The most common malignant glioma, glioblastoma multiforme (GBM), remains an intractable tumor despite advances in therapy. Its proclivity to infiltrate surrounding brain tissue contributes greatly to its treatment failure and the grim prognosis of patients. Radiation is a staple in modern therapeutic regimens, though cells surviving radiation become more aggressive and invasive. Consequently, it is imperative to define further the cellular mechanisms that control GBM invasion and identify promising novel therapeutic targets. Melanoma differentiation associated gene-9 (MDA-9/Syntenin) is a highly conserved PDZ domain-containing scaffolding protein that promotes invasion and metastasis in human melanoma models. We show that MDA-9/Syntenin is robustly expressed in GBM cell lines and patient samples, and expression increases by tumor grade. These findings are confirmed through database analysis, which revealed MDA-9/Syntenin expression correlates with shorter survival times and patient tumors high in MDA-9/Syntenin have a worse prognosis when undergoing radiotherapy. Modulating MDA-9/Syntenin levels produced changes in invasion, angiogenesis, and signaling, indicating MDA-9/Syntenin enhances glioma pathogenesis. Overexpression of MDA-9/Syntenin enhances invasion, while knockdown inhibits invasion, migration, and anchorage-independent growth in soft agar. MDA-9/Syntenin increases activation of c-Src, P38MAPK, and NF-kB, leading to elevated MMP2 expression and IL-8 secretion. Through an orthotopic tumor model, we show that shmda-9 tumor cells formed smaller tumors and had a less invasive phenotype in vivo. Knockdown of MDA-9/Syntenin radiosensitizes GBM cells and significantly reduces post-radiation invasion gains through abrogation of radiation-induced Src and EphA2 activity. In efforts to pharmacologically inhibit MDA-9/Syntenin, we describe the effects of a novel small molecule, PDZ1i, which targets the PDZ1 domain of MDA-9/Syntenin and successfully reduces invasion gains in GBM cells following radiation. While it does not effect astrocyte radiosensitivity, PDZ1i radiosensitizes GBM cells. PDZ1i inhibits crucial GBM signaling including FAK and mutant EGFR, EGFRvIII, and can negate gains in secreted proteases, such as MMP2 and MMP9, following radiation. In a model of glioma, PDZ1i treatment combined with radiation results in less invasive tumors and extends survival. Our findings indicate that MDA-9/Syntenin is a novel and important mediator of GBM pathogenesis, and further identify it as a targetable protein that enhances radiotherapy for treatment in glioma.

L’objectif était de mieux définir les relations entre l’exposition à certaines fibres minérales et les anomalies génétiques somatiques associées à la transformation tumorale de cellules de l’appareil respiratoire. Deux études indépendantes ont été conduites à partir du modèle murin Nf2+/- de mésothéliome malin (MM) développé dans le laboratoire, exposé par inoculation intrapéritonéale à des fibres d’amiante crocidolite (souris abs-Nf2+/- et abs-Nf2+/+) et à des fibres céramiques réfractaires (FCR) (souris ceram-Nf2+/-).Ce choix a été fondé selon une stratégie raisonnée à partir de la connaissance des anomalies génétiques observées dans le MM. La validité de ce modèle a été vérifiée en comparant les MM murins et humains. Des MM ont été induits par le crocidolite chez des souris abs-Nf2+/- et abs-Nf2+/+. Les souris abs-Nf2+/- ont significativement développé plus de MM que les souris abs-Nf2+/+. Les caractéristiques histologiques des MM murins sont analogues aux MM humains, avec des altérations génétiques similaires, en terme de fréquence et de mécanismes d’inactivation (mutations ponctuelles pour le gène TP53, délétions pour les gènes NF2 et P16/CDKN2A). Ce modèle murin a été ensuite utilisé pour évaluer la toxicité de FCR. Les souris ceram-Nf2+/- ont développé des MM similaires aux MM humains du point de vue histologique et moléculaire. Ainsi, le profil des altérations génétiques des MM murins ceram-Nf2+/- est semblable à celui des MM murins abs-Nf2+/- et abs-Nf2+/+, et humains. Les cellules mésotheliales des souris exposées aux FCR et à l’amiante semblent suivre les mêmes voies de transformation néoplasique. Une étude à la recherche d’altérations génétiques