Perfil Epidemiológico de cáncer de mama HER-2 positivo en pacientes atendidos en el Hospital Nacional Hipólito Unanue entre Junio del 2012 a Junio del 2015Aparicio Cerna, Yanira January 2016 (has links)
Objetivo: Determinar el perfil epidemiológico del cáncer de mama HER2- positivo en pacientes atendidos en el Hospital Nacional Hipólito Unanue entre Junio del 2012 a Junio del 2015. Material: revisión retrospectiva de fichas de notificación, (Directiva Sanitaria de Vigilancia Epidemiológica del Cáncer. Registros Hospitalarios) de 34 pacientes con cáncer de mama HER 2 – positivo entre Junio del 2012 a Junio del 2015, en el Hospital Nacional Hipólito Unanue, en la Unidad de cáncer de mama y patología mamaria. Resultados: la edad media fue de 48 años (11,76%), el tamaño tumoral más frecuente fue de 2 a 5 cm (47,06%), el grado histológico más frecuente corresponde a pobremente diferenciado (64,71%), el mayor porcentaje (61,76%) no tuvo recurrencia local, el mayor porcentaje (94,12%) no tuvo metástasis, el tratamiento más frecuente fue el de terapia doble (50,00%), que incluye mastectomía radical y quimioterapia. Conclusiones: La clasificación del cáncer de mama basada en parámetros inmunohistoquímicos (IHQ) permite una mejor definición del pronóstico.
Tumor Associated Antigens Harbor Readily Defined and Universally Immunogenic Regions Relevant For Cancer ImmunotherapyMcCurry, Dustin 11 May 2017 (has links)
A Thesis submitted to The University of Arizona College of Medicine - Phoenix in partial fulfillment of the requirements for the Degree of Doctor of Medicine. / Recent advances in cancer immunology, highlighted by immune checkpoint inhibitors, have demonstrated that immunotherapy is a viable option in the oncologist’s armamentarium. Despite these advances, many patients are nonresponders. Preliminary studies have suggested that non-responders lack a de-novo anti-tumor antigen immune response that can be unmasked by checkpoint blockade; thus, strategies to induce anti-tumor immune responses are needed. We hypothesized that many tumor associated antigens (Ag) are readily susceptible to immune attack, but only in the context of identifying the tumor antigen epitopes that can reliably initiate an immune response, regardless of individual patient human leukocyte antigen (HLA) haplotype restrictions. We further hypothesized that epitope prediction strategies which seek to identify pan- or highly promiscuous-HLA binding epitopes would reduce the number of potential candidates and be more likely to accurately identify high-priority tumor Ag epitopes. Utilizing known HLA-serotype frequencies and setting a threshold of ninety percent of population coverage, regardless of race or ethnicity, twenty-nine different HLA-DRB1 haplotypes were chosen for antigen prediction utilizing the open source epitope prediction algorithm netMHCIIpan. Predictions were also performed for HLA-A serotypes utilizing the open source algorithm netMHCpan. Predicted epitopes were synthesized in the form of synthetic long peptides and tested in immune system sensitization assays involving unfractionated peripheral blood mononuclear cells (PBMC). Briefly, PBMC were subjected to a two-step culture, first synchronizing their exposure to the long peptides with aggressive surrogate activation of innate immunity, followed by IL-7-modulated T-cell hyperexpansion. Predictions resulted in identification of highly promiscuous-HLA binding epitopes. Unexpectedly, these epitopes clustered together forming high priority regions: unique “hot spots” with high densities of promiscuous HLA-binding epitopes from the widely expressed oncoproteins MUC1, HER2/neu and CMV-pp65 (p<0.0001, for predicted HLA-DRB1 binding affinities, compared to non-hot spot regions). Added synthetic long peptides (>20aa) derived from “hot spot” regions of MUC1, HER2/neu, and CMVpp65 reliably produced selective and sustained expansion of both CD4+ and CD8+ peptide-specific, interferon-γ (IFNγ)-producing Tcells when synchronized with step 2 exposure to exogenous IL-7 (p<0.0001 and p=0.0048, for CD4+ and CD8+ Ag-specific T-cells, respectively, compared to T-cells directed against peptides from non-hot spot regions). “Hot spot” peptide Ag-specific T-cells preferentially recognized endogenous tumor derived MUC1, either in MUC1 expressing tumor cell killing assays (p=0.038, compared to non-peptide Ag-specific T-cells) or as MUC1 tumor lysate when pulsed onto restimulatory PBMC (p=0.022 and 0.025, for CD4+ and CD8+ T-cells, respectively, compared to T-cells directed against peptides from non-hot spot regions). This mechanistically rational antigen selection sequence, effective even for unvaccinated donors, regardless of HLA-haplotype, enables rapid identification of tumor protein regions relevant for cancer immunology, including adoptive immunotherapy, vaccines, and even identification of tumor neo-antigens unique to each patient.
