<p>У овој дисертацији испитивана су антитуморска дејства антихипергликемијског лека метформина, вазодилататорног лека нитроглицерина, и комбинација ових лекова са дијагностичким средством 2-деокси-D-глукозом и/или радио и хемио сензибилизатором кофеином на хуманим културама аденокарцинома плућа (A549), колоректалног карцинома (HT29), аденокарцинома цервикса (HeLa), као и на контролној ћелијској култури нормалних фибробласта плућа (МRC 5). In vitro испитивање утицаја метформина, нитроглицерина, 2-деокси-D-глукозе и кофеина на проли- ферацију ћелија карцинома грлића материце (HeLa), ћелијској култури аденокарциномa плућа (A549) и ћелијској линији карцинома дебелог црева (HT29). Ћелије у експоненцијалној фази раста третиране су растућим концентрацијама метформина, нитроглицерина и 2-деокси-D-глукозе и утврдила се дозна зависност цитотоксичног ефекта. Метформин, кофеин и 2-деокси-D-глукоза су утицали на смањење процента преживљавања туморских ћелија, док је применом нитроглицерина овај ефекат изостао, иако у експериментима код истовремене примене нитроглицерина и кофеина постоји пад процента преживелих ћелија. Најпотентнији ефекат је постигнут код истовремене примене метформина и кофеина, док је разлог за одсуство снажног цитотоксичног ефекта метформина и 2-деокси-D-глукозе код комбиноване примене молекуларни механизам деловања појединачних супстанци. Снажан пролиферативни ефекат је евидентиран применом метформина и кофена на здравим фибробластима плућа.</p> / <p>U ovoj disertaciji ispitivana su antitumorska dejstva antihiperglikemijskog leka metformina, vazodilatatornog leka nitroglicerina, i kombinacija ovih lekova sa dijagnostičkim sredstvom 2-deoksi-D-glukozom i/ili radio i hemio senzibilizatorom kofeinom na humanim kulturama adenokarcinoma pluća (A549), kolorektalnog karcinoma (HT29), adenokarcinoma cerviksa (HeLa), kao i na kontrolnoj ćelijskoj kulturi normalnih fibroblasta pluća (MRC 5). In vitro ispitivanje uticaja metformina, nitroglicerina, 2-deoksi-D-glukoze i kofeina na proli- feraciju ćelija karcinoma grlića materice (HeLa), ćelijskoj kulturi adenokarcinoma pluća (A549) i ćelijskoj liniji karcinoma debelog creva (HT29). Ćelije u eksponencijalnoj fazi rasta tretirane su rastućim koncentracijama metformina, nitroglicerina i 2-deoksi-D-glukoze i utvrdila se dozna zavisnost citotoksičnog efekta. Metformin, kofein i 2-deoksi-D-glukoza su uticali na smanjenje procenta preživljavanja tumorskih ćelija, dok je primenom nitroglicerina ovaj efekat izostao, iako u eksperimentima kod istovremene primene nitroglicerina i kofeina postoji pad procenta preživelih ćelija. Najpotentniji efekat je postignut kod istovremene primene metformina i kofeina, dok je razlog za odsustvo snažnog citotoksičnog efekta metformina i 2-deoksi-D-glukoze kod kombinovane primene molekularni mehanizam delovanja pojedinačnih supstanci. Snažan proliferativni efekat je evidentiran primenom metformina i kofena na zdravim fibroblastima pluća.</p> / <p>In this dissertation, the anti-cancer effects of an antihyperglycaemic agent of metformin, a vasodilator drug nitroglycerin, and a combination of these drugs with a 2-deoxy-D-glucose diagnostic agent and / or radio and hemio sensitizer with caffeine on human cultures of adenocarcinoma of the lungs (A549), colorectal carcinoma (HT29), cervix adenocarcinoma (HeLa), as well as on the control cell culture of normal fibroblasts of the lungs (MRC 5). An in vitro study of the effects of metformin, nitroglycerin, 2-deoxy-D-glucose and caffeine on the proliferation of cervical cancer cells (HeLa), cell culture of the lung adenocarcinoma (A549), and colon cancer of the colon (HT29). The cells at the exponential growth stage were treated with rising concentrations of metformin, nitroglycerin and 2-deoxy-D-glucose, and the cytotoxic effect was determined. Metformin, caffeine, and 2-deoxy-D-glucose reduced the number of tumor cells, while nitroglycerin did not it could be concluded. Although there is a decrease in survival in experiments with the simultaneous administration of nitroglycerin and caffeine, the most effective effect is achieved in the simultaneous use of metformin and caffeine, while the reason for the absence of a potent cytotoxic effect of metformin and -deoxy-D-glucose is the molecular mechanism of the action of individual substances. The most significant effect was achieved with the simultaneous administration of metformin and caffeine to the cell culture of lung adenocarcinoma. A potent proliferative effect was recorded using metformin and 2-deoxy-Dglucose on healthy lung fibroblasts.</p>

