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  • 1
    In: Nature Cancer, Springer Science and Business Media LLC, Vol. 3, No. 7 ( 2022-06-09), p. 852-865
    Abstract: Nutrient-deprived conditions in the tumor microenvironment (TME) restrain cancer cell viability due to increased free radicals and reduced energy production. In pancreatic cancer cells a cytosolic metabolic enzyme, wild-type isocitrate dehydrogenase 1 (wtIDH1), enables adaptation to these conditions. Under nutrient starvation, wtIDH1 oxidizes isocitrate to generate α-ketoglutarate (αKG) for anaplerosis and NADPH to support antioxidant defense. In this study, we show that allosteric inhibitors of mutant IDH1 (mIDH1) are potent wtIDH1 inhibitors under conditions present in the TME. We demonstrate that low magnesium levels facilitate allosteric inhibition of wtIDH1, which is lethal to cancer cells when nutrients are limited. Furthermore, the Food & Drug Administration (FDA)-approved mIDH1 inhibitor ivosidenib (AG-120) dramatically inhibited tumor growth in preclinical models of pancreatic cancer, highlighting this approach as a potential therapeutic strategy against wild-type IDH1 cancers.
    Type of Medium: Online Resource
    ISSN: 2662-1347
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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  • 2
    In: Cancer Treatment Reviews, Elsevier BV, Vol. 103 ( 2022-02), p. 102334-
    Type of Medium: Online Resource
    ISSN: 0305-7372
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
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  • 3
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Research Vol. 82, No. 12_Supplement ( 2022-06-15), p. 3021-3021
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 12_Supplement ( 2022-06-15), p. 3021-3021
    Abstract: With an overall survival of less than 3%, pancreatic ductal adenocarcinoma (PDAC) is the 3rd leading cause of cancer-related death in the U.S. at its advanced stages. With the most promising therapeutics, the overall survival after a stage IV PDAC diagnosis is only at 11.1 months. The marginal effects of current therapeutics emphasize the importance of developing new approaches to treat PDAC. In a wide range of cancer subtypes, a ketogenic diet has shown encouraging effects as combination therapy. However, the underlying anti-tumorigenic pathways involved in this diet alone are still not well understood. The ketogenic diet’s core elements and direct physiologic effects (ketone bodies, fatty acids, low glucose, low insulin levels) potentially alter PDAC biology that span from redox homeostasis to mitochondrial metabolism, and epigenetic modifications. We hypothesized that in carefully controlled in vitro and in vivo experiments, KD components delay growth of PDAC. Additionally, we hypothesize that understanding the underlying drivers of the anti-tumor effects of a ketogenic diet could be leveraged into the rational design of combination therapies that augment these anti-tumor effects. We show that in the subcutaneous mouse model of PDAC, tumor growth is markedly delayed under ketogenic diet restrictions Furthermore, in PDAC cell culture models, we observed anti-cancer effects when the ketogenic diet core elements are isolated. Specifically, fatty acids and ketone bodies inhibit PDAC cell growth, particularly under high glucose conditions. These effects are somewhat attenuated under low glucose, suggesting that these elements result in competing effects on PDAC cells (i.e., support some pro-survival pathways while inhibiting others). Future studies seek to better delineate the mechanistic impact of the principal ketogenic diet elements on metabolic pathways with a focus on mitochondrial metabolism, as well effects on epigenetic signaling. Citation Format: Omid Hajihassani, Ali Vaziri-Gohar, Mehrdad Zarei, Jonathan Hue, Helen Cheng, Anusha Mudigonda, Erryk Katayama, Hallie Graor, Jordan Winter. Understanding the effects of a ketogenic diet against pancreatic cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3021.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 4
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    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Molecular Cancer Therapeutics Vol. 21, No. 12 ( 2022-12-02), p. 1810-1822
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 21, No. 12 ( 2022-12-02), p. 1810-1822
    Abstract: Metabolites of tryptophan degradation are known to alter mood. Their effects have only been superficially examined in the context of pancreatic cancer. Herein, we study the role of indoleamine 2,3-dioxygenase 1 (IDO1), an enzyme important in the conversion of tryptophan to kynurenine, in a murine model of pancreatic cancer–associated depression. Behavioral tests (open field, forced swim, tail suspension, and elevated plus maze) and biochemical assays (LC-MS metabolomics) were used to characterize a depressive-phenotype in tumor-bearing mice (relative to non–tumor-bearing mice). In addition, we determine whether pharmacologic blockade of IDO1 affects mood in tumor-bearing mice. Immunocompetent mice bearing orthotopic pancreatic tumors exhibit depressive-like behavior relative to non–tumor-bearing mice. Pancreatic tumors strongly express IDO1. Consequently, serum kynurenine levels in tumor-bearing mice are elevated relative to non–tumor-bearing mice. Tumor-bearing mice treated with epacadostat, an IDO1 inhibitor, exhibited improved mood relative to mice receiving vehicle. There was a 95% reduction in serum kynurenine levels in mice receiving epacadostat relative to mice treated with vehicle. As confirmatory evidence of on-target activity, tumors of mice treated with epacadostat exhibited a compensatory increase in IDO1 protein levels. Escitalopram, an approved antidepressant, was ineffective at improving mood in tumor-bearing mice as measured by behavioral assays and did not affect kynurenine levels. Neither epacadostat, nor escitalopram, affected overall survival relative to vehicle. Mice with pancreatic cancer exhibit depressive-like behavior. Epacadostat was effective as an antidepressant for pancreatic cancer–associated depression in mice. These data offer a rationale to consider IDO1 inhibition as a therapeutic strategy to mitigate depressive symptoms in patients with pancreatic cancer.
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 5
    In: Psycho-Oncology, Wiley, Vol. 31, No. 8 ( 2022-08), p. 1390-1398
    Abstract: To determine the frequency of depression or anxiety preceding a diagnosis of pancreatic cancer (PC). Further, to examine the association of PC‐associated depression or anxiety with treatment compliance and survival. Methods 856 patients with PC from a single institution were identified using International Classification of Diseases (ICD) codes. For each case, two non‐cancer age‐ and sex‐matched controls were included. Dates of depression or anxiety diagnosis identified using ICD codes were compared to the date of PC diagnosis. The medical record was queried to further explore psychiatric symptoms. Multivariable analyses were performed to examine if prediagnosