Triple‐negative breast cancer (TNBC) is the most refractory subtype of breast cancer to current treatments and accounts disproportionately for the majority of breast cancer‐related deaths. Research has not yet identified specific therapies for TNBC and chemotherapy remains the conventional therapy in the clinic. While conventional chemotherapy regimens have demonstrated success at reducing bulk tumor burden, they have been shown to enrich cancer stem cells (CSCs). CSCs promote chemoresistance, metastasis, heterogeneous tumor regeneration and disease relapse. Owing to tumor plasticity and the conversion between CSC and non-CSC subpopulations development of a strategy capable of inhibiting both non-CSC and CSC subpopulations is crucial for TNBC therapy. In this compilation of my main research projects, several new approaches for the treatment of TNBC were identified which target not only the bulk tumor population but also the CSC populations residing within the tumor: 1. Co-suppression of Wnt, HDAC, and ESR1 using clinically relevant low‐dose inhibitors effectively repressed both bulk and CSC subpopulations and converted CSCs to non‐CSCs in TNBC cells. 2. Co-inhibition of mTORC1, HDAC, and ESR1 was capable of reducing both bulk and CSC subpopulations as well as the conversion of fractionated non-CSC to CSCs in in a human TNBC xenograft model and hampered tumorigenesis following treatment. 3. Inhibition of Wnt and YAP retarded tumor growth of TNBC cells in either epithelial or mesenchymal states, and both CD44high/CD24low and ALDH+ CSC subpopulations were diminished in a human xenograft model reducing tumorigenicity following treatment.

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Untersuchung des Wirkmechanismus von AEZS 126 auf drei triple negative Mammakarzinomzelllinien HCC1937, HCC1806 und MDA-MB468 und eine Oestrogenrezeptor positive Zelllinie MCF-7 mittels Kristallviolett assay, FACS und Western Blot. Es konnte gute Antitumorwirkung des Inhibitors in vitro gezeigt werden. / Of more than one million global cases of breastcancer diagnosed each year, a high percentage are characterized as triple-negative, lacking the oestrogen, progesterone and Her2/neu receptors. The incidence exceeds the incidence of malignancies like CML by far. Lack of effective therapies, younger age at onset and early metastatic spread have contributed to the poor prognosis and outcomes associated with these malignancies. Here, we investigate the ability of the PI3 K/AKT inhibitor AEZS 126 to selectively target the triple negative breast cancer (TNBC) cell proliferation and survival in vitro by MTT-assays and FACS-based analysis. Furthermore, the mechanism of cytotoxicity is analysed by FACS-based assays and Western blots. Results AEZS 126 showed good antitumour activity in in vitro models of TNBC as well as in MCF-7 cells. We demonstrated the highly efficient antitumour activity of AEZS 126 in in vitro models of TNBC. Due to the good anti-tumour activity and the expected favourable toxicity profile, AEZS 126 in combination with chemotherapy seems to be a promising candidate for clinical testing in TNBC especially in the basal-like subgroup of TNBC.

