Six long chain fatty acid esters of quercetin-3-O-glucoside (Q3G) acylated enzymatically were used for determining their antiproliferative action in comparison to precursor compounds (quercetin, Q3G and six fatty acids namely, stearic acid, oleic acid, linoleic acid, alpha-linolenic acid, eicosapentaenoic and docosahexanoic acids) using HepG2 cells. Long chain fatty acid esters of Q3G showed significant inhibition of cell proliferation (approximately 85% to 90%) compared to the precursor compounds and two prescribed anticancer-drugs (Sorafenib and Cisplatin) after 6 hrs and 24 hrs by inducing cell cycle arrest, apoptosis and DNA topoisomerase II inhibition. Among the six fatty acid esters of Q3G, oleic acid ester (OA-Q3G) displayed the greatest anti-proliferation action and upon further investigation showed significant regulation of expression of genes involved in cell cycle, growth, survival and apoptosis at gene and protein level. Overall, results of the study suggest strong potential of these novel compounds in treatment of liver cancer.

Mon projet de thèse repose sur l'idée de l'optimisation du rapport bénéfice /risque (fonction d'utilité) des doses de traitements ciblés en oncologie en intégrant la notion de l'efficacité dans les essais de phase précoce plus que la toxicité. Ceci est réalisé par le choix d'un schéma d'administration/dose optimal en se basant sur la modélisation pharmacocinétique-pharmacodynamique (PK-PD). L'application pratique de ce concept fait l'objet de mon projet de thèse, qui se présente par un essai multiparamétrique de phase 1, dont l'objectif principal est d'évaluer la tolérance de l'association de deux agents anticancéreux, évérolimus et sorafenib, à différentes doses et selon différents schémas d'administration, chez des patients ayant un cancer solide métastatique. Dans ce contexte, un modèle mathématique, multi-échelle de translation destiné à quantifier les relations entre différentes doses, pharmacocinétique, pharmacodynamie des effets radiologiques et cliniques est développé pour explorer les intéractions PK-PD ; ce qui permettra ensuite de choisir le protocole d'administration optimal de cette association. Ceci demande une bonne maîtrise de l'approche de population, une méthodologie basée sur un modèle d'effet mixte non linéaire en utilisant le logiciel (NONMEM 7), qui sert à ajuster les modèles aux données ainsi que les analyses pharmacocinétiques des données / The development of everolimus and sorafenib combination was stopped by drug companies, due to the high toxicity index and the lack of a clear benefit/toxicity ratio to guide dose recommendations for a phase II trial.We designed the first multi-parameter phase I study (EVESOR), based on mathematical modeling of data provided from an adequately designed trial. We aimed to identify optimal doses and dosing schedules for the everolimus ands orafenib combination and maximize the simulated benefit/toxicity ratioThere is strong rationale to combine everolimus and sorafenib in treatment of solid tumor patients. Indeed these drugs block 2 important interacting signaling pathways involved in tumor growth: PI3K-AKT-mTor and RAS-RAF-ERK pathways. The determination of the best drug doses and dosing schedules of this combination is a challenge.The combination has been assessed in several phase 1 trials. Preliminary outcomes suggest promising efficacy but potential limiting toxicities such as hand foot syndrome and biological disorders. In these trials, the impact of administration sequences of one drug with respect to other one has not been assessed. Daily monotherapy regimens of both drugs were used. However sorafenib dosing schedule may impact on everolimus tumor delivery and thus on toxicity & efficacy. It should be possible to determine the optimized doses and dosing schedules of both drugs, which are able to maximize the benefit/toxicity ratio using modeling and simulation studies. Adequate data from a phase 1 trial designed with this objective are requiredMathematical modeling may be a promising tool for establishing the links between doses, dosing schedules, pharmacokinetics, pharmacodynamics, pharmacogenomics, radiological and clinical effects and for simulating the benefit/toxicity ratio induced by different doses and dosing schedules of drug combinations

Le traitement des cancers constitue un problème de santé publique et repose entre autres sur la chirurgie, la radiothérapie, la chimiothérapie, l’hormonothérapie et les thérapies ciblées. Les progrès médicaux récents ont permis l’amélioration de la survie sans progression des patients atteints de cancer, ainsi que de la survie globale. Parmi les nouvelles stratégies thérapeutiques, le blocage de l’angiogenèse fait l’objet de nombreux essais cliniques.Cependant, l’intervention de transporteurs membranaires (influx et / ou efflux), joue un rôle important sur le plan pharmacocinétique, pharmacogénétique et dans la résistance aux médicaments anticancéreux.Nous avons observé chez des patients atteints de CHC une grande variabilité des paramètres pharmacocinétiques du sorafénib (inhibiteur de tyrosine kinase, anti-angiogénique et substrat de la P-gp et de la BCRP) et une tendance à une meilleure réponse clinique dans le groupe hétérozygote, ABCB1 3435 CT, ABCG2 34 GA, ABCG2 1143CT et ABCG2 421CA par rapport aux groupes homozygotes (type sauvage et mutant) avec une association significative aux concentrations plasmatiques normalisées aux poids.Nos travaux ont montré in vitro qu’un prétraitement avec des médicaments anti-angiogéniques tels que le bévacizumab et le sorafénib entrainait une réversion de la résistance à la doxorubicine (substrat de la P-gp) dans un modèle de cellules IGR OV1-DXR (résistantes à la doxorubicine et surexprimant la P-gp) par modulation de la fonctionnalité de la P-glycoprotéine. Cette réversion a été objectivée par l’augmentation significative des concentrations intracellulaires de la doxorubicine dans les cellules IGR OV1-DXR.In vivo chez la souris xénogreffée de cancer colorectal humain, un prétraitement par le bévacizumab a entrainé une augmentation significative des concentrations plasmatiques du SN38 (métabolite actif de l’irinotécan et substrat de la P-gp), de même que de l'AUC et de la Cmax plasmatique de l'irinotécan (susbtrat de la P-gp) après administration orale de l’irinotecan. Une augmentation significative de l'AUC plasmatique du