Stimuler la réponse immunitaire anti-tumorale constitue une voie d’avenir indiscutable pour le traitement des cancers. Aujourd'hui, les thérapies ciblées à base d'anticorps ont une place majeure dans l’immunothérapie des cancers du sein de par leur impact positif sur le pronostic des patientes. Cependant, les cancers du sein triple négatifs (TNBC) résistent aux innovations thérapeutiques actuelles, et, par défaut de traitement ciblé efficace, restent de sombre pronostic. Notre équipe développe des stratégies d’immunothérapie à base d'anticorps bispécifiques (bsFabs) conçus à partir de fragments d'anticorps de camélidés qui présentent la particularité de cibler simultanément les cellules immunitaires et tumorales. Ainsi, mon projet visait à évaluer le potentiel anti-tumoral de deux bsFabs sur des modèles précliniques de TNBC à travers leur capacité à activer et à rediriger le système immunitaire contre les cellules tumorales. La finalité du projet est de proposer un nouvel axe de thérapie ciblée susceptible d'améliorer le pronostic des patientes atteintes de TNBC. / Mounting evidence of the key contribution of NK cells in immunity against cancer has boosted the investigations on NK cell-based therapies. Among these strategies, monoclonal antibody-based therapeutics (mAbs) are currently the fastest growing segment of the medicine market. Despite therapeutic innovations, triple negative breast cancers (TNBC) remain insensitive to the current targeted or hormono-therapies. Our objective is to manipulate NK cell functions and tumor targets using an original format of nanobody-based bispecific antibodies (bsFab) to revert the dampened immune response for treating TNBC. Thus, we generate two bsFabs able to crosslink NK and tumor cells. NK antitumor effects driven by mAbs and bsFabs, alone or in combination, were investigated in vitro and in vivo on preclinical TNBC models. Here, we demonstrate the potential of bsFabs to enlarge the number of patients eligible for breast cancer immunotherapy and prompt to consider combination strategies.

Breast cancer is the most prevalent cancer in women in the UK with over 50,000 new cases diagnosed each year. Almost all breast cancer deaths are due to metastatic disease. The RUNX1-CBFbeta transcription factor complex has been implicated in the development of human breast cancer and recent evidence from our laboratory indicated that it might have a role in metastasis. The aim of this project was therefore to determine the role of the RUNX1 transcription factor in breast cancer metastasis. Initial experiments to knockdown RUNX1 by shRNA also decreased the expression of RUNX2. Therefore, due to the off-target effect of shRUNX1, CRISPR-Cas9n was used to establish a RUNX1-negative cell line by targeting the first exon of the RUNX1 gene. Migration and invasion capacity of the cells decreased in the absence of RUNX1 and it was comparable to the absence of RUNX2 and CBFbeta respectively, which are known to play roles in migration and invasion of MDA-MB-231 cells. The cells also formed spherical clusters in 3D culture which was associated with the changes in cell morphology from stellate to round shape in the absence of RUNX1. The expression of the metastasis-related genes MMP13, MMP9, OPN and SLUG also decreased in parallel with the loss of the mesenchymal-like phenotype whilst the expression of the epithelial markers cytokeratin, desmoplakin and E-cadherin increased concomitantly. Importantly, re-expression of RUNX1 in the RUNX1-negative cell lines using an inducible expression system rescued migration and invasion. Therefore, RUNX1 is required to maintain the mesenchymal-like phenotype of MDA-MB-231 cells and hence is important for the epithelial to mesenchyme transition (EMT), a key characteristic of metastatic cells. The transcription factor SLUG is a known regulator of EMT. Data obtained shows that RUNX1 down-regulates the expression of SLUG. ChIP analysis demonstrated that RUNX1 was bound to the SLUG promoter and RUNX1 was subsequently shown to activate the promoter activity. Finally, experiments to inhibit the activity of the RUNX transcription factors pharmacologically showed changes in cell differentiation and also affected cell viability, possibly by off-target effects. Taken together, data presented in this work demonstrates that RUNX1 is required for EMT in the metastatic breast cancer cells and it is therefore a potential therapeutic target to prevent breast cancer metastasis.