de ces 3 gènes et des gènes Ki-ras et EGFr fréquemment mutés dans le cancer broncho-pulmonaire (CBP) a été conduite à partir de cas de CBP sélectionnés (50 sujets exposés à l’amiante (E+) et 50 sujets non exposés (E-) appariés sur l’âge, le sexe, le type histologique et le tabagisme) provenant d’une série de cas opérés. A l’instar du MM, l’analyse du gène P16/CDKN2A suggère que le mécanisme d’inactivation pourrait être différent chez les sujets E+ (par délétion) par rapport aux sujets E- (par hyperméthylation du promoteur), indépendamment de l’âge et du tabagisme. Deux SNP (rs12947788 et rs12951053) du gène TP53 sont plus fréquemment retrouvés chez les sujets E+. En revanche, aucune différence significative n’est retrouvée pour les autres gènes entre ces 2 groupes. Ainsi, les mutations du gène NF2 dans le MM seraient plus liées à une spécificité cellulaire et à une fonction particulière de la protéine nf2 dans ces cellules / Résumé en anglais non communiqué

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Introdução: Gliomas são os tumores cerebrais mais frequentes em pacientes com neoplasias de Sistema Nervoso Central (SNC), sendo o Glioblastoma Multiforme (GBM) o mais agressivo e letal deles. Apesar dos esforços na melhoria dos tratamentos atuais, o prognóstico para os pacientes com GBM continua sendo incerto. Sendo necessário o uso de novas estratégias terapêuticas que visem melhorar o manejo dos gliomas malignos. A combinação de terapias que agem nas principais vias de sinalização celular envolvidas na progressão do câncer poderia potencializar o efeito antitumoral das monoterapias. Métodos: As linhagens celulares U-87 e A-172 foram tratadas com o anti-EGFR tyrphostin AG1478, o inibidor de histonas deacetilases butirato de sódio (NaB) ou a combinação de ambos, por 72 horas. Tanto a viabilidade avaliada em 72 horas quanto a proliferação celular a longo prazo foram medidas através do ensaio de exclusão com azul de tripan em câmara de Neubauer. A influência do tratamento no ciclo celular e a capacidade de formar colônias foram avaliadas através da marcação com iodeto de propídeo e ensaio clonogênico, respectivamente. Resultados: Foi possível observar que o tratamento combinado com AG1478 e NaB foi capaz de reduzir a viabilidade e a proliferação celular na linhagem U-87 de GBM. Conclusão: Nosso trabalho mostrou que a inibição da via do receptor do fator de crescimento epidérmico (EGFR) combinada com a inibição das histonas deacetilases foi mais efetiva que as monoterapias na inibição da viabilidade e a proliferação celular. Esta redução foi significativa na linhagem U-87. Futuros estudos devem ser feitos para descobrir as possíveis interações entre as duas vias de sinalização em GBM. / Introduction: Gliomas are the most frequent brain tumors, in patients with Central Nervous system (NCS) malignancies, being the Glioblastoma Multiforme the most aggressive and lethal of all. Despite current multimodality treatment efforts, the prognosis for GBM patients remains poor. New therapeutic strategies that target these pathways to improve the treatment of malignant gliomas are needed. Combination of therapies with synergistic effects in the cellular signaling pathways of cancer could potentiate the anti-tumor effect of monotherapy alone. Methods: U87 and A172 cell lines were treated with the anti-EGFR Thyrphostin AG1478, the Histone Deacetylase inhibitor (HDACi) Sodyum Butyrate (NaB), or combination of both, for 72 hours. The cellular proliferation in short and in a long time was measured through the trypan-blue assay on neubauer chamber, the influence on the cell cycle and the capability of form colonies was evaluated by nuclear staining with propidium iodide and clonogenic assay respectively. Results: We found that combined treatment with AG1478 and NaB, are able to reduce the viability and proliferation in U-87. Conclusion: Our work show that combined inhibition of both epidermal growth factor receptor and histone deacetylases was able to reduce cell proliferation in GBM cell lines. This reduction was considerably significant in U-87 cell lines when compared with individual treatments. Further studies should be performed to discover the possible crosstalk between the signaling pathways of both targets in GBM.