sorafénib après un prétraitement par le bévacizumab a été également observée sur le même modèle expérimental.La connaissance et l’utilisation de la modulation d’activité des transporteurs d’efflux par les thérapies ciblées anti-angiogéniques seraient intéressantes à transposer en thérapeutique cancéreuse pour l’augmentation de la réponse clinique et pour la réversion de la résistance des cellules tumorales et endothéliales surexprimant les transporteurs d’efflux en particulier la P-gp. / Treatment of cancers is a public health problem and based on surgery, radiotherapy, chemotherapy, hormone therapy and targeted therapies. Recent medical advances allowed progression-free survival of cancer patients, and even their overall survival. Among the new therapeutic strategies, blocking of angiogenesis was the subject of several clinical trials.Intervention of membrane transporters (influx and / or efflux) plays an important pharmacokinetic and pharmacogenetic role in anticancer drugs resistance.We observed in patients with HCC, a great pharmacokinetics parameters variability of sorafenib (tyrosine kinase inhibitor, anti-angiogenic drug and P-gp and BCRP substrat) and a tendency to a better clinical response in the ABCB1 3435 CT, ABCG2 34 GA, ABCG2 1143CT and ABCG2 421CA heterozygous group than in the homozygous group (wild type and mutant).Our work showns in vitro that pretreatment with anti-angiogenic drugs such as bevacizumab and sorafenib resulted in a resistance reversion to doxorubicin (P-gp substrate) in an IGROV1 – DXR cells (resistant to doxorubicin and P-gp overexpressing cells) by modulating the functionality of P-glycoprotein. This reversion is measured by the significant increase in intracellular doxorubicin concentrations in IGR OV1-DXR cells.In vivo in human colorectal cancer xenograft mice, bevacizumab pretreatment led to a significant increase in plasma concentrations of SN38 (active metabolite of irinotecan and P-gp substrate), as well as plasma AUC and Cmax of irinotecan (P-gp substrate) after oral administration of irinotecan. Similarly, a significant increase in plasma AUC of sorafenib after bevacizumab pretreatment was observed on the same experimental model.Knowledge and use of activity modulation of efflux pumps by anti-angiogenic targeted therapies would be interesting to translate into cancer therapy for increased clinic response and resistance reversion of the tumor and endothelial cells overexpressing efflux transporters, particularly P-gp.

The first study examined the interaction between low doses of the multi-kinase inhibitor sorafenib and the histone deacetylase inhibitor vorinostat in colon cancer cells. Sorafenib and vorinostat synergized to kill HCT116 and SW480 cells. In SW480 cells, sorafenib+vorinostat toxicity correlated with CD95 activation and CD95-stimulated autophagy. Drug lethality in SW480 cells was blocked by knock down of CD95. In SW620 cells that are patient matched to SW480 cells, sorafenib+vorinostat toxicity was significantly reduced that correlated with a lack of CD95 activation and lower expression of ceramide synthase 6 (LASS6). Overexpression of LASS6 in SW620 cells enhanced drug-induced CD95 activation and tumor cell killing, whereas knock down of LASS6 in SW480 cells suppressed CD95 activation. In HCT116 cells, sorafenib+vorinostat did not increase CD95 plasma membrane levels, weakly induced caspase 8 association with CD95, and knock down of CD95 enhanced drug lethality. In HCT116 cells sorafenib+vorinostat treatment caused CD95-dependent autophagy that was a protective signal. Thus, treatment of tumor cells with sorafenib+vorinostat activates CD95 that promotes viability via autophagy or degrades survival via extrinsic or intrinsic pathways. Drug-induced activation of the de novo ceramide synthesis pathway plays a key role in CD95 activation. The second project explores the mechanism by which the combination of 17AAG, an hsp90 inhibitor, and PD184352, a MEK1/2 inhibitor alters survival in colon cancer cells. 17AAG and PD184352 synergized to kill HCT116 and SW480 cells. In HCT116 cells drug-exposure increased CD95 plasma membrane levels In SW620 cells, 17AAG and PD184352 toxicity was significantly reduced that correlated with a lack of CD95 activation and lower expression LASS6. Overexpression of LASS6 in SW620 cells enhanced drug-induced CD95 activation and tumor cell killing. In Mia Paca2 cells, a pancreatic cell line, inhibition of caspase 8 or overexpression of c-FLIP-s suppressed cell killing by PD184352 and 17AAG exposure. Drug lethality in Mia Paca2 cells was blocked by knock down of CD95. Additionally, overexpression of Bcl-xL or knockdown of caspase 9 decreased cell killing in 17AAG and PD184352 combination treatment. Thus, 17AAG+PD184352 exposure activates the extrinsic and intrinsic apoptotic pathways to kill Mia Paca2 cells. This document was created in Microsoft Word 2000.

The present studies sought to determine whether the lethality of the drug combination [sorafenib + sildenafil] could be enhanced by the anti-inflammatory agent celecoxib, using ovarian cancer and other tumor cell lines as models. Also, in a dose dependent fashion celecoxib enhanced [sorafenib + sildenafil] lethality in multiple ovarian cancer cell lines. In a dose dependent fashion celecoxib enhanced the ability of [sorafenib + sildenafil] to reduce expression of multiple chaperone proteins in parallel with lower levels of the drug efflux pumps ABCB1 and ABCG2. Over-expression of GRP78 and HSP27 maintained pump expression in the presence of drugs. Cell killing by the 3 drug combination was mediated by mitochondrial / caspase 9 -dependent apoptotic signaling and by RIP-1 / caspases 2 and 4 / AIF -dependent necroptotic signaling. Pre-treatment of intrinsically resistant primary ovarian cancer cells with [celecoxib + sorafenib + sildenafil] significantly enhanced tumor cell killing by a subsequent cisplatin exposure. Similar data were obtained in some cancer cell lines, but not all, using the related platinum containing drugs, oxaliplatin and carboplatin. As our prior publications have also validated in vivo the combinations of [celecoxib + sildenafil] and [sorafenib + sildenafil] as cytotoxic to multiple tumor cell types, combined with the present findings, we would argue that the combination of celecoxib/sorafenib/sildenafil should be explored in a new phase I trial in ovarian cancer.

