Breast cancer is a heterogeneous disease comprised of distinct biological entities that correlate with diverse clinical outcomes. Gene expression profiling has divided this heterogeneity into luminal, ERBB2+ and basal molecular subtypes. Basal breast cancers are difficult to treat as they lack expression of candidates suitable for targeted therapies and are associated with poor outcome. / Elevated protein level of the hepatocyte growth factor receptor, MET, is observed in 20% of human breast cancers and correlates with poor prognosis. However, the role of MET in mammary tumorigenesis is poorly understood. To address this, we generated a murine model that expresses weakly oncogenic mutants of Met (Metmt) in the mammary epithelium under the transcriptional control of the mouse mammary tumor virus promoter. We demonstrate that Metmt induces mammary carcinomas with diverse phenotypes and used gene expression microarrays to elucidate gene expression changes induced by Met. Since mammary tumors contained variable contents of epithelium and stroma, we used laser capture microdissection to procure epithelial cells for microarray analysis. Based on immunohistochemistry and expression profiling, we show that Metmt produces tumors with luminal or basal characteristics. From hierarchical clustering, Metmt-induced basal tumors clustered with murine models that share features of epithelial to mesenchymal transition and human basal breast cancers. Moreover, Metmt basal tumors clustered with human basal breast cancer. The status of MET among the human breast cancer subtypes has not previously been addressed. We demonstrate that MET levels are variable across molecular subtypes but show elevation in the basal subtype and correlates with poor outcome. We used a candidate gene approach derived from microarray data to gain an understanding of signals required for Met-dependent tumorigenesis. We investigated Nck adaptor proteins and demonstrate a role for Nck in cell motility and actin dynamics of Met-dependent breast carcinoma cells and show elevated expression in human basal breast cancers. By generating a unique mouse model in which Met is expressed in mammary epithelia, with the examination of MET levels in human breast cancer, we have established a novel link between MET and basal breast cancer. This work identifies poor outcome basal breast cancers that may benefit from anti-MET therapies.

Background. Both basal-like subtype and BRCA1-related breast cancers tend to have a poor overall prognosis and lack of effective treatments. Given that the lung cancer drug gefitinib and the leukemia drug dasatinib inhibit proteins also belonging to the molecular signature of this subtype, we and others hypothesized that they might be useful therapies for those two breast cancer subgroups. / Methods. Eight breast cancer cell lines were characterized by immunohistochemistry and western blotting and were treated with both drugs. Response was measured by using the sulphorhodamine B (SRB) assay. / Results. Two out of six basal-like cell lines were sensitive to gefitinib and five of six to dasatinib. BRCA1-related breast cancers were also responsive to dasatinib (three out of four). Moreover, EGFR and caveolin-1 act as markers for dasatinib sensitivity, but do not appear to be the primary targets of this drug. The presence of SRC but not ABL is necessary to achieve a response to dasatinib. / Conclusion. Dasatinib is more effective in the treatment of basal-like breast cancers than gefitinib and acts by inhibiting SRC and other molecules that are yet to be determined.

No description available.

No description available.