21 December 2018
Over the past two decades, the mammalian Ste20-like kinase (SLK) has been characterized for its role in regulating cellular migration, proliferation and apoptosis in fibroblasts and myoblasts. In mammary epithelial cells, SLK has been shown to be required for efficient epithelial-to-mesenchymal transition and to be activated downstream of the HER2/Neu-oncogene to control chemotactic cellular migration. Here, we assessed the role of SLK in HER2/Neu-induced mammary tumorigenesis in vivo. As SLK is activated downstream of HER2/Neu, we hypothesized that the loss of SLK would significantly delay tumor progression in a mouse model of HER2-positive breast cancer. As we have shown that global attenuation of SLK kinase activity results in embryonic lethality, a conditional SLK knockout mouse model was generated. To study the role of SLK in HER2-positive breast cancer, we crossed these conditional SLK knockout mice with mice expressing HER2/Neu linked to Cre recombinase in the mammary luminal epithelium. Unexpectedly, we have demonstrated that conditional deletion of SLK significantly accelerates Neu-induced mammary tumor onset and decreases overall survival. SLK deletion results in the induction of Sox10 which drives mammary stem/progenitor activity and cooperates with HER2/Neu to drive tumor growth. Using the Cancer Genome Atlas, we have supported previous findings and validated Sox10 as a potential biomarker of the Triple-negative Breast Cancer subtype. Furthermore, we have uncovered that SLK deletion results in enhanced activation of both PDK1 and AKT. We provide evidence that Sox10 induction requires signaling through a novel AKT/Sox9-dependent pathway following SLK deletion. Taken together, our data suggests that SLK may be required to maintain cells in a fully differentiated state and that loss of SLK in HER2/Neu-induced breast cancer drives a more basal/stem-like phenotype through the induction of Sox10.
Herd, Olivia Jayne
17 September 2010
MSc (Med), Faculty of Health Sciences, University of the Witwatersrand / The HER2 gene is amplified in 20-30% of breast cancers, a common cancer amongst South African women. HER2 amplification is associated with a poor prognosis and predicts response to treatments such as Herceptin. The gold standard for HER2 testing is Fluorescent in situ Hybridisation (FISH) with dual colour probes for the HER2 gene and chromosome 17 centromere (CEP17) internal control. According to international guidelines, a HER2/CEP17 ratio >2.2 is considered positive. The HER2 FISH test is complicated by the emergence of ambiguous cases with increased CEP17 signals that cannot be accounted for by chromosome 17 polysomy (> 6 copies of CEP17) and that may hide true HER2 gene amplification. The aims of this study were to characterise the HER2 amplicon, in particular the copy number of genes in the vicinity of the HER2 gene, and to design an alternative control probe that could clarify the HER2 gene status in ambiguous cases. In addition, results on 1558 breast cancer specimens sent for routine testing were analysed to determine the trends of HER2 amplification amongst South African women. The rate of HER2 gene amplification was significantly higher (p < 0.05) in African patients (52%) than in Caucasian patients (43%). In Caucasian women, the rate of HER2 amplification in the younger group (68%) was significantly higher (p < 0.05) than in the general Caucasian group (43%), while the same was not seen in the African cohort. Nineteen ambiguous cases with more than 9 copies of CEP17 were further investigated. FISH assays with four different probe kits (PathVysion HER-2: Poseidon Repeat free TOP2A, HER2, CEP17: and Vysis PML-RARA respectively) were performed to determine the copy number of the HER2, TOP2A, RARA genes and CEP17. An in-house dual colour probe kit was designed using the ACTG1 gene as a control for HER2. Of the 19 ambiguous cases, 16 had centromeric amplification, showing that CEP17 is no longer an adequate internal control in FISH HER2 testing. The TOP2A gene was only amplified in HER2 positive cases and the RARA gene was only amplified when the TOP2A gene was