O carcinoma hepatocelular (HCC) é o sexto mais frequente e a segunda maior causa de mortalidade por câncer no mundo, além de apresentar alta taxa de recidiva. A associação de sorafenibe (SO) com agentes quimiopreventivos representa uma estratégia importante para aumentar a eficácia do tratamento e minimizar a reincidência da doença. Em estudos anteriores demonstrou-se o potencial quimiopreventivo da tributirina (TB), pró-fármaco do ácido butírico (AB), em modelo de hepatocarcinogênese experimental. A atividade da TB tem sido relacionada à inibição do desenvolvimento de lesões préneoplásicas, bem como à indução de apoptose. Assim, o presente estudo teve como objetivo avaliar a ação anticarcinogênica da TB e do SO, isoladamente ou em associação no HCC. Nesse sentido, implantes singênicos foram realizados no flanco de ratos Fischer- 344 a partir de células da linhagem neoplásica JM-1. Os animais foram distribuídos nos seguintes grupos: Grupo controle isocalórico [CO; Maltodextrina (300 mg/100 g p.c.) e solução veículo (solução de etanol a 12.5% e Cremofor a 12.5% em água estéril)]; Grupo TB (200 mg/100 g p.c. e solução veículo); Grupo SO [Maltodextrina (300 mg/100 g p.c. tosilato de SO (3 mg/100 g p.c.) em solução veículo] e Grupo associação [AS; TB (200 mg/100 g p.c) e tosilato de SO (3 mg/100 g p.c.) em solução veículo]. Os implantes de células JM-1 originaram neoplasias com características pouco diferenciadas. Os tratamentos com SO e AS retardaram (p<0,05) o desenvolvimento das neoplasias, além de reduzirem (p<0,05) suas massa e aumentem (p<0,05) a sobrevida em relação ao grupo CO. Não houve diferença na porcentagem de área necrótica das neoplasias entre os tratamentos. Porém, foi observada uma correlação negativa (p<0,05) entre o tamanho da neoplasia e a área necrótica, sendo que quanto menor a área da neoplasia maior a extensão da necrose, independente do tratamento. Foi observado aumento (p<0,05) das concentrações hepáticas de AB nos grupos TB, SO e AS. Já na neoplasia, apenas os grupos TB e SO demonstraram aumento (p<0,05) na concentração de AB. Além disso, os tratamentos com SO e AS aumentaram (p<0,05) a concentração tecidual de SO na neoplasia em relação ao CO. Nesse sentido, foi observado que grupo AS apresentou 5 vezes mais SO na neoplasia quando comparado ao grupo SO. Os tratamentos com TB e SO isoladamente ou em associação reduziram (p<0,05) a expressão de CK19 em relação ao grupo CO. Em relação à avaliação da proliferação celular, os grupos TB, SO e AS apresentaram redução (p<0,05) do índice de proliferação celular quando comparados ao grupo CO. Foi observado por meio da análise imunoistoquímica para pERK, que os animais tratados com SO e AS reduziram (p<0,05) as áreas positivas quando comparadas às dos animais do grupo CO. Além disso, também foi observada por meio de marcação imunoistoquímica uma redução (p<0,05) nas áreas positivas para CK8 nos grupos SO e AS quando comparadas às do grupo CO. Em relação à caspase-3 clivada, foi observado por imunoistoquímica que o tratamento com TB aumentou (p<0,05) o índice de células positivas para caspase-3 clivada quando comparado ao CO. Esse dado foi comprovado pela análise de western blot. Foi observado por meio da análise imunoistoquímica para H3K9, um aumento (p<0,05) da acetilação no grupo TB quando comparado ao grupo CO. Em relação à expressão em nível proteico de pAKT, foi observado por meio da análise imunoistoquímica uma redução (p<0,05) no grupo TB em comparação ao grupo CO. O presente estudo demonstrou que os implantes de células JM-1 no flanco de ratos Fischer-344 originaram neoplasias com características que lembram a organização hepatocítica de um HCC convencional. O tratamento com TB foi capaz de reduzir a proliferação celular e induzir apoptose. Os tratamentos com SO e com a AS foram capazes de retardar o desenvolvimento, aumentar a sobrevida, reduzir a massa das neoplasias, induzirem diferenciação celular e reduzirem a proliferação celular, melhorando o prognóstico da doença. Os tratamentos com SO e AS apresentaram atividade quimioterápica semelhante. No entanto, a coadministração de SO e TB foi capaz de aumentar a biodisponibilidade do SO para a neoplasia. / Hepatocellular carcinoma (HCC) is the sixth most frequent and the second largest cause of cancer mortality in the world, besides presenting a high rate of recurrence. The association of sorafenib (SO) with chemopreventive agents represents an important strategy to increase the efficacy of the treatment and to minimize recurrence of the disease. In previous studies the chemopreventive potential of tributyrin (TB), a butyric acid prodrug (AB), was demonstrated in a model of experimental hepatocarcinogenesis. TB activity has been linked to inhibition of the development of pre-neoplastic lesions as well as to the induction of apoptosis. Thus, the present study aimed to evaluate the anticarcinogenic action of TB and SO, either alone or in combination in HCC. In this sense, syngeneic implants were performed on the flank of Fischer-344 rats from cells of the JM-1 neoplastic lineage. The animals were divided into the following groups: Control group [CO; Maltodextrin (300 mg / 100g p.c.) and carrier solution (12.5% ethanol solution and 12.5% Cremophor in sterile water)]; TB group (200 mg / 100 g p.c. and carrier solution); Group SO [Maltodextrin (300 mg / 100 g pc tosylate of SO (3 mg / 100 g pc) in vehicle solution] and Association group [AS; TB (200 mg / 100 g pc) and SO tosylate (3 mg / 100 (p <0.05), the development of the neoplasms, as well as the reduction (p <0.05), and the survival rate was higher (p <0.05) than the CO group. There was no difference in the percentage of necrotic area of the neoplasms between the