Les cancers de l’ovaire représentent la première cause de mortalité due aux cancers gynécologiques dans les pays développés. La plupart de ces cancers sont diagnostiqués à des stades tardifs quand les cellules cancéreuses ovariennes ont disséminé et colonisé les parois de la cavité abdominale. En conséquence, ces cancers sont associés à un sombre pronostic.Plus d’un tiers des patientes présentent une accumulation de liquide d’ascite au moment du diagnostic. L’ascite est un fluide exsudatif ayant une composante cellulaire et également une composante liquide acellulaire, constituant un réservoir dynamique de molécules bioactives. Malgré une réponse efficace aux traitements standards, les taux de récidive de cette pathologie restent élevés. L’acquisition d’une chimiorésistance et le mode de propagation atypique des cellules cancéreuses sont deux éléments importants impliqués dans la récidive des cancers ovariens.Le rôle de l’ascite et plus particulièrement de la composante matricielle ascitique, dans le processus de dissémination et dans la chimiorésistance des cellules cancéreuses ovariennes reste peu étudié et constitue le cœur de ce travail de thèse.L’objectif des travaux a été d’étudier l’influence de l’ascite et de deux glycoprotéines matricielles purifiées à partir d’échantillons d’ascites sur les comportements cellulaires propices à la dissémination et à la récidive des cancers ovariens. De plus, l’influence de l’ascite sur la réponse des cellules aux traitements à base de platine a également été recherchée et estimée.L’étude démontre que l’ascite est un microenvironnement propice à la dissémination des cellules cancéreuses ovariennes et que la fibronectine et la vitronectine ascitiques ainsi que leurs récepteurs d’adhérence spécifiques sont des éléments qui participent à la régulation de cette dissémination. L’ascite exerce également un effet protecteur contre l’effet cytotoxique des agents chimiothérapeutiques.Ces résultats mettent en perspectives l’intérêt potentiel de la fibronectine et de la vitronectine ascitiques comme outils diagnostiques et/ou cibles thérapeutiques des cancers ovariens et nous engagent à approfondir l’étude de ces deux molécules et de leurs conséquences sur la progression de la maladie. / Ovarian cancers are the leading cause of death among gynaecological cancers in western countries. Most of these cancers are diagnosed at a late stage, when ovarian cancer cells have spread and colonized the walls of the abdominal cavity. Therefore, these cancers are associated to a poor prognosis.More than one third of the patients show an accumulation of ascites at the time of the diagnosis. Ascites are exudative fluids composed of a cellular and also an acellular fraction. In fact, ascites constitute a dynamic reservoir of bioactive molecules. Even if the response of ovarian cancers to the current first-line therapy, that consit in debulking surgery followed by chemotherapy, is satisfactory, the rate of recurrence remains important. The gain of a chemoresistance and the atypical widespread of cancer cells are two important factors involved in the recurence of the ovarian cancers.The role of ascites and more particularly, of the ascitic matrix componants on the dissemination process and on the chemoresitance of the ovarian cancer cells remain poorly studied and is the aim of this work.The objective of this study was to investiguate the influence of ascites and of two matrix glycoproteins purified from samples of ascites i) on the cells behavior convenient to the dissemination and the recurrence of the ovarian cancers and ii) on the response of cells to therapeutics treatments with platinum.This study suggests that ascites are a permissive microenvironment to the dissemination of ovarian cancer cells and that ascitic fibronectin and vitronectin as well as their specific receptors are actors which participate to the regulation of this dissemination. Ascites also protect ovarian cancer cells against the cytotoxicity of chemotherapeutic drugs.These results illustrate the potential interest of ascites derived fibronectin and vitronectin as diagnosis tools and/or therapeutic targets for ovarian cancers and encourage us to deepen the study of these two molecules and their consequences in the progress of the disease.

