Au sein d’une tumeur des régions hypoxiques se forment ce qui conduit à l’activation du facteur de transcription HIF1. HIF1, composé des deux protéines HIF1a et HIF1b, permet l’adaptation des cellules à des faibles concentrations d’oxygène en activant la transcription de gène cible. Un de ces gènes est celui codant pour la lysyl oxydase (LOX). Cette enzyme structure la matrice extracellulaire et est impliquée dans la tumorigénèse. Pour comprendre les liens entre LOX et HIF1a, nous avons modulé leurs expressions dans des lignées humaines de carcinome du côlon. En condition hypoxique, HIF1a contrôle l’expression de LOX et réciproquement, LOX régule la synthèse protéique d’HIF1a via l’activation de la voie de signalisation PI3K/AKT. Nous avons donc mis en évidence l’existence d’une boucle de régulation positive entre LOX et HIF1 en conditions hypoxique. Sachant que ces deux protéines sont des acteurs majeurs de la progression tumorale, nous avons cherché à comprendre le rôle de cette régulation mutuelle dans ce processus. Nos résultats démontrent que l’activité enzymatique de LOX promeut la croissance tumorale in vitro et in vivo et que son action est potentialisée par la présence de son partenaire HIF1a. De plus, LOX et HIF1a agissent en synergie afin d’augmenter la potentiel métastatiques des cellules tumorale de côlon in vitro. Ainsi, ce travail de thèse a permis de mettre en évidence l’existence d’une boucle de régulation entre HIF1a et LOX qui est critique dans la progression tumorale et semble également être impliquée dans le processus métastatiques / The microenvironment of solid tumors is exposed to hypoxic conditions which lead to the activation of Hypoxia‐Inducible Factor 1 (HIF1). HIF1, composed by a heterodimer of HIF1a and HIF1b protein, is a key transcription factor involved in cellular adaptation to changes in oxygen level, inducing the expression of several transcriptional targets such as Lysyl Oxidase (LOX). LOX is an amine oxidase that catalyzes crosslinking of fibrillar collagens and elastin in the extracellular matrix. Furthermore, LOX is implied in tumor progression. To clarify, the link between LOX and HIF1a, their expression were modulated in human colorectal carcinoma cell lines. We pointed out that besides HIF1‐dependant regulation of LOX, LOX can also act on the HIF1 pathway under hypoxic conditions. Indeed, LOX enzymatic activity upregulates HIF1a protein synthesis, and this action is mediated by the PI3K/AKT pathway. Thus, these results emphasize the existence of a regulation loop between HIF‐1a and LOX, which represent two main actors of tumoral progression. Thus, we wanted to determine the implication of this amplification loop in tumor progression. Our results show that LOX enzymatic activity increase tumor growth in vitro and in vivo, and this role is partially dependant of its partner HIF1a. Furthermore, we established that that LOX and HIF1a act in synergy to foster metastatic potential in colorectal carcinoma cell lines. Taken together, our results demonstrate a regulation loop between LOX and HIF1a with is critical for tumor progression and metastasis formation

INTRODUÇÃO: As recidivas e as metástases são os fatores responsáveis pela morte de pacientes com câncer de pulmão (representando 90% dos casos), indicando a necessidade de conhecer as múltiplas vias sinalizadoras envolvidas em sua patogênese, progressão, invasão e metástase. Adenocarcinomas e carcinomas de grandes células invadem primariamente vasos sanguíneos e linfáticos, metastatizando à distância. Já os carcinomas de células escamosas envolvem diretamente o mediastino, sobretudo, linfonodos e pericárdio. Carcinomas neuroendócrinos de baixo grau (carcinoides típicos e atípicos) invadem e metastatizam apesar de serem indolentes, enquanto que carcinomas neuroendócrinos de alto grau (carcinoma neuroendócrino de grandes células e carcinoma de pequenas células), rapidamente metastatizam à distância. Esse espectro diferencial de invasividade nos carcinomas de pulmão ainda não pôde ser definitivamente demarcado por biomarcadores, sobretudo nas variantes neuroendócrinas. Neste aspecto, acredita-se que a EMT esteja mais intimamente envolvida no processo de invasão, despontando como potencial biomarcador. OBJETIVO: Realizar o mapeamento genético da EMT nos carcinomas pulmonares, estabelecendo uma assinatura gênica capaz de prever o potencial de invasão nos diferentes tipos histológicos do câncer de pulmão. MÉTODOS: Espécimes de tumores ressecados cirurgicamente e criopreservados de 60 pacientes foram submetidos a análise de expressão gênica através da qPCR em tempo real, por meio do kit RT2 Profiler PCR array para a EMT com 84 genes de interesse. RESULTADOS: Observou-se a elevada expressão de 24 genes (AKT1, COL1A2, COL3A1, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGA5, ITGAV, ITGB1, JAG1, MAP1B, MMP2, MMP3, SNAI2, SPARC, SPP1, STAT3, TCF3, TGF?3, VPS13A, WNT5A) que