treatments. (p <0.05) of the hepatic AB concentrations in the TB, SO and AS groups, although the size of the neoplasia and the necrotic area were higher. In the neoplasia, only the TB and SO groups showed an increase (p <0.05) in AB concentration. In addition, treatments with SO and AS increased (p <0.05) the tissue concentration of SO in the neoplasia in relation to CO. In this sense, it was observed that AS group presented 5 times more SO in the neoplasia when compared to the SO group. Treatments with TB and SO alone or in combination reduced (p <0.05) the expression of CK19 in relation to the CO group. In relation to the evaluation of cell proliferation, the TB, SO and AS groups presented a reduction (p <0.05) in the cell proliferation index when compared to the CO group. It was observed by the immunohistochemical analysis for pERK that the animals treated with SO and AS reduced (p <0.05) the positive areas when compared to the animals of the CO group. In addition, a reduction (p <0.05) in the CK8 positive areas in the SO and AS groups when compared to the CO groups was also observed by immunohistochemical labeling. In relation to the cleaved caspase-3, it was observed by immunohistochemistry that the TB treatment increased (p <0.05) the index of caspase-3 positive cells cleaved when compared to CO. This was confirmed by western blot analysis. It was observed by immunohistochemical analysis for H3K9, an increase (p <0.05) in the acetylation of the TB group when compared to the CO group. Regarding the protein level expression of pAKT, a reduction (p <0.05) in the TB group was observed through the immunohistochemical analysis when compared to the CO group. The present study demonstrated that JM-1 cell implants in the flank of Fischer-344 mice originated neoplasms with features reminiscent of the hepatocyte organization of a conventional HCC. TB treatment was able to reduce cell proliferation and induce apoptosis. SO and AS treatments were able to delay the development, increase survival, reduce the mass of neoplasms, induce cell differentiation and reduce cell proliferation, improving the prognosis of the disease. SO and AS treatments showed similar chemotherapy activity. However, co-administration of SO and TB was able to increase the bioavailability of SO to the neolasia.

O câncer primário de fígado (CPF) apresenta mau prognóstico, o que torna importante sua quimioprevenção. Nesse sentido, a tributirina (TB), um pró-fármaco do ácido butírico (AB), presente em laticínios e no mel, mostrou-se um agente quimiopreventivo promissor da hepatocarcinogênese experimental. Os efeitos inibitórios da TB têm sido relacionados à inibição do desenvolvimento de lesões pré-neoplásicas, bem como indução de apoptose e hiperacetilação de histonas. A quimioterapia é uma das abordagens mais comuns para o tratamento de diversos tipos de câncer, inclusive o CPF. Neste caso, o tratamento com sorafenibe (SO) é capaz de prolongar a sobrevida média dos pacientes com a doença em fases avançadas em aproximadamente apenas três meses. Em vista disso, são necessários estudos da associação do sorafenibe com outros compostos que possam aumentar a eficácia do tratamento quimioterápico. Desta forma, a associação de fármacos anti-neoplásicos com compostos bioativos dos alimentos pode consistir em uma estratégia potencial para aumentar a eficácia contra o câncer. No presente estudo, foi avaliada a atividade anticarcinogênica da TB e do SO, isoladamente ou em associação, na etapa de progressão da hepatocarcinogênese. Para tanto, foram realizados implantes singênicos no flanco de ratos Fischer-344 a partir de células da linhagem tumoral GP7TB. Quando as neoplasias atingiram 1 cm3, os animais foram aleatorizados em grupos experimentais: Grupo controle (CO), constituído por 10 ratos Fischer 344 que receberam Maltodextrina (300mg/ 100 g. p. c.), controle isocolarico e solução de etanol à 12,5% e Cremofor à 12,5% em agua estéril; Grupo Tributirina (TB), constituído por 9 ratos Fischer 344 que receberam TB (200mg/ 100 g. p. c.) e solução de etanol à 12,5% e Cremofor à 12,5% em água estéril; Grupo sorafenibe (SO) constituído por 9 ratos Fischer 344 que receberam Maltodextrina (300 mg/ 100 g. p. c.), controle isocalorico e tosilato de sorafenibe (3mg / 100 g. p. c. ) em água estéril; Grupo associação da tributirina com o sorafenibe (AS) constituído por 9 ratos Fischer 344 que receberam TB (20 mg/ 100 g. p. c.) e tosiliato de sorafenibe (3mg/ 100 g. p. c.); tratados por administração intragástrica (i.g) diariamente por 5 semanas consecutivas. As concentrações de AB e SO foram analisadas por cromatografia gasosa associada à espectrometria de massa e as neoplasias foram caracterizadas por imunoistoquímica. Em relação à evolução do tamanho das neoplasias o grupo AS apresentou menor (p=0,009) tamanho das mesmas em relação ao grupo CO. No entanto, estas diferenças não atingiram diferenças significativas (p>0,05) entre os grupos TB e CO, bem como entre os grupos SO e CO. Contudo, quando ajustados os valores do tamanho da neoplasia pela latência, observou-se alterações significativas (p<0,05) nos diversos grupos quando comparados ao grupo CO. O grupo SO aumentou a área necrótica das neoplasias, embora esta diferença não tenha atingido diferença significativa (p>0,05), enquanto que o grupo TB reduziu essa área necrótica em relação ao grupo CO (p=0,005). O grupo TB e AS apresentaram significativamente maiores (p<0,05) concentrações hepáticas e neoplásicas de AB em relação ao grupo CO. O grupo SO e AS apresentaram significativamente maiores (p<0,05) concentrações neoplásicas de SO em relação ao grupo CO. Os grupos SO e AS reduziram a expressão de PTEN, quando comparados ao grupo CO, embora