Estudos sugerem que a presença de células metastáticas ocultas em medula óssea pode ser fator prognóstico em câncer de mama. Além disso, é possível que um perfil gênico tumoral específico, caracterizado por repressão da expressão gênica, esteja associado à detecção de células tumorais na medula óssea. O silenciamento de genes é controlado pela desacetilação de histonas e metilação de DNA, esta última catalisada por enzimas DNA metil transferases. Outro alvo de metil-transferases são as histonas, e histona H3 quando sofre metilação em lisina 9, gera sítio de ligação a proteínas HP1 (Heterocromatin protein-1 ou cromobox). Membros da família HP1 (HP1Hsalfa, HP1Hsbeta e HP1HsY) participam da formação da heterocromatina e da regulação da expressão de genes. Logo, nosso objetivo foi determinar no tumor primário de mama, a expressão de HP1Hsalfa, HP1Hsbeta e HP1Hsy , que participam da repressão gênica, em relação à presença ou ausência de células metastáticas ocultas na medula óssea. Neste estudo foram incluídas 37 pacientes de forma prospectiva, atendidas no Instituto Brasileiro de Controle do Câncer (IBCC) no período de junho de 2004 a julho de 2005, com diagnóstico histopatológico de carcinoma invasivo de mama, estádio clínico (EC) I (16,2%), II (51,4%) ou III (32,4%), segundo a classificação patológica. A idade mediana das pacientes foi 63 anos (41 a 90) e 62.2% delas encontravam-se na pós-menopausa, sendo que 24.3% relatava história familiar para câncer de mama. O tipo histológico predominante foi carcinoma ductal invasivo (89.2% dos casos), sendo, o restante, representado por carcinoma lobular invasivo (10.8%). Foram coletadas amostras de tumor primário de mama e de aspirado de medula óssea de cada paciente. A presença de células metastáticas ocultas (CMO) na medula óssea (MO) foi detectada através da expressão de citoqueratina 19 (CK19) pelo método de nested RT-PCR. A expressão relativa dos genes HP1Hsalfa, HP1Hsbeta e HP1Hsy foi determinada no tumor primário, usando-se a técnica de RT-PCR em tempo real. Presença de CMO foi detectada na MO de 20 pacientes (54.1%). Não observamos diferença na expressão de HP1Hs? (1,93 ± 2,25 MO- vs 3,84 ± 5,53 MO+), HP1Hs? (6,74 ± 6,31 MO- vs 6,49 ± 5,86 MO+) e HP1Hs? (24,58 ± 11,14 MO- vs 24,91 ± 15,88 MO+) entre as amostras tumorais de pacientes com presença (MO+) ou ausência (MO-) de micrometástase medular. Também não observamos variação da expressão de genes HP1 em relação ao comprometimento linfonodal, dimensão e grau histológico do tumor, expressão tumoral de receptores de estrógeno e estado menopausal da paciente. A expressão de HP1Hsalfa em tumores de pacientes com câncer de mama ERBB2 negativos, entretanto, foi maior do que em tumores ERBB2 positivos. Nossos dados indicam que em tumores de mama, a expressão de HP1Hsalfa, HP1Hsbeta e HP1Hsy não parece se associar à presença de células ocultas em medula óssea / Studies suggest that the presence of occult metastatic cells (OMC) in the bone marrow (BM) may be a prognostic factor in breast cancer. Besides, it is possible that a specific tumor gene profile, characterized by repression of gene expression, may be associated to the presence of tumoral cells in the bone marrow. Gene silencing is controlled by histone deacetylation and DNA methylation, the last one catalized by enzymes DNA methyltransferases (DNMTs). Histones are another target of methyltransferases, and methylation of histone H3 on lysine-9 generate a binding site for HP1 proteins (Heterocromatin protein-1 or chromobox). Members of the HP1 family (HP1Hsalfa, HP1Hsbeta e HP1Hsy) take part in heterochromatin formation and gene expression regulation. Hence, our aim was to determine in the primary tumor of the breast, the expression of HP1Hsalfa, HP1Hsbeta e HP1Hsy, which participate in gene repression, in the presence or absence of occult metastatic cells in the bone marrow. In this study, 37 patients treated at Instituto Brasileiro de Controle do Câncer, from June 2004 to July 2005, with invasive breast cancer histopathologically confirmed, pathological clinical stages I (16,2%), II (51,4%) or III (32,4), were included. The median age of the patients was 63 years (41 to 90), 62.2% were post-menopausal and 24.3% reported family history of breast cancer. Invasive ductal carcinoma was diagnosed in most patients (89.2%), and invasive lobular carcinoma was detected in the other patients (10.8%). Tumor samples and bone marrow aspirates were obtained from each patient. The presence of CMO in BM was detected by keratin-19 (CK19) expression by nested RT-PCR. The