Cancer, which is characterised by aggressiveness and increased capacity for metastatic spread still requires basic researchers and clinicians to direct enormous efforts toward the development of novel therapeutic targets. Potential novel targets can be identified and exploited in combination with currently existing therapeutic approaches to improve their efficacy and overcome treatment resistance of tumour cells, protecting the patient from recurrence. To achieve this, different strategies and techniques can be proposed to identify the most promising candidate molecules for further exploitation as therapeutic targets. Human epidermal growth factor receptors (HERs) and NF-E2-related factor 2 (NRF2) are regulators of cellular proliferation and determinants of cancer initiation and progression. NRF2 and HERs confer cancers with resistance to several therapeutic agents. Nevertheless, there is limited understanding of the regulation of HER expression and activation, and the link between NRF2 and HER signalling pathways. This research has demonstrated that pharmacological activation of NRF2 by tert-butyl hydroquinone (tBHQ) upregulates the expression of HER family receptors, HER1 and HER4, elevates phospho protein kinase B (pAKT) levels, and enhances the proliferation of ovarian cancer cells. Pharmacological inhibition using retinoic acid (RA) and bexarotene and genetic inhibition using small interfering RNA (siRNA), did the opposite. Further, tBHQ caused transcriptional induction of HER1 and HER4 with different levels of expression, while siRNA-mediated knockdown of NRF2 prevented this and further caused transcriptional repression. A panel of potent NRF2 inhibitors were screened with the hope of finding the most potent for further investigation. Bexarotene was found to be the most potent and was used either alone, or in combination with lapatinib or erlotinib. The use of these drugs in combination with bexarotene resulted in the repression of HER1, HER2, HER3 and HER4 expression, inhibition of NRF2, elevation of ROS, depletion of glutathione and enhanced cytotoxicity in PEO1, OVCAR3, SKOV3 and MCF7-AREc32 cell lines. This explained the crosstalk mechanism between HER receptor family and NRF2 and the role of NRF2 in drug resistance and as a relevant anti-cancer target which opens up novel avenues of targeting HER receptor kinase family and NRF2 pathways for improving cancer therapy.

Malignant glioma have poor prognosis resulting mainly from high level of cell proliferation and invasion and resistance to conventional therapy. Identification of novel targets that are critical elements in gliomagenesis may help improve therapeutic outcome. Using genome-wide explorations of a comprehensive glioma specimen population, we identified whole gain of chromosome 19 as one of the major chromosomal aberrations in high grade glioma that correlates to patients' outcomes. Our analysis revealed for the first time NOTCH3 as one of the most significant gene amplifications mapped to chromosome 19. This amplification is associated with worse outcome compared to tumors with non-amplified locus. NOTCH signaling pathway is essential for cell proliferation, stem cell maintenance and differentiation and its deregulation has been reported in several human cancers. NOTCHs are key positive regulators of cell-cell interactions, angiogenesis, cell adhesion and stem cell niche development which have been shown to play critical roles in gliomagenesis and glioma drug resistance. Our objective is to determine NOTCH3 molecular roles in glioma pathogenesis and aggressiveness. Here we show for the first time that NOTCH3 plays a role in glioma cell proliferation, cell migration, invasion and apoptosis. We also found a NOTCH3 glioma addiction phenomenon. Therefore, our study uncovers, for the first time, the prognostic value and the oncogenic function of NOTCH3 in gliomagenesis and supports NOTCH3 as a promising target of therapy in high grade glioma. Our studies allow the identification of a subset of population that may benefit from GSI-based therapies. This may lead to the design of novel strategies to improve therapeutic outcome of patients with glioma by establishing medical and scientific basis for personalized medicine.