esta diferença não tenha atingido diferença significativa (p>0,05). O grupo TB por sua vez expressou maiores niveis de PTEN, embora esta diferença não tenha atigindo significância estatística (p>0,05). Todos os grupos expressaram maiores niveis de caspase 3 clivada quando comparada ao grupo CO (p>0,05). OS grupos TB e SO reduziram a expressão de pERK &#189; quando comparados ao grupo CO. embora estas diferenças não tenham atingidos diferença estatística (p>0,05). O grupo AS apresentou maior expressão de pERK &#189; quando comparada ao grupo CO, embora esta diferença não tenha atingido diferença significativa (p>0,05). A caracterização das neoplasias do grupo CO foi padronizada por imunoistoquímica, apresentando-se positivas para CK 7, CK8, CK19 e Arginase e negativas para HepPar1 e CK18. Assim, os resultados sugerem que as neoplasias obtidas por implantes com células da linhagem GP7TB apresentam características de CPF oriundo de células tronco neoplásicas. Além disso, os grupos experimentais TB e AS apresentaram atividade anticarcinogênica promissora no modelo de implantes singênicos com células GP7TB, que eventualmente envolvem mecanismos de ação distintos da atividade quimioterápica apresentada pelo SO. / Primary liver cancer (PLC) presents poor prognosis, which makes its chemoprevention important. In this sense, tributyrin (TB), a prodrug of butyric acid (AB), present in dairy products and honey, has been shown to be a promising chemopreventive agent for experimental hepatocarcinogenesis. The inhibitory effects of TB have been related to inhibition of the development of pre-neoplastic lesions, as well as induction of apoptosis and hyperacetylation of histones. Chemotherapy is one of the most common approaches for treating various types of cancer, including PLC. In this case, treatment with sorafenib (SO) is able to prolong the average survival of patients with the disease in advanced stages in approximately three months. In view of this, studies of the association of sorafenib with other compounds that may increase the efficacy of chemotherapeutic treatment are necessary. Thus, the association of anti-neoplastic drugs with bioactive compounds in food may be a potential strategy to increase efficacy against cancer. In the present study, the anticarcinogenic activity of TB and SO was evaluated, alone or in combination, in the progression stage of hepatocarcinogenesis. For this purpose, syngenic implants were performed on the flank of Fischer-344 mice from GP7TB tumor cells. When the neoplasms reached 1 cm3, the animals were randomized into experimental groups: Control group (CO), consisting of 10 Fischer 344 rats receiving Maltodextrin (300mg / 100 g.p.c), isocaloric control and 12.5% ethanol solution, and Cremofor to 12.5% in sterile water; Tributyrin group (TB), consisting of 9 Fischer 344 rats that received TB (200mg / 100 g.p.c.) and 12.5% ethanol solution and Cremofor 12.5% in sterile water; Sorafenib group (SO) consisting of 9 Fischer 344 rats receiving maltodextrin (300 mg / 100 g, w / w), isocaloric control and sorafenib tosylate (3 mg / 100 g, w / w) in sterile water; The association group of tributyrin and sorafenib (AS) consisted of 9 Fischer 344 rats receiving TB (20 mg / 100 g p.o.) and sorafenib tosylate (3 mg / 100 g p.o.); treated intragastric (i.g) daily for 5 consecutive weeks. The concentrations of AB and SO were analyzed by gas chromatography associated with mass spectrometry and the neoplasms were characterized by immunohistochemistry. In relation to the evolution of the size of the neoplasias, the AS group presented smaller (p = 0.009) size of the same ones in relation to the CO group. However, these differences did not reach significant differences (p> 0.05) between the TB and CO groups, as well as between the SO and CO groups. However, when adjusted for size of the neoplasm by latency, significant changes (p <0.05) were observed in the different groups when compared to the CO group. The SO group increased the necrotic area of the neoplasias, although this difference did not reach a significant difference (p> 0.05), while the TB group reduced this necrotic area in relation to the CO group (p = 0.005). The TB and AS groups presented significantly higher (p <0.05) hepatic and neoplastic AB concentrations than the CO group. The SO and AS groups presented significantly higher (p <0.05) neoplastic concentrations of SO in relation to the CO group. The SO and AS groups reduced the PTEN expression when compared to the CO group, although this difference did not reach a significant difference (p> 0.05). The TB group in turn expressed higher levels of PTEN, although this difference did not increase statistical significance (p> 0.05). All groups expressed higher levels of caspase 3 cleaved when compared to the CO group (p> 0.05). The TB and SO groups reduced the expression of pERK &#189; when compared to the CO group. although these differences did not reach statistical difference (p> 0.05). The AS group presented higher pERK &#189; expression when compared to the CO group, although this difference did not reach a significant difference (p> 0.05). Characterization of the neoplasias of the CO group was standardized by immunohistochemistry, presenting positive for CK 7, CK8, CK19 and Arginase and negative for HepPar1 and CK18. Thus, the results suggest that the neoplasias obtained by implants with GP7TB cells present CPF characteristics originating from neoplastic stem cells. In addition, the experimental groups TB and AS presented promising anticarcinogenic activity in the model of syngeneic implants with GP7TB cells, which eventually involve mechanisms of action distinct from the chemotherapy activity presented by SO.

