Drug resistance in cancer cells is a frequent cause of breast cancer therapy failure. The aim of this thesis was to elucidate mechanisms of resistance to taxanes, that are used in therapy of various types of cancer, including breast cancer. We particularly assessed the role of autophagy and changes in βII- and βIII isotype gene expression in development of taxane resistance. As model of breast cancer we used human sensitive cell lines SK-BR-3, MCF-7 a T47-D and resistant sublines SK-BR-3-PAC/REZ a MCF-7- PAC/REZ which grow in paclitaxel concentration lethal for sensitive sublines. In cell lines SK-BR-3 and MCF-7, taxane application decreased the level of autophagy, however in cell line T47-D led to its activation. We detected no difference between basal levels of autophagy in sensitive subline SK-BR-3 compared to resistant subline SK-BR-3-PAC/REZ, but we observed increased basal level of autophagy in sensitive subline MCF-7 compared to the resistant subline. Increase or decrease level of autophagy did not affect taxane resistance, except activation of autophagy in resistant subline SK-BR-3-PAC/REZ, that further increased the resistance to paclitaxel. Taxane application in cell line T47-D increased the levels of βII- and βIII-tubuline expression, however we did not find any similar effect in other tested...

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Pharmacogenetics (PGx) and personalised medicine are new disciplines that, gathering the existing knowledge about the genetic and phenotypic factors that underpin drug response, aim to deliver more targeted therapies that avoid the existing problems of adverse drug reactions or lack of drug efficacy. PGx and personalised medicine imply a shift in the way drugs are prescribed, as they require introducing diagnostic tools and implementing pre-screening mechanisms that assess patients' susceptibility to new or existing drugs. The direct benefit is an improvement in drug safety and/or efficacy. However, neither pharmacogenetics nor personalised medicine, are widely used in clinical practice. Both technologies face a number of controversies that hamper their widespread use in clinical practice. This thesis investigates the scientific; technological; social; economic; regulatory and ethical implications of PGx and personalised medicine, to understand the enablers and barriers that drive the process of technology diffusion in three conditions: autoimmune diseases, acute lymphoblastic leukaemia and non-small cell lung cancer.The thesis uses concepts of the sociology of science and a qualitative approach, to explore the arguments for and against the use of the technology by different actors (pharmaceutical and biotechnology companies, researchers, clinicians, regulators and patient organisations). The core of this analysis lies in the understanding of how, diagnostic testing (TPMT testing in the case of autoimmune diseases, acute lymphoblastic leukaemia, and EGFR testing in the case of non-small-cell lung cancer) may affect the existing drug development and service delivery mechanisms, with a particular focus on the user-producer interactions and feedback mechanisms that underpin diffusion of medical innovations and technological change in medicine.The thesis concludes by identifying gaps in knowledge and common issues among TPMT and EGFR testing, which might be used, in the future, to inform policy on how to improve PGx service delivery through a public Health System such as the NHS.

Breast cancer is the most common cancer in women worldwide and the solid tumor type for which the highest number of drugs have been approved to date. This study examines new drug approvals for breast cancer by the United States Food and Drug Administration (FDA) and the European Medicines Agency (EMA), based on an analysis of regulatory documents from both agencies for the period from 1995 to 2018. Of the 29 breast cancer drugs approved over this time span, 17 received positive decisions from both the FDA and EMA, including all drugs licensed after 2008. Nineteen of the 25 FDA-approved drugs, but none of the EMA approvals, benefited from special regulatory pathways (such as fast track, breakthrough therapy, or priority review). In the U.S.A., four accelerated approvals were granted (of which one, for bevacizumab, was later revoked), while only two drugs received provisional approvals following EMA review. New breast cancer drugs were approved approximately twelve months earlier in the United States than in Europe. These results suggest that a broader use of special regulatory pathways by EMA could help to accelerate access to novel drugs for European breast cancer patients.