Le cancer bronchique non-à petites cellules (CBNPC) représente 80% des cancers du poumon et possède un pronostic extrêmement médiocre, avec une survie à 5 ans inférieure à 15%. Le gefitinib, une molécule appartenant à la famille des inhibiteurs de la tyrosine kinase de l'EGFR (EGFR-TKI) a montré de puissants effets anti-prolifératifs dans les CBNPC, mais la grande variabilité des réponses a incité la recherche de marqueurs capables de prédire une résistance ou une sensibilité à ce traitement. Les patients porteurs de CBNPC résistants au gefitinib ont des taux d'amphiréguline (AREG) sérique élevés, suggérant l'implication de l'AREG dans la résistance au gefitinib. Nous avons d'abord cherché à démontrer le rôle de l'AREG dans la résistance au gefitinib des cellules de CBNPC avant d'en décrire le mécanisme moléculaire. Notre travail montre que l'AREG permet de résister à l'apoptose induite par le gefitinib in vitro et in vivo en inactivant la protéine proapoptotique Bax. L'AREG induit une diminution du niveau d'expression de Bax et augmente son interaction avec la protéine Ku70, par un mécanisme dépendant de l'acétylation de Ku70. Nous décrivons ainsi un mécanisme original de résistance au gefitinib, dépendant de l'acétylation et contrôlé par un facteur de croissance, l'AREG. Dans un contexte où le cancer pulmonaire est un problème majeur de santé publique et où la résistance aux traitements reste une des principales préoccupations des professionnels de santé, nos travaux suggèrent des applications potentielles pour la prise en charge clinique des patients porteurs de CBNPC. Ces applications concernent à la fois les domaines diagnostique et thérapeutique. En effet, nous démontrons le rôle central de l'AREG dans la résistance au gefitinib et proposons son utilisation comme biomarqueur prédictif d'une résistance à ce traitement. De plus, nous proposons d'associer les EGFR-TKI à une thérapie anti-AREG ou aux inhibiteurs d'histone-déacétylases, notamment chez les patients porteurs de CBNPC résistants au gefitinib.

La dépendance de la croissance des tumeurs prostatiques vis-à-vis des androgènes est mise à profit pour traiter les cancers diagnostiqués à un stade avancé. Lablation androgénique entraine inévitablement lapparition de cancers résistants à la thérapie antihormonale. Dans ces cancers, la signalisation du récepteur aux androgènes (RA) semble réactivée par différents mécanismes, en dépit de la concentration sérique réduite en androgènes. A coté de la signalisation androgénique, la signalisation induite par les récepteurs de la famille du REGF (encore appelée famille ERBB) est impliquée dans la prolifération, la survie, linvasion et langiogenèse du cancer de la prostate. Ces récepteurs sont aussi capables de se substituer aux androgènes pour activer le RA. Des résultats antérieurs obtenus par dautres équipes ont montré que les androgènes régulaient lexpression du REGF et dERBB2 dans les cellules cancéreuses prostatiques, sans préciser à quel(s) niveau(x) seffectue cette régulation. Le but de ce travail est de déterminer par quels mécanismes les androgènes agissent pour contrôler lexpression des récepteurs ERBB1-3 dans des lignées cancéreuses prostatiques présentant différentes sensibilités aux androgènes, à savoir les cellules LNCaP dont la prolifération est androgéno-dépendante et les cellules 22Rv1 dont la prolifération est androgéno-indépendante. En plus du RA, les cellules 22Rv1 expriment un RA dépourvu du domaine carboxy-terminal contenant le domaine de liaison à lhormone (RAΔCTD) et dont lorigine et la fonction nétaient pas connues. Dans les cellules LNCaP, nous avons montré que le RA activé par la dihydrotestostérone (DHT) stimule le taux des transcrits et des protéines REGF et répriment ceux dERBB2 en agissant à un niveau transcriptionnel. La DHT ninfluence pas les taux dERBB3. Dans les cellules 22Rv1, la DHT ninfluence pas les taux du REGF et dERBB2 ni