Die Metastasierung in den Knochen ist beim fortgeschrittenen Mammakarzinom ein häufiges Problem. Insbesondere die Mammakarzinome, welche keinen Östrogenrezeptor α (ERα), keinen Östrogenrezeptor ß (ERß) und keine Überexpression des human epidermal growth factor receptor 2 (Her2/neu) aufweisen, die so genannten triple-negativen Mammakarzinome (TNBCs), werden als sehr aggressiv angesehen und haben eine schlechte Prognose. Kürzlich konnten wir zeigen, dass die Invasion von Mammakarzinomzellen in Kokultur mit der Osteoblastenähnlichen Zelllinie MG63 stark anstieg. Unter Verwendung dieses Modells haben wir nun untersucht, inwieweit der ERß eine Rolle bei der Zellinvasion von TNBC-Zellen in vitro spielt. Die ERα-und ERß-Proteinexpression wurde mithilfe des Western Blot-Verfahrens untersucht. Die Zellinvasion wurde mithilfe der Migrationsrate von TNBC-Zellen durch eine künstliche Basalmembran in einer modifizierten Boyden-Kammer während Kokultur mit der Osteoblastenähnlichen Zelllinie MG63 quantifiziert. Die Migration wurde mithilfe eines Scratch-Assays untersucht. Die Wirkung der ERß-Agonisten auf die CXC motif chemokine receptor 4 (CXCR4)-Proteinexpression während der Kokultur mit der Osteoblastenähnlichen Zelllinie MG63 wurde mithilfe des Western Blot-Verfahrens analysiert. Die Proliferation ist mit dem almarBlue®assay untersucht worden. Die TNBC-Zellen HCC1806 und HCC1937 zeigten keine ERα-Proteinexpression, jedoch eine hohe ERß-Proteinexpression. Die Zellinvasion der TNBC-Zelllinien HCC1806 und HCC 1937 zeigte in Kokultur mit Osteoblastenähnlichen Zelllinie MG63 einen signifikanten Anstieg. Die Behandlung mit den selektiven ERß-Agonisten Liquiritigenin und ERB-41 reduzierte die Invasion der TNBC-Zellen durch eine künstliche Basalmembran als Antwort auf eine zelluläre Stimulation. Während der Kokultur stieg die CXCR4-Proteinexpression der TNBC- Zelllinien HCC1806 und HCC1937 signifikant an. Die Behandlung mit Liquiritigenin resultierte in einem signifikanten Abfall der CXCR4-Proteinexpression. Beide ERß-Agonisten zeigten keinen Effekt auf die Proliferation der TNBC-Zelllinien. Unsere Ergebnisse weisen darauf hin, dass der ERß eine wesentliche Rolle bei der Invasion von TNBC-Zellen spielt. Die knochengerichtete Invasion kann durch ERß-Agonisten inhibiert werden.

Triple negative breast cancer (TNBC) represents an aggressive subtype for which only chemotherapy is available. The RB1 tumour suppressor is frequently lost in human breast cancer, primarily in TNBC. Loss of RB1 deregulates the cell cycle and is thought to affect BC response to endocrine, radiation, and chemotherapy. However, the global chemosensitivity of Rb null BC is not known. Here I demonstrate that RB1-deficient TNBC cells are highly sensitive to radiation, and moderately sensitive to doxorubicin and methotrexate. However, loss of RB1 does not increase sensitivity to multiple other drugs. Moreover, a non-biased screen of 2 RB-deficient versus 2 RB-proficient lines with ~3500 drugs did not reveal any difference in sensitivity, but identified disulfiram as a potent drug, which compared favourably with current chemotherapeutics against TNBC. Disulfiram’s efficacy was validated against 13 human TNBC lines with an average IC50 of 300nM. IQGAP1 was identified as a potential target of disulfiram.

Triple negative breast cancer (TNBC) represents an aggressive subtype for which only chemotherapy is available. The RB1 tumour suppressor is frequently lost in human breast cancer, primarily in TNBC. Loss of RB1 deregulates the cell cycle and is thought to affect BC response to endocrine, radiation, and chemotherapy. However, the global chemosensitivity of Rb null BC is not known. Here I demonstrate that RB1-deficient TNBC cells are highly sensitive to radiation, and moderately sensitive to doxorubicin and methotrexate. However, loss of RB1 does not increase sensitivity to multiple other drugs. Moreover, a non-biased screen of 2 RB-deficient versus 2 RB-proficient lines with ~3500 drugs did not reveal any difference in sensitivity, but identified disulfiram as a potent drug, which compared favourably with current chemotherapeutics against TNBC. Disulfiram’s efficacy was validated against 13 human TNBC lines with an average IC50 of 300nM. IQGAP1 was identified as a potential target of disulfiram.

