor stroma may serve as a predictor of the therapeutic effect of endocrine therapy for patients with stage IV ER-positive breast cancer.

Citation Format: Kashiwagi S, Asano Y, Goto W, Takada K, Takashima T, Morisaki T, Noda S, Onoda N, Ohsawa M, Hirakawa K, Ohira M. Predicting therapeutic effect by on tumor invasion lymphocytes (TILs) in endocrine therapy for stage IV breast cancer [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-04-20.

Abstract P2-05-05: Prediction of survival after neoadjuvant chemotherapy for breast cancer by evaluation of tumor-infiltrating lymphocytes (TILs) and residual cancer burden (RCB)

Background: The tumor immune environment not only modulates the effects of immunotherapy, but also the effects of other anticancer drugs and treatment outcomes. Thus, the importance of inhibiting and improving the tumor immune microenvironment is now recognized. These immune responses can be evaluated with tumor-infiltrating lymphocytes (TILs), which has frequently been verified clinically. On the other hand, residual cancer burden (RCB) evaluation has been shown to be a useful predictor of survival after neoadjuvant chemotherapy (NAC). In this study, RCB and TILs evaluations were combined to produce an indicator that we have termed “RCB-TILs”, and its clinical application to NAC for breast cancer was verified by subtype-stratified analysis.

Materials and Methods:A total of 177 patients with resectable early-stage breast cancer were treated with NAC.The correlation between TILs evaluated according to the standard method, and prognosis, including the efficacy of NAC, was investigated retrospectively. The RCB was calculated using the Residual Cancer Burden Calculator on the website of the MD Anderson Cancer Center. The RCB and TILs evaluations were combined to create the “RCB-TILs”. Patients who were RCB-positive and had high TILs were considered RCB-TILs-positive, and all other combinations were RCB-TILs-negative.

Results: Univariable analysis of patients with high TILs found that this contributed significantly to prolonging DFS in all patients (p = 0.022, hazard ratio = 0.420), TNBC patients (p = 0.004, hazard ratio = 0.177), and HER2BC patients (p = 0.026, hazard ratio = 0.123). For HRBC patients, however, high TILs did not contribute to survival (p = 0.990, hazard ratio = 0.992). Being RCB-TILs-positive, however, contributed significantly to prolonging DFS in all patients (p &lt; 0.001, hazard ratio = 0.181), TNBC patients (p &lt; 0.001, hazard ratio = 0.099), HER2BC patients (p = 0.026, hazard ratio = 0.123), and HRBC patients (p = 0.039, hazard ratio = 0.258). On multivariable analysis, being RCB-TILs-positive was an independent factor for recurrence after NAC in all patients (p &lt; 0.001, hazard ratio = 0.048), TNBC patients (p = 0.018, hazard ratio = 0.041), HER2BC patients (p = 0.036, hazard ratio = 0.134), and HRBC patients (p = 0.002, hazard ratio = 0.081).

Conclusion: The results of the present study suggest that RCB-TILs is a significant predictor for breast cancer recurrence after NAC and may be a more sensitive indicator than TILs alone.

Citation Format: Asano Y, Kashiwagi S, Goto W, Takada K, Takashima T, Morisaki T, Noda S, Onoda N, Ohsawa M, Hirakawa K, Ohira M. Prediction of survival after neoadjuvant chemotherapy for breast cancer by evaluation of tumor-infiltrating lymphocytes (TILs) and residual cancer burden (RCB) [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P2-05-05.

Host SHP1 phosphatase antagonizes Helicobacter pylori CagA and can be downregulated by Epstein-Barr virus

Most if not all gastric cancers are associated with chronic infection of the stomach mucosa with Helicobacter pylori cagA-positive strains(1-4). Approximately 10% of gastric cancers also harbour Epstein-Barr virus (EBV) in the cancer cells(5,6). Following delivery into gastric epithelial cells via type IV secretion(7,8), the cagA-encoded CagA protein undergoes tyrosine phosphorylation on the Glu-Pro-Ile-Tyr-Ala (EPIYA) motifs initially by Src family kinases (SFKs) and then by c-Abl(9,10). Tyrosine-phosphorylated CagA binds to the pro-oncogenic protein tyrosine phosphatase SHP2 and thereby deregulates the phosphatase activity(11,12), which has been considered to play an important role in gastric carcinogenesis(13). Here we show that the SHP2 homologue SHP1 interacts with CagA independently of the EPIYA motif. The interaction potentiates the phosphatase activity of SHP1 that dampens the oncogenic action of CagA by dephosphorylating the CagA EPIYA motifs. In vitro infection of gastric epithelial cells with EBV induces SHP1 promoter hypermethylation, which strengthens phosphorylation-dependent CagA action via epigenetic downregulation of SHP1 expression. Clinical specimens of EBV-positive gastric cancers also exhibit SHP1 hypermethylation with reduced SHP1 expression. The results reveal that SHP1 is the long-sought phosphatase that can antagonize CagA. Augmented H. pylori CagA activity, via SHP1 inhibition, might also contribute to the development of EBV-positive gastric cancer.