Les dommages de l’ADN, induits par les traitements de chimiothérapie, sont responsables de l’induction de la sénescence, un arrêt définitif du cycle cellulaire dépendant des voies p53-p21 et p16-Rb. L'efficacité de cette suppression n’est pas optimale en raison d’une hétérogénéité de réponse à la chimiothérapie. Dans cette étude, nous avons analysé l’échappement à la sénescence en réponse à l’irinotécan, un traitement des cancers colorectaux. Dans les cellules LS174T, le processus de sénescence est induit mais des cellules conservent leurs capacités prolifératives et l’exercent après l’élimination du traitement. Les cellules proliférantes (PLD) et sénescentes (PLS) forment un mélange hétérogène appelé cellules persistantes (PLCs). Alors qu’elles sont constituées d’une part importante de cellules sénescentes, les PLCs sont capables de former des tumeurs in vivo, de manière comparable aux cellules parentales. De façon intéressante, le traitement est également associé à l’augmentation de l’agressivité caractérisée par la croissance en faible adhérence. L’émergence des PLD et la résistance à l’anoikis sont dépendantes de l’expression des protéines Mcl-1, Bcl-xL et p21. L’enrichissement des PLD et PLS, réalisé par cytométrie en flux, a permis d’identifier les PLS comme nécessaires à la résistance à l’anoikis. Les PLS pourraient donc créer un environnement favorable à la transformation de cellules non touchées par le traitement. Alors que le rôle de Mcl-1 et Bcl-xL dans chaque population reste à déterminer, l’utilisation d’inhibiteurs de ces protéines combinés à l’irinotécan pourrait limiter l’hétérogénéité de réponse à la chimiothérapie et l’agressivité tumorale. / Activated by chemotherapy, senescence is a suppressive response which prevents cell cycle progress through activation of the p53-p21 and p16-Rb signaling pathways. However, despite the efficiency of this suppression, cancer cells can emerge to induce clinical relapse. In this study, we analyzed senescence escape in response to irinotecan, one of the first line treatment used in colorectal cancer. After treatment, senescence is induced in LS174T cell but a subpopulation of cells finally resume proliferation. Persistent cells (PLCs) are composed of an heterogenous mixture of senescent (PLS) and dividing cells (PLD). In spite of PLS, PLCs are able to grow in vivo as efficiently as parental LS174T cells. Importantly, persistence induced the emergence of more transformed cells characterized by the ability to grow in low adhesion conditions. PLD emergence and anoikis resistance depend on Mcl-1, Bcl-xL and p21. PLD and PLS enrichment, by flow cytometry, allowed us to identify PLS as essential for anoikis resistance. Our results suggest that PLS establish a favorable environment for the transformation of unaffected cells. Mcl-1 and Bcl-xL role in each population remains to be determined, but inhibitors of these protein used in combination with irinotecan should restrict the heterogeneity of the response and tumoral aggressiveness.

La leucémie aiguë myéloïde (LAM) est une hémopathie maligne à progression rapide, qui se caractérise par une expansion clonale de précurseurs myéloïdes présentant un contrôle défectueux de leur prolifération et de leur différenciation. Une rémission complète peut être obtenue chez environ 80% à 85% des patients en associant cytarabine et anthracycline qui sont respectivement un inhibiteur de la synthèse d’ADN et un agent intercalant. Néanmoins, les résultats globaux pour les patients atteints de LAM restent médiocres et le taux de survie à 5 ans des patients âgés de plus de 60 ans, est inférieur à 10%. Le paradigme bien accepté de la leucémogenèse est que la leucémie résulte de la transformation d'une cellule unique appelée cellule souche leucémique (SCL) ou cellule initiatrice de leucémie (LIC) qui se développe par autorenouvellement et engendre par division asymétrique les blastes leucémiques bloqués dans leur différentiation. Les LIC vont être responsables du maintien et de la rechute de la maladie après le traitement chimiothérapeutique car si les traitements actuels sont relativement efficaces contre les blastes leucémiques, ils échouent au niveau des LIC. Un autre facteur important impliqué dans la résistance aux traitements est le microenvironnement de la moelle osseuse qui forme la niche hématopoïétique. Des études ont montré que différents composants cellulaires de la niche peuvent transférer des mitochondries à des cellules normales soumises à un stress métabolique ou dans un contexte pathologique, vers des cellules cancéreuses. Durant ma thèse, j'ai pu montrer que les cellules murines de la lignée MS-5 et/ou des cellules stromales primaires humaines dérivées de la moelle osseuse, utilisées comme cellules nourricières dans des expériences de co-culture, sont capables de transférer des mitochondries fonctionnelles aux cellules leucémiques. En utilisant différentes approches moléculaires et d'imagerie, nous avons pu montrer que les cellules de LAM peuvent, par ce transfert, augmenter leur masse mitochondriale jusqu'à 14%. Dans la co-culture, les cellules LAM receveuses ont montré une augmentation de 1,5 fois de la production d'adénosine triphosphate (ATP) mitochondriale et se sont révélées moins sujettes à une dépolarisation mitochondriale après chimiothérapie, affichant une survie plus élevée. Ce transfert unidirectionnel, renforcé par certains agents chimiothérapeutiques, nécessite des contacts cellule-cellule et semble se dérouler par une voie endocytaire qui reste à déterminer. Enfin, nous démontrons que le transfert mitochondrial est observé in vivo dans un modèle de xénogreffe de souris immunodéficientes NSG et se produit également dans les cellules et les progéniteurs initiateurs de la leucémie humaine et leur conférant une capacité plus élevée à initier des cultures leucémiques à long terme. Nous avons ainsi apporté la preuve qu'un transfert horizontal de mitochondries provenant des cellules stromales de la niche hématopoïétique participe aux phénomènes de chimiorésistance des cellules leucémiques receveuses. De ce fait, cibler ce transfert mitochondrial pourrait représenter une future cible thérapeutique originale pour un traitement adjuvant des LAM visant à interférer avec le soutien de leur microenvironnement. / Acute myelogenous leukemia (AML) is a heterogeneous group of hematopoietic malignancies arising from hematopoietic stem and/or progenitor cells that display defective control of their proliferation, differentiation, and maturation. Complete remission is achieved using anthracycline and cytarabine combination therapy in 80% to 85% of older patients. Nevertheless, the overall outcomes for AML patients remain poor, and the 5-year survival rate for patients over 60 is less than 10%. The well-accepted paradigm of leukemogenesis is that leukemia arises from the transformation of a single cell and is maintained by a small population of leukemic stem cells (LSC) or leukemia initiating cells (LICs). It is theorized that current treatments, although highly effective against the leukemic bulk, fail to eradicate the LICs that are therefore responsible for leukemia relapse. Another important factor involved in resistance to treatments is the microenvironment of the bone marrow, which is called the hematopoietic niche. Studies have shown that different niche cell components can transfer mitochondria to normal cells that undergo a metabolic stress and in a pathological context, to cancer cells. During my PhD we demonstrate that in an ex vivo niche-like coculture system, cells both primary and cultured AML cells take up functional mitochondria from murine or human bone marrow stromal cells. Using different molecular and imaging approaches, we show that AML cells can increase their mitochondrial mass by up to 14%. After coculture, recipient AML cells showed a 1.5-fold increase in mitochondrial ATP production and were less prone to mitochondrial depolarization after chemotherapy, displaying a higher survival. This unidirectional transfer enhanced by some chemotherapeutic agents required cell–cell contacts and proceed through an ill-defined endocytic pathway. Transfer was greater in AML blasts compared with normal cord blood CD34+ cells. Finally, we demonstrate that mitochondrial transfer was observed in vivo in an NSG immunodeficient mouse xenograft model and also occurred in human leukemia initiating cells and progenitors. As mitochondrial transfer provides a clear survival advantage following chemotherapy and a higher leukemic long-term culture initiating cell potential, targeting mitochondrial transfer could represent a future therapeutic target for AML treatment.

Modern drug development is an astronomically expensive and time consuming undertaking. Because of this, studying the pharmacokinetic properties of drugs in vitro has become an integral step early in the process of drug development, with the goal of preventing costly failures late in the process, and dangerous side effects. Artificial phospholipid bilayers known as droplet interface bilayers (DIBs) have the potential to be used for these pharmacokinetics assays, combining the low cost of cell-free assays with the ability to more closely mimic structures found in life than current cell-free in vitro techniques. Combined with the reproducibility, ease of use, and low reagent consumption found with microfluidic methods, disruptive new low cost techniques for assessing pharmacokinetics in drug development may be possible using DIBs as an artificial cell membrane model. In this work, I establish the potential of DIBs to be used as a pharmacokinetics modelling platform, and advance the use of microfluidic methods for carrying out pharmacokinetics assays in drug discovery. I first developed a new microfluidic platform for the formation of DIBs, which sought to solve some of the shortcomings of current microfluidic methods for DIB formation (Chapter 2). This device is the first that can be used to form DIB networks from dissimilar droplets in parallel, without use of active controls, and with droplet contact gentle enough to enable use of biomimetic lipid mixtures. I examine for the first time the behaviour of phospholipids on microfluidic devices, and characterise the interaction that they have with a common material used to construct microfluidic devices (Chapter 3). Not only has this interaction never been studied before, but