Resumé<p><p>Le cancer reste une maladie grave car il représente une des causes principales de décès dans les pays développés. Plus d'un tiers de cancers solides réagi très faiblement à la chimiothérapie conventionnelle et/ou développe rapidement une résistance au traitement. Des thérapies ciblées, utilisées en association avec les traitements conventionnels, pourraient augmenter la survie des patients. C’est dans le cadre des thérapies ciblées que ce travail de thèse s’inscrit.<p><p>Nous nous sommes intéressés à synthétiser de nouvelles molécules qui pourraient être efficaces contre les cancers résistants à l'apoptose et donc aux traitements conventionnels. La principale cible de notre projet était la kinase DYRK1A, qui a été décrite comme étant impliquée dans la prolifération cellulaire et la résistance à l'apoptose. Dans ce but, une série de nouvelles molécules, principalement des dérivés de la tétrahydro-β-carboline, a été synthétisée et leurs propriétés antitumorales ont été caractérisées in vitro. En effet, ces structures ressemblent à celle de l’harmicine, un alcaloïde apparenté à l’harmine, l’inhibiteur de DYRK1A le plus sélectif et le plus puissant connu à ce jour. <p><p> Une méthodologie "one-pot" très efficace, développée au Laboratoire de Chimie Organique (ULB), a été utilisée pour obtenir les squelettes de type tétrahydro-β-carboline. Le deuxième chapitre de cette thèse détaille cette méthodologie et décrit la librairie de 47 dérivés qui ont été synthétisés. <p><p>Un second objectif de ce travail était de développer une version énantiosélective de cette méthodologie afin de la rendre encore plus intéressante. Cette partie, décrite dans le troisième chapitre, a été réalisée avec succès en collaboration avec l’Unité de Recherche en Chimie Organique et Macromoléculaire de l'Université du Havre (Le Havre, France). Les expériences que nous avons réalisées ont permis, non seulement d'obtenir le composé le plus actif avec un bon excès énantiomérique, mais également de mieux comprendre les aspects mécanistiques qui constituent la base de l'énantiosélectivité. <p><p>L'évaluation des propriétés anticancereuses des composés synthétisés est ensuite détaillée dans le quatrième chapitre. Les analyses toxicologiques et pharmacologiques ont montré que trois molécules présentent une bonne activité antitumorale in vitro avec une sélectivité prometteuse entre les cellules cancéreuses et les cellules normales. D’une manière inattendue, les tests biologiques plus poussés, que nous avons réalisés, ont suggéré que ces molécules n'agissent pas comme des inhibiteurs de kinases. Elles interfèrent en fait sur la prolifération cellulaire, en ciblant des facteurs de transcription spécifiques, par des mécanismes qui doivent encore être élucidés. Ces expériences biologiques ont été réalisées en collaboration avec le Laboratoire de Toxicologie et Cancérologie Expérimentale (ULB).<p><p>/<p><p>Summary<p><p>Cancer is a devastating disease which remains one of the major causes of death in developed countries. More than one third of adult solid cancers respond very poorly to chemotherapy and/or rapidly develop resistance to treatment. Targeted therapies, used in combination with conventional treatments could be used to increase the survival of cancer patients.<p><p>In this work we were interested in developing new molecules related to the targeted therapy concept that could be effective against cancer types that are resistant to apoptosis and thereby to conventional treatments. The leading target of our project was the DYRK1A kinase, which was described as being involved in cell proliferation and resistance to apoptosis. For this purpose, a series of new molecules, mainly tetrahydro β carboline derivatives, has been synthesized and their antitumoral properties were characterized in vitro. Indeed these structures resemble harmicine, an alkaloid similar to harmine, the most selective and potent DYRK1A inhibitor known to date.