Paradoxerweise aktiviert Sorafenib in menschlichen polyklonal expandierten NK-Zellen den MAPK/ERK- Signaltransduktionsweg und führt zeit- und dosisabhängig zu einer Verstärkung der Effektorfunktionen. Polyklonal expandierte NK-Zellen von gesunden menschlichen Blutspendern wurden mit Sorafenib bzw. dem spezifischen RAF-Inhibitor ZM336372 in variierenden Konzentrationen und Expositionsdauern behandelt und die Effekte auf NK-Zell Effektorfunktionen sowie Signaltansduktion geprüft. Paradoxerweise führte die Behandlung mit Sorafenib sowie ZM336372 in einem bestimmten Konzentrationsbereich zeitabhängig zu einer Verstärkung der Effektorfunktionen. Diese Effekte waren mit einem erhöhten Phosphorylierungsniveau von ERK1/2 sowie CRAF verbunden, während keine Effekte auf AKT zu beobachten waren. / Sorafenib paradoxically activates NK cell effector function in polyclonal expanded NK cells in a time- and dose dependent manner. Polyclonal NK cells from healthy blood donors were treated with with Sorafenib or ZM336372 with varying concentations and exposition duration. Treatment with Paradoxicall Sorafenib and the specific RAF Inhibitor ZM336372 led in a certain dosing range to an increase in NK cell effector function and increased phosphorylation Level of CRAF and ERK1/2. The phosphorylation level of AKT was not altered.

O câncer primário de fígado (CPF) apresenta mau prognóstico, o que torna importante sua quimioprevenção. Nesse sentido, a tributirina (TB), um pró-fármaco do ácido butírico (AB), presente em laticínios e no mel, mostrou-se um agente quimiopreventivo promissor da hepatocarcinogênese experimental. Os efeitos inibitórios da TB têm sido relacionados à inibição do desenvolvimento de lesões pré-neoplásicas, bem como indução de apoptose e hiperacetilação de histonas. A quimioterapia é uma das abordagens mais comuns para o tratamento de diversos tipos de câncer, inclusive o CPF. Neste caso, o tratamento com sorafenibe (SO) é capaz de prolongar a sobrevida média dos pacientes com a doença em fases avançadas em aproximadamente apenas três meses. Em vista disso, são necessários estudos da associação do sorafenibe com outros compostos que possam aumentar a eficácia do tratamento quimioterápico. Desta forma, a associação de fármacos anti-neoplásicos com compostos bioativos dos alimentos pode consistir em uma estratégia potencial para aumentar a eficácia contra o câncer. No presente estudo, foi avaliada a atividade anticarcinogênica da TB e do SO, isoladamente ou em associação, na etapa de progressão da hepatocarcinogênese. Para tanto, foram realizados implantes singênicos no flanco de ratos Fischer-344 a partir de células da linhagem tumoral GP7TB. Quando as neoplasias atingiram 1 cm3, os animais foram aleatorizados em grupos experimentais: Grupo controle (CO), constituído por 10 ratos Fischer 344 que receberam Maltodextrina (300mg/ 100 g. p. c.), controle isocolarico e solução de etanol à 12,5% e Cremofor à 12,5% em agua estéril; Grupo Tributirina (TB), constituído por 9 ratos Fischer 344 que receberam TB (200mg/ 100 g. p. c.) e solução de etanol à 12,5% e Cremofor à 12,5% em água estéril; Grupo sorafenibe (SO) constituído por 9 ratos Fischer 344 que receberam Maltodextrina (300 mg/ 100 g. p. c.), controle isocalorico e tosilato de sorafenibe (3mg / 100 g. p. c. ) em água estéril; Grupo associação da tributirina com o sorafenibe (AS) constituído por 9 ratos Fischer 344 que receberam TB (20 mg/ 100 g. p. c.) e tosiliato de sorafenibe (3mg/ 100 g. p. c.); tratados por administração intragástrica (i.g) diariamente por 5 semanas consecutivas. As concentrações de AB e SO foram analisadas por cromatografia gasosa associada à espectrometria de massa e as neoplasias foram caracterizadas por imunoistoquímica. Em relação à evolução do tamanho das neoplasias o grupo AS apresentou menor (p=0,009) tamanho das mesmas em relação ao grupo CO. No entanto, estas diferenças não atingiram diferenças significativas (p>0,05) entre os grupos TB e CO, bem como entre os grupos SO e CO. Contudo, quando ajustados os valores do tamanho da neoplasia pela latência, observou-se alterações significativas (p<0,05) nos diversos grupos quando comparados ao grupo CO. O grupo SO aumentou a área necrótica das neoplasias, embora esta diferença não tenha atingido diferença significativa (p>0,05), enquanto que o grupo TB reduziu essa área necrótica em relação ao grupo CO (p=0,005). O grupo TB e AS apresentaram significativamente maiores (p<0,05) concentrações hepáticas e neoplásicas de AB em relação ao grupo CO. O grupo SO e AS apresentaram significativamente maiores (p<0,05) concentrações neoplásicas de SO em relação ao grupo CO. Os grupos SO e AS reduziram a expressão de PTEN, quando comparados ao grupo CO, embora esta diferença não tenha atingido diferença significativa (p>0,05). O grupo TB por sua vez expressou maiores niveis de PTEN, embora esta diferença não tenha atigindo significância estatística (p>0,05). Todos os grupos expressaram maiores niveis de caspase 3 clivada quando comparada ao grupo CO (p>0,05). OS grupos TB e SO reduziram a expressão de pERK &#189; quando comparados ao grupo CO. embora estas diferenças não tenham atingidos diferença estatística (p>0,05). O grupo AS apresentou maior expressão de pERK &#189; quando comparada ao grupo CO, embora esta diferença não tenha atingido diferença significativa (p>0,05). A caracterização das neoplasias do grupo CO foi padronizada por imunoistoquímica, apresentando-se positivas para CK 7, CK8, CK19 e Arginase e negativas para HepPar1 e CK18. Assim, os resultados sugerem que as neoplasias obtidas por implantes com células da linhagem GP7TB apresentam características de CPF oriundo de células tronco neoplásicas. Além disso, os grupos experimentais TB e AS apresentaram atividade anticarcinogênica promissora no modelo de implantes singênicos com células GP7TB, que eventualmente envolvem mecanismos de ação distintos da atividade quimioterápica apresentada pelo SO. / Primary liver cancer (PLC) presents poor prognosis, which makes its chemoprevention important. In this sense, tributyrin (TB), a prodrug of butyric acid (AB), present in dairy products and honey, has