Le complexe transcriptionnel AP-1 est une famille ubiquitaire de facteurs de transcription dimériques. Ses composants les mieux étudiés sont les membres des familles multigéniques Fos et Jun. Les mécanismes transcriptionnels gouvernés par ce complexe sont encore mal caractérisés, en raison du grand nombre de dimères AP-1 possibles, de l’abondance et de l’activité finement régulées de ses constituants qui dépendent des contextes cellulaires et physiopathologiques. De plus, les limitations techniques ont longtemps donné l'impression que AP-1 régule l’expression de ses gènes cibles en se fixant principalement à proximité de leurs promoteurs. Fra-1 est la protéine de la famille Fos la plus souvent impliquée dans les cancers épithéliaux. En particulier, elle est surexprimée dans les cancers du sein triple négatifs (TNBCs) où elle contribue à la tumorigenèse et à l'agressivité tumorale par des effets pléiotropes. Dans ce contexte, l’objectif de mes travaux de thèse était d’aboutir à une meilleure compréhension des actions transcriptionnelles de Fra-1 au niveau du génome dans une lignée cellulaire TNBC de référence, la lignée MDA-MB-231. Pour ce faire, j'ai combiné des données transcriptomiques avec des données de ChIP-seq et de NG-Capture C (technique à haute résolution et à haut débit dérivée du 3C). J'ai également inclus dans ces études le membre Fra-2, de la famille Fos, qui présente la même spécificité de fixation à l’ADN et est également exprimé dans les TNBCs, bien qu'à un niveau beaucoup plus bas, où il contribue aussi au phénotype tumoral. En accord avec leurs effets pléiotropes, Fra-1 et Fra-2 activent ou répriment, soit individuellement soit de façon redondante ou complémentaire, l’expression de nombreux gènes associés à une large gamme de processus biologiques. Il est intéressant de noter que la régulation des gènes cibles est rarement due à la liaison de Fra-1 et/ou Fra-2 au niveau des régions promotrices de ces gènes mais fait intervenir leur liaison sur des enhancers distaux. Mes résultats de NG-Capture C suggèrent la présence d’interactions chromatiniennes à longue distance enhancer/promoteur, ainsi que des réseaux d’enhancers. Ces réseaux contiennent des enhancers liés par Fra-1 et d’autres indépendants de celui-ci. Aucune preuve d’un rôle de Fra-1 dans le contrôle des interactions chromatiniennes au niveau de ces réseaux n'a été trouvée en utilisant un panel de 35 gènes régulés par ce facteur. En parallèle, j'ai abordé les mécanismes de la répression transcriptionnelle médiée par Fra-1, mécanismes très rarement étudiés dans la littérature, en utilisant deux gènes modèles, TGFB2 et SMAD6. Ces études ont mis en évidence des mécanismes différents mis en jeu par Fra-1 pour la répression de ces deux gènes, ce qui montre la complexité des mécanismes de la régulation transcriptionnelle médiée par Fra-1. / The AP-1 transcription complex is a ubiquitous family of dimeric transcription factors. Its best-studied components are the members of the Fos and Jun multigene families. The mechanisms whereby AP-1 exerts its transcriptional actions are still ill-understood due to the wide number of possible AP-1 dimers and the exquisitely regulated abundance and activity of its constituents, that all depend on the cell types and physiopathological contexts. Moreover, technical limitations have long given the impression that AP-1 mostly operates in the vicinity of gene promoters. Fra-1 is the Fos family protein that is most often implicated in epithelial cancers. In particular, it is overexpressed in triple negative breast cancers (TNBCs) where it contributes to tumorigenesis and tumor aggressiveness through pleiotropic effects. Based on this, the aim of my thesis was to gain a more comprehensive view of Fra-1 transcriptional actions at the genome-wide level in the MDA-MB-231 reference TNBC cell line, . To this aim, I have combined transcriptomic data with ChIP-seq and NG-Capture C (high resolution, high throughput 3C-derived technique) data. I have also included in my studies its Fos family kin Fra-2, as it displays the same DNA binding specificity and is also expressed in TNBCs, albeit at a much lower level, where it also contributes to the tumor phenotype. Consistently with their pleiotropic effects, Fra-1 and Fra-2 were found to up- or down-regulate either individually, together or redundantly many genes associated with a wide range of biological processes. Interestingly, the regulation of target genes is rarely due to Fra-1 and Fra-2 binding at gene promoters, but involves their binding to distal enhancers. My NG-Capture C results imply the presence of long-range chromatin interactions in Fra-1 modes of action, as well as enhancer hubs containing Fra-1- and non-Fra-1-binding enhancers. No evidence for a role for Fra-1 in the control of chromatin looping was however found using a panel of 35 Fra-1-regulated genes. Moreover, I have addressed the mechanisms of transcriptional repression mediated by Fra-1, as these have practically never been studied, using two model genes, TGFB2 and SMAD6. These studies underlined different mechanisms employed by Fra-1 for the repression of these genes, embodying the complexity of Fra-1 transcriptional regulation mechanisms.

