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Overall survival of the metastatic forms of epithelial derived cancers, especially head and neck squamous cell carcinomas (HNSCC), has not significantly improved even with the application of aggressive combined modality approaches incorporating radiation and chemotherapy. Cumulative evidence implicates the epidermal growth factor receptor (EGFR) as an important therapeutic target in HNSCC. We have previously demonstrated that the combination of lovastatin, a potent inhibitor of the mevalonate pathway, with EGFR tyrosine kinase inhibitors induced robust synergistic cytotoxicity. However, the use of high dose statins in our clinical trial was associated with significant toxicities including higher than anticipated rate of muscle pathologies. Our goal was to uncover novel downstream targets of the mevalonate pathway that may enhance the efficacy or limit toxicities of this novel combination therapeutic approach. In this study we have demonstrated that GGTI-298, an inhibitor of protein geranylgeranylation, through its ability to disrupt the actin cytoskeleton, inhibits EGFR dimerization and cellular trafficking. This novel mechanism targeting the EGFR has clinical implications as GGTI-298 in combination with tarceva, a clinically relevant EGFR inhibitor, showed enhanced cytotoxicity and inhibitory effects on EGFR activation and its downstream signaling.

BackgroundHead and neck squamous cell carcinoma (HNSCC) is a common cancer. Positron emission tomography (PET) with 18F-fluorodeoxyglucose (18F-FDG) is a widely used imaging modality in HNSCC.PurposeTo provide evident data about associations between 18F-FDG PET and histopathology in HNSCC.Material and MethodsThe MEDLINE database was screened for associations between maximum standard uptake values (SUVmax) derived from 18F-FDG PET and histopathological features in HNSCC up to May 2020. Only papers containing correlation coefficients between SUVmax and histopathology were acquired. Overall, 23 publications were collected.ResultsThe following correlations were calculated: KI 67: 12 studies (345 patients), pooled correlation coefficient (PCC): 0.23 (95% confidence interval [CI] 0.06–0.40); hypoxia-inducible factor-1α: eight studies (240 patients), PCC: 0.24 (95% CI 0.06–0.42); microvessel density: three studies (64 patients), PCC: 0.33 (95% CI 0.02–0.65); vascular endothelial growth factor: two studies (59 cases), PCC: 0.27 (95% CI 0.02–0.51); tumor suppressor protein p53: four studies (159 patients), PCC: 0.05 (95% CI –0.41 to 0.51); epidermal growth factor receptor: two studies (124 patients), PCC: 0.21 (95% CI 0.05–0.37); tumor cell count: three studies (67 patients), PCC: 0.18 (95% CI –0.06 to 0.42); tumor cell apoptosis: two studies (40 patients), PCC: 0.07 (95% CI = –0.85 to 0.99); B-cell lymphoma-2 protein: two studies (118 patients); PCC: 0.04 (95% CI –0.65 to 0.74); glucose-transporter 1: 10 studies (317 patients), PCC: 0.20 (95% CI 0.10–0.30).ConclusionSUVmax derived from 18F-FDG PET cannot reflect relevant histopathological features in HNSCC.