been shown to be a promising chemopreventive agent for experimental hepatocarcinogenesis. The inhibitory effects of TB have been related to inhibition of the development of pre-neoplastic lesions, as well as induction of apoptosis and hyperacetylation of histones. Chemotherapy is one of the most common approaches for treating various types of cancer, including PLC. In this case, treatment with sorafenib (SO) is able to prolong the average survival of patients with the disease in advanced stages in approximately three months. In view of this, studies of the association of sorafenib with other compounds that may increase the efficacy of chemotherapeutic treatment are necessary. Thus, the association of anti-neoplastic drugs with bioactive compounds in food may be a potential strategy to increase efficacy against cancer. In the present study, the anticarcinogenic activity of TB and SO was evaluated, alone or in combination, in the progression stage of hepatocarcinogenesis. For this purpose, syngenic implants were performed on the flank of Fischer-344 mice from GP7TB tumor cells. When the neoplasms reached 1 cm3, the animals were randomized into experimental groups: Control group (CO), consisting of 10 Fischer 344 rats receiving Maltodextrin (300mg / 100 g.p.c), isocaloric control and 12.5% ethanol solution, and Cremofor to 12.5% in sterile water; Tributyrin group (TB), consisting of 9 Fischer 344 rats that received TB (200mg / 100 g.p.c.) and 12.5% ethanol solution and Cremofor 12.5% in sterile water; Sorafenib group (SO) consisting of 9 Fischer 344 rats receiving maltodextrin (300 mg / 100 g, w / w), isocaloric control and sorafenib tosylate (3 mg / 100 g, w / w) in sterile water; The association group of tributyrin and sorafenib (AS) consisted of 9 Fischer 344 rats receiving TB (20 mg / 100 g p.o.) and sorafenib tosylate (3 mg / 100 g p.o.); treated intragastric (i.g) daily for 5 consecutive weeks. The concentrations of AB and SO were analyzed by gas chromatography associated with mass spectrometry and the neoplasms were characterized by immunohistochemistry. In relation to the evolution of the size of the neoplasias, the AS group presented smaller (p = 0.009) size of the same ones in relation to the CO group. However, these differences did not reach significant differences (p> 0.05) between the TB and CO groups, as well as between the SO and CO groups. However, when adjusted for size of the neoplasm by latency, significant changes (p <0.05) were observed in the different groups when compared to the CO group. The SO group increased the necrotic area of the neoplasias, although this difference did not reach a significant difference (p> 0.05), while the TB group reduced this necrotic area in relation to the CO group (p = 0.005). The TB and AS groups presented significantly higher (p <0.05) hepatic and neoplastic AB concentrations than the CO group. The SO and AS groups presented significantly higher (p <0.05) neoplastic concentrations of SO in relation to the CO group. The SO and AS groups reduced the PTEN expression when compared to the CO group, although this difference did not reach a significant difference (p> 0.05). The TB group in turn expressed higher levels of PTEN, although this difference did not increase statistical significance (p> 0.05). All groups expressed higher levels of caspase 3 cleaved when compared to the CO group (p> 0.05). The TB and SO groups reduced the expression of pERK &#189; when compared to the CO group. although these differences did not reach statistical difference (p> 0.05). The AS group presented higher pERK &#189; expression when compared to the CO group, although this difference did not reach a significant difference (p> 0.05). Characterization of the neoplasias of the CO group was standardized by immunohistochemistry, presenting positive for CK 7, CK8, CK19 and Arginase and negative for HepPar1 and CK18. Thus, the results suggest that the neoplasias obtained by implants with GP7TB cells present CPF characteristics originating from neoplastic stem cells. In addition, the experimental groups TB and AS presented promising anticarcinogenic activity in the model of syngeneic implants with GP7TB cells, which eventually involve mechanisms of action distinct from the chemotherapy activity presented by SO.

O carcinoma hepatocelular (HCC) é o sexto mais frequente e a segunda maior causa de mortalidade por câncer no mundo, além de apresentar alta taxa de recidiva. A associação de sorafenibe (SO) com agentes quimiopreventivos representa uma estratégia importante para aumentar a eficácia do tratamento e minimizar a reincidência da doença. Em estudos anteriores demonstrou-se o potencial quimiopreventivo da tributirina (TB), pró-fármaco do ácido butírico (AB), em modelo de hepatocarcinogênese experimental. A atividade da TB tem sido relacionada à inibição do desenvolvimento de lesões préneoplásicas, bem como à indução de apoptose. Assim, o presente estudo teve como objetivo avaliar a ação anticarcinogênica da TB e do SO, isoladamente ou em associação no HCC. Nesse sentido, implantes singênicos foram realizados no flanco de ratos Fischer- 344 a partir de células da linhagem neoplásica JM-1. Os animais foram distribuídos nos seguintes grupos: Grupo controle isocalórico [CO; Maltodextrina (300 mg/100 g p.c.) e solução veículo (solução de etanol a 12.5% e Cremofor a 12.5% em água estéril)]; Grupo TB (200 mg/100 g p.c. e solução veículo); Grupo SO [Maltodextrina (300 mg/100 g p.c. tosilato de SO (3 mg/100 g p.c.) em solução veículo] e Grupo associação [AS; TB (200 mg/100 g p.c) e tosilato de SO (3 mg/100 g p.c.) em solução veículo]. Os implantes de células JM-1 originaram neoplasias com características pouco diferenciadas. Os tratamentos com SO e AS retardaram (p<0,05) o desenvolvimento das neoplasias, além de reduzirem (p<0,05) suas massa e aumentem (p<0,05) a sobrevida em relação ao grupo CO. Não houve diferença na porcentagem de área necrótica das neoplasias entre os tratamentos. Porém, foi observada uma correlação negativa (p<0,05) entre o tamanho da neoplasia e a área necrótica, sendo que quanto menor a área da neoplasia maior a extensão da