Le cancer du sein triple-négatif est un sous-type représentant environ 15 % des cancers du sein, qui est caractérisé par l'absence de récepteurs hormonaux aux œstrogènes et à la progestérone et l'absence d'expression du facteur de croissance HER-2. Le cancer du sein triple-négatif est également associé à un profil clinique défavorable avec un haut risque de rechute métastatique précoce. Actuellement, de nombreuses molécules sont testées comme cible thérapeutique dans ce type de cancer. La cathepsine D, une aspartyl protéase lysosome, est un marqueur de mauvais pronostic du cancer du sein associé au risque métastatique. Cette protéase est surexprimée par les cellules cancéreuses mammaires et hypersécrétée dans le microenvironnement tumoral. Notre équipe a apporté des contributions importantes pour élucider le rôle de la cath-D dans le cancer du sein. La cath-D stimule la prolifération des cellules cancéreuses, la croissance et l'angiogenèse tumorales ainsi que la formation des métastases. Au niveau moléculaire, le proenzyme sécrété par la cellule tumorale stimule la croissance invasive du fibroblaste mammaire via le récepteur LRP1 (low-density lipoprotein receptor-related protein-1). De plus, au pH extracellulaire acide des tumeurs, la pro-cathepsine D secrétée dégrade un des plus puissants inhibiteurs des cystéines cathepsines, la cystatine C, stimulant ainsi leurs activités protéolytiques.Mon travail a consisté à développer des anticorps anti-cath-D, présentant un effet thérapeutique dans le cancer du sein triple-négatif. Nous avons utilisé deux approches l'une par la technologie des hybridomes qui a permis d'isoler 50 anticorps, qui se sont avérés être des IgM. L'autre, par phage display, où 8 anticorps fragments scFv anti-cath-D ont été sélectionnés par ELISA. Ces 8 scFv ont été criblés pour leur capacité à bloquer l'activité biologique de la cathepsine D : inhibition de l'interaction avec LRP1 et inhibition du clivage d'un substrat fluorescent. Les anticorps E2 et F1 reformatés en IgG1 inhibent in vitro le phénomène de cicatrisation, la clonogénéicité, la croissance tridimensionnelle dans le matrigel et in vivo la croissance tumorale des cellules de cancer du sein triple-négatif MDA-MB-231. Cette étude est une première étape vers le développement de thérapie anti-cath-D dans le cancer du sein. / Cancer is the leading cause of death in the developed world. This project focuses t on the high incidence triple-negative breast cancers (ER- and PR-negative, HER2-non amplified) who present unsatisfactory treatments. Tumor progression is known to be due to cross-talk between cancer cells and their surrounding supporting tissue, the tumor stroma. The lysosomal aspartic protease cathepsin D is over-produced and abnormally hypersecreted by epithelial breast cancer cells. This protease is an independent marker of poor prognosis in breast cancer correlated with the incidence of clinical metastasis. Cathepsin D stimulates tumor progression by both proteolytic and non-proteolytic molecular mechanisms. Our team has shown that secreted pro-cathepsin D can alter the tumor microenvironment by interacting with partners such as the LRP1 (low-density lipoprotein receptor-related protein-1) receptor, and/or by cleaving endogenous substrates like cystatin C. My pHD project aimed to target extracellular procathepsin D released in breast cancer by developing specific therapeutic antibodies to block its catalytic and binding capacities. We have isolated 50 hybridomas, that secreted IgM, a pentameric antibody format with high avidity but low affinity, and 8 anti-cath-D scFv by phage display. The anti-human cath-D scFv were selected by functional screenings for their ability to inhibit both the proteolytic activity of Cath-D and its binding to the fibroblastic LRP1 receptor. Two scFv cloned under IgG1 format (F1 and E2) inhibited wound healing, colony formation and three-dimensional outgrowth in Matrigel of MDA-MB-231 triple-negative breast cancer cells, and their tumor growth in athymic nude mice. Our findings strongly suggest that antibody-based targeting of Cath-D within the breast tumor microenvironment may have therapeutic efficacy for breast cancer treatment.