<p><p> An efficient “one-pot” methodology, developed in the Laboratoire de Chimie Organique (ULB) was used to obtain the tetrahydro β carboline scaffolds. Chapter II of this work describes the use of this methodology for the synthesis of a library of 47 derivatives.<p><p>A second goal of this work was to further improve this methodology by developing an enantioselective version. This part, described in chapter III, was carried out successfully in collaboration with the Research Unit in Macromolecular and Organic Chemistry of Université du Havre (Le Havre, France). The experiments we have performed enabled us not only to obtain the most active compound with a good enantiomeric excess, but also to gain insight of the mechanism responsible for the enantioselectivity.<p><p>The fourth chapter details the evaluation of the anti cancer properties of the synthesised compounds. The pharmacological and toxicological analyses showed that 3 molecules display actual anti-tumor activity in vitro with a promising selectivity between cancerous and normal cells. Surprisingly, further biological assays we have performed suggested that these molecules do not act as kinase inhibitors but influence cell proliferation through the targeting of specific transcription factors by mechanisms that remain to be deciphered. The biological experiments were performed in collaboration with the Cancerology and Experimental Toxicology Laboratory (ULB).<p><p><p><p><p><p> / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

Les tumeurs pulmonaires, qu’elles soient primaires (principalement représentées par le cancer du poumon non-à-petites cellules) ou secondaires (métastases), causent la mort de plusieurs centaines de milliers de personnes par an à travers le monde. Malgré les modalités de traitements existantes, un plateau thérapeutique a été atteint avec un taux de survie à 5 ans de maximum 15%. Actuellement, il est connu que le cancer du poumon non-à-petites cellules ainsi que les métastases sont intrinsèquement résistants à l’apoptose.<p>Pour apporter des réponses aux principales problématiques rencontrées avec l’administration systémique de la chimiothérapie conventionnelle qui est principalement constituée d’agents pro-apoptotiques, nous avons développé des formulations à base d’agents antinéoplasiques aux propriétés anticancéreuses non pro-apoptotiques qui sont destinées à être administrées de manière localisée par la voie inhalée. Il faut savoir que l’inhalation est la voie d’administration préférentielle des principales affections respiratoires telles que l’asthme, la bronchopneumonie chronique obstructive et la mucoviscidose. <p>La première partie de ce travail a consisté à produire et à évaluer des formulations à base de témozolomide destinées à être administrées chez la souris porteuse de pseudo-métastases pulmonaires (issues d’un mélanome expérimental, le modèle B16F10), soit via la voie intraveineuse (iv) conventionnelle soit via la voie inhalée à l’aide d’un dispositif endotrachéal approprié. La suspension pour inhalation a été produite à l’aide de technique de réduction de taille et a été stabilisée à l’aide de phospholipides compatibles avec la voie pulmonaire. L’activité anticancéreuse in vitro a été vérifiée pour le témozolomide formulé sous forme de suspension pour inhalation et de solution intraveineuse par rapport à du témozolomide non formulé sur des lignées de cellules cancéreuses de cancer humain NSCLC A549, de glioblastome humain T98G et de mélanome murin B16F10. Cette dernière lignée a été utilisée pour générer les pseudo-métastases pulmonaires chez la souris en injectant les cellules de mélanomes dans la voie systémique via la veine caudale. La reproductibilité de la dose et de l’aérosol générés à partir de la suspension pour inhalation à l’aide du dispositif d’administration endotrachéal et la déposition des gouttelettes dans les poumons de la souris ont pu être respectivement évaluées avec précision par une méthode de quantification du témozolomide qui a été validée par nos soins, par des techniques de diffraction laser et par des techniques de microscopie à fluorescence et d’analyse d’images histologiques. Enfin, l’activité antitumorale in vivo et la tolérance des traitements conventionnels