Tumour-infiltrating CD8 to FOXP3 lymphocyte ratio in predicting treatment responses to neoadjuvant chemotherapy of aggressive breast cancer

BACKGROUND

Tumour-infiltrating lymphocytes (TILs) can be used to monitor the immune response, and are important in predicting treatment responses and outcomes for various types of cancer. Recently, specific TIL subsets have been reported to be clinically useful in predicting treatment responses. The CD8+/FOXP3+ TIL ratio (CFR) may be a more sensitive indicator for monitoring immune function. This study investigated the clinical significance and value of CFR as a biomarker to predict treatment responses to neoadjuvant chemotherapy for breast cancer.

METHODS

Patients with resectable early-stage breast cancer treated with neoadjuvant chemotherapy at Osaka City University Hospital, Japan, between 2007 and 2013 were included. Oestrogen receptor, progesterone receptor, human epidermal growth factor receptor (HER) 2, Ki-67, CD8 and FOXP3 status were assessed by immunohistochemistry, and correlated with pathological complete response (pCR).

RESULTS

A total of 177 patients were included, of whom 90 had a high CFR and 87 a low CFR. Triple-negative breast cancer (TNBC) was more common in the high-CFR group than in the low-CFR group (46 versus 23 per cent; P = 0·002), as was HER2-enriched breast cancer (HER2BC) (27 versus 14 per cent; P = 0·033). Among these patients, the pCR rate was significantly higher in the high-CFR group than in the low-CFR group (TNBC: P = 0·022; HER2BC: P < 0·001). In multivariable analysis high-CFR status was an independent predictor of a favourable prognosis: hazard ratio 0·24 (95 per cent c.i. 0·05 to 0·72; P = 0·015) for TNBC and 0·10 (0·10 to 0·90; P = 0·041) for HER2BC.

CONCLUSION

The CFR may be a useful biomarker to predict treatment response to neoadjuvant therapy in aggressive breast cancer subtypes, such as TNBC and HER2BC.

Abstract P3-07-33: Prediction of the treatment response to neoadjuvant chemotherapy in breast cancer by subtypes using tumor-infiltrating lymphocytes

Purpose: Monitoring the host immunological response to cancer in the microenvironment of the interaction between tumor and the body plays an important role in predicting treatment response and outcomes. Recent interest has focused on the morphological evaluation of tumor-infiltrating lymphocytes (TILs) in breast cancer (BC) and on the evidence showing their clinical relevance. Meanwhile, no consensus has yet been reached on standard methods for pathological evaluation of TILs. Therefore, methods of evaluation have differed in reports to date showing the clinical relevance of TILs. An International Working Group (2014) announced recommendations for evaluating TILs in an effort to improve consistency and reproducibility. In this study, the clinical validity and utility of TILs in NAC were investigated based on this recommendation with a stratified analysis by BC subtypes. Changes in TILs after recurrence, which have seldom been reported to date, are also discussed.

Experimental Design: TILs was evaluated in 177 patients with breast cancer treated with NAC and subsequent curative surgery. All patients received a standardized protocol of NAC consisting of four courses of FEC100 (500 mg/m2 fluorouracil, 100 mg/m2 epirubicin, and 500 mg/m2 cyclophosphamide) every 3 weeks, followed by 12 courses of 80 mg/m2 paclitaxel administered weekly. Forty-five patients had HER2-positive breast cancer and were additionally administered weekly (2 mg/kg) or tri-weekly (6 mg/kg) trastuzumab during paclitaxel treatment. The correlation between TILs evaluated according to the standard method, and prognosis, including the efficacy of NAC, was investigated retrospectively.

Results: In the 96 high-TIL group, compared to the 81 low-TIL group, triple-negative breast cancer (TNBC) (p &lt; 0.001) and HER2-enriched (p = 0.040) were significantly more frequent, and the pathological complete response (pCR) rate were significantly higher (p = 0.003). On multivariate analysis also demonstrated that high-TIL status was an independent factor to indicate significantly more favorable prognosis of the patients compared with low-TIL status (p = 0.036, HR = 0.45). Among the 61 TNBC and the 36 HER2-enriched patients, the pCR rate was significantly higher in the high-TIL group than in the low-TIL group (p = 0.013) (p = 0.014). On multivariate analysis also showed that high-TIL status was an independent factor to predict the favorable prognosis (p = 0.023, HR = 0.24) (p = 0.036, HR = 0.13). Biopsy specimens from local recurrence after successful NAC frequently showed decreased TILs.