le taux des transcrits de trois gènes endogènes androgéno-sensibles que nous avons testés. A laide de siRNA dirigés contre la région codant le domaine amino-terminal (NTD) ou carboxy-terminal du RA, nous avons montré que le RAΔCTD résulte de la présence de transcrit différent de celui codant la forme longue. La capacité de ces siRNA à éteindre lexpression de la forme longue, ou de la forme longue et de la forme courte du RA, nous a permis détudier la contribution des deux isoformes à réguler lexpression de gènes et la viabilité des cellules 22Rv1. Nous avons ainsi montré que la présence du RAΔCTD contrôle le taux des protéines REGF et ERBB2 à un niveau post-transcriptionnel. De plus, le RAΔCTD et dans une moindre mesure, le RA contribuent à lexpression des trois gènes androgéno-sensibles endogènes testés et à la viabilité des cellules 22Rv1 cultivées dans un milieu appauvri en stéroïdes. Une inhibition plus importante de la viabilité cellulaire était observée en présence dun inhibiteur tyrosine kinase des récepteurs. En conclusion, notre étude montre que différents mécanismes régulés par les androgènes ou leurs récepteurs contrôlent lexpression du REGF et dERBB2 dans des cellules présentant différentes sensibilités aux androgènes. Nous avons par ailleurs identifié le RAΔCTD comme un régulateur important du phénotype hormono-réfractaire des cellules 22Rv1. Des études complémentaires devront déterminer si la participation du RAΔCTD à la viabilité des cellules 22Rv1 passe par la régulation de lexpression du REGF ou dERBB2. De plus, si lexpression du RAΔCTD venait à se confirmer dans les cancers de la prostate, le développement de nouvelles thérapies ciblant le domaine NTD ou lexpression du RA constituerait une alternative intéressante aux thérapies actuelles dirigées contre le CTD.

Primary brain tumours, and especially the most common form malignant gliomas, usually display a pronounced resistance to other treatment modalities when surgery fails to cure. Growth factors, such as EGF and its receptor, frequently amplified and overexpressed in malignant gliomas, and factors associated with multidrug resistance have been suggested to at least partially explain the poor outcome. The aim of this thesis was to characterise factors in primary brain tumours associated with the development of resistance with focus on the epidermal growth factor receptor (ErbB) family, and multidrug resistance (MDR). Influences of irradiation on the expression and activity of P-glycoprotein (Pgp) in malignant gliomas was evaluated. The effects showed that irradiation increased the efflux activity of Pgp in rat brain vascular endothelial cells, but not in glioma cells. In the intracranial BT4C glioma model, Pgp was detected in the capillary endothelium in the tumour tissue but not in glioma cells. Expression of several factors coupled to MDR (Pgp, MRP1, LRP, and MGMT) in primary brain tumours were analysed and correlated to clinical data. In gliomas, Pgp and MRP1 were predominantly observed in capillary endothelium and in scattered tumour cells, whereas LRP occurred only in tumour cells. In meningiomas, expression of the analysed markers was demonstrated in the capillary endothelium, with a higher expression of Pgp and MRP1 in transitional compared to meningothelial meningiomas. A pronounced expression of MGMT was found independently of the histopathological grade or tumour type. Survival analysis indicated a shorter overall survival for patients suffering from low-grade gliomas with high expression of Pgp. To explore the importance of the epidermal growth factor receptor (EGFR), expression levels of the family members (EGFR, ErbB2-4) were analysed and their relations to various clinical parameters were evaluated in gliomas and meningiomas. In gliomas, the highest EGFR expression was observed in high-grade tumours, while ErbB4 expression was most pronounced in low-grade tumours. In