relative expression of the genes HP1Hsalfa, HP1Hsbeta e HP1Hsy was determined by real-time RT-PCR. Occult metastatic cells (OMC) in BM were detected in 20 patients (54.1%). No differences were observed in the expression of HP1Hs? (1,93 ± 2,25 BM- vs 3,84 ± 5,53 BM+), HP1Hsalfa (6,74 ± 6,31 BM- vs 6,49 ± 5,86 BM+) and HP1Hsbeta (24,58 ± 11,14 BM- vs 24,91 ± 15,88 BM+) between tumor samples of BM+ patients and BM- patients. Variations of HP1 gene expression were neither observed according to lymph node involvement, tumor size, histological grade, estrogen receptor status and menopausal status. However, HP1Hsbeta expression in ERBB2-negative tumors was higher than in ERBB2-positive tumors. Our data indicate that in breast cancer tumors, expression of HP1Hsalfa, HP1Hsbeta e HP1Hsy does not seem to be associated with the presence of occult metastatic cells in the bone marrow

Ongoing research in the fields of genetics and biotechnology hold the promise of improved diagnosis and treatment of genetic diseases, and potentially the development of individually tailored pharmaceuticals and gene therapies. Difficulty, however, arises in determining how these services are to be evaluated and integrated equitably into public health care systems such as Canada's. The current context is one of increasing fiscal restraint on the part of governments, limited financial resources being dedicated to health care, and rising costs for new health care services and technologies. This has led to increasing public debate in the last few years about how to reform public health care, and whether we should prohibit, permit or perhaps even encourage private purchase of health care services. In Canada, some of these concerns have crystallized around the issue of gene patents and commercial genetic testing, in particular as illustrated by the case of Myriad Genetics' patented BRACAnalysis test for hereditary breast and ovarian cancer. While most Canadians who currently access genetic services do so through the public health care system, for those with the means, private purchase is becoming an option. This situation raises serious concerns - about justice in access to health care; about continued access to safe and reliable genetic testing supported by unbiased patient information; and about the broader effects of commercialization for ongoing research and the Canadian public health care system. Commercial genetic testing presents a challenge to health care professionals, policy analysts, and academics concerned with the social, ethical and policy implications of new genetic technologies. Using the Myriad case as an exemplar, tools from moral philosophy, the social sciences, and health policy and law will be brought to bear on the larger issues of how as a society we should regulate commercial research and product development, and more coherently decide which services to cover under public health insurance and which to leave to private purchase. Generally, the thesis is concerned with the question of "how best to bring capital, morality, and knowledge into a productive and ethical relationship" (Rabinow 1999, 20).

Estudos sugerem que a presença de células metastáticas ocultas em medula óssea pode ser fator prognóstico em câncer de mama. Além disso, é possível que um perfil gênico tumoral específico, caracterizado por repressão da expressão gênica, esteja associado à detecção de células tumorais na medula óssea. O silenciamento de genes é controlado pela desacetilação de histonas e metilação de DNA, esta última catalisada por enzimas DNA metil transferases. Outro alvo de metil-transferases são as histonas, e histona H3 quando sofre metilação em lisina 9, gera sítio de ligação a proteínas HP1 (Heterocromatin protein-1 ou cromobox). Membros da família HP1 (HP1Hsalfa, HP1Hsbeta e HP1HsY) participam da formação da heterocromatina e da regulação da expressão de genes. Logo, nosso objetivo foi determinar no tumor primário de mama, a expressão de HP1Hsalfa, HP1Hsbeta e HP1Hsy , que participam da repressão gênica, em relação à presença ou ausência de células metastáticas ocultas na medula óssea. Neste estudo foram incluídas 37 pacientes de forma prospectiva, atendidas no Instituto Brasileiro de Controle do Câncer (IBCC) no período de junho de 2004 a julho de 2005, com diagnóstico histopatológico de carcinoma invasivo de mama, estádio clínico (EC) I (16,2%), II (51,4%) ou III (32,4%), segundo a classificação patológica. A idade mediana das pacientes foi 63 anos (41 a 90) e 62.2% delas encontravam-se na pós-menopausa, sendo que 24.3% relatava