ou localisés ont été vérifiées chez la souris porteuse de ces pseudo-métastases pulmonaires B16F10. Les résultats ont montré que le dispositif endotrachéal utilisé permettait de produire des doses et des aérosols reproductibles et de déposer les gouttelettes d’aérosol profondément dans les poumons des souris. De plus, lors de l’étude in vivo, les traitements administrés étaient bien tolérés et la dose de témozolomide administré sous forme de suspension pour inhalation à l’aide du dispositif endotrachéal avait permis d’obtenir une efficacité antitumorale similaire à une dose similaire de témozolomide administrée par la voie iv conventionnelle. De plus, 11% (3/27) de souris « long-survivantes » avaient été observées avec le groupe traité par inhalation trois fois par semaine pendant trois semaines consécutives et les poumons de ces long-survivants avaient présenté une éradication quasi complète des tumeurs pulmonaires. Ce phénomène n’avait pas été observé dans les groupes de souris traitées de manière conventionnelle.<p>Ensuite, la seconde partie de notre travail a consisté en l’élaboration du témozolomide sous forme de poudres sèches pour inhalation destinées à être délivrées à l’aide d’un dispositif à poudre sèche à usage humain. Pour ce faire, nous avons développé les poudres sèches pour inhalation à l’aide de techniques de réduction de taille pour microniser la poudre de départ et d’atomisation pour évaporer le solvant et élaborer un enrobage autour des particules micronisées. La nature de l’enrobage était soit hydrophile soit lipophile. Ensuite les caractéristiques physicochimiques telles que les propriétés thermiques, les propriétés cristallines, la distribution de taille particulaire et la morphologie des formulations de poudre sèche pour inhalation ont été évalués à l’aide de techniques appropriées telles que la calorimétrie différentielle à balayage, la diffraction des rayons X sur poudre, la diffraction de la lumière laser et la microscopie électronique à balayage. Les profils de déposition pulmonaire et de dissolution ont été respectivement déterminés in vitro à l’aide de l’essai de la pharmacopée européenne utilisant l’impacteur à cascade multi-étages et d’un test de dissolution adapté aux formes pulmonaires. Les quatre formulations élaborées présentaient des caractéristiques physicochimiques intéressantes pour la stabilité à long-terme de la substance active et des formulations. De plus, deux formulations de poudre sèche pour inhalation (les formulations F1 et F2) présentaient des propriétés aérodynamiques tout à fait attrayantes avec une fraction minimale de poudre déposée au niveau du tractus respiratoire supérieure et une fraction maximale de poudre déposée au niveau du tractus respiratoire inférieur où se localisent les tumeurs pulmonaires. De plus, l’ensemble des formulations ont montré que la fraction sélectionnée des particules fines des poudres sèches pour inhalation libérait 75% du témozolomide dans le liquide simulant le fluide pulmonaire endéans les dix premières minutes du test de dissolution in vitro adapté aux formes pulmonaires. <p>Enfin, nous avons comparé l’efficacité et la tolérance in vivo d’une de nos formulations de poudre sèche de témozolomide pour inhalation administrée soit sous forme de suspension, soit sous forme de poudre sèche, à l’aide du dispositif endotrachéal approprié chez la souris porteuse de pseudo-métastases pulmonaires. L’uniformité de la dose délivrée par les différents dispositifs a été évaluée à l’aide d’une technique quantitative validée. Les résultats de cette étude ont montré qu’en administrant une formulation de poudre sèche sous forme d’un mélange de poudres plutôt que sous forme d’une suspension liquide, les doses en témozolomide à administrer pour obtenir une efficacité comparable était au moins deux fois moins élevées. Cependant, le dispositif endotrachéal pour les formulations de poudre présentait plus de variabilité au niveau de la dose délivrée que le dispositif endotrachéal pour les formulations liquides ce qui induit une variabilité dans les doses délivrées. Pour clôturer ce travail, nous avons appliqué certaines techniques que nous avons développées pour le témozolomide à une nouvelle molécule de synthèse, le trivanillate