Introdução: O cãncer de mama com fenótipo triplo negativo é definido como um tumor com receptor de estrógno e progesterona negativos e human epidermal growth factor receptor 2 (HER2) negativo. Desde sua primeira descrição, alguns artigos tentaram descrever sua aparência radiológica, sem nenhum consenso. Estas pacientes podem ter características clínicas e imaginológicos distintas. Seria interessante verificar se as características radiológicas desses tumores são as mesmas relatadas no câncer de mama familiar e com mutação do gene BRCA1, muitas vezes associados a esse subtipo tumoral. Estas características que muitas vezes simulariam doenças benignas poderiam atrasar o diagnóstico precoce, refletindo a necessidade de seu conhecimento radiológico na prática. Neste contexto, este estudo poderia auxiliar no reconhecimento precoce de lesões mamárias e alertar o médico para solicitar uma biópsia, consequentemente, resultando num diagnóstico precoce. Objetivo: O principal objetivo desse estudo foi avaliar as características radiológicas dos carcinomas ductais invasivos de mama nos seguintes métodos de diagnóstico por imagem: mamografia, ultrassonografia e ressonância magnética, utilizando a padronização do American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS®), comparando os casos de carcinomas com fenótipo triplo negativo dividindo-os em não basal e basal com o uso da citoqueratina 5. Pacientes e Métodos: Revisamos os arquivos de imagens do Instituto de Radiologia (InRad) da Faculdade de Medicina da Universidade de São Paulo (FMUSP) e do Instituto do Câncer do Estado de São Paulo (ICESP), durante o período da coleta de dados, que envolveu 12 anos. Trata-se de estudo descritivo observacional, realizado após a aprovação do comitê de ética. Foram avaliadas 6.952 resultados de biópsias cirúrgicas ou percutâneas por agulha grossa de mama e após a verificação do material radiológico e histológico, chegamos ao resultado de 106 casos. Todas as reações imunohistoquímicas foram lidas por dois patologistas e os exames radiológicos foram avaliados por dois radiologistas, todos especialistas em doenças da mama em suas respectivas áreas. Resultados: A maioria das pacientes incluídas foram mulheres brancas, com idade entre 24-81 anos. Na mamografia, a principal lesão observada foi o nódulo (74,7%), com margem espiculada (36,9%) e forma oval (60,0%), seguido pela assimetria focal (12,6%), lesões ocultas (9,2%) e assimetria global (3,4%). Nenhuma lesão principal se manifestou como microcalcificações. Os tumores avaliados pela ressonância magnética se manifestaram principalmente como lesão nodular (92,0%), com forma irregular (60,0%), margem irregular (44%) e realce heterogêneo (56,0%). A curva tipo 3 (91,7%) foi comumente observada. O isosinal em T2 foi mais freqüentemente observado (52,2%). A ausência de áreas císticas foi observada na maioria das lesões (47,8%). Todos os tumores avaliados pelo ultrassom foram vistos, principalmente como nódulos (98,1%), hipoecoicos (90,3%), com forma irregular (61,2%), margem mal definida (34,7%) e o reforço acústico posterior (32,0%) e halo ecogênico (46,6%) foram comumente observados. Conclusão: Não foram encontradas associações estatisticamente significativas das características tumorais e demográficas com os subtipos de tumores (p > 0,05) na mamografia, ultrassom e ressonância magnética. Houve correlaçãos inversa entre a idade e o tamanho do tumor. Apenas no USG os linfonodos positivos apresentaram em média estatisticamente maior tamanho tumoral associado que os linfonodos negativos (p=0,045). Em nossa série, observamos que embora algumas características tenham sido mais frequentes, não houveram características que