história familiar para câncer de mama. O tipo histológico predominante foi carcinoma ductal invasivo (89.2% dos casos), sendo, o restante, representado por carcinoma lobular invasivo (10.8%). Foram coletadas amostras de tumor primário de mama e de aspirado de medula óssea de cada paciente. A presença de células metastáticas ocultas (CMO) na medula óssea (MO) foi detectada através da expressão de citoqueratina 19 (CK19) pelo método de nested RT-PCR. A expressão relativa dos genes HP1Hsalfa, HP1Hsbeta e HP1Hsy foi determinada no tumor primário, usando-se a técnica de RT-PCR em tempo real. Presença de CMO foi detectada na MO de 20 pacientes (54.1%). Não observamos diferença na expressão de HP1Hs? (1,93 ± 2,25 MO- vs 3,84 ± 5,53 MO+), HP1Hs? (6,74 ± 6,31 MO- vs 6,49 ± 5,86 MO+) e HP1Hs? (24,58 ± 11,14 MO- vs 24,91 ± 15,88 MO+) entre as amostras tumorais de pacientes com presença (MO+) ou ausência (MO-) de micrometástase medular. Também não observamos variação da expressão de genes HP1 em relação ao comprometimento linfonodal, dimensão e grau histológico do tumor, expressão tumoral de receptores de estrógeno e estado menopausal da paciente. A expressão de HP1Hsalfa em tumores de pacientes com câncer de mama ERBB2 negativos, entretanto, foi maior do que em tumores ERBB2 positivos. Nossos dados indicam que em tumores de mama, a expressão de HP1Hsalfa, HP1Hsbeta e HP1Hsy não parece se associar à presença de células ocultas em medula óssea / Studies suggest that the presence of occult metastatic cells (OMC) in the bone marrow (BM) may be a prognostic factor in breast cancer. Besides, it is possible that a specific tumor gene profile, characterized by repression of gene expression, may be associated to the presence of tumoral cells in the bone marrow. Gene silencing is controlled by histone deacetylation and DNA methylation, the last one catalized by enzymes DNA methyltransferases (DNMTs). Histones are another target of methyltransferases, and methylation of histone H3 on lysine-9 generate a binding site for HP1 proteins (Heterocromatin protein-1 or chromobox). Members of the HP1 family (HP1Hsalfa, HP1Hsbeta e HP1Hsy) take part in heterochromatin formation and gene expression regulation. Hence, our aim was to determine in the primary tumor of the breast, the expression of HP1Hsalfa, HP1Hsbeta e HP1Hsy, which participate in gene repression, in the presence or absence of occult metastatic cells in the bone marrow. In this study, 37 patients treated at Instituto Brasileiro de Controle do Câncer, from June 2004 to July 2005, with invasive breast cancer histopathologically confirmed, pathological clinical stages I (16,2%), II (51,4%) or III (32,4), were included. The median age of the patients was 63 years (41 to 90), 62.2% were post-menopausal and 24.3% reported family history of breast cancer. Invasive ductal carcinoma was diagnosed in most patients (89.2%), and invasive lobular carcinoma was detected in the other patients (10.8%). Tumor samples and bone marrow aspirates were obtained from each patient. The presence of CMO in BM was detected by keratin-19 (CK19) expression by nested RT-PCR. The relative expression of the genes HP1Hsalfa, HP1Hsbeta e HP1Hsy was determined by real-time RT-PCR. Occult metastatic cells (OMC) in BM were detected in 20 patients (54.1%). No differences were observed in the expression of HP1Hs? (1,93 ± 2,25 BM- vs 3,84 ± 5,53 BM+), HP1Hsalfa (6,74 ± 6,31 BM- vs 6,49 ± 5,86 BM+) and HP1Hsbeta (24,58 ± 11,14 BM- vs 24,91 ± 15,88 BM+) between tumor samples of BM+ patients and BM- patients. Variations of HP1 gene expression were neither observed according to lymph node involvement, tumor size, histological grade, estrogen receptor status and menopausal status. However, HP1Hsbeta expression in ERBB2-negative tumors was higher than in ERBB2-positive tumors. Our data indicate that in breast cancer tumors, expression of HP1Hsalfa, HP1Hsbeta e HP1Hsy does not seem to be associated with the presence of occult metastatic cells in the bone marrow