polyphénolique 13c, qui montre des propriétés anticancéreuses intéressantes dans le cadre des tumeurs pulmonaires. En effet, une méthode quantitative a été développée et a été validée. Une étude de pré-formulation et des essais de formulation pour produire une suspension, des complexes d’inclusion et des microparticules lipidiques ont été entrepris avec de relativement bons résultats pour les complexes d’inclusion élaborés avec des gamma cyclodextrines qui permettaient d’augmenter la solubilité dans l’eau de la molécule de 13c d’un facteur d’au moins 1,5×106. De plus, les particules de 13c montraient la particularité de se solubiliser dans un mélange dichlorométhane/éthanol (1 :1 v/v) ce qui nous a permis d’élaborer des microparticules lipidiques pour lesquelles les propriétés de mouillage devront être améliorées dans l’avenir./<p>Primary lung tumors, mainly represented by non-small-cell lung cancers (cancers NSCLC), or secondary lung tumors (metastasis) cause the death of hundred thousand human beings worldwide. Despite the therapeutic modalities used, the five-year survival rate reaches only 15%. Nowadays, it is known that cancers NSCLC and metastasis are intrinsically resistant to apoptosis.<p>To overcome the main problems occurring with the systemic delivery of conventional chemotherapy which are mainly constituted of non-specific and non selective pro-apoptotic agents, we have developed some formulations based on non pro-apoptotic antineoplasic drugs which are designed to be delivered by a localized administration, the inhalation. Indeed, inhalation is the preferential route to treat the main pulmonary affections such as asthma, chronic obstructive pulmonary disease or cystic fibrosis.<p>The first part of this work consisted to produce and evaluate temozolomide-based formulations designed to be delivered to mice bearing pulmonary pseudo-metastases (using a experimental melanoma, the B16F10 model), either by the conventional intravenous (iv) route or by inhalation using an endotracheal device appropriate to mice. The suspension for inhalation was produced by means of a high pressure homogenizing technique using phospholipids compatible with the lungs to stabilize the suspension. The in vitro anticancer activity was evaluated for both temozolomide-based formulations in comparison with non-formulated temzolomide on three cancer cell lines, a human NSCLC cancer cells (A549), a human glioblastoma cancer cells (T98G) as positive control and a murine melanoma cancer cells (B16F10). The latter was used to generate lung tumors in mice by injecting the melanoma cells by iv. Reproducibility of delivered dose and generated aerosol by the endotracheal device from the suspension for inhalation and the deposition of droplets in the mouse lungs were precisely evaluated by means of a validated HPLC determination method, a laser diffraction technique and fluorescent microscopy and histological image analysis, respectively. Then, the tolerance and the antitumor efficacy of iv or inhaled temozolomide-based treatments were evaluated on mice bearing pulmonary pseudo-metastases B16F10. The results showed that endotracheal device produced reproducible doses and aerosols and that the aerosol droplets were deposited deeply in the mouse lungs. Moreover, the temozolomide-based treatments were well tolerated in terms of weight evolution and the inhaled based-temozolomide treatments were able to get the same antitumor efficacy in terms of median survival rate as the conventional iv based-temozolomide treatments delivered at a same frequency. Moreover with the group treated by inhalation three times a week during three consecutive weeks, 11% (3/27) mice survived with an almost complete eradication of lung tumors which was not observed with the groups treated by conventional route.