mostraram diferença estatisticamente significante entre os subtipos. Assim, não se pode atribuir qualquer característica específica que possa melhorar a acurácia diagnóstica / Introduction: Breast cancer with triple negative phenotype is defined as estrogen receptor negative tumor, progesterone receptor negative and human epidermal growth factor receptor 2 (HER2) negative. Since its first description, some articles have tried to describe its radiological appearance, with no consensus. These patients can have adverse clinical and imaging characteristics. It would be interesting to check if the radiological characteristics of these tumors are the same related in the familiar breast cancer and associated to the mutation of gene BRCA1, many times associated to this tumor subtype. These characteristics, that many times would simulate benign diseases, could delay the early diagnosis, reflecting the need of its radiological knowledge in practice. In this context, this study could help in the early recognition of breast lesions and alert the doctor to require a biopsy, consequently resulting in an early diagnosis. Objectives: The main objective of this study was to evaluate the radiological characteristics of breast invasive ductal breast carcinomas with triple negative invasive phenotype in the following diagnostic image methods: mammography, ultrasound and magnetic resonance, using the American College of Radiology Breast Imaging Reporting and Data System (ACR BIRADS ®) criteria, divided in basal and not basal subtypes with the use of cytokeratin 5. Patients and Methods: We\'ve reviewed the images from the Radiology Institute (InRad) from Faculty of Medicine of the University of São Paulo (FMUSP) and from the Cancer Institute of São Paulo (ICESP), during the period of data collecting, which took 12 years. This aims to be an observational descriptive study, realized after the Ethic Committee\'s approval. 6952 results of breast surgical or percutaneous needle biopsies were evaluated and after checking the radiological and histological material, we came to the result of 106 cases. All the immunohistochemical reactions were read by two pathologists and the radiological exams were evaluated by two radiologists, all specialists in breast illnesses in their respective areas. Results: Most patients included were white women, aging between 24-81 years old. In the mammography, the main lesion observed was the nodule (74,7%), spiculated margin (36,9%) and oval shape (60%), followed by focal asymmetry (12,6%), hidden lesions (9,2%) and global asymmetry (3,4%). No main lesion showed microcalcifications. The tumors evaluated by magnetic resonance imaging showed mainly as nodule (92,0%), irregular shaped (60,0%), irregular margin (44,0%) and heterogeneous enhancement (56,0%). The curve type 3 (91,7%) was generally observed. The isosignal in T2 was most frequently observed (52,2%). The absence of cystic areas was observed in most of the lesions (47,8%). The tumors evaluated by the ultrasound were seen principally as nodules (98,1%), hypoechoic (90,3%), irregular shaped (61,2%), ill-defined margin (34,7%) and with posterior acoustic enhancement (32,0%) and echogenic halo (46,6%). Conclusion: There were no statistically significant associations of tumor and demographic characteristics with tumor subtypes (p > 0.05) in mammography, ultrasound and magnetic resonance imaging. There were inverse correlations between the age and the size of the tumor. Only in USG positive lymph nodes had on average larger tumor size with a statistically significant result that the negative lymph nodes (p = 0,045). In our series, we\'ve observed that, although some characteristics have been more frequent, there were no characteristics which showed difference statistically significant among the subtypes. Therefore, we can not attribute any specific characteristic that can improve the diagnostic accuracy