participam do processo da EMT e atuam no desenvolvimento da neoplasia pulmonar. Tumores em estádio avançado e com metástases linfonodais apresentaram significante maior expressão dos seguintes genes, COL1A2, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGAV, ITGB1, MAP1B, SNAI2 e VPS13A. Comparando-se carcinomas nãoneuroendócrinos (CEC e AD) e neuroendócrinos (CT, CA, CPPC, CNEGC), observou-se que os neuroendócrinos apresentaram elevada expressão significativa dos genes: FR11, GSK3B, ILK, ITGB1, JAG1, MAP1B e VPS13A. Em relação à sobrevida, a análise univariada demonstrou menor sobrevida para pacientes em estádio avançado do tumor com metástase linfonodal e portador de carcinoma neuroendócrino que apresenta a hiperxpressão de todos os 24 genes da EMT, com exceção dos genes COL3A1 e SPP1. Pela análise multivariada demonstrou-se que pacientes com carcinomas neuroendócrinos com expressão elevada de MMP2 e SPARC apresentaram maior risco de morte (OR 5,41 e 4,94, respectivamente), enquanto que pacientes portadores de carcinomas de células escamosas ou adenocarcinomas com baixa expressão gênica de ILK, SPP1, COL1A2, ITGB1 apresentaram menor risco de morte (OR -7,02; -0,4, -1,3 e -3,02). CONCLUSÃO: Através do presente estudo estabeleceu-se uma assinatura gênica de 24 genes capaz de prever o potencial de agressividade histológica, de invasão e de metástases nos carcinomas pulmonares neuroendócrinos e não-neuroendócrinos / INTRODUCTION: Metastasis are responsible for the death of 90% of patients with lung cancer, indicating the need to know the multiple signaling pathways involved. Adenocarcinomas (Adc) and large cell carcinomas primarily invade blood vessels with distant metastasis, whereas squamous cell carcinoma (SqCC) involves the mediastinal lymph nodes. Neuroendocrine carcinomas of low-grade (typical and atypical carcinoid) are indolent, while high-grade neuroendocrine carcinoma (large cell neuroendocrine carcinoma and small cell carcinoma) metastasize rapidly. Biomarkers of aggressiveness in lung carcinomas remain to be determined, especially in neuroendocrine variants. In these fields, Epithelial to mesenchymal transition (EMT) genes profile emerge promise as an indicator of invasion and metastasis. AIMS: Carry out the genetic mapping of EMT in lung cancer, establishing a gene signature capable of predicting the invasion potential of different histological types of lung cancer. METHODS: Were included specimens of 60 patients and the EMT gene expression was quantified with a quantitative real-time (RT)- PCR carried out on StepOnePlus(TM) Real-Time PCR System (Applied Biosystems) with RT2 Profiler PCR Array System for the EMT pathway wih 84 target genes. (Qiagen, Dusseldorf, Germany). Associations of the gene signature and clinicopathological features, as well as prognostic factors were evaluated. RESULTS: Was observed high expression of 24 genes (AKT1, COL1A2, COL3A1, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGA5, ITGAV, ITGB1, JAG1, MAP1B, MMP2, MMP3, SNAI2, SPARC, SPP1, STAT3, TCF3, TGFbeta3, VPS13A, WNT5A) that are involved in the EMT process and act in the development of pulmonary neoplasia. Tumors at the advanced stage and with lymph node metastasis shown a significant higher expression of the genes COL1A2, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGAV, ITGB1, MAP1B, SNAI2 and VPS13A. Comparing the histological subtypes non-neuroendocrine (SqCC and AD) and neuroendocrine carcinomas (TC, AT, SCLC, LCNEC), was observed that the neuroendocrine variant shown a higher significant expression of the genes FR11, GSK3B, ILK, ITGB1, JAG1, MAP1B and VPS13A. Regarding survival, univariate analysis showed lower survival for patients in the advanced tumor stage, with lymph node metastasis and with neuroendocrine carcinoma histology that presenting overexpression for all 24 EMT genes, with the exception of the COL3A1 and SPP1 genes. Cox regression controlled by, histological types and gene expression of ILK, MMP2, SPP1, SPARC, COL1A2 and ITGB1 showed that patients with neuroendocrine carcinomas with higher expression of MMP2 and SPARC had a higher risk of death (OR 5.41 and 4.94, respectively), whereas patients with squamous cell carcinomas or adenocarcinomas with lower gene expression of ILK, SPP1, COL1A2, ITGB1 showed lower risk of death (OR -7.02, -0.4, -1.3 and -3.02). CONCLUSION: Was established a potential gene signature of 24 genes involved in the EMT process and capable of predicting the histological aggressiveness, invasion and metastasis in neuroendocrine and non-neuroendocrine variants of lung carcinomas