<p>Then, the second part of our work consisted to produce temozolomide-based dry powders for inhalation able to be delivered with a dry powder inhaler for human use. We developed the dry powders for inhalation using a high-pressure homogenizing technique to micronize temozolomide particles and then spray-drying technique to coat temozolomide microparticles. The coating was either hydrophilic or lipophilic. Then, the physicochemical characteristics such as thermal or crystalline properties, the particle size distribution and the particle morphology were evaluated for the four dry powders for inhalation by means of differential scanning calorimetry, x-ray powder diffraction, laser light scattering and scanning electron microscopy, respectively. The in vitro pulmonary deposition and dissolution were respectively determined by European pharmacopeia assay for the aerodynamic assessment of fine particles using a multi-stage liquid impinger and by dissolution test optimized for inhaler products. The four formulations produced presented physicochemical properties promoting long-term stability of temozolomide and formulations.Moreover, two of them (dry powder without coating or with a thin lipid coating) showed attractive aerodynamic properties with a minimal fraction of powder deposited in the oropharyngeal and tracheal zones and maximal fraction deposited in the lungs (almost 50% of the nominal dose) where the lung tumors are localized. Moreover, fine particle fraction of all formulations showed a fast release and dissolution of temozolomide with more than 75% of temozolmide dissolved within 10 minutes in the simulated lung fluid during the in vitro dissolution test optimized for dry powders for inhalation.<p>Then, we compared the in vivo antitumor efficacy and tolerance of one of dry powders for inhalation on mice bearing pulmonary pseudo-metastases B16F10. The dry powder for inhalation was administered either by dispersing it as a extemporaneous suspension able to be delivered by the endotracheal device for liquid forms or by mixing it with a spray-dried diluent able to be delivered by the endotracheal device for dry powders. The uniformity of delivered dose by the different endotracheal device was evaluated by a validated quantitative method. The results showed that the delivery of the powder mixture presented the same antitumor efficacy as the extemporaneous suspension but for a half dose of temozolomide. However, the endotracheal device for dry powders presented a higher variability of delivered dose than the endotracheal device for liquid forms.<p>Finally, we apply the pulmonary application on a polyphenol developed in the Faculty of Pharmacy, the molecule 13c, that showed very interesting in vitro anticancer properties against lung tumors. So, a quantitative method was developed and was validated. A preformulation studie was performed and formulation developements are on-going.<p> / Doctorat en Sciences biomédicales et pharmaceutiques / info:eu-repo/semantics/nonPublished

Inhibiting BCR-ABL kinase activity with tyrosine kinase inhibitors (TKIs) has been the frontline therapy for CML. Resistance to TKIs frequently occurs, but the mechanisms remain elusive. First, to uncover survival pathways involved in TKI resistance in CML, I conducted a genome-wide RNAi screen in human CML cells to identify genes governing cellular sensitivity to the first generation TKI called IM (Gleevec). I identified genes converging on and activating the MEK/ERK pathway through transcriptional up-regulation of PRKCH. Combining IM with a MEK inhibitor synergistically kills TKI-resistant CML cells and CML stem cells. Next, I performed single cell RNA-seq to compare expression profiles of CML stem cells and hematopoietic stem cells isolated from the same patient. Among the genes that are preferentially expressed in CML stem cells is PIM2, which encodes a pro-survival serine-threonine kinase that phosphorylates and inhibits the pro-apoptotic protein BAD. Inhibiting PIM2 function sensitizes CML stem cells to IM-induced apoptosis and prevents disease relapse in a CML mouse model. Last, I devised a CRISPR-Cas9 based strategy to perform insertional mutagenesis at a defined genomic location in murine hematopoietic Ba/F3 cells. As proof of principle, we showed its capability to perform unbiased, saturated point mutagenesis in a 9 amino acid region of BCR-ABL encompassing the socalled “gatekeeper” residue, an important determinant of TKI binding. We found that the ranking order of mutations from the screen correlated well with their prevalence in IM-resistant CML patients. Overall, my findings reveal novel resistance mechanisms in CML and provide alternative therapeutic strategies.