Dans les cancers du sein triple négatif sporadiques, BRCA1 est fréquemment inactivé au niveau transcriptionnel, et il a été rapporté que cette inactivation peut être réalisée par une méthylation du promoteur. Plus récemment, il a été constaté que BRCA1 peut également être régulée au niveau post-transcriptionnel par les microARNs. L'accumulation de preuves indique que les miARNs ont un rôle causal dans la tumorigenèse. Nos travaux se sont axés sur l'étude de l’expression et des fonctions des microARN in vitro, in silico et ex vivo.Basé sur nos résultats de profilage de l'expression, quatre miARN candidats (miR-10b, miR-26a, miR-146a et miR-153) ont été choisis comme étant potentiellement impliqués dans le développement du cancer du sein triple négatif. Des essais d'expression exogènes ont révélé que miR-10b et miR-26a, mais pas miR-146a, peuvent réguler négativement l'expression du gène BRCA1 dans les cellules cancéreuses triple négatif MDA-MB-231 et luminales MCF7, alors que miR-153 pourrait réguler négativement l'expression du gène BRCA1 uniquement dans les cellules MCF7. L'analyse in silico des données de Cancer Genome Atlas (TCGA) a confirmé que miR-146a est significativement plus exprimé dans les tumeurs du sein triple négatif par rapport à d'autres tumeurs (non triple négatif) mammaires. L’étude ex vivo a montré que le niveau élévé d’expression de miR-146a et de miR-26 est associé à l’absence des métastases ganglionnaires dans le cancer du sein triple négatif. Aussi une corrélation entre l’expression de 4 miARNs est révélée permettant l’identification de différentes voies de signalisations impliquées dans le cancer du sein triple negatif.Nos travaux fournissent des preuves de l'implication des miARNs spécifiques comme des biomarqueurs potentiels dans le développement du cancer de sein triple négatif. / In sporadic triple-negative breast cancers BRCA1 is frequently inactivated at the transcriptional level, and it has been reported that this inactivation may be brought about by promoter methylation. More recently, it was found that BRCA1 may also be regulated at the post-transcriptional level by miRNAs. Accumulating evidence indicates that miRNAs have a causal role in tumorigenesis. Our work focused on the study of microRNAs expression and functions in vitro, in silico and ex vivo.Based on our expression profiling results, four candidate miRNAs (miR-10b, miR-26a, miR-146a and miR-153) were selected as being potentially involved in triple-negative breast cancer development. Exogenous expression assays revealed that miR-10b and miR-26a, but not miR-146a, can down-regulate the expression of BRCA1 in both triple-negative MDA-MB-231 and luminal epithelial MCF7 breast cancer-derived cells, whereas miR-153 could down-regulate BRCA1 expression only in MCF7 cells. In silico analysis of The Cancer Genome Atlas (TCGA) data confirmed that miR-146a is significantly higher expressed in triple-negative breast tumors compared to other (non triple-negative) breast tumors. The ex vivo study showed that the high level expression of miR-146a and miR-26 is associated with the absence of lymph node metastasis in triple negative breast cancer. Also a correlation between the expression of the 4 miRNAs was revealed, allowing the identification of different signaling pathways involved in the triple negative breast cancer.Our work provides evidence of the involvement of specific miRNAs as potential biomarkers in breast cancer triple negative development.