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / As metaloproteinases-2 (MMP-2) e -14 (MMP-14) e o inibidor tecidual de metaloproteinases tipo 2 (TIMP-2) participam de modo fundamental na transiÃÃo epitelial-mesenquimal e progressÃo tumoral-linfonodal de muitos tipos de cÃncer, inclusive o gÃstrico. O objetivo deste trabalho à avaliar a expressÃo das trÃs enzimas no carcinoma gÃstrico e metÃstases linfonodais e suas possÃveis participaÃÃes na progressÃo tumoral. Foram utilizados 83 casos de gastrectomias por cÃncer gÃstrico (histotipo intestinal = 53 casos; difuso = 30 casos), e seus respectivos linfonodos, dos arquivos do Departamento de Patologia e Medicina Legal/UFC. Foi realizado tissue microarray e imunohistoquÃmica com anticorpo monoclonal anti-MMP-2, anti-MMP-14 e anti-TIMP-2, avaliada atravÃs dos seguintes escores: 0 = ausÃncia de imunomarcaÃÃo ou raras cÃlulas marcadas (< 5%); 1 = marcaÃÃo discreta na maioria (> 50%) das cÃlulas tumorais ou inflamatÃrias mononucleadas (muitos dos quais identificados como macrÃfagos pelo CD68) ou marcaÃÃo moderada em minoria de cÃlulas (< 50%); 2 = marcaÃÃo moderada na maioria (> 50%) das cÃlulas tumorais ou inflamatÃrias mononucleadas ou marcaÃÃo intensa em minoria de cÃlulas (< 50%); 3 = marcaÃÃo intensa na maioria (> 50%) das cÃlulas tumorais ou inflamatÃrias mononucleadas. A expressÃo de MMP-2, MMP-14 e TIMP-2 nos mononucleares associados a tumores ocorreu com maior frequÃncia comparada à imunomarcaÃÃo em mononucleares da mucosa normal, com diferenÃa significativa em relaÃÃo a TIMP-2 (40/53 vs 12/26; *p = 0,0128, teste exato de Fisher). MMP-2 foi muito mais presente nas mulheres (p = 0,0248) enquanto TIMP-2 ocorreu predominantemente apÃs os 50 anos (p = 0,0034). A expressÃo dos trÃs biomarcadores nos carcinomas gÃstricos primÃrios foi muito superior nos mononucleares, em relaÃÃo Ãs cÃlulas neoplÃsicas, sobretudo para a MMP-2 (16/46 vs 5/46; *p = 0,0118), que tambÃm prevaleceu em mononucleares das metÃstases linfonodais em tumores dos histotipos intestinal e difuso (13/16 vs 4/19; ***p = 0,0006). Neste estudo, a expressÃo preponderante dos trÃs imunomarcadores pelos mononucleares do conjuntivo reforÃa o papel central destas cÃlulas e do microambiente tumoral na progressÃo do cÃncer gÃstrico. A maior expressÃo de TIMP-2 no sÃtio primÃrio à sugestiva do efeito inibitÃrio desta enzima sobre MMP-2 e MMP-14, que parecem participar principalmente em fases mais avanÃadas da progressÃo tumoral-linfonodal. A MMP-14, atravÃs dos mononucleares, parece estar mais envolvida na progressÃo do cÃncer gÃstrico difuso do que a MMP-2 e seu inibidor tissular.

Our laboratory delineated a role for alternative pre-mRNA splicing (AS) in triple negative breast cancer (TNBC). We found the translational regulator cytosolic polyadenylation element binding protein 2 (CPEB2) which has two isoforms, CPEB2A and CPEB2B, is alternatively spliced during acquisition of anoikis resistance (AnR) and metastasis. The splicing event which determines the CPEB2 isoform is via inclusion/ exclusion of exon four in the mature mRNA transcript. The loss of CPEB2A with a concomitant increase in CPEB2B is required for TNBC cells to metastasize in vivo. We examined RNAseq profiles of TNBC cells which had CPEB2 isoforms specifically downregulated to examine the mechanism by which CPEB2 isoforms mediate opposing effects on cancer-related phenotypes. Downregulation of the CPEB2B isoform inhibited pathways driving the epithelial-to-mesenchymal transition (EMT) and hypoxic response, whereas downregulation of the CPEB2A isoform did not have this effect. Specifically, CPEB2B functioned as a translational activator of TWIST1 and HIF1a. Functional studies showed that specific downregulation of either HIF1α or TWIST1 inhibited the ability of CPEB2B to induce AnR and drive metastasis. The mechanism governing inclusion/ exclusion of exon 4 was determined to be serine/ arginine-rich splicing factor 3 (SRSF3). Binding of SRSF3 to a consensus sequence within CPEB2 exon 4 promoted its inclusion in the mature mRNA, and mutation of this sequence abolished association of SRSF3 with exon 4. SRSF3 expression was upregulated in TNBC cells upon acquisition of AnR correlating with a reduction in the CPEB2A/B ratio. Importantly, downregulation of SRSF3 by siRNA in these cells induced the exclusion of exon 4. Downregulation of SRSF3 also reversed the CPEB2A/B ratio in a wild-type CPEB2 exon 4 minigene construct, but not a mutant CPEB2 minigene with the SRSF3 RNA cis-element ablated. Physiologic studies demonstrated SRSF3 downregulation ablated AnR in TNBC cells, and was “rescued” by ectopic expression of CPEB2B. Importantly, biostatistical analysis of The Cancer Genome Atlas database showed a positive relationship between alterations in SRSF3 expression and lower overall survival in TNBC. Overall, this study demonstrates that SRSF3 modulates CPEB2 AS to induce the expression of the CPEB2B isoform that drives TNBC phenotypes correlating with aggressive human breast cancer.