Globally, breast cancer is the leading cause of death in the female population aged 45 and below with a breast cancer incidence reaching 18.1 million in the year 2018. Triple negative breast cancer (TNBC) is part of a group of cancers that lack the expression of Progesterone receptor (PR), Estrogen receptor (ER) and Human epidermal growth factor receptor 2 (HER2). TNBC is commonly associated with early stage metastasis with low survival rates as well as a high frequency of recurrence and proves to be problematic in both the young and elderly female populations. Conventional diagnostic methods for TNBCs include mammography, magnetic resonance imaging (MRI) and ultrasound while therapeutic methods include mastectomy and breast conserving surgery (coupled with radiation therapy). The lack of effective therapeutic options, poor prognostic value and high rates of metastasis, has made treatment of TNBC difficult. The major focus of this work was on the following tumour associated antigens (TAAs): CSPG4 (a transmembrane protein found in 50% of TNBC cases), EGFR (which is overexpressed in 13-76% of TNBCs), and MSLN (which is overexpressed in 67% of TNBCs) as potential targets for monospecific therapy. The evolution of antibody-based immunotherapy strategies has led to applications of single chain variable fragment (scFv) & single domain/nanobody (VHH) antibody formats for diagnostic and therapeutic purposes. In this work, these recombinant antibody fragments have been combined with SNAP-tag, a modified version of the human DNA repair enzyme O6-alkylguanine-DNA-alkyltransferase (AGT), which autocatalytically binds benzyl-guanine modified substrates such as fluorophores or small molecule toxins covalently in a 1:1 stoichiometry. In this study, the primary aim was the comparison of different antibody formats fused to SNAPtag and the potential of these biopharmaceuticals towards immunodiagnosis and therapy of TNBCs. First functionalities of two scFv SNAP fusion proteins and one VHH SNAP fusion protein previously not having been described are provided through binding analyses on receptor positive tumour cell lines. This was achieved by in-silico design and molecular cloning of genetically fused antiCSPG4(scFv), -MSLN(scFv), -MSLN(VHH), -EGFR(scFv) & -EGFR(VHH) to SNAP-tag. The final constructs were confirmed by Sanger sequencing and subsequently transfected into a mammalian vector system (HEK293T) for transient expression of the engineered fusion proteins. Full length protein purified from cell culture supernatant was analysed for diagnostic/therapeutic activities dependant on the substrate attached in the form of a fluorophore or small molecule toxin resulting in recombinant antibody-drug conjugates (ADCs). The study shows promise in providing new immunodiagnostic and therapeutic agents that are specific and less harmful than the current state of the art procedure

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Le cancer du sein triple négatif (TNBC) représente entre 15-20% des cancers du sein et est l'un des types les plus agressifs. De plus, un sous-groupe de ces patientes est résistant à la radiothérapie (RT) et développe fréquemment une récidive hâtive de la maladie. Des études précédentes ont démontré que l’inflammation induite par la RT accélère la progression du cancer et le développement des métastases. Cette hypothèse a donc été validée dans un modèle pré-clinique de TNBC en implantant les cellules de carcinome de souris triple négatives D2A1 dans les glandes mammaires de la souris Balb/c. Premièrement, la tumeur primaire à été irradiée à une dose sous-curative une semaine post-implantation des cellules. En deuxième lieu, le tissu mammaire de la souris a été pré-irradié avant d'implanter les cellules cancéreuses afin de bien discerner l'effet du microenvironnement irradié sur celles-ci. Ces deux modèles ont mené à une augmentation significative des cellules tumorales circulantes ainsi que du nombre de métastases pulmonaires. Plusieurs molécules inflammatoires dont l'interleukine-1 bêta (IL-1β), l'interleukine-6 (IL-6) ou encore la cyclooxygénase 2 (COX-2) ont été identifiées comme facteurs clés impliqués dans la migration radio-induite des cellules cancéreuses du sein. Conséquemment, un inhibiteur large-spectre comme la chloroquine (CQ), entre autres utilisé comme traitement anti-malarien et anti-inflammatoire, a su prévenir ces effets secondaires associés à la RT. Étant donné que l'action de la CQ est peu sélective, une répression de l'expression de l'ARNm de la métalloprotéinase (MMP) de membrane de type 1 (MT1-MMP), une MMP de surface impliquée notamment dans la migration cellulaire, l'invasion tumorale et l'angiogenèse, a été réalisée afin d'éclaircir le mécanisme d'inhibition des métastases radio-induites. Cette répression de la MT1-MMP prévient la formation des métastases pulmonaires radio-induites, démontrant ainsi un des mécanisme important de l'invasion radio-induite. Ce résultat confirme donc l'importance de la MT1-MMP dans ce phénomène et son potentiel comme biomarqueur de prédiction de l'efficacité des traitements de RT, particulièrement chez les patientes atteintes de TNBC.