also amplified. FISH with ACTG1 as v a control clearly revealed HER2 amplification in ambiguous cases on image analysis and gave HER2/ACTG1 ratios significantly higher than HER2/CEP17 ratios. However, screening of an additional 40 unambiguous cases showed an increased copy number, although limited ( 8), of the ACTG1 gene in four patients; this warrants further testing to assess the value of this gene as a control. Interestingly, a trend was observed for ACTG1 increased copy number in HER2 negative cases, this may point to the presence of a driver gene whose amplification tends to be mutually exclusive from HER2 amplification.
Durable and Complete Response to Herceptin Monotherapy in Patients with Metastatic Gastroesophageal CancerSwofford, Brenen P., Dragovich, Tomislav 11 December 2017 (has links)
Gastroesophageal cancer is the sixth leading cause of cancer-related death worldwide. The 2 most common histologies are squamous cell carcinoma and adenocarcinoma, which has seen an increase in incidence correlating with an increase in obesity in developed countries. Gastroesophageal adenocarcinoma has a preponderance to metastasize early, making it a highly lethal cancer with a low 5-year survival rate of similar to 15-25%. Therefore, for the majority of patients, treatment focuses on palliation and prolongation of survival. Combination chemotherapy regimens, mostly platinum-based, have only modestly prolonged survival in patients with stage IV disease. Recently, it was discovered that the activation of the HER2 receptor plays an important role in a minority of adenocarcinomas of the distal esophagus and stomach. This introduced the treatment option of trastuzumab (Herceptin), a monoclonal antibody directed at the HER2 receptor, which has demonstrated improvement in overall and progression-free survival as noted in the ToGA trial. Currently, the role of Herceptin therapy beyond first-line therapy and outside of combination regimens is not well established. In this case report we review 2 cases of patients with gastroesophageal cancer, with HER2 overexpression, who achieved a robust response to trastuzumab in combination with chemotherapy and were able to maintain a durable response with maintenance trastuzumab monotherapy. (c) 2017 The Author(s) Published by S. Karger AG, Basel.
Trastuzumab som adjuvant behandling avbröstcancerpatienter med HER2-positivitet : Hur effektivt är det?Stigsohn, Lovisa January 2011 (has links)
Breast cancer is the most common tumor disease among women in Sweden. About 7000persons, having a median age of 65, are diagnosed each year with this disease. Withmammography screening, breast cancer can be detected in an early stage which improves theoverall survival (OS). 20-30 % of the breast cancer tumors are overexpressing humanepidermal growth factor receptor 2 (HER2), which is a protein that stimulates cell proliferation.Trastuzumab (Herceptin®) is a humanised monoclonal antibody that targets the HER2-proteinand prevent the signals for cell proliferation.Trastuzumab has earlier been used for treatment of metastatic breast cancer. In the year of 2007trastuzumab was approved for adjuvant treatment of patients who has been medicated withsurgery and/or radiation.The aim of this study was to investigate the effects of adjuvant treatment with trastuzumab inHER2-positive breast cancer patients. The method was a literature study based on scientificarticles identified from the database PubMed.The articles that were choosen were two meta-analysis and three cohort studies. The benefitsand effects of trastuzumab administration on patients with HER2-positive breast cancer weredescribed in these articles. Primary endpoint was disease-free survival (DFS). All articlesshowed that the DFS increased in breast cancer patients treated with adjuvant trastuzumab but alonger follow-up of four years, showed a reduction of both DFS and OS.The conclusion of this study was that trastuzumab as adjuvant treatment is favorable and shouldbe considered as treatment of breast cancer with HER2 overexpression that has been analyzedby immunohistochemistry (IHC) or fluorescence in situ hybridization (FISH).