Indiana University-Purdue University Indianapolis (IUPUI). / The abysmal five year pancreatic cancer survival rate of less than 6% highlights the need for new treatments for this deadly malignancy. Cytotoxic drugs normally target rapidly dividing cancer cells but unfortunately often target stem cells resulting in toxicity. This warrants the development of compounds that selectively target tumor cells. An inhibitor of the mitotic kinase, MPS1, which has been shown to be more selective towards cancer cells than non-tumorigenic cells, shows promise but its effects on stem cells has not been investigated. MPS1 is an essential component of the Spindle Assembly Checkpoint and is proposed to be up-regulated in cancer cells to maintain chromosomal segregation errors within survivable limits. Inhibition of MPS1 kinase causes cancer cell death accompanied by massive aneuploidy. Our studies demonstrate that human adipose stem cells (ASCs) and can tolerate higher levels of a small molecule MPS1 inhibitor than pancreatic cancer cells. In contrast to PANC-1 cancer cells, ASCs and telomerase-immortalized pancreatic ductal epithelial cells did not exhibit elevated chromosome mis-segregation after treatment with the MPS1 inhibitor for 72hrs. In contrast, PANC-1 pancreatic cancer cells exhibited a large increase in chromosomal mis-segregation under similar conditions. Furthermore, growth of ASCs was minimally affected post treatment whereas PANC-1 cells were severely growth impaired suggesting a favorable therapeutic index. Our studies, demonstrate that MPS1 inhibition is selective towards pancreatic cancer cells and that stem cells are less affected in vitro. These data suggest MPS1 inhibition should be further investigated as a new treatment approach in pancreatic cancer.

Microtubule targeting agents (MTAs) are chemotherapeutics commonly used in the treatment of breast, ovarian, lung, and lymphoma cancers. There are two main classes of MTAs based upon their effects on microtubule stability. The two classes are the destabilizing agents, which include the drug vincristine, and the stabilizing agents, which include paclitaxel and epothilone B. These drugs are highly effective antineoplastics, but their use is often accompanied by several side effects, one of which is peripheral neuropathy. Peripheral neuropathy can be characterized by burning pain, tingling, loss of proprioception, or numbness in the hands and feet. In some patients, the MTA-induced peripheral neuropathy is debilitating and dose-limiting; however, there are no effective prevention strategies or treatment options for peripheral neuropathy as the mechanisms mediating this side effect are unknown. The goal of this work was to investigate MTA-induced effects on neuronal activity and morphology in order to elucidate the underlying mechanisms involved in the development of MTA-induced peripheral neuropathy. As an indicator of sensory neuronal activity, the basal and stimulated release of the putative nociceptive peptide, calcitonin gene-related peptide (CGRP), was measured from sensory neurons in culture after exposure to the MTAs paclitaxel, epothilone B, and vincristine. Neurite length and branching were also measured in sensory neuronal cultures after treatment with these MTAs. The results described in this thesis demonstrate that MTAs alter the stimulated release of CGRP from sensory neurons in differential ways depending on the MTA agent employed, the CGRP evoking-stimulus used, the concentration of the MTA agent, the duration of exposure to the MTA agent, and the presence of NGF. It was also observed that MTA agents decrease neurite length and branching, independent of the concentration of NGF in the culture media. Thus, this thesis describes MTA-induced alterations of sensory neuronal sensitivity and neurite morphology and begins to elucidate the underlying mechanisms involved in MTA-induced alterations of sensory neurons. These findings will undoubtedly be used to help elucidate the mechanisms underlying MTA-induced peripheral neuropathy.

No / PURPOSE: This phase I dose-escalation study was undertaken to establish the maximum tolerated dose of the sequence-selective minor groove DNA binding agent SJG-136 in patients with advanced solid tumors. The study also investigated antitumor activity and provided pharmacokinetic and pharmacodynamic data. EXPERIMENTAL DESIGN: Sixteen patients were assigned sequentially to escalating doses of SJG-136 (15-240 microg/m(2)) given as a 10-minute i.v. infusion every 21 days. The dose was subsequently reduced in incremental steps to 45 microg/m(2) due to unexpected toxicity. RESULTS: The maximum tolerated dose of SJG-136 was 45 microg/m(2). The main drug-related adverse event was vascular leak syndrome (VLS) characterized by hypoalbuminemia, pleural effusions, ascites, and peripheral edema. Other unexpected adverse events included elevated liver function tests and fatigue. The VLS and liver toxicity had delayed onset and increased in severity with subsequent cycles. Disease stabilization was achieved for >6 weeks in 10 patients; in 2 patients this was maintained for >12 weeks. There was no evidence of DNA interstrand cross-linking in human blood lymphocytes with the use of the comet assay. Evidence of DNA interaction in lymphocytes and tumor cells was shown through a sensitive gamma-H2AX assay. SJG-136 had linear pharmacokinetics across the dose range tested. CONCLUSIONS: SJG-136 was associated with dose-limiting VLS and hepatotoxicity when administered by short injection every 21 days. DNA damage was noted, at all dose levels studied, in circulating lymphocytes. The etiology of the observed toxicities is unclear and is the subject of further preclinical research. Alternative clinical dosing strategies are being evaluated.