my unexpected findings indicate a new area requiring further study in order to advance the adoption of DIBs on microfluidic devices. In collaboration with my colleague Jaime Korner, I use my newly developed microfluidic platform to carry out an on-chip permeation assay for the first time using biomimetic lipid formulations and bespoke compartments modelled after the human intestine. We demonstrate that this on-chip assay has predictive accuracy greater than that of a current widely used cell-free technique (Chapter 4). Finally, I demonstrate that a DIB based microfluidic platform enables, and is critical for, characterising the effect of structural features such as membrane asymmetry on drug permeation. With this, I find measurable, previously unknown effects of membrane asymmetry on the absorption of the chemotherapy drug doxorubicin, highlighting a possible contributing factor to chemoresistance in some cancers (Chapter 5). I find, and demonstrate throughout the body of this work that microfluidic methods and DIBs can not only provide alternatives to current cell-free in vitro pharmacokinetics assays, but that they can exceed the performance of existing assays, and be used for entirely new ways of examining pharmacokinetics. Through building bespoke artificial cell membranes from the ground up, I hope to demonstrate herein the great potential of these powerful new cell-free methods. / Graduate / 2022-09-12

Le cancer de la prostate est le second cancer diagnostiqué chez les hommes dans le monde. Malgré le développement de nouveaux traitements au cours de ces cinq dernières années, les chimiothérapies par taxanes, docetaxel et cabazitaxel, restent des traitements de référence dans la prise en charge des patients atteints de cancer de la prostate métastatique résistant à la castration. Cependant, des résistances primaires et acquises émergent chez environ la moitié des patients. C’est pourquoi, il est urgent de découvrir et de comprendre les mécanismes de résistance aux taxanes afin d’identifier de nouvelles cibles thérapeutiques. En effet, de nouvelles thérapies ciblées peuvent émerger de la compréhension des voies de signalisation impliquées dans le cancer de la prostate pour contourner la chimiorésistance et améliorer les traitements. Les protéines chaperonnes jouent un rôle clef dans la régulation de l’homéostasie cellulaire et dans le développement de résistance aux traitements. Elles constituent donc des cibles thérapeutiques potentielles pour contourner la chimiorésistance. En réalisant un criblage fonctionnel par siARN à partir de profils d’expression génique, nous avons identifié FKBP7, une chaperonne moléculaire encore jamais étudiée chez l’homme, impliquée dans la résistance au docetaxel et au cabazitaxel. FKBP7 est surexprimée dans les tumeurs de la prostate et son expression est corrélée avec la récurrence chez les patients ayant reçu du docetaxel en thérapie néoadjuvante. De plus, FKBP7 est surexprimée dans des lignées cancéreuses prostatiques résistantes aux taxanes et son expression est nécessaire à leur croissance in vitro et à la croissance tumorale dans un modèle murin de résistance au docetaxel. Par des approches de protéomique haut-débit, nous avons identifié la voie de signalisation régulée par FKBP7 qui est responsable de la survie des cellules chimiorésistantes. Enfin, nous proposons une stratégie thérapeutique pour contourner la chimiorésistance au docetaxel et au cabazitaxel en ciblant l’effecteur moléculaire en aval de FKBP7. / Prostate cancer is the second cancer diagnosed among men worldwide. Beside approval of new therapies in the last five years, chemotherapeutic agents, docetaxel and cabazitaxel taxanes remain key treatments for metastatic castration resistant prostate cancers. However, primary and acquired resistance to taxanes still emerged in about half of patients. There is therefore an urgent need to discover and understand the taxane resistance mechanisms in order to identify new therapeutic targets. Indeed, targeted therapies that exploit the signaling pathways involved in prostate cancer are required to overcome chemoresistance and improve treatment outcomes. Molecular chaperones play a key role in the regulation of cellular homeostasis and the development of treatment resistance, and are promising therapeutic targets. Using high throughput siRNA functional screening based on a gene expression signature, we identified FKBP7, involved in acquired resistance to docetaxel and cabazitaxel. FKBP7 is a molecular chaperone that has not been studied in human so far. FKBP7 is overexpressed in prostate tumors and its expression is correlated with recurrence in patients who received docetaxel as neoadjuvant therapy. Moreover, FKBP7 is upregulated in taxane resistant prostate cancer cell lines and its expression sustains their growth in vitro and in a mice model of Docetaxel resistance. Using a high throughput proteomic approach, we identified the signaling pathway regulated by FKBP7 which is responsible for the survival of chemoresistant cells. Finally, we proposed a promising therapeutic strategy to overcome both docetaxel and cabazitaxel chemoresistance by targeting the downstream effector of FKBP7.