Conclusion: TILs may be a biomarker to predict treatment response to NAC in patients with TNBC and HER2-enriched subtypes of BC. A decrease in TILs may also be associated with tumor recurrence.

Citation Format: Kashiwagi S, Asano Y, Goto W, Morisaki T, Noda S, Takashima T, Onoda N, Hirakawa K. Prediction of the treatment response to neoadjuvant chemotherapy in breast cancer by subtypes using tumor-infiltrating lymphocytes. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P3-07-33.

Abstract P4-04-14: Prediction of treatment responses to neoadjuvant chemotherapy in triple-negative breast cancer by analysis of immune checkpoint protein expression

Purpose: "Avoiding immune destruction" has recently been established as one of the hallmarks of cancer. The programmed cell death (PD)-1/programmed cell death-ligand (PD-L) 1 pathway is also an important immunosuppression mechanism that allows cancer cells to escape host immunity. The effect of the tumor immune environment not only on immunotherapy effectiveness, but also on conventional anti-tumor therapy effectiveness and prognosis, has recently been demonstrated. Thus, improvement of the tumor immune environment is important. In other words, the tumor immune environment plays a role in the anti-tumor effects of conventional anti-tumor drugs. Moreover, immune checkpoint proteins such as PD-1, PD-L1, and PD-L2 may play an important role in improving the tumor immune environment. Given this background, the clinical significance of immune checkpoint protein expression was investigated in patients receiving neoadjuvant chemotherapy (NAC) for breast cancer using conventional anti-cancer drugs, and whether this would be useful as a marker to predict treatment response was evaluated.

Experimental Design: A total of 177 patients with resectable early-stage breast cancer were treated with NAC. All patients received a standardized protocol of NAC consisting of four courses of FEC100 (500 mg/m2 fluorouracil, 100 mg/m2 epirubicin, and 500 mg/m2 cyclophosphamide) every 3 weeks, followed by 12 courses of 80 mg/m2 paclitaxel administered weekly. Forty-five patients had HER2-positive breast cancer and were additionally administered weekly (2 mg/kg) or tri-weekly (6 mg/kg) trastuzumab during paclitaxel treatment. ER, PR, HER2, Ki67, PD-L1, PDL-2 and PD-1 status were assessed by immunohistochemistry on core needle biopsy specimens.

Results: There were 37 (20.9%) patients with high PD-1 expression, 42 (23.7%) patients had high PD-L1 expression, and 52 (29.4%) patients had high PD-L2 expression. The patients with high PD-1 and PD-L1 expressions had a significantly higher rate of triple-negative breast cancer (TNBC) (p=0.041) (p&lt;0.001). Univariate analysis showed that PD-1 and PD-L1 expressions were associated with significantly shorter DFS (p=0.008, HR=2.752) (p=0.002, HR=3.194). However, although multivariate analysis showed that lymph node metastases were an independent poor prognostic factor (p=0.046, HR=4.330), PD-1 and PD-L1 expressions were not independent prognostic factors (p=0.492, HR=1.415) (p=0.084, HR=2.613). In TNBC, patients with high PD-1 and PD-L1 expressions had significantly higher rates of non-pCR (p=0.003) (p&lt;0.001). Univariate analysis showed that PD-1 and PD-L1 expressions also significantly shortened disease free survival in TNBC (p=0.048, HR=3.318) (p=0.007, HR=8.375). However, multivariate analysis found that only PD-L1 expression was an independent prognostic factor (p=0.041, HR=9.479).

Conclusions: PD-1 and PD-L1 expressions may be useful as biomarkers to predict treatment responses to NAC in breast cancer. Above all, PD-L1 expression may also be useful as biomarkers for more effective chemotherapy in TNBC.

Citation Format: Asano Y, Kashiwagi S, Goto W, Morisaki T, Noda S, Takashima T, Onoda N, Hirakawa K. Prediction of treatment responses to neoadjuvant chemotherapy in triple-negative breast cancer by analysis of immune checkpoint protein expression. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P4-04-14.