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La capacité des cellules à être invasives et métastasiques est une caractéristique fondamentale de la malignité tumorale. Nous avons récemment montré que le facteur d’ADP-ribosylation 1 (ARF1) est surexprimé dans les lignées cellulaires hautement invasives du cancer du sein et que la stimulation du récepteur au facteur de croissance épidermique (EGFR) peut activer cette isoforme pour contrôler la migration ainsi que la prolifération. Cependant, le rôle de cette GTPase dans la régulation du processus d’invasion cellulaire et les mécanismes moléculaires associés demeure inconnu. Nous avions comme objectifs dans cette thèse, de définir les voies de signalisation sous le contrôle d’ARF1 dans les cellules de cancer du sein et démontrer que l’expression et l’activation de cette GTPase est associée à un phénotype hautement invasif. Nos études démontrent que la modulation de l'expression et l'activité d’ARF1 affecte la capacité des cellules MDA-MB-231 (pour M. D. Anderson-metastatic breast-231), une ligne hautement invasive, à dégrader la matrice extracellulaire via l'activité de la métalloprotéinase MMP-9. ARF1 contrôle les deux principales structures impliquées dans l'invasion, en jouant sur la maturation d’invadopodes ainsi que la relâche de microvésicules membranaires. D’un point de vue mécanistique, l'axe de signalisation ARF1, RhoA-RhoC et la chaine légère de la myosine (MLC) explique ces phénomènes. De plus, nous démontrons que l'un des mécanismes par lequel ARF1 régule la migration est en contrôlant l'assemblage des points adhésions focaux et ce, dans plusieurs types de cellules cancéreuses du sein. ARF1, en étant un membre du complexe d’adhésion, réglemente le recrutement et l’activité de protéines clés à la β1-intégrine tels que la paxilline, la talin et la kinase d’adhésion focale (FAK). Pour finir, nous rapportons que ARF1 et ARF6 ont un rôle majeur dans la transition épithélio-mésenchymateuse. ARF1 est retrouvé fortement exprimé dans les tissus de sous-types les plus agressifs et les plus avancés de cancer du sein. Dans un modèle murin, la modulation à la baisse de l’expression d’ARF1 dans les cellules MDA-MB-231 corrèle avec la diminution de croissance des tumeurs primaires et l’installation des métastases pulmonaires. De plus, nous rapportons que la surexpression des ARF dans des cellules non invasives, les MCF7 (pour Michigan Cancer Foundation-7), permet la nidification de métastases. En effet, dans les MCF7, ARF1 contrôle l’adhésion intercellulaire via la β-caténine et l’E-cadhérine, promeut l’activation de l’oncogène Ras (pour Rat Sarcoma/ Rat Fibrosarcoma virus) et l’expression de plusieurs inducteurs de transition épithélio-mésenchymateuse comme snail et slug. De plus, ARF1 contrôle l’invasion, la prolifération cellulaire et même la résistance à certains agents chimio-thérapeutiques. Globalement, nos études identifient ARF1 comme un interrupteur moléculaire de la progression tumorale et suggèrent que la limitation de son expression/activité pourrait améliorer le devenir des patients atteints du cancer du sein. / Invasive and metastatic chapacities are fundamental features for tumor malignancy. We have recently shown that the ADP-ribosylation factor 1 (ARF1) is over-expressed in highly invasive breast cancer cell lines and stimulation of the epidermal growth factor receptor (EGFR) may activate this isoform to regulate migration and proliferation. However, the role of this GTPase in regulating cell invasion process and related molecular mechanisms remain unknown. In this thesis, we had as objectives, to define the signaling pathways under the control ARF1 in breast cancer cells and show that the expression and activation of the GTPase is associated with highly invasive phenotype. Our studies show that the modulation of the expression and activity of ARF1 affect the ability of MDA-MB-231 cells (M. D. Anderson-metastatic breast-231), a highly invasive line, to degrade the extracellular matrix via the activity of the metalloproteinase MMP-9. ARF1 controls the two main structures involved in the invasion, playing on invadopodia maturation and shedding of membrane microvesicles. The molecular mechanisms involve the regulation of RhoA and RhoC activity by ARF1 and the following downtream events associated with and the myosin light chain (MLC) phosphorylation. Furthermore, we demonstrate that ARF1 also regulates migration by controlling the assembly of focal adhesion complexes in many types of breast cancer cells. ARF1, also prensent in adhesion complexes, regulates the recruitment and activity of key proteins such as paxillin, talin and focal adhesion kinase (FAK) to β1 integrin. Finally, we report that ARF1 and ARF6 play a major role in the epithelial-mesenchymal transition (EMT). ARF1 is found highly expressed in tumor tissue of the most aggressive and advanced subtypes of breast cancer. Lowered expression of ARF1 in vivo in the MDA-MB-231 cells impars tumor growth in primary tumors and inhibits lung metastasis. We report that upregulation of the ARF in non-invasive cells, MCF7 (Michigan Cancer Foundation-7) induce metastasis nidification. Indeed, we show in MCF7 that ARF1 controls intercellular adhesion via the β-catenin and E-cadherin, promotes Ras (Rat Sarcoma/ Rat Fibrosarcoma virus) oncogene activation, and conrols expression of several epithelial-mesenchymal transition markers such as snail and slug. Moreover, we demonstrate that ARF1 controls invasion, proliferation and even resistance to certain chemo-therapeutic agents, in MCF7 cells. Overall, our studies identify ARF1, as a molecular switch of tumor progression and suggest that limiting its expression / activity could improve the outcome of breast cancer patients.