Downregulation of neuropilin-1 on macrophages modulates antibody-mediated tumoricidal activity / マクロファージにおけるニューロピリン-１の抑制は抗体依存性抗腫瘍効果を調節するKawaguchi, Kousuke 23 January 2018 (has links)
Kyoto University (京都大学) / 0048 / 新制・課程博士 / 博士(医学) / 甲第20799号 / 医博第4299号 / 新制||医||1025(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 竹内 理, 教授 武藤 学, 教授 河本 宏 / 学位規則第4条第1項該当
Discovery and Characterization of a Novel Fatty Acid Synthase Inhibitor with Antineoplastic Activity against Breast CancerAlwarawrah, Yazan January 2016 (has links)
<p>During oncogenesis, cancer cells go through metabolic reprogramming to maintain their high growth rates and adapt to changes in the microenvironment and the lack of essential nutrients. Several types of cancer are dependent on de novo fatty acid synthesis to sustain their growth rates by providing precursors to construct membranes and produce vital signaling lipids. Fatty acid synthase (FASN) catalyze the terminal step of de novo fatty acid synthesis and it is highly expressed in many types of cancers where it’s up-regulation is correlated with cancer aggressiveness and low therapeutic outcome. Many FASN inhibitors were developed and showed potent anticancer activity however, only one inhibitor advanced to early stage clinical trials with some dose limiting toxicities. Using a modified fluorescence-linked enzyme chemoproteomic strategy (FLECS) screen, we identified HS-106, a thiophenopyrimiden FASN inhibitor that has anti-neoplastic activity against breast cancer in vitro and in vivo. HS-106 was able to inhibit both; purified human FASN activity and cellular fatty acid synthesis activity as evaluated by radioactive tracers incorporation into lipids experiments. In proliferation and apoptosis assays, HS-106 was able to block proliferation and induce apoptosis in several breast cancer cell lines. Several rescue experiment and global lipidome analysis were performed to probe the mechanism by which HS-106 induces apoptosis. HS-106 was found to induce several changes in lipids metabolism: (i) inhibit fatty acids synthesis. (ii) Inhibit fatty acids oxidation as indicated by the ability of inhibiting Malonyl CoA accumulation to block HS-106 induced apoptosis and the increase in the abundance of ceramides. (iii) Increase fatty acids uptake and neutral lipids formation as confirmed 14C Palmitate uptake assay and neutral lipids staining. (iv)Inhibit the formation of phospholipids by inhibiting de novo fatty acid synthesis and diverting exogenous fatty acids to neutral lipids. All of these events would lead to disruption in membranes structure and function. HS-106 was also tested in Lapatinib resistant cell lines and it was able to induce apoptosis and synergizes Lapatinib activity in these cell lines. This may be due the disruption of lipid rafts based on the observation that HS-106 reduces the expression of both HER2 and HER3. HS-106 was found to be well tolerated and bioavailable in mice with high elimination rate. HS-106 efficacy was tested in MMTV neu mouse model. Although did not significantly reduced tumor size (alone), HS-106 was able to double the median survival of the mice and showed potent antitumor activity when combined with Carboplatin. Similar results were obtained when same combinations and dosing schedule was used in C3Tag mouse model except for the inability of HS-106 affect mice survival.</p><p>From the above, HS-106 represent a novel FASN inhibitor that has anticancer activity both in vivo and in vitro. Being a chemically tractable molecule, the synthetic route to HS-106 is readily adaptable for the preparation of analogs that are similar in structure, suggesting that, the pharmacological properties of HS-106 can be improved.</p> / Dissertation
Développement de nanovecteurs polymériques et lipidiques fonctionnalisés par des anticorps pour cibler des cellules cancéreuses / Development of antibody functionalized polymeric and lipidic nanoparticles for targeting cancer cellsWan, Yali 20 December 2012 (has links)