acase@tulane.edu / Triple-negative breast cancer (TNBC) presents a clinical challenge due to the aggressive nature of the disease and a lack of targeted therapies. Constitutive activation of the mitogen-activated protein kinase (MAPK)/extracellular signal-regulated kinase (ERK) pathway has been linked to chemoresistance and metastatic progression through distinct mechanisms, including activation of epithelial-to-mesenchymal transition (EMT) whereby cells adopt a motile and invasive phenotype through loss of epithelial markers, namely Cadherin 1/E-Cadherin (CDH1), and acquisition of mesenchymal markers, such as vimentin (VIM) and Cadherin 2/N-Cadherin (CDH2). While MAPK/ERK1/2 kinase inhibitors (MEKi) have shown promise as antitumor agents in the preclinical setting, application has had limited success clinically. Activation of compensatory signaling, potentially contributing to the emergence of drug resistance, has shifted the therapeutic strategy to combine MEK1/2 inhibitors with agents targeting oncoproteins (RAF) or parallel growth pathways (PI3K). Conventional MAPK family members have been well-characterized in modulation of cellular processes involved in tumor initiation and progression, yet the role of MEK5-ERK5 in cancer biology is not completely understood. Recent studies have highlighted the importance of the MEK5 pathway in metastatic progression of various cancer types, including those of the prostate, colon, bone and breast. Furthermore, elevated levels of ERK5 expression and activity observed in breast carcinomas are linked to worse prognosis in TNBC patients. The purpose of this work is to explore MEK5 regulation of the EMT axis and to evaluate a novel pan-MEK inhibitor on clinically aggressive TNBC cells. Our results show a distinction between the MEK1/2 and MEK5 cascades in maintenance of the mesenchymal phenotype, suggesting that the MEK5 pathway may be necessary and sufficient in EMT regulation while MEK1/2 signaling further sustains the mesenchymal state of TNBC cells. Furthermore, additive effects on MET induction are evident through the inhibition of both MEK1/2 and MEK5. Taken together, these data demonstrate the need for a better understanding of the individual roles of MEK1/2 and MEK5 signaling in breast cancer and provide rationale for combined targeting of these pathways to circumvent compensatory signaling and subsequent therapeutic resistance. / 1 / Van Hoang

abstract: In the United States, 12% of women are typically diagnosed with breast cancer, where 20-30% of these cases are identified as Triple Negative Breast Cancer (TNBC). In the state of Arizona, 810 deaths occur due to breast cancer and more than 4,600 cases are diagnosed every year (American Cancer Society). The lack of estrogen, progesterone, and HER2 receptors in TNBC makes discovery of targeted therapies further challenging. To tackle this issue, a novel multi-component drug vehicle is presented. Previously, we have shown that mitoxantrone, a DNA damaging drug, can sensitize TNBC cells to TRAIL, which is a protein that can selectively kill cancer cells. In this current study, we have formulated aminoglycoside-derived nanoparticles (liposomes) loaded with mitoxantrone, PARP inhibitors, for delivery to cancer cells. PARP inhibitors are helpful in preventing cancer cells from repairing their DNA following damage with other drugs (e.g. mitoxantrone). Various treatment liposome groups, consisting of lipid-containing polymers (lipopolymers) synthesized in our laboratory, were formulated and characterized for their size, surface charge, and stability. PARP inhibitors and treatment of cells for in-vitro and in-vivo experiments with these liposomes resulted in synergistic death of cancer cells. Finally, studies to evaluate the pre-clinical efficacy of these approaches using immuno-deficient mouse models of TNBC disease have been initiated. / Dissertation/Thesis / Masters Thesis Chemical Engineering 2018