In this paper I describe a set of algorithms used to partly automate the labeling and preparation of images of zebrafish embryos used as models of tumor progression and metastasis. These algorithms show promise for saving time for researchers using zebrafish in this way.

FERREIRA, M. V. P. Frutalina, lectina α-D galactose ligante de Artocarpus incisa L.: um estudo com câncer de mama. 2001. 99 f. Tese (Doutorado em Bioquímica) - Centro de Ciências, Departamento de Bioquímica e Biologia Molecular, Universidade Federal do Ceará, Fortaleza, 2001. / Submitted by José Jairo Viana de Sousa (jairo@ufc.br) on 2015-05-22T19:56:41Z No. of bitstreams: 1 2001_tese_mvpferreira.pdf: 10323646 bytes, checksum: 915dc1a0b3f69f5479705c6390e8748d (MD5) / Approved for entry into archive by José Jairo Viana de Sousa(jairo@ufc.br) on 2015-05-22T19:57:15Z (GMT) No. of bitstreams: 1 2001_tese_mvpferreira.pdf: 10323646 bytes, checksum: 915dc1a0b3f69f5479705c6390e8748d (MD5) / Made available in DSpace on 2015-05-22T19:57:15Z (GMT). No. of bitstreams: 1 2001_tese_mvpferreira.pdf: 10323646 bytes, checksum: 915dc1a0b3f69f5479705c6390e8748d (MD5) Previous issue date: 2001 / Lectins are proteins which bind specifically to carbohydrates. Recently considerable interest has been devoted to cell surface carbohydrates, since they are related to differentiation and maturation phenomena. Neoplastic transformation in cells is associated to altered cell surface membranes, particularly with an abnormal composition. This may determine of neoplastics cell characteristics. Lectins have been used as tools in many areas of diagnostic investigation especially related to changes in the expressions of membrane and cytoplasmatic carbohydrates. In this study it has been examined the expression of glycoconjugates especific to Artocarpus incisa lectin (frutalina) in various histological stages of tumor progression in the breast tissues. These included normal epithelium, apocrine metaplasia, ductal hyperplasia, without and with atypia, ductal carcino-ma in situ, invasive ductal carcinoma and nodal metastasis. This tissue was stained to bind to the lectin using two different histochemical techniques: frutalina reacting directly (Technique I) and antibody anti-frulalina as a bridge; antibody anti-frutalina reacting directly (Technique II). In both techniques the staining was more frequent in malignant than in benign breast epithelium. Most of the ductal carcinomas in situ stained the membrane as well as the citoplasm. All invasive ductal carcinomas were stained by frutalina. During the tumor progression there occurred modifications on the glycoconjugate cellular surfaces showing galactose residues. The most interesting aspect of this study was that the antibody anti-frutalina did not stained any of the cases of atypical hyperplasia / Lectinas são proteínas que apresentam afinidade por carboidratos específicos. Existe um considerável interesse pelos carboidratos de superfície celular posto que estão relacionados com fenômenos de diferenciação e maturação. Durante a transformação neoplásica ocorrem alterações da membrana celular, principalmente na composição de carboidratos, que determinam características especiais às células. Lectinas têm sido utilizadas como ferramentas em muitas áreas de investigação diagnóstica, especialmente no estudo dos glicoconjugados celulares. No presente estudo investigou-se a expressão de glicoconjugados específicos para Artocarpus incisa (frutalina) em vários estágios histoló-gicos de progressão tumoral na mama. Foram incluídas amostras de epitélio normal, metaplasia apócrina, hipreplasia ductal típica e atípica, carcinoma ductal in situ, carci-noma ductal invasivo e metástase ganglionar. As amostras foram marcadas utilizando o método da Estrepto–Avidina–Biotina–Peroxidase com duas técnicas diferentes: a frutali-na, como sonda primária e o anticorpo anti-frutalina como ponte (Técnica I); anticorpo anti-frutalina como sonda primária (Técnica II). Em ambas as técnicas ocorreu coloração mais forte no epitélio alterado do que no normal, sendo o predomínio da coloração membranar. Muitos dos carcinomas ductais in situ também coraram tanto a membrana quanto a citoplasma, pela Técnica I; com a técnica II, o predomínio foi de citoplasma. Todos os carcinomas ductais invasivos coraram fortemente, com ligeira predominância do citoplasma, quando foi utilizada a Técnica I. Um número menor de casos corou com a Técnica II. Com esta técnica nenhuma das hiperplasias atípicas corou a membrana, aliás, a partir das hiperplasias atípicas houve um decréscimo na marcação das membranas e um ganho na marcação do citoplasma. Este trabalho mostrou que a frutalina é um marcador de células epiteliais. Revela que durante a progressão tumoral houve modificação de glicoconjugados da superfície celular expondo resíduos de galactose. O anticorpo anti-frutalina marcou células epiteliais, aparentemente de forma específica, porém sempre em menor número de casos