AQ4N (banoxantrone) is a prodrug that, under hypoxic conditions, is enzymatically converted to a cytotoxic DNA-binding agent, AQ4. Incorporation of AQ4N into conventional chemoradiation protocols therefore targets both oxygenated and hypoxic regions of tumors, and potentially will increase the effectiveness of therapy. This current pharmacodynamic and efficacy study was designed to quantify tumor exposure to AQ4 following treatment with AQ4N, and to relate exposure to outcome of treatment. A single dose of 60 mg/kg AQ4N enhanced the response of RT112 (bladder) and Calu-6 (lung) xenografts to treatment with cisplatin and radiation therapy. AQ4N was also given to separate cohorts of tumor-bearing mice 24 hours before tumor excision for subsequent analysis of metabolite levels. AQ4 was detected by high performance liquid chromatography/mass spectrometry in all treated samples of RT112 and Calu-6 tumors at mean concentrations of 0.23 and 1.07 microg/g, respectively. These concentrations are comparable with those shown to be cytotoxic in vitro. AQ4-related nuclear fluorescence was observed in all treated tumors by confocal microscopy, which correlated with the high performance liquid chromatography/mass spectrometry data. The presence of the hypoxic marker Glut-1 was shown by immunohistochemistry in both Calu-6 tumors and RT112 tumors, and colocalization of AQ4 fluorescence and Glut-1 staining strongly suggested that AQ4N was activated in these putatively hypoxic areas. This is the first demonstration that AQ4N will increase the efficacy of chemoradiotherapy in preclinical models; the intratumoral levels of AQ4 found in this study are comparable with tumor AQ4 levels found in a recent phase I clinical study, which suggests that these levels could be potentially therapeutic.

Infiltration of myeloid cells in the tumor microenvironment is often associated with enhanced angiogenesis and tumor progression, resulting in poor prognosis in many types of cancer. The polypeptide chemokine PK2 (Bv8, PROK2) has been shown to regulate myeloid cell mobilization from the bone marrow, leading to activation of the angiogenic process, as well as accumulation of macrophages and neutrophils in the tumor site. Neutralizing antibodies against PK2 were shown to display potent anti-tumor efficacy, illustrating the potential of PK2-antagonists as therapeutic agents for the treatment of cancer. In this study we demonstrate the anti-tumor activity of a small molecule PK2 antagonist, PKRA7, in the context of glioblastoma and pancreatic cancer xenograft tumor models. For the highly vascularized glioblastoma, PKRA7 was associated with decreased blood vessel density and increased necrotic areas in the tumor mass. Consistent with the anti-angiogenic activity of PKRA7 in vivo, this compound effectively reduced PK2-induced microvascular endothelial cell branching in vitro. For the poorly vascularized pancreatic cancer, the primary anti-tumor effect of PKRA7 appears to be mediated by the blockage of myeloid cell migration/infiltration. At the molecular level, PKRA7 inhibits PK2-induced expression of certain pro-migratory chemokines and chemokine receptors in macrophages. Combining PKRA7 treatment with standard chemotherapeutic agents resulted in enhanced effects in xenograft models for both types of tumor. Taken together, our results indicate that the anti-tumor activity of PKRA7 can be mediated by two distinct mechanisms that are relevant to the pathological features of the specific type of cancer. This small molecule PK2 antagonist holds the promise to be further developed as an effective agent for combinational cancer therapy. / Dissertation

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