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Gastric cancer (GC) is one of leading causes of death in the world, and peritoneal metastases (PM) are a major site of recurrence. PM from GC implies a poor prognosis, with median overall survival (mOS) approximately 3 months and no survival at five years. The aims of this thesis were to explore the incidence and evaluate prognostic factors for mOS of PM from GC in a defined population; to investigate the outcome of a new multimodal treatment; to analyse the treatment costs, and to investigate differences in drug sensitivity between individual patient samples and between various tumours. The incidence of loco-regional advanced GC was 3.8 per 100,000 person-years. Synchronous loco-regional GC in combination with synchronous distant metastasis was a negative prognostic factor while chemotherapy and good performance status, and radiotherapy plus chemotherapy were positive prognostic factors . There were no significant differences in mOS for the group of patients included during the period 2000-2004 versus 2005-2009, and this lack of improvement in mOS during the past decade justifies new treatment approaches. In a Phase II study of patients treated with neoadjuvant systemic chemotherapy followed by cytoreductive surgery + hyperthermic intraperitoneal chemotherapy, mOS was 14.3 months and for patients with macroscopically radical surgery mOS was 19.1 months. The mean overall cost of the loco-regional treatment was $145,700 compared to $59,300 with systemic chemotherapy treatment. In an ex vivo chemo-sensitivity test, it was determined that GC samples were equivalent to colorectal cancer in chemo-sensitivity to standard drugs and targeted drugs, whereas ovarian cancer samples were more sensitive. The individual GC samples varied considerably in sensitivity to increasing concentrations of the drugs, arguing for individualized drug selection. The incidence of loco-regional advanced GC was more common than previously reported and there were no improvements in mOS over the past decade. The mOS for patients with neoadjuvant systemic chemotherapy followed by macroscopically radical cytoreductive surgery + hyperthermic intraperitoneal chemotherapy was better than in recent reports on treatment with systemic chemotherapy. Treatment of advanced GC patients is costly irrespective of treatment modality. The GC samples varied considerably between individuals in terms of sensitivity to increasing concentrations of the drugs and were comparable to colorectal cancer in chemo-sensitivity.

The interaction of drugs with DNA is a significant feature in pharmacology and plays a vital role in the designing of more efficient and specifically targeted drugs.The concept of hybridization of two bioactive molecules often leads to increased activity due to synergistic effects of anticancer drugs have been studied.Two important pharmacophores: Acridine and thiophene were widely studied as antitumor, antiparasitic and antibacterial agents. We hypothesize that a conjugate comprised two pharmacophores with different mechanisms of antiproliferative action can result in enhanced DNA damage. Electrochemical Studies in aprotic and protic media, electrochemical DNA biosensor at Glassy carbon electrode, electrochemical New Hairpin DNA biosensor at the Gold electrode (SL-DNA/GE), Molecular Modeling and Spectroscopic UV-Vis, were used to determine the damage caused to DNA by six Acridine-thiophene conjugates. In this work, we report the synthesis of six synthetic DNA intercalators based on the acridine linked with thiophene conjugates (7CNAC01, 6CNAC01, 7ESTAC01, 6ESTAC01, ACS6CN, and ASC5CN). We identified the electrochemical behavior of these active redox drugs is strongly influenced by the nature of solvent (DMF and pH=7.2 phosphate buffer media).We recorded redox properties of 7CNAC01, 6CNAC01, 7ESTAC01, and 6ESTAC01 involve adsorption controlled quasi- reversible process and were investigated using differential pulse voltammetry (DPV) at a glassy carbon and Gold electrode. An effective and new electrochemical biosensor based on hairpin DNA (SL-DNA/GE) immobilized and functionalized on the surface of the gold electrode (GE) to detect oxidative Guanine damage was developed. As a result, two kinds of biosensor were tested with reduced acridinethiophene conjugates showing better sensitivity the SL-DNA/GE sensor for the detection of DNA damage using the electrochemical signal of Oxidation of Guanine bases. Also, Molecular docking results showed predominantly hydrophobic interaction, and either high binding constant was recorded for Molecular docking and UV-Vis absorption spectroscopy showing an isosbestic point presence with dsDNA, for 7ESTAC01, 6ESTAC01, ACS6CN, ACS5CN. Our findings indicate that three reduced acridine-thiophene compounds (7CNAC01, 6CNAC01, and ACS5CN) cause direct dsDNA damage and all our six reduced hybrid compounds are causing damage to singled stranded ssDNA. Finally, we proposed for the first time a direct correlation between binding constant (Kb) and half-wave potential (E1/2) for four acridine-thiophene derivates (7ESTAC01, 6ESTAC01, ACS6CN, and ASC5CN). Our results showed a promise sensitive electrochemical SL-DNA/GE sensor for the detection of DNA damage using the electrochemical signal of Oxidation of Guanine bases, to detect DNA-cancer drug interaction. / A interação de drogas com DNA é uma característica significativa na farmacologia e desempenha um papel vital na concepção de drogas mais eficientes e especificamente direcionadas. O conceito de hibridização de duas moléculas bioativas leva ao aumento da atividade devido aos efeitos sinérgicos de drogas híbridas anticâncer com o uso dos farmacóforos importantes: Acridina e Tiofeno. Estes dois sítios ativos foram amplamente estudados como agentes antitumorais, antiparasitários e antibacterianos. Suspeitamos que um conjugado, composto por dois farmacóforos com diferentes mecanismos de ação antiproliferativa, pode resultar em danos ao DNA. Estudos eletroquímicos em meios prótico e aprótico, biossensor de DNA eletroquímico em eletrodo de carbono vítreo, Hairpin DNA em eletrodo de ouro (SL-DNA/GE), modelagem molecular e Espectroscopia UV-Vis foram usados para determinar os danos causados ao DNA por seis conjugados de Acridina-Tiofeno. Neste trabalho, relatamos o estudo de seis intercaladores de DNA com base na acridina ligada a conjugados de tiofeno (7CNAC01, 6CNAC01, 7ESTAC01, 6ESTAC01, ACS6CN e ASC5CN). As propriedades redox da 7CNAC01, 6CNAC01, 7ESTAC01 e 6ESTAC01 envolvem processo quase-reversível com corrente controlada por difusão. As propriedades redox desses compostos foram investigadas usando voltametrias cíclica e de pulso diferencial (VPD) em eletrodo de carbono vítreo e eletrodo de ouro. Foi desenvolvido um novo e eficiente biossensor eletroquímico baseado no Hairpin DNA (SL-DNA/GE) imobilizado e funcionalizado na superfície do eletrodo de ouro para detectar danos oxidativos da guanina através da interação com 7ESTAC01. Os biosensores SL-DNA e dsDNA foram testados com conjugados de acridina-tiofeno reduzidos, apresentando melhor sensibilidade o sensor SLDNA na detecção de danos ao DNA. Além disso, os resultados de modelagem molecular mostraram predominantemente interação hidrofóbica e uma alta constante de ligação. Já os resultados de espectroscopia de absorção no UV-Vis mostraram a presença de ponto isosbéstico com dsDNA, para os conjugados 7ESTAC01, 6ESTAC01, ACS6CN, ACS5CN. Nossos resultados indicaram que três compostos de acridina-tiofeno reduzidos (7CNAC01, 6CNAC01 e ACS5CN) causaram danos direto ao dsDNA, e os seis compostos híbridos reduzidos, causaram danos ao DNA de cadeia simples. Finalmente, propusemos pela primeira vez uma correlação direta entre constante de ligação (Kb) e potencial de meia onda (E1 / 2) para quatro derivados de acridina-tiofeno (7ESTAC01, 6ESTAC01, ACS6CN e ASC5CN). Além disso, o biosensor eletroquímico de SL-DNA/GE mostrou-se bastante sensível para a detecção dos danos causados ao DNA, através da interação entre o DNA e os compostos estudados.