<p>According to the Global Cancer Incidence, Mortality, and Prevention (GLOBOCAN) study for 2018, 2,089,000 women will have been diagnosed with breast cancer worldwide, with 627,000 breast cancer-related mortalities. It is estimated that between 15 – 20 % of breast cancer diagnoses are of the triple-negative subtype. Triple-negative breast cancers (TNBCs) do not express the receptors for estrogen, progesterone, and human epidermal growth factor 2, and hence cannot be treated using hormone receptor-targeted therapy. </p> <p>TNBCs are commonly of the basal-like phenotype, with high expression levels of proteins involved in epithelial-mesenchymal transition, extracellular-matrix (ECM) remodeling, cell cycle progression, survival and drug resistance, invasion, and metastasis. 5-year survival rates are significantly lower for TNBC patients, and the disease is characterized by poorer grade at the time of diagnosis as well as higher 5-year distant relapse rates, with a greater chance of lung and CNS metastases. Current treatments for TNBC take the form of aggressive cytotoxic chemotherapy regimens with multiple adverse side-effects. An important goal of on-going studies is to identify new compounds with significant TNBC-specificity, in order to improve patient survival outcomes while preserving a high quality of life during treatment.</p> <p> For several decades, compounds originally isolated from bioactive natural extracts, such as the taxanes and vinca<i> </i>alkaloids, have been at the forefront of chemotherapy. However, due to their non -specific mechanisms of action, treatment with these compounds eventually leads to significant toxicity to normal cells and tissues. Modern transcriptomics, metabolomics, and proteomics tools have greatly improved our understanding of the mechanisms governing cancer initiation and progression, and revealed the considerable heterogeneity of tumor cells. This has allowed for the identification of potential vulnerabilities in multiple cancers, including TNBCs. By leveraging these new technologies and insights with the tremendous diversity of bioactive compounds from organisms that remain unstudied, new classes of onco-drugs targeting pathways specific to TNBC cells could be identified in the near future.</p> <p>Here, we describe the cytotoxic effects of extracts from <i>Lippia origanoides </i>- a species of medicinal shrub native to Central and South America - on TNBC cells. We report that these extracts induce rapid, sustained, and irreversible apoptosis in TNBC cells <i>in vitro</i>, with significantly reduced cytotoxicity against normal mammary epithelial cells. The <i>L. origanoides </i>extracts LOE and L42 exploited two TNBC-specific characteristics to induce apoptosis in these cells: i) inhibiting the constitutively active survival and inflammatory NF-kB signaling pathway, and ii) significantly dysregulating the expression levels of mitochondrial enzymes required to maintain the TCA cycle and oxidative phosphorylation; metabolic pathways that are required for the maintenance of TNBC cell growth and proliferation.</p> <p>Finally, to lay the foundations for future studies on the abilities of these extracts to prevent tumor initiation and inhibit tumor growth <i>in vivo</i>, we also show that the <i>L. origanoides </i>extract, L42, is non-toxic<i> </i>to immunocompetent C57BL/6 mice, and have developed an <i>in vivo </i>model of human TNBC in athymic <i>nu/nu</i> mice. </p> <p>Collectively, our studies are the first to identify the anti-TNBC-specific properties of bioactive extracts from the <i>Lippia </i>species, and reveal that targeting NF-kB signaling and mitochondrial metabolism are potential avenues to new therapeutics against this subtype of breast cancer. Future work in our lab will focus on identifying the bioactive components (BACs) of the extract mediating its apoptotic effects, and shedding light on their protein binding partners within the cell.</p>

Les défauts dans les voies de réparation de l’ADN sont aujourd’hui largement exploités pour le traitement du cancer. En effet, la capacité des tumeurs à réparer les lésions induites par les traitements génotoxiques (chimio- et radiothérapie) leur confère une résistance intrinsèque ou acquise à ces traitements. Développer des inhibiteurs de réparation de l’ADN permettrait de contrecarrer cette résistance et de sensibiliser les tumeurs à ces thérapies conventionnelles. Les inhibiteurs de la Poly(ADP-ribose) polymérase (PARPi), premiers candidats de cette famille d’inhibiteurs de réparation de l’ADN, ont montré des résultats encourageants mais sont néanmoins restreints à une sous-population de tumeurs avec une déficience dans la voie de réparation par recombinaison homologue (DRH). De plus, des résistances à ces PARPi ont été constatées suite à la réactivation de la voie RH ou de voies alternatives. Il est donc urgent de développer des agents plus efficaces qui permettraient de limiter la problématique de résistance. Dans le laboratoire, nous avons identifié une nouvelle classe d’inhibiteurs de réparation de l’ADN, les Dbait, consistant en une petite molécule d’ADN double-brin qui miment une cassure double-brin (CDB). AsiDNA, une molécule de la famille Dbait, agit en séquestrant et hyper activant la protéine PARP et ses partenaires, ainsi que la protéine DNA-PK qui modifie la chromatine, inhibant ainsi le recrutement au niveau du site du dommage de plusieurs protéines de réparation des voies RH ou NHEJ. Dans ce manuscrit, nous avons étudié la question des mécanismes de sensibilité à AsiDNA, et nous avons identifié l’instabilité génétique, générée essentiellement par des défauts dans les voies de réparation des CDBs, comme caractéristique majeure pour être sensible à AsiDNA dans différents modèles de cellules et de xénogreffes. De façon intéressante, l’instabilité génétique ne corrélait pas avec la sensibilité aux PARPi, qui présentaient également un profil d’action différent d’AsiDNA. En se basant sur ces différences, et sur le mode d’action d’AsiDNA agissant en tant qu’inhibiteur de la voie RH, la combinaison de ces deux molécules permettrait de s’affranchir de la restriction génétique (DRH) essentielle pour l’efficacité des PARPi. Pour valider cette hypothèse, nous avons montré par des analyses moléculaires que l’olaparib, un PARPi, et AsiDNA préviennent le recrutement au niveau des sites des dommages de XRCC1 et de RAD51/53BP1, respectivement. La combinaison de ces deux inhibiteurs permettait l’accumulation des dommages non réparés résultant en une augmentation de la mort de cellules tumorales de différentes origines, et un retard significatif de la croissance des xénogreffes. Cependant, les cellules non tumorales ne présentaient ni une augmentation des dommages ni de la mort cellulaire. Ces résultats soulignent l’intérêt thérapeutique de la combinaison d’AsiDNA avec les PARPi qui permettrait de s’affranchir de la dépendance au statut DRH et d’élargir leur champ d’application. Dans cette thèse, nous avons également traité la question de la résistance acquise à AsiDNA. En effet, contrairement à l’imatinib et au 6-thioguanine, nous n’avons pas isolé de clones résistants à AsiDNA après des expériences de mutagénèse ou après des traitements répétés sur différents modèles cellulaires. Un tel comportement défie notre acceptation commune de la théorie Darwinienne pour expliquer la résistance des cellules tumorales aux traitements. / Defects in the DNA repair pathways are now widely exploited for the treatment of cancer. Indeed, the ability of tumors to repair the damage induced by genotoxic treatments (chemotherapy and radiotherapy) gives them an intrinsic or acquired resistance to these treatments. Developing DNA repair inhibitors would help to counteract this resistance and sensitize tumors to these conventional therapies. Poly(ADP-ribose) polymerase inhibitors (PARPi), first candidates for this family of DNA repair inhibitors, have shown encouraging results but are nevertheless restricted to a tumor subpopulation with Deficiencies in the Homologous Recombination repair pathway (HRD). In addition, resistances to these PARPi were observed following the reactivation of the HR pathway or alternative pathways. It is therefore urgent to develop more effective agents to limit the resistance problem. In the laboratory, we have identified a new class of DNA repair inhibitors, Dbait, consisting of a small double-stranded DNA molecule that mimics a double-strand break (DSB). AsiDNA, a molecule of the Dbait family, acts by hijacking and hyper activating the PARP protein and its partners, as well as DNA-PK protein that modifies chromatin, thereby inhibiting recruitment at the damage site of several DNA repair proteins. In this manuscript, we studied the issue of mechanisms of sensitivity to AsiDNA, and we identified the genetic instability, generated mainly by defects in the DSBs’ repair, as major feature to be sensitive to AsiDNA in different models of tumor cells and xenografts. Interestingly, genetic instability does not correlate with sensitivity to PARPi, which also had a different action profile than AsiDNA. Based on these differences, and on the mode of action of AsiDNA acting as an inhibitor of the HR pathway, the combination of these two molecules would allow bypassing the genetic restriction (HRD) essential for PARPi efficiency. To validate this hypothesis, we have shown by molecular analyzes that olaparib, a PARPi, and AsiDNA prevent the recruitment at damage sites of the repair proteins XRCC1 and RAD51 / 53BP1, respectively. The combination of these two inhibitors allowed the accumulation of unrepaired damage resulting in an increase of tumor cells’ death, and a significant delay in the growth of xenografts. However, non-tumor cells were not sensitive to this combined treatment. These results highlight the therapeutic interest of combining AsiDNA with PARPi to recapitulate synthetic lethality in all tumors independently of their HR status. In this thesis, we also addressed the issue of acquired resistance to AsiDNA. Indeed, contrary to imatinib and 6-thioguanine, we didn’t recover resistant clones to AsiDNA after mutagenesis or after repeated cycles of treatment on different cell models. Such behavior challenges our common acceptation of a Darwin evolution theory to explain tumor cells resistance to treatment.