La protéine p53 (« Gardien du génome ») doit être altérée pour que le cancer puisse se développer. Les nombreuses thérapies anti-cancéreuses disponibles sont très efficaces mais la réponse clinique est souvent transitoire et les cancers disséminés rechutent ou progressent du fait de l'évolution de sous-populations cancéreuses résistantes au traitement, impliquant souvent TP53 qui est le gène le plus muté dans les formes agressives de nombreux cancers. Nous l’avons étudié dans la leucémie lymphoïde chronique (LLC) et les syndromes myélodysplasiques avec délétion 5q (SMD del(5q)). Grâce à l’étude rétrospective longitudinale de 40 patients atteints de SMD del(5q), nous avons généré des données de NGS ciblé et montré que le statut mutationnel de TP53 au diagnostic ne permettait pas de prédire la progression tumorale, contrairement à ce qui avait été publié précédemment (Jädersten et al., JCO 2011). Nous avons montré que c’était l’évolution clonale du gène TP53 qui était l’élément clé de la progression des SMD del(5q). Nous avons observé de nombreuses émergences de clones mutés entre le stade diagnostique et un stade ultérieur de la maladie, toujours après initiation du traitement par lénalidomide.Le lénalidomide a été approuvé comme nouveau traitement spécifique et très efficace contre l’anémie liée aux SMD del(5q), permettant à la plupart des patients d’être indépendants des transfusions sanguines. Le lénalidomide permet souvent d’éradiquer le clone tumoral porteur de l’anomalie génétique del(5q) isolée, induisant une rémission clinique. Malheureusement, cette rémission est courte avec une durée médiane de 2 ans, puis, dans environ 1 cas sur 2, survient une transformation en leucémie aiguë secondaire de pronostic péjoratif.Nous avons étudié un possible lien entre le traitement par lénalidomide et l’évolution clonale de TP53 par annotation clinico-bio-thérapeutiques des résultats de séquençage de TP53 chez les 24 patients dont les échantillons séquentiels avaient été analysés. Dans notre étude, les patients avec progression tumorale (dont 10 évolutions clonales de TP53 et 1 évolution clonale de RUNX1) avaient reçu une dose cumulée de lénalidomide supérieure à celle reçue par les patients dont la tumeur était restée stable (p = 0.036). Nous avons observé chez plusieurs patients que l’éradication de la tumeur n’était pas utile à l’amélioration de la qualité de vie des patients. La non-éradication semblait même permettre un maintien de l’équilibre clonal et une compétition entre les différents sous-clones de la tumeur, résistants ou non au lénalidomide.Nous discutons de l’évolution de l'écologie de la tumeur au cours du traitement, i.e., l’évolution de ses interactions avec son micro-environnement qui se modifie après chaque nouvelle dose de traitement. Un modèle évolutif dit théorie de la thérapie adaptative, développée récemment remet en question les protocoles conventionnels de thérapie anti-cancéreuse qui préconisent souvent d'administrer la dose maximale tolérée par le patient (Gatenby, 2009). Elle suggère que la dose minimale efficace présenterait l’avantage de ne pas éradiquer les cellules cancéreuses sensibles au traitement pour qu'elles restent en compétition avec les cellules cancéreuses résistantes et limiter la progression ou la rechute. Nous suggérons de prendre en compte également la diminution des effets indésirables pour le patient, améliorant ainsi sa qualité de vie, et enfin la diminution des dépenses de santé pour la collectivité. A ce jour, peu d’études cliniques évaluent l’intérêt de l’adoption de tels protocoles de thérapie adaptative.Néanmoins, des modèles in vivo (xénogreffes) et in silico (modèles statistiques) ont permis d’analyser la dynamique évolutive des populations tumorales en fonction du traitement reçu. Ces modèles prédisent que la survie de l’hôte peut être maximisée par la mise en place d’une thérapie adaptative. / P53 protein is named «guardian of the genome » because it must be altered to let cancer grow.TP53 is the most mutated gene in agressive cancers.Numerous systemic therapies are successful for treatment of disseminated cancers. However, clinical response is often transient, and cancer undergo relapse or progression due to emergence of resistant populations. These latter often harbour TP53 mutations. We studied TP53 in chronic lymphoid leukemia (CLL) and lower-risk myelodysplastic syndroms with del(5q), MDS del(5q). We conducted a retrospective longitudinal study in 40 patients suffering from MDS del(5q). We obtained targeted NGS data showing that TP53 mutational status at diagnosis could not predict tumor progression, by contrast with previously published data (Jädersten