meningiomas, expression of EGFR, ErbB2, and ErbB4 was observed in the majority of the tumours. An intriguing observation in low-grade gliomas was a significantly decreased overall survival for patients with high EGFR protein expression. The effects of different time schedules for administration of the selective EGFR inhibitor ZD1839 in relation to irradiation of glioma cells were analysed. The analyses showed a heterogeneity in the cytotoxic effects of ZD1839 between cell lines, and it was obvious that some of the cell lines showed sensitivity to ZD1839 despite no or low expression of EGFR. The study also demonstrated the importance of timing of ZD1839 administration when this agent is combined with irradiation. In conclusion, in order to enhance the efficacy of radiotherapy by various drugs in malignant gliomas it may be essential to inhibit drug efflux activity in endothelial cells and to deliver drugs in an optimal timing in relation to radiotherapy. The heterogeneity in expression of drug resistance markers, as well as the ErbB family reflects the complexity in classification of primary brain tumours, and indicates that subgroups of patients with low-grade gliomas expressing Pgp and EGFR might benefit from more aggressive and individualised treatment.

Astrocytic tumors are the most common malignancies of the central nervous system, accounting for more than 60% of all primary brain tumors. The prognosis for high grade astrocytoma patients is dismal and there is no curative treatment, today. A molecular hallmark of astrocytic tumors is dysregulated receptor tyrosine kinase signaling, especially of the epidermal growth factor receptor (EGFR, ErbB1). The aim of the present thesis was to identify endogenous human proteins that downregulate the function of the ErbB1 receptor. We identified a human gene family, the leucine-rich repeats and immunoglobulin-like domains family (LRIG), consisting of LRIG1, LRIG2 and LRIG3, which might fulfill this criterion. Two candidates were identified, LRIG1 and LRIG2, which genes were localized to regions frequently deleted in human cancers, chromosome bands 3p14 and 1p13, respectively. LRIG1 and LRIG2 mRNA were expressed in all tissues analyzed, with high expression in brain and other organs. The LRIG mRNA were predicted to encode integral membrane proteins. Antibodies against LRIG1 and LRIG2 were developed and the protein expression was analyzed. LRIG1 was found to have an apparent molecular weight of 143 kDa and was expressed in most tissues with high expression in glandular tissues of the breast and prostate, and the peptic cells of the stomach. LRIG2 was slightly smaller and had an apparent molecular weight of 132 kDa. The LRIG proteins were localized to the cell surface and to perinuclear structures, where LRIG1 co-localized with the trans-Golgi network and early endosomes. LRIG1 was found to restrict growth factor signaling by enhancing receptor ubiquitylation and degradation. We showed that LRIG1 interacted with all four members of the ErbB family and induced their downregulation. The interaction with ErbB1 involved both the LRR-domains and the Ig-like domains of LRIG1. LRIG1 enhanced receptor degradation by recruiting the E3 ubiquitin ligase c-Cbl to the LRIG1-ErbB1 complex. LRIG1, LRIG2, and LRIG3 were expressed in glioma cell lines and tumor tissues. The LRIG expression was analyzed in 404 astrocytic tumor samples. We found that perinuclear LRIG protein expression correlated with increased survival of patients with astrocytic tumors. Especially perinuclear LRIG3 showed strong correlations with patient survival and tumor cell proliferation index. In summary, this thesis contains the discovery and characterization of human LRIG1 and LRIG2. LRIG1 was found to interact with ErbB receptors and downregulate their function. In a clinical material, expression of LRIG proteins correlated with survival in patients with astrocytic tumors.