Ongoing research in the fields of genetics and biotechnology hold the promise of improved diagnosis and treatment of genetic diseases, and potentially the development of individually tailored pharmaceuticals and gene therapies. Difficulty, however, arises in determining how these services are to be evaluated and integrated equitably into public health care systems such as Canada's. The current context is one of increasing fiscal restraint on the part of governments, limited financial resources being dedicated to health care, and rising costs for new health care services and technologies. This has led to increasing public debate in the last few years about how to reform public health care, and whether we should prohibit, permit or perhaps even encourage private purchase of health care services. In Canada, some of these concerns have crystallized around the issue of gene patents and commercial genetic testing, in particular as illustrated by the case of Myriad Genetics' patented BRACAnalysis test for hereditary breast and ovarian cancer. While most Canadians who currently access genetic services do so through the public health care system, for those with the means, private purchase is becoming an option. This situation raises serious concerns - about justice in access to health care; about continued access to safe and reliable genetic testing supported by unbiased patient information; and about the broader effects of commercialization for ongoing research and the Canadian public health care system. Commercial genetic testing presents a challenge to health care professionals, policy analysts, and academics concerned with the social, ethical and policy implications of new genetic technologies. Using the Myriad case as an exemplar, tools from moral philosophy, the social sciences, and health policy and law will be brought to bear on the larger issues of how as a society we should regulate commercial research and product development, and more coherently decide which services to cover under public health insurance and which to leave to private purchase. Generally, the thesis is concerned with the question of "how best to bring capital, morality, and knowledge into a productive and ethical relationship" (Rabinow 1999, 20). / Graduate and Postdoctoral Studies / Graduate

O efeito antiproliferativo do calcitriol foi detectado principalmente em linhagens de carcinoma mamário expostas in vitro a alta concentração hormonal (10 - 100nM), que é associado com hipercalcemia em seres humanos. Nossa hipótese era que a administração intratumoral de calcitriol permitiria maior concentração do hormônio e ativação da via genômica. Para testar esta hipótese, um modelo de enxerto tumoral que reproduz o mais próximo das características moleculares do tumor primário, foi estabelecida. As amostras de câncer de mama recolhidos foram enxertados em camundongos nude e depois da sexta semana, semana, os enxertos tumorais foram tratados semanalmente com injeções intra-tumorais de veículo (controle) ou o calcitriol 0,06 mcg (dose que pode permitir que picos séricos de calcitriol na faixa terapêutica prevista) durante seis semanas. A proliferação e apoptose do enxerto tumoral Veículo (controlo) ou o calcitriol 0,06 mcg (dose que pode permitir que o soro de pico, assim como, a expressão dos genes alvos foram avaliadas através de reações imunohistoquímica ou RT-PCR. A expressão de VDR foi detectada em todas as amostras, assim como uma tendência para maior expressão de mRNA CYP24A1 (indução 10-18 vezes) em amostras tratadas com calcitriol, indicando que a via genómica foi induzida pelo hormonio. O elevado índice proliferativo, avaliado pela expressão de Ki67, foi detectado. No entanto, não havia diferenças na expressão de marcadores de proliferação (incorporação de BrdU, Ki67 e CDKN1B expressão) nem marcadores de apoptose (caspase-3 clivada e BCL2 expressão) entre os enxertos tumorais tratados por veículo e calcitriol tratado. Além disso, não houve diferença entre os grupos detectada na expressão de mRNA do CDKN1A. Em resumo, os efeitos antitumorais não foram observados neste modelo de enxerto tumoral. A indução do gene alvo CYP24A1 pode ter em parte impedido os efeito antitumorais da vitamina D / Antiproliferative effects of calcitriol were mainly detected in breast carcinoma lineages exposed in vitro to high hormone concentrations (10-100 nM), which is associated with hypercalcemia in human beings. Our hypothesis was that intra-tumoral administration of calcitriol would allow higher issue concentration of the hormone and activation of the genomic pathway. To test this hypothesis, a tumorgraft model, that more closely reproduces the molecular characteristics of the primary tumor, was established. Freshly collected breast cancer samples were grafted in nude mice and after the 6th week, tumorgrafts were treated weekly with intra-tumoral injections of vehicle (control) or calcitriol 0.06 mcg (dose that may allow peak serum calcitriol levels in the predicted therapeutic range) for six weeks. Tumorgraft proliferation and apoptosis, as well as expression of target genes, were evaluated through