necrose, independente do tratamento. Foi observado aumento (p<0,05) das concentrações hepáticas de AB nos grupos TB, SO e AS. Já na neoplasia, apenas os grupos TB e SO demonstraram aumento (p<0,05) na concentração de AB. Além disso, os tratamentos com SO e AS aumentaram (p<0,05) a concentração tecidual de SO na neoplasia em relação ao CO. Nesse sentido, foi observado que grupo AS apresentou 5 vezes mais SO na neoplasia quando comparado ao grupo SO. Os tratamentos com TB e SO isoladamente ou em associação reduziram (p<0,05) a expressão de CK19 em relação ao grupo CO. Em relação à avaliação da proliferação celular, os grupos TB, SO e AS apresentaram redução (p<0,05) do índice de proliferação celular quando comparados ao grupo CO. Foi observado por meio da análise imunoistoquímica para pERK, que os animais tratados com SO e AS reduziram (p<0,05) as áreas positivas quando comparadas às dos animais do grupo CO. Além disso, também foi observada por meio de marcação imunoistoquímica uma redução (p<0,05) nas áreas positivas para CK8 nos grupos SO e AS quando comparadas às do grupo CO. Em relação à caspase-3 clivada, foi observado por imunoistoquímica que o tratamento com TB aumentou (p<0,05) o índice de células positivas para caspase-3 clivada quando comparado ao CO. Esse dado foi comprovado pela análise de western blot. Foi observado por meio da análise imunoistoquímica para H3K9, um aumento (p<0,05) da acetilação no grupo TB quando comparado ao grupo CO. Em relação à expressão em nível proteico de pAKT, foi observado por meio da análise imunoistoquímica uma redução (p<0,05) no grupo TB em comparação ao grupo CO. O presente estudo demonstrou que os implantes de células JM-1 no flanco de ratos Fischer-344 originaram neoplasias com características que lembram a organização hepatocítica de um HCC convencional. O tratamento com TB foi capaz de reduzir a proliferação celular e induzir apoptose. Os tratamentos com SO e com a AS foram capazes de retardar o desenvolvimento, aumentar a sobrevida, reduzir a massa das neoplasias, induzirem diferenciação celular e reduzirem a proliferação celular, melhorando o prognóstico da doença. Os tratamentos com SO e AS apresentaram atividade quimioterápica semelhante. No entanto, a coadministração de SO e TB foi capaz de aumentar a biodisponibilidade do SO para a neoplasia. / Hepatocellular carcinoma (HCC) is the sixth most frequent and the second largest cause of cancer mortality in the world, besides presenting a high rate of recurrence. The association of sorafenib (SO) with chemopreventive agents represents an important strategy to increase the efficacy of the treatment and to minimize recurrence of the disease. In previous studies the chemopreventive potential of tributyrin (TB), a butyric acid prodrug (AB), was demonstrated in a model of experimental hepatocarcinogenesis. TB activity has been linked to inhibition of the development of pre-neoplastic lesions as well as to the induction of apoptosis. Thus, the present study aimed to evaluate the anticarcinogenic action of TB and SO, either alone or in combination in HCC. In this sense, syngeneic implants were performed on the flank of Fischer-344 rats from cells of the JM-1 neoplastic lineage. The animals were divided into the following groups: Control group [CO; Maltodextrin (300 mg / 100g p.c.) and carrier solution (12.5% ethanol solution and 12.5% Cremophor in sterile water)]; TB group (200 mg / 100 g p.c. and carrier solution); Group SO [Maltodextrin (300 mg / 100 g pc tosylate of SO (3 mg / 100 g pc) in vehicle solution] and Association group [AS; TB (200 mg / 100 g pc) and SO tosylate (3 mg / 100 (p <0.05), the development of the neoplasms, as well as the reduction (p <0.05), and the survival rate was higher (p <0.05) than the CO group. There was no difference in the percentage of necrotic area of the neoplasms between the treatments. (p <0.05) of the hepatic AB concentrations in the TB, SO and AS groups, although the size of the neoplasia and the necrotic area were higher. In the neoplasia, only the TB and SO groups showed an increase (p <0.05) in AB concentration. In addition, treatments with SO and AS increased (p <0.05) the tissue concentration of SO in the neoplasia in relation to CO. In this sense, it was observed that AS group presented 5 times more SO in the neoplasia when compared to the SO group. Treatments with TB and SO alone or in combination reduced (p <0.05) the expression of CK19 in relation to the CO group. In relation to the evaluation of cell proliferation, the TB, SO and AS groups presented a reduction (p <0.05) in the cell proliferation index when compared to the CO group. It was observed by the immunohistochemical analysis for pERK that the animals treated with SO and AS reduced (p <0.05) the positive areas when compared to the animals of the CO group. In addition, a reduction (p <0.05) in the CK8 positive areas in the SO and AS groups when compared to the CO groups was also observed by immunohistochemical labeling. In relation to the cleaved caspase-3, it was observed by immunohistochemistry that the TB treatment increased (p <0.05) the index of caspase-3 positive cells cleaved when compared to CO. This was confirmed by western blot analysis. It was observed by immunohistochemical analysis for H3K9, an increase (p <0.05) in the acetylation of the TB group when compared to the CO group. Regarding the protein level expression of pAKT, a reduction (p <0.05) in the TB group was observed through the immunohistochemical analysis when compared to the CO group. The present study demonstrated that JM-1 cell implants in the flank of Fischer-344 mice originated neoplasms with features reminiscent of the hepatocyte organization of a conventional HCC. TB treatment was able to reduce cell proliferation and induce apoptosis. SO and AS treatments were able to delay the development, increase survival, reduce the mass of neoplasms, induce cell differentiation and reduce cell proliferation, improving the prognosis of the disease. SO and AS treatments showed similar chemotherapy activity. However, co-administration of SO and TB was able to increase the bioavailability of SO to the neolasia.