Dans un contexte où la forte prévalence du cancer du sein chez les femmes demeure depuis plusieurs années un enjeu de société majeur, les nouvelles stratégies visant à réduire la mortalité associée à cette maladie sont le sujet de nombreuses recherches scientifiques. Les facteurs d’ADP-ribosylation sont des petites protéines G monomériques importantes pour la réorganisation du cytosquelette d’actine, le remodelage des lipides membranaires et la formation de vésicules. Notre laboratoire a précédemment montré qu’ARF1 est surexprimée dans les cellules hautement invasives du cancer du sein et contribue à leur phénotype migratoire accru. Dans le cadre de ce mémoire, nous avons défini le rôle de cette GTPase dans la migration de telles lignées cellulaires. Pour ce faire, nous avons étudié le rôle d’ARF1 dans l’activation de Rac1, un membre de la famille des GTPases Rho connu pour son implication dans la formation de lamellipodes ainsi que dans la migration cellulaire. Globalement, nous avons déterminé que l’activation d’ARF1 permet l’activation subséquente de Rac1 ainsi que de la voie de signalisation nécessaire au processus de migration. Par une approche d’interférence à l’ARN dans les cellules MDA-MB-231, nous avons d’abord montré la contribution essentielle de Rac1 la migration dépendante d’ARF1. Puis, de façon à établir le mécanisme derrière cette régulation, nous avons montré que l’inhibition de l’expression endogène d’ARF1 altère l’activation de Rac1 dépendante de l’EGF. Nous avons ensuite examiné les conséquences d’une telle inhibition sur les partenaires d’interaction de Rac1. Nous avons découvert qu’ARF1 et Rac1 forment un complexe constitutif, puis qu’ARF1est nécessaire à l’association de Rac1 à IRSp53, une protéine importante dans la formation de lamellipodes. La translocation dépendante de l’EGF du complexe Rac1/IRSp53 à la membrane plasmique est également sous le contrôle d’ARF1. En conclusion, cette étude fournit un nouveau mécanisme par lequel ARF1 régule la migration cellulaire et identifie cette GTPase en tant que cible pharmacologique prometteuse pour freiner le développement des métastases chez les patients atteints du cancer du sein. / ADP-ribosylation factors (ARFs) are monomeric G proteins important for actin cytoskeleton reorganization, lipid membrane remodeling, and vesicule formation. Our laboratory has previously shown that ARF1 is overexpressed in highly invasive breast cancer cells and contribute to their enhanced proliferation and migration phenotype. In this study, we propose to define the role of ARF1 on the activation of Rac1, an important member of the Rho family of GTPases implicated in the formation of lamellipodia and in the migration process. Globally, we evaluated whether ARF1 activation could affect Rac1 activation and the signaling pathway necessary for cell migration. Using an RNAi approach in MDA-MB-231 breast cancer cells, we first determined the essential contribution of Rac1 in ARF1-dependant migration. Mechanistically, endogenous inhibition of ARF1 expression altered EGF-dependent Rac1 activation. We next investigated the consequences of such effect on Rac1 interaction partners. We showed that ARF1 and Rac1 are constitutively complexed but that ARF1 is necessary for EGF-dependent Rac1 association with IRSp53, an essential protein for lamellipodia formation. When unable to interact, Rac1/IRSp53 complex translocation to plasma membrane was considerably inhibited. In conclusion, this study provides a new mechanism by which ARF1 regulates cell migration and identifies this GTPase as a promising pharmacological target to reduce metastasis formation in breast cancer patients.