immnunohistochemistry reactions or RT-PCR. VDR expression was detected in all samples as well as a trend towards higher expression of CYP24A1 mRNA (10-18 fold induction) in calcitriol treated samples, indicating that the genomic pathway was induced by the hormone. A high proliferative index, evaluated by Ki67 expression, was detected. However, there were neither differences in the expression of proliferation markers (BrdU incorporation, Ki67 and CDKN1B expression) nor in apoptosis markers (cleaved caspase 3 and BCL2 expression) between vehicle and calcitriol treated tumorgrafts. In addition, no difference between groups was detected for the expression of CDKN1A mRNA. In summary, calcitriol antitumoral effects were not observed in this tumorgraft model. Calcitriol induction of the target gene CYP24A1, might have in part, precluded vitamin D antitumoral effects

O efeito antiproliferativo do calcitriol foi detectado principalmente em linhagens de carcinoma mamário expostas in vitro a alta concentração hormonal (10 - 100nM), que é associado com hipercalcemia em seres humanos. Nossa hipótese era que a administração intratumoral de calcitriol permitiria maior concentração do hormônio e ativação da via genômica. Para testar esta hipótese, um modelo de enxerto tumoral que reproduz o mais próximo das características moleculares do tumor primário, foi estabelecida. As amostras de câncer de mama recolhidos foram enxertados em camundongos nude e depois da sexta semana, semana, os enxertos tumorais foram tratados semanalmente com injeções intra-tumorais de veículo (controle) ou o calcitriol 0,06 mcg (dose que pode permitir que picos séricos de calcitriol na faixa terapêutica prevista) durante seis semanas. A proliferação e apoptose do enxerto tumoral Veículo (controlo) ou o calcitriol 0,06 mcg (dose que pode permitir que o soro de pico, assim como, a expressão dos genes alvos foram avaliadas através de reações imunohistoquímica ou RT-PCR. A expressão de VDR foi detectada em todas as amostras, assim como uma tendência para maior expressão de mRNA CYP24A1 (indução 10-18 vezes) em amostras tratadas com calcitriol, indicando que a via genómica foi induzida pelo hormonio. O elevado índice proliferativo, avaliado pela expressão de Ki67, foi detectado. No entanto, não havia diferenças na expressão de marcadores de proliferação (incorporação de BrdU, Ki67 e CDKN1B expressão) nem marcadores de apoptose (caspase-3 clivada e BCL2 expressão) entre os enxertos tumorais tratados por veículo e calcitriol tratado. Além disso, não houve diferença entre os grupos detectada na expressão de mRNA do CDKN1A. Em resumo, os efeitos antitumorais não foram observados neste modelo de enxerto tumoral. A indução do gene alvo CYP24A1 pode ter em parte impedido os efeito antitumorais da vitamina D / Antiproliferative effects of calcitriol were mainly detected in breast carcinoma lineages exposed in vitro to high hormone concentrations (10-100 nM), which is associated with hypercalcemia in human beings. Our hypothesis was that intra-tumoral administration of calcitriol would allow higher issue concentration of the hormone and activation of the genomic pathway. To test this hypothesis, a tumorgraft model, that more closely reproduces the molecular characteristics of the primary tumor, was established. Freshly collected breast cancer samples were grafted in nude mice and after the 6th week, tumorgrafts were treated weekly with intra-tumoral injections of vehicle (control) or calcitriol 0.06 mcg (dose that may allow peak serum calcitriol levels in the predicted therapeutic range) for six weeks. Tumorgraft proliferation and apoptosis, as well as expression of target genes, were evaluated through immnunohistochemistry reactions or RT-PCR. VDR expression was detected in all samples as well as a trend towards higher expression of CYP24A1 mRNA (10-18 fold induction) in calcitriol treated samples, indicating that the genomic pathway was induced by the hormone. A high proliferative index, evaluated by Ki67 expression, was detected. However, there were neither differences in the expression of proliferation markers (BrdU incorporation, Ki67 and CDKN1B expression) nor in apoptosis markers (cleaved caspase 3 and BCL2 expression) between vehicle and calcitriol treated tumorgrafts. In addition, no difference between groups was detected for the expression of CDKN1A mRNA. In summary, calcitriol antitumoral effects were not observed in this tumorgraft model. Calcitriol induction of the target gene CYP24A1, might have in part, precluded vitamin D antitumoral effects