et al., JCO 2011). We show that TP53 clonal evolution is the key feature of tumor progression in MDS del(5q). We observed numerous mutated sub-clones emerging between diagnosis and follow-up. In our study, this emergence always followed onset of lenalidomide treatment. Lenalidomide was recently approved as a new therapy specifically improving anemia in patients with MDS del(5q). It allows most patients to become red-blood-cells-transfusion independent. Lenalidomide often eradicates the major tumor clone harbouring the isolated genetic abnormality deletion (5q) and allows clinical remission. Unfortunately, this remission is short (median, 2 years) and is followed, in 1 case out of 2, by a secondary acute leukemic transformation with a very poor prognosis.We studied the issue of a possible link between lenalidomide therapy and TP53 clonal evolution by annotating TP53 sequencing results with acute biological, clinical and therapeutic features in the 24 patients with sequential samples analyzed. In our study, patients with tumor progression (10 TP53 clonal evolution and 1 RUNX1 clonal evolution) were given a higher cumulative dose of lenalidomide compared to patients with stable disease (p = 0.036). Similarly to « adaptive therapy theory »(Gatenby 2009), we observed that eradication of the tumor wasn’t useful for improvement of quality of life. Absence of eradication might even allow to maintain a clonal equilibrium and a clonal competition between the distinct tumor sub-clones, resistant to lenalidomide or not, and therefore maintain stable disease.This theory of adaptive therapy questions the classical protocols of treatments against cancer, in which the maximal tolerated dose is preferred to the minimal effective dose. The latter might however slow down cancer progression or cancer relapse, with decreased side effects in patients, and decreased health costs.To date, few clinical trials (if any) questions such protocols of adaptive therapy. However, in vivo experiments (xenografts) and in silico statistical models allowed to study evolutionary dynamics of tumor sub-populations with and without therapy.The models predict that host survival can be maximized if “treatment-for-cure strategy” is replaced by “treatment-for-stability.” Specifically, the models predict that an optimal treatment strategy will modulate therapy to maintain a stable population of chemosensitive cells that can, in turn, suppress the growth of resistant populations under normal tumor conditions, Dr Gatenby said.

INTRODUÇÃO: As recidivas e as metástases são os fatores responsáveis pela morte de pacientes com câncer de pulmão (representando 90% dos casos), indicando a necessidade de conhecer as múltiplas vias sinalizadoras envolvidas em sua patogênese, progressão, invasão e metástase. Adenocarcinomas e carcinomas de grandes células invadem primariamente vasos sanguíneos e linfáticos, metastatizando à distância. Já os carcinomas de células escamosas envolvem diretamente o mediastino, sobretudo, linfonodos e pericárdio. Carcinomas neuroendócrinos de baixo grau (carcinoides típicos e atípicos) invadem e metastatizam apesar de serem indolentes, enquanto que carcinomas neuroendócrinos de alto grau (carcinoma neuroendócrino de grandes células e carcinoma de pequenas células), rapidamente metastatizam à distância. Esse espectro diferencial de invasividade nos carcinomas de pulmão ainda não pôde ser definitivamente demarcado por biomarcadores, sobretudo nas variantes neuroendócrinas. Neste aspecto, acredita-se que a EMT esteja mais intimamente envolvida no processo de invasão, despontando como potencial biomarcador. OBJETIVO: Realizar o mapeamento genético da EMT nos carcinomas pulmonares, estabelecendo uma assinatura gênica capaz de prever o potencial de invasão nos diferentes tipos histológicos do câncer de pulmão. MÉTODOS: Espécimes de tumores ressecados cirurgicamente e criopreservados de 60 pacientes foram submetidos a análise de expressão gênica através da qPCR em tempo real, por meio do kit RT2 Profiler PCR array para a EMT com 84 genes de interesse. RESULTADOS: Observou-se a elevada expressão de 24 genes (AKT1, COL1A2, COL3A1, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGA5, ITGAV, ITGB1, JAG1, MAP1B, MMP2, MMP3, SNAI2, SPARC, SPP1, STAT3, TCF3, TGF?3, VPS13A, WNT5A) que participam do processo da EMT e atuam no desenvolvimento da neoplasia pulmonar. Tumores em estádio avançado e com metástases linfonodais apresentaram significante maior expressão dos seguintes genes, COL1A2, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGAV, ITGB1, MAP1B, SNAI2 e VPS13A. Comparando-se carcinomas nãoneuroendócrinos (CEC e AD) e neuroendócrinos (CT, CA, CPPC, CNEGC), observou-se que os neuroendócrinos apresentaram elevada expressão significativa dos genes: FR11, GSK3B, ILK, ITGB1, JAG1, MAP1B