Ce travail, qui fait partie d’un projet européen, « NANOTHER », est focalisé sur la fonctionnalisation de nanoparticules polymériques et lipidiques fonctionnalisées par des anticorps Herceptine® pour cibler des cellules du cancer du sein HER2+. Deux stratégies de fonctionnalisation ont été étudiées : une a reposé sur l’utilisation de protéines de fusion, l’Anx5-ZZ, composée d’Annexine A5 et deux domaines Z homologues de la protéine A de Staphylococcus aureus qui peuvent se fixer des anticorps d’une manière orientée par leur fragment cristallisable ; l’autre a porté sur le couplage direct d’anticorps modifiés pour exposer des groupes sulfhydryles aux nanoparticules exposant des groupes maléimides.La première partie concerne le développement d’un agent de ciblage simplifié du complexe l’Anx5-ZZ-anticorps, à savoir l’Anx5-scFv (single-chain variable fragment). Puisque la cible n’avait pas été décidée au début de ce travail, deux scFvs ont été utilisé comme système modèle. L’expression de protéines de fusion a été essayée chez Escherichia Coli avec différentes constructions de protéines de fusion, différentes conditions d’expression et différentes souches bactériennes. Toutes les protéines sont soient agrégées soient non surexprimées.La deuxième partie consiste à fonctionnaliser les polymersomes par l’Herceptine® via l’Anx5-ZZ. D’abord, nous avons validé une méthode de modification de la surface de polymersome pour présenter des groupes maléimides. Ensuite, le couplage covalent de l’Anx5(SH)-ZZ aux polymersomes-maléimide a été réalisé et quantifié. Nous avons obtenu maximum 30 Anx5-ZZ par polymersome. Puis, la liaison d’affinité d’anticorps aux polymersomes-Anx5-ZZ a été caractérisée, réalisée et quantifiée. Pour 30 Anx5-ZZ par polymersome, nous avons 60 Herceptine® par polymersome. Cependant, l’efficacité de ciblage de ces systèmes est très faible.La troisième partie consiste à fonctionnaliser les liposomes par l’Herceptine® via couplage direct. Tout d’abord, la modification de l’Herceptine® pour présenter des groupes SH a été caractérisée et contrôlée. Ensuite, le couplage covalent d’Herceptine®-SH aux liposomes-maléimides a été réalisé et quantifié. L’étude de ciblage montre que les liposomes fonctionnalisés par une molécule d’Herceptine® sont capable de cibler les cellules HER2+. / This work, which is part of a European project "NANOTHER", focus on the functionalization of polymeric and lipidic nanoparticles by Herceptin® to target HER2+ cancer cells. Two functionalization strategies were studied: one was based on the use of a fusion protein, Anx5-ZZ, composed of Annexin A5 and two Z domains which are homologous with the protein A of Staphylococcus aureus that can bind antibodies by their crystallizable fragment in a oriented way; the other focused on the direct coupling of modified antibodies exposing sulfhydryl groups to nanoparticles exposing maleimid groups.The first part concerns the development of a targeting agent simplified from the Anx5-ZZ-antibody complex, namely Anx5-scFv (single-chain variable fragment). Since the target had not been decided at the beginning of this work, two scFvs were used as model system. The expression of fusion proteins was tested in Escherichia coli with different fusion protein constructions, different expression conditions and different bacterial strains. All proteins are either aggregated or non-overexpressed.The second part is to functionalize the polymersomes by Herceptin® via Anx5-ZZ. First, we validated a method for modifying the surface of polymersome to expose maleimid groups. Then, the covalent coupling of Anx5(SH)-ZZ to polymersomes-maleimid was performed and quantified. We obtained maximum 30 Anx5-ZZ per polymersome. Then, the affinity binding of antibodies to polymersomes-Anx5-ZZ was characterized, performed and quantified. For 30 Anx5-ZZ per polymersome, we have 60 Herceptin® per polymersome. However, the targeting efficiency of this system is very low.The third part consists in functionalizing the liposomes by Herceptin® via direct coupling. Firstly, the modification of Herceptin® to expose SH groups was characterized and controlled. Then, the covalent coupling of Herceptin®-SH to liposomes exposing maleimid groups was performed and quantified. The targeting study shows that liposomes functionalized with one Herceptin® are able to target HER2+ cells.