La voie de signalisation Ras/MAPK (Ras/mitogen-activated protein kinase) régule une variété de protéines intracellulaires qui jouent un rôle important dans la croissance et la prolifération cellulaire. La régulation inappropriée de cette voie de signalisation conduit au développement de nombreux cancers comme le mélanome, qui est caractérisé par des mutations activatrices au niveau des gènes NRAS et BRAF. La protéine kinase RSK (p90 ribosomal S6 kinase) est un composant central de la voie Ras/MAPK, mais son rôle dans la croissance et la prolifération cellulaire n’est pas bien compris. RSK a été montrée pour participer à la résistance des mélanomes aux chimiothérapies, mais le mécanisme moléculaire reste encore à élucider. Nous montrons à l’aide d’un anticorps phospho-spécifique que MDM2 est phosphorylée en réponse à des agonistes et des mutations oncogéniques activant spécifiquement la voie Ras/MAPK. En utilisant des méthodes in vitro et in vivo, nous avons constaté que RSK phosphoryle directement MDM2 sur les Sérines 166 et 186, ce qui suggère que MDM2 est un substrat de RSK. La mutagénèse dirigée envers ces sites nous indique que ces résidus régulent l’ubiquitination de MDM2, suggérant que RSK régule la stabilité de MDM2 et de p53. De plus, nous avons observé que l’inhibition de RSK conduit à une augmentation du niveau protéique de p53 après un dommage à l’ADN dans les cellules de mélanomes. En conclusion, nos travaux suggèrent un rôle important de la protéine kinase RSK dans la régulation de MDM2 et de sa cible, p53. L’étude de ces mécanismes moléculaires aidera à mieux définir le rôle de RSK dans la croissance tumorale, mais également dans la résistance aux agents chimiothérapeutiques. / The Ras/mitogen-activated protein kinase (Ras/MAPK) signaling cascade regulates various intracellular targets involved in growth and proliferation. Inappropriate regulation of this pathway leads to many types of cancer, including melanomas, which are characterized by activating mutations in NRAS and BRAF. The protein kinase RSK (p90 ribosomal S6 kinase) is a central component of the Ras/MAPK pathway, but its role in cell growth and proliferation is not well understood. RSK has also been shown to participate in the resistance of melanoma cells to chemotherapy, but the mechanisms involved remain elusive. We show that MDM2 becomes phosphorylated in response to agonists and oncogenes of the Ras/MAPK pathway. Using in vitro and in vivo approaches, we found that RSK directly phosphorylates MDM2 at Ser166 and Ser186, suggesting that MDM2 is a bona fide RSK substrate. Site-directed mutagenesis indicated that these residues regulate MDM2 ubiquitination, suggesting that RSK regulates p53 function in an MDM2-dependent manner. Overexpression of active and inactive mutants of RSK revealed that this kinase regulates p53 stability, suggesting a role for RSK in the DNA damage response. Taken together, our results suggest an important role for RSK in the regulation of MDM2 and its target p53. In view of the role of p53 in the response to DNA-damaging agents, our results provide a potential mechanism involved in melanoma chemoresistance.

Ovarian cancer (OVCA) is the most lethal gynecological cancer with a 5-year survival rate less than 50%. Despite new therapeutic strategies, such as targeted therapies and immune checkpoint blockers (ICBs), tumor recurrence and drug resistance remain key obstacles in achieving long term therapeutic success. Therefore, there is an urgent need to understand the cellular and molecular mechanisms of immune dysregulation in chemoresistant ovarian cancer in order to harness the host’s immune system to improve cancer survival. Early diagnosis and residual disease are key determinants of favorable survival in OVCA; however, CA125 which is the conventional marker is not reliable and has modest diagnostic accuracy. There is therefore an urgent need to discover reliable biomarkers to optimize individualized treatment and diagnostic recommendations. Plasma gelsolin (pGSN; an actin binding protein) is the secreted isoform of the gelsolin (GSN) gene implicated in inflammatory disorders, colon cancer and prostate cancer. Increased expression of total GSN is associated with poor survival of patients with gynecological cancers. As to whether this is due to pGSN is yet to be investigated. Increased expression of pGSN is significantly associated with the down-regulation of immune cell markers; however, the exact mechanism has not been explored. If and how pGSN is involved in the cellular and molecular mechanisms of OVCA remains to be determined. In our current research, we have demonstrated that pGSN is involved in the regulation of immune cells, early diagnosis, tumor recurrence and chemoresistance in OVCA, using standard in vitro techniques and human clinical samples (North America, Asia and public datasets). We have shown that pGSN is highly expressed and secreted in chemoresistant OVCA cells than their chemosensitive counterparts. pGSN, secreted and transported via exosomes, upregulated HIF1α–mediated pGSN expression in