e VPS13A. Em relação à sobrevida, a análise univariada demonstrou menor sobrevida para pacientes em estádio avançado do tumor com metástase linfonodal e portador de carcinoma neuroendócrino que apresenta a hiperxpressão de todos os 24 genes da EMT, com exceção dos genes COL3A1 e SPP1. Pela análise multivariada demonstrou-se que pacientes com carcinomas neuroendócrinos com expressão elevada de MMP2 e SPARC apresentaram maior risco de morte (OR 5,41 e 4,94, respectivamente), enquanto que pacientes portadores de carcinomas de células escamosas ou adenocarcinomas com baixa expressão gênica de ILK, SPP1, COL1A2, ITGB1 apresentaram menor risco de morte (OR -7,02; -0,4, -1,3 e -3,02). CONCLUSÃO: Através do presente estudo estabeleceu-se uma assinatura gênica de 24 genes capaz de prever o potencial de agressividade histológica, de invasão e de metástases nos carcinomas pulmonares neuroendócrinos e não-neuroendócrinos / INTRODUCTION: Metastasis are responsible for the death of 90% of patients with lung cancer, indicating the need to know the multiple signaling pathways involved. Adenocarcinomas (Adc) and large cell carcinomas primarily invade blood vessels with distant metastasis, whereas squamous cell carcinoma (SqCC) involves the mediastinal lymph nodes. Neuroendocrine carcinomas of low-grade (typical and atypical carcinoid) are indolent, while high-grade neuroendocrine carcinoma (large cell neuroendocrine carcinoma and small cell carcinoma) metastasize rapidly. Biomarkers of aggressiveness in lung carcinomas remain to be determined, especially in neuroendocrine variants. In these fields, Epithelial to mesenchymal transition (EMT) genes profile emerge promise as an indicator of invasion and metastasis. AIMS: Carry out the genetic mapping of EMT in lung cancer, establishing a gene signature capable of predicting the invasion potential of different histological types of lung cancer. METHODS: Were included specimens of 60 patients and the EMT gene expression was quantified with a quantitative real-time (RT)- PCR carried out on StepOnePlus(TM) Real-Time PCR System (Applied Biosystems) with RT2 Profiler PCR Array System for the EMT pathway wih 84 target genes. (Qiagen, Dusseldorf, Germany). Associations of the gene signature and clinicopathological features, as well as prognostic factors were evaluated. RESULTS: Was observed high expression of 24 genes (AKT1, COL1A2, COL3A1, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGA5, ITGAV, ITGB1, JAG1, MAP1B, MMP2, MMP3, SNAI2, SPARC, SPP1, STAT3, TCF3, TGFbeta3, VPS13A, WNT5A) that are involved in the EMT process and act in the development of pulmonary neoplasia. Tumors at the advanced stage and with lymph node metastasis shown a significant higher expression of the genes COL1A2, COL5A2, DSP, EGFR, FR11, GSK3B, ILK, ITGAV, ITGB1, MAP1B, SNAI2 and VPS13A. Comparing the histological subtypes non-neuroendocrine (SqCC and AD) and neuroendocrine carcinomas (TC, AT, SCLC, LCNEC), was observed that the neuroendocrine variant shown a higher significant expression of the genes FR11, GSK3B, ILK, ITGB1, JAG1, MAP1B and VPS13A. Regarding survival, univariate analysis showed lower survival for patients in the advanced tumor stage, with lymph node metastasis and with neuroendocrine carcinoma histology that presenting overexpression for all 24 EMT genes, with the exception of the COL3A1 and SPP1 genes. Cox regression controlled by, histological types and gene expression of ILK, MMP2, SPP1, SPARC, COL1A2 and ITGB1 showed that patients with neuroendocrine carcinomas with higher expression of MMP2 and SPARC had a higher risk of death (OR 5.41 and 4.94, respectively), whereas patients with squamous cell carcinomas or adenocarcinomas with lower gene expression of ILK, SPP1, COL1A2, ITGB1 showed lower risk of death (OR -7.02, -0.4, -1.3 and -3.02). CONCLUSION: Was established a potential gene signature of 24 genes involved in the EMT process and capable of predicting the histological aggressiveness, invasion and metastasis in neuroendocrine and non-neuroendocrine variants of lung carcinomas

Le cycle cellulaire est l'ensemble des étapes qui conduisent une cellule mère à se diviser en deux cellules filles. La protéine Checkpoint kinase 1 (Chk1) est importante pour sa progression. Nous avons d'une part cherché à savoir si Chk1 intervenait lors des mécanismes de production des plaquettes, car ces cellules permettant la coagulation du sang sont issues d'un cycle cellulaire particulier. Par ailleurs, nous avons étudié le rôle de Chk1 dans la Leucémie Aiguë Myéloïde (LAM), cancer des cellules sanguines. Les patients atteints de LAM sont traités par une chimiothérapie visant à endommager l'ADN afin d'entrainer la mort des cellules cancéreuses. Chk1 est garante du contrôle de la réparation des dommages de l'ADN, ce qui contrecarre l'effet de la