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京都大学 / 新制・課程博士 / 博士(医学) / 甲第23784号 / 医博第4830号 / 新制||医||1057(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 鈴木 実, 教授 中島 貴子, 教授 伊達 洋至 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23785号 / 医博第4831号 / 新制||医||1057(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 伊達 洋至, 教授 中本 裕士, 教授 鈴木 実 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(薬科学) / 甲第25230号 / 薬科博第192号 / 新制||薬科||21(附属図書館) / 京都大学大学院薬学研究科医薬創成情報科学専攻 / (主査)教授 掛谷 秀昭, 教授 樋口 ゆり子, 教授 二木 史朗 / 学位規則第4条第1項該当 / Doctor of Agricultural Science / Kyoto University / DFAM

京都大学 / 新制・課程博士 / 博士(医学) / 甲第25492号 / 医博第5092号 / 新制||医||1073(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 斎藤 通紀, 教授 浅野 雅秀, 教授 柊 卓志 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Overall, this study enhances our understanding of the role of c-Myc activation in chromosome 11 repositioning in mouse PreB v-abl/myc cells and a possible interaction between telomeres, TRF2, and lamin A/C underlying this phenomenon. Additionally, the importance of human 17q25.3 is confirmed as a potential region involved in NSCLC tumorigenesis. A utilizationof the 3D telomeric organization profiles is demonstrated a tendency to categorize NSCLC patients into different prognostic subgroups, underscoring a potential future value of its clinical application. / February 2017

To improve relatively poor outcomes for locally-advanced lung cancer patients, many current efforts are dedicated to minimizing uncertainties in radiotherapy. This enables the isotoxic delivery of escalated tumor doses, leading to better local tumor control. The current dissertation specifically addresses inter-fractional uncertainties resulting from patient setup variability. An automatic block-matching registration (BMR) algorithm is implemented and evaluated for the purpose of directly localizing advanced-stage lung tumors during image-guided radiation therapy. In this algorithm, small image sub-volumes, termed “blocks”, are automatically identified on the tumor surface in an initial planning computed tomography (CT) image. Each block is independently and automatically registered to daily images acquired immediately prior to each treatment fraction. To improve the accuracy and robustness of BMR, this algorithm incorporates multi-resolution pyramid registration, regularization with a median filter, and a new multiple-candidate-registrations technique. The result of block-matching is a sparse displacement vector field that models local tissue deformations near the tumor surface. The distribution of displacement vectors is aggregated to obtain the final tumor registration, corresponding to the treatment couch shift for patient setup correction. Compared to existing rigid and deformable registration algorithms, the final BMR algorithm significantly improves the overlap between target volumes from the planning CT and registered daily images. Furthermore, BMR results in the smallest treatment margins for the given study population. However, despite these improvements, large residual target localization errors were noted, indicating that purely rigid couch shifts cannot correct for all sources of inter-fractional variability. Further reductions in treatment uncertainties may require the combination of high-quality target localization and adaptive radiotherapy.

Le but de cette étude a été d’analyser l’intérêt de l’aérosolthérapie d’anticorps monoclonaux (AcM) dans le traitement du cancer broncho-pulmonaire non à petites cellules (CBNPC) en utilisant le cetuximab, un AcM anti-EGFR. L’expression du récepteur FcRn, essentiel dans la pharmacocinétique et la biodistribution des IgGs thérapeutiques a été étudiée dans le CBNPC. Nos résultats montrent que l’AcM peut résister aux contraintes physiques de la nébulisation. Les données de biodistribution et pharmacocinétique, obtenues dans un modèle animal, indiquent que l’Ac administré par aérosol, s’accumule de façon prolongée au niveau pulmonaire. De plus, les tumeurs chez la souris paraissent sensibles à l’aérosolthérapie avec l’AcM. Par ailleurs, le récepteur FcRn est moins exprimé au niveau transcriptionnel et protéique dans le tissu tumoral que dans le tissu sain adjacent à la tumeur dans le CBNPC. Cette altération de l’expression pourrait être due à l’hyperméthylation du promoteur de ce gène. / The project aims at determining whether aerosoltherapy is well suited for monoclonal antibodies (Mab), in Non-Small Cell Lung Cancer (NSCLC). In addition, exploration of the expression of FcRn, an IgG receptor contributing to increased half-life and biodistribution of Mab, has been studied in NSCLC. Using cetuximab, an anti-EGFR Mab, we showed that Mab resist the physical constraints of nebulization. Biodistribution and pharmacokinetic analyses, using a murine model, revealed that cetuximab is highly and durably accumulated within the lungs and slowly and weakly released into the bloodstream following airways delivery. Moreover, animal tumors seem sensitive to cetuximab aerosoltherapy. Expression analysis of FcRn at both the transcript and protein levels showed that the receptor is downregulated in NSCLC. FcRn alteration of expression in the tumor might be due to hypermethylation of the gene promoter as often found in cancer.

A dissertation submitted to the Faculty of Science, University of Witwatersrand, Johannesburg, in fulfilment of the requirements for the degree of Master of Science. March 2015 / Lung cancer is currently the most deadly form of cancer due to the fact that metastasis occurs in the lymph nodes making it difficult to remove by surgical means. Chemotherapy has been the most successful method of treatment, although it has been harmful to human health as a consequence of non-specific cytotoxicity. There has been, therefore, a growing interest in cancer research to develop alternative cancer treatments, which are less toxic. Currently plant-derived drugs are perceived to be more effective as they display both cytotoxic activity and are less harmful to overall human health. Thus the aim of the study was to determine the cytotoxic effects of the plant Lobostemon fruticosus on A549 cells. The IC50 of the methanol and butanol extracts of L. fruticosus were obtained at 40 μg/ml and 50 μg/ml, respectively. DNA fragmentation was observed after 48 hour exposure to treatments, indicating that the plant extracts induced apoptosis. Cell cycle analysis indicated that the plant extracts inhibited cell cycle progression at the sub-G0 phase, which indicated that the cells had undergone apoptosis. RT-PCR showed that the expression of p53 was down-regulated; however, p21 and Bax were up-regulated in all treatments. LC-MS identified that the compounds from the plant extracts are known apoptotic inducers. The results lead to the conclusion that the extracts of L. fruticosus, induce cell death in A549 cells. The plant extracts induced a p53-independent apoptotic mechanism, which was mediated by Bax and p21. Key words: Lobostemon fruticosus, camptothecin, taxol, Non-small cell lung cancer (NSCLC)