Little is known about the signaling pathways that contribute to treatment response in advanced stage head and neck tumors. Increased expression of epidermal growth factor receptor (EGFR) and downstream pathways such as nuclear factor kappa B (NFκB) are implicated in aggressive tumor phenotypes and limited response to therapy. This study explored the rationale for combining the proteasome inhibitor bortezomib with the EGFR inhibitor gefitinib in a subset of head and neck squamous cell carcinomas with high EGFR gene amplification. Drug responses of gefitinib and bortezomib as single agents and in combination within head and neck squamous cell carcinoma cell lines were analyzed using MTS assays. The effects of gefitinib on the activation of EGFR and itsthree major downstream pathways, Akt, STAT3 and MAPK were determined by western blotting. The activation status of NFκB and the effects of bortezomib on the canonical pathway were assessed by DNA binding assays. Resistance to lower doses of gefitinib was associated with elevated EGFR and activated Akt expression. Gefitinib was able to effectively inhibit activation of STAT3, Akt and MAPK in HNSCC to varying degrees depending on EGFR expression status. Bortezomib treatment inhibited TNFα –induced nuclear NFκB/RelA expression but demonstrated variability in levels of baseline nuclear NFκB/RelA expression between sensitive and resistant cell lines. Bortezomib effectively suppresses NFκB/RelA nuclear activation but demonstrates additional modes of cellular toxicity beyond the NFκB pathway in sensitive cell lines. Further understanding of tumor response to the targeted inhibitors gefitinib and bortezomib may provide novel approaches in managing HNSCCs.

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O presente estudo comparou os efeitos da ativação e inibição do EGFR em duas linhagens de câncer de pulmão, cultivadas em monocamada ou esferoides. Os esferoides foram cultivados sem elementos de matriz extracelular. As células A549 e HK2 apresentaram, respectivamente, 3 e 6 cópias do gene ErbB1 por núcleo, embora a expressão de EGFR seja menor nas células HK2. A ativação de EGFR por EGF ou inibição por AG1478 não promoveu mudanças na proliferação celular. Entretanto, as células cultivadas em monocamada, estimuladas com EGF, exibiram alterações na disposição dos microfilamentos de actina e aumento na velocidade de migração celular. UO126 e LY294002 foram adicionados às culturas para inibir, respectivamente, as vias ERK e Akt. A linhagem A549, cultivada em monocamada, não apresentou envolvimento das vias de sinalização de ERK e Akt na migração celular induzida por EGF, mas foi observado o envolvimento dessas vias nos esferoides. Já a linhagem HK2 apresentou o envolvimento de Akt para promover a migração celular após estímulo com EGF nas duas formas de cultivo. / This study compared the effects of activation and inhibition of EGFR in two cell lines of lung cancer, grown in monolayer or spheroids. Spheroids were cultured without extracellular matrix components. HK2 and A549 cells showed, respectively, 3 and 6 ErbB1 gene copies per nucleus, while EGFR expression is lower in the HK2 cells. The activation by EGF or EGFR inhibition by AG1478 did not cause changes in cell proliferation. However, cells cultured in monolayers stimulated with EGF, showed changes in the arrangement of actin microfilaments and increased the speed of cell migration. UO126 and LY294002 were added to the cultures to inhibit, respectively, the ERK and Akt pathways. A549 cells grown in monolayer did not show involvement of ERK and Akt signaling pathways in the cell migration induced by EGF, but was observed involvement of such pathways in the spheroids. HK2 cells showed involvement of Akt to promote cell migration after EGF stimulation in monolayers and in spheroids.