chimiothérapie. Elle pourrait donc favoriser l'apparition de résistance. Son rôle dans les LAM étant peu connu, l'objectif de ce projet est donc de vérifier si Chk1 favorise la résistance des cellules leucémiques aux chimiothérapies. / The cell cycle is a series of events that takes place in a mother cell, leading to its division into two daughter cells. The protein Checkpoint kinase 1 (Chk1) is mandatory for its coordinated progression. In this PhD projet, we wondered on the one hand whether Chk1 could be involved in the platelets production process, because these componants of blood that enables coagulation are produced due to a particular cell cycle dedicated to this end. On the other hand, we studied the role of Chk1 in Acute Myeloid Leukemia (LAM) physiopathology. LAM is a cancer of blood cells, in which patients are treated with drugs that create DNA damages, causing the death of tumoral cells. The role of Chk1 in the drug response in LAM is not well studied, but, as it enables DNA repair, it may render theses medicines less efficient, leading to relapses to therapies. So the goal of this project is to check wether Chk1 favors the resistance of some LAM cells to chemotherapeutic treatments.

La progression tumorale, qui conduit à la formation de métastases, est le résultat de profondes modifications des différents niveaux de régulation de l'expression des gènes comme la transcription ou l'épissage alternatif. Au cours de ma thèse, j'ai étudié le rôle de DDX5 et DDX17, deux ARN hélicases qui, au cours de la progression tumorale, sont impliquées dans la régulation transcriptionnelle, l'épissage alternatif et la biogénèse des microARNs. Pour cela, j'ai utilisé deux modèles de progression tumorale : le modèle murin 4T1, composé de cellules cancéreuses qui présentent des propriétés métastatiques différentes, et les cellules humaines MCF10A qui, après traitement au TGF-beta, sont capables de réaliser la transition épithélio-mésenchymateuse, un processus de trans-différenciation qui contribue à la formation des métastases. Dans le modèle 4T1, j'ai montré que Ddx17 et Ddx5 contribuent à l'invasivité des cellules tumorales en contrôlant des programmes transcriptionnels et d'épissage alternatif. Plus précisément, j'ai démontré que Ddx5 et Ddx17 favorisent l'agressivité des cellules cancéreuses en régulant l'épissage des variants de l'histone macroH2A1 qui, à leur tour, contrôlent l'expression de gènes impliqués dans la progression tumorale. Dans le modèle MCF10A où la transition épithélio-mésenchymateuse peut être induite sous TGF-beta, j'ai montré que DDX5 et DDX17 orchestrent dynamiquement des programmes transcriptionnels et d'épissage. Le travail effectué pendant ma thèse met en évidence l'importance des ARN hélicases DDX5 et DDX17 comme régulateurs clés de la progression tumorale, et souligne le rôle de l'épissage alternatif lors de la progression tumorale. De plus, ce travail met l'accent sur l'importance d'intégrer les différents niveaux de régulation de l'expression des gènes (transcription, épissage, microARN) pour une compréhension globale de la progression tumorale / Tumor progression leading to the formation of metastases result from deep modifications of gene expression programs at several levels, including transcription and splicing. During my PhD, I investigated the role in tumor progression of DDX5 and DDX17, two highly related multifunctional DEAD box RNA helicases that are involved in transcription and splicing as well as in microRNA biogenesis. For this purpose, I used two breast cancer models of tumor progression : the 4T1 mouse model composed of cancer cells that exhibit different metastatic properties and MCF10a human cells that undergo epithelial-to-mesenchymal transition upon Tgf-beta treatment, a trans-differentiation process contributes to metastasis formation. In the 4T1 mouse model, I showed that Ddx17 and Ddx5 contribute to tumor-cell invasiveness by controlling both transcriptional and splicing programs. More specifically, I demonstrated that Ddx5 and Ddx17 promote cancer cells aggressiveness by regulating the splicing of the macroH2A1 histone which in turn impacts on the expression of genes implicated in tumor cell invasiveness. In the Tgf-beta induced epithelial-to-mesenchymal trans-differentiation model, I showed that DDX5 and DDX17 dynamically orchestrate transcription, microRNA and splicing programs. The work performed during my PhD highlights the importance of DDX5 and DDX17 RNA helicases as key regulators of tumor progression in breast cancer, and also underlines the role of alternative splicing during tumor progression. Furthermore, this work emphasizes the importance of integrating the different layers of the gene expression process (transcription, splicing, microRNA) for a comprehensive understanding of tumor progression