Contrôle de la progression tumorale broncho-pulmonaire par FHIT : Implication du récepteur HER2 / Control of lung tumor progression by FHIT : Involvement of HER2 receptorJouida, Amina 17 March 2017 (has links)
Dans les cancers du poumon, une des altérations les plus souvent observées est la perte ou l’atténuation de l’expression du gène FHIT (Fragile Histidine Triad). Nous avons précédemment montré que FHIT est un suppresseur d’invasion tumorale. En effet, FHIT contrôle l’invasion des cellules tumorales bronchiques en régulant négativement l'expression de gènes associés à la transition épithélio-mésenchymateuse (TEM), en particulier la vimentine et la MMP-9 via l’inhibition d’une voie orchestrée par l’EGFR. Un intérêt particulier a donc été porté aux relations entre FHIT et un autre membre de la famille de l’EGFR : HER2. Nous avons non seulement mis en évidence, in vivo et in vitro, une corrélation inverse entre les taux de FHIT et l’activité du récepteur HER2 dans les CBNPC mais également montré que FHIT est capable de réguler l’activité du récepteur HER2 dans les cellules tumorales pulmonaires et ce grâce à sa dimérisation avec HER3. De plus, l’utilisation de deux inhibiteurs spécifiques d’HER2, le Trastuzumab et l’Irbinitinib, nous a permis de mettre en évidence, que l’activation du récepteur HER2 lors de l’inhibition de FHIT, participe à l’acquisition par les cellules tumorales bronchiques de caractéristiques invasives via la régulation de certaines cibles de la TEM, telles la vimentine, la MMP-14 ou encore le facteur de transcription TWIST-1. Ces résultats montrent que FHIT régule l’activité d’HER2 dans les cellules tumorales pulmonaires et que les inhibiteurs d’HER2 sont capables de limiter l’invasion induite par l’inhibition de FHIT. Cette étude laisse envisager de nouvelles perspectives thérapeutiques pour le cancer du poumon. / The lack or decrease of FHIT (fragile histidine triad) expression is a common event in lung cancer. We recently showed that FHIT acts as a suppressor of tumor invasion. Indeed, FHIT controls the invasive phenotype of lung tumor cells by regulating the expression of genes associated with epithelial-mesenchymal transition (EMT) such as vimentin or MMP-9 through an EGFR signaling pathway. Accordingly, we focused on the relationships between FHIT and another member of this tyrosine kinase receptor family: HER2. First, we observed in vivo and in vitro a negative correlation between FHIT expression and the activated form of HER2 in lung tumor cells. Moreover, FHIT controls HER2 activation through its dimerization with HER3. The use of HER2 specific inhibitors, Trastuzumab and Irbinitinib, allowed to demonstrate that the in vitro invasion induced by FHIT inhibition is HER2-dependent. Furthermore, FHIT controls the HER2-dependent invasion by regulating genes associated with EMT such as vimentin, MMP-14 or TWIST-1. In conclusion, we showed that FHIT regulates HER2 activity in lung tumor cells and that HER2 inhibitors reduce invasion induced by FHIT inhibition. This study would allow for the identification of new therapeutic leads for lung cancer.
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