Determination of the catalytic activity of LEOPARD syndrome-associated SHP2 mutants toward parafibromin, a bona fide SHP2 substrate involved in Wnt signaling

SHP2, encoded by the PTPN11 gene, is a protein tyrosine phosphatase that plays a key role in the proliferation of cells via RAS-ERK activation. SHP2 also promotes Wnt signaling by dephosphorylating parafibromin. Germline missense mutations of PTPN11 are found in more than half of patients with Noonan syndrome (NS) and LEOPARD syndrome (LS), both of which are congenital developmental disorders with multiple common symptoms. However, whereas NS-associated PTPN11 mutations give rise to gain-of-function SHP2 mutants, LS-associated SHP2 mutants are reportedly loss-of-function mutants. To determine the phosphatase activity of LS-associated SHP2 more appropriately, we performed an in vitro phosphatase assay using tyrosine-phosphorylated parafibromin, a biologically relevant substrate of SHP2 and the positive regulator of Wnt signaling that is activated through SHP2-mediated dephosphorylation. We found that LS-associated SHP2 mutants (Y279C, T468M, Q506P, and Q510E) exhibited a substantially reduced phosphatase activity toward parafibromin when compared with wild-type SHP2. Furthermore, each of the LS-associated mutants displayed a differential degree of decrease in phosphatase activity. Deviation of the SHP2 catalytic activity from a certain range, either too strong or too weak, may therefore lead to similar clinical outcomes in NS and LS, possibly through an imbalanced Wnt signal caused by inadequate dephosphorylation of parafibromin.

Comparison between Monte Carlo simulation and measurement with a 3D polymer gel dosimeter for dose distributions in biological samples

In this research, we used a 135 MeV/nucleon carbon-ion beam to irradiate a biological sample composed of fresh chicken meat and bones, which was placed in front of a PAGAT gel dosimeter, and compared the measured and simulated transverse-relaxation-rate (R2) distributions in the gel dosimeter. We experimentally measured the three-dimensional R2 distribution, which records the dose induced by particles penetrating the sample, by using magnetic resonance imaging. The obtained R2 distribution reflected the heterogeneity of the biological sample. We also conducted Monte Carlo simulations using the PHITS code by reconstructing the elemental composition of the biological sample from its computed tomography images while taking into account the dependence of the gel response on the linear energy transfer. The simulation reproduced the experimental distal edge structure of the R2 distribution with an accuracy under about 2 mm, which is approximately the same as the voxel size currently used in treatment planning.

A possible contribution of lipocalin-2 to the development of dermal fibrosis, pulmonary vascular involvement and renal dysfunction in systemic sclerosis

BACKGROUND

Lipocalin-2 is an adipocytokine implicated in apoptosis, innate immunity, angiogenesis, and the development of chronic kidney disease.

OBJECTIVES

To investigate the role of lipocalin-2 in systemic sclerosis (SSc).

MATERIALS AND METHODS

Serum lipocalin-2 levels were determined by enzyme-linked immunosorbent assay in 50 patients with SSc and 19 healthy subjects. Lipocalin-2 expression was evaluated in the skin of patients with SSc and bleomycin (BLM)-treated mice and in Fli1-deficient endothelial cells by reverse transcriptase-real time polymerase chain reaction, immunoblotting and/or immunohistochemistry.

RESULTS

Although serum lipocalin-2 levels were comparable between patients with SSc and healthy controls, the prevalence of scleroderma renal crisis was significantly higher in patients with SSc with elevated serum lipocalin-2 levels than in those with normal levels. Furthermore, serum lipocalin-2 levels inversely correlated with estimated glomerular filtration rate in patients with SSc with renal dysfunction. Among patients with SSc with normal renal function, serum lipocalin-2 levels positively correlated with skin score in patients with diffuse cutaneous SSc with disease duration of < 3 years and inversely correlated with estimated right ventricular systolic pressure in total patients with SSc. Importantly, in SSc lesional skin, lipocalin-2 expression was increased in dermal fibroblasts and endothelial cells. In BLM-treated mice, lipocalin-2 was highly expressed in dermal fibroblasts, but not in endothelial cells. On the other hand, the deficiency of transcription factor Fli1, which is implicated in SSc vasculopathy, induced lipocalin-2 expression in cultivated endothelial cells.

CONCLUSIONS

Lipocalin-2 may be involved in renal dysfunction and dermal fibrosis of SSc. Dysregulated matrix metalloproteinase-9/lipocalin-2-dependent angiogenesis due to Fli1 deficiency may contribute to the development of pulmonary arterial hypertension associated with SSc.

Effect of 1,25-dihydroxycholecalciferol on the duodenal villi and alkaline phosphatase in the developing chick embryo

Administration of 1,25-(OH)2D3 to developing 14-day chick embryo gave precocious induction of alkaline phosphatase in 20-day chick embryonic duodenum. 1,25-(OH)-2D3-induced alkaline phosphase involved in changes in Km and Vmax values. Furthermore, polyacrylamide gel disc electrophoresis of n-butanol-solubilized alkaline phosphatase from control and 1,25-(OH)2D3-treated chick embryonic duodenum revealed that 1,25-(OH)2D3 involved the transformation of neuraminidase-resistant fast migrating form to the neuraminidase-sensitive faster migrating one. Scanning electron microscopic data showed that the injection of 1,25-(OH)2D3 stimulated the elongation of duodenal microvilli, although there was no effect on the duodenal absorptive epithelial cell height.