Despite significant progress in the development of anti-cancer drugs, there is still a need for novel therapeutic strategies that would improve the outcome of cancer patients. Using proteomic technologies and cell lines with different phenotype of p53 tumour suppressor, we monitored cancer cell response to anti-cancer treatment with focus on the development of drug resistance. The different levels of metabolic proteins were identified in our study which may help to explain different anti-cancer activity of drugs with only a subtle difference in structure. More importantly, proteins associated with the development of drug resistance were identified and such expression changes have become a focus of interest. Our findings demonstrate a higher protein level of serine hydroxymethyltransferase, serpin B5 and calretinin in cancer cells resistant to Aurora kinase inhibitors. Such proteins promote the tumour growth with no apparent impact of p53 phenotype whilst voltage-dependent anion-selective channel protein 2 contributes to the development of resistance only in cells with functional p53 which is accompanied by the decreased level of elongation factor 2. On the other hand, cancer cells with loss of p53 appear to amplify alternative mechanisms such as protection against oxidative stress. The results...

Animal testing is still the common method to test the efficacy of new drugs, but tissue engineered in vitro models are becoming more acceptable for replacing and reducing animal testing in anti-cancer drug screening by developing in vitro three-dimensional (3D) tumour models for anti-cancer drug testing. In this study, three-dimensional (3D) culture methods were developed to mimic the tumour microenvironment. 3D culturing is to seed, maintain and expand cultured cells in three-dimensional space, in contrast to the traditional two-dimensional (2D) method in which the cells attach to the bottom of culture containers as monolayers. To mimic the intercellular interplay for tumour study, cell co-culture was applied. In this thesis, perfusion culture showed a better homeostasis for 3D tumour model growth over 17 days, with a more controllable working platform and a more reliable response-dose correlation for data interpretation. In the Matrigel sandwich system, the co-culture of breast cancer cells and endothelial cells demonstrated the morphology featuring a vascular network and tumour structures, with the thickness of the three-dimensional structure around 100µm and tubule length 200-400 µm, and maintained for 10 days. The comparisons studies between Matrigel sandwich and other methods suggest that though not fully characterised, Matrigel is still a valuable scaffold choice for developing co-culture 3D tumour model. Finally, the combination of perfusion and co-culture showed the potential of applying this model in angiogenesis assay, with a drug response profile combining cell viability and morphology to mimic in vivo tumour physiology.