chemoresistant OVCA cells in an autocrine manner as well as conferred cisplatin resistance in otherwise chemosensitive OVCA cells. pGSN also induced the OVCA expression of the antioxidant and tumor growth promoter, glutathione (GSH), by activating Nuclear factor erythroid 2-related factor 2 (NRF2), a response that attenuated cisplatin (CDDP)-induced apoptosis. In human tumor tissues, increased pGSN mRNA and protein expressions were significantly associated with advanced tumor stage, suboptimal residual disease, tumor recurrence, chemoresistance and poor survival regardless of patients’ ethnic background and histologic subtypes. Increased Infiltration of CD8+ T cells was significantly associated with favorable patient survival; however, increased pGSN hindered the survival impact of these infiltrated CD8+ T cells. Further investigation revealed that pGSN induced CD8+ T cell death via caspase-3 activation, an action that resulted in decreased IFNγ levels. Increased epithelial pGSN expression was significantly associated with reduced survival benefits of infiltrated M1 macrophages, through caspase-3-dependent apoptosis as well as reduced production of TNFα and iNOS. The clinical application of circulatory pGSN as a biomarker for early detection and patients’ survival was investigated. Pre-operative circulating pGSN presented as a favorable and independent biomarker for early disease detection and residual disease prediction compared with CA125. The test accuracy of pGSN was significantly enhanced when combined with CA125 in multianalyte index assay. The findings suggest that pGSN is a potential target for chemoresistant OVCA and presents as a diagnostic marker for early stage disease and surgical outcomes, interventions that could maximize the therapeutic success of immunotherapies.

Despite progress being made in our understanding of triple negative breast cancer (TNBC), the overall survival and disease-free survival for TNBC patients continues to be considerably poorer than their ER/PR/HER2+ counterparts. Metastasis and chemoresistance are the pivotal issues holding back the long-term success of TNBC treatments. In addition to the bulk tumor cells, cancer stem cells (CSCs) have emerged as important targets for alleviating TNBC progression and relapse. Cisplatin, a platinum based chemotherapeutic agent, has shown promising potential for the treatment of TNBC in clinical trials; however, cisplatin treatment is associated with tumor hypoxia that in turn promotes CSC enrichment and drug resistance. My work is to develop a combinational treatment to improve the long-term therapeutic potential of cisplatin that not only targeted the bulk TNBC population but also ALDHhigh and CD44+/CD24- CSC populations. Through clinical dataset analysis, I found that patient TNBC tumors expressed high levels of epidermal growth factor receptor (EGFR) and hypoxia genes. A similar expression pattern was demonstrated in cisplatin-resistant ovarian cancer. I therefore developed a combinational therapeutic to co-inhibit EGFR and hypoxia using metformin (an AMPK activator) and gefitinib (an EGFR inhibitor), which sensitized bulk TNBC cells to cisplatin and also led to the effective inhibition of both CD44+/CD24- and ALDHhigh CSCs. I obtained similar results by using clinically relevant TNBC patient samples ex vivo. Since these drugs are already frequently used in the clinic, this study illustrates a novel, clinically translatable therapeutic approach to improve the long-term therapeutic outcome of cisplatin for TNBC treatment.

Breast and ovarian cancers are the most serious cancers among women. Relatively high mortality at advanced stages of the disease is often associated with the development of resistance to the cytotoxic agents. Chemoresistance usually develops on the base of different adaptive mechanisms that significantly decrease therapy efficiency. Currently TRIP6, ABCC3 and CPS1 enzyme has been identified based on high-capacity expression profile monitoring in tumor cell and tissue profiles as one such candidate playing a role in taxane resistance. The main goal of this thesis was to clarify the role or possible association of the ABCC3, CPS1 and TRIP6 genes with the development of tumor cell resistance to taxanes in models of sensitive and paclitaxel-resistant ovarian cancer cells and in the cohorts of patients with ovarian and breast cancer. The in vitro part compares the efficacy of paclitaxel and taxane derivatives in the sensitive and resistant ovarian cancer cell lines and clarifies the association between the different structure of taxane derivatives and the change in CPS1 expression after their application. The study in patient's cohorts with ovarian cancer reveals a relationship between higher levels of the CPS1 gene and shorter progression-free survival. The achieved results may serve as a base for data...

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20614号 / 医博第4263号 / 新制||医||1023(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 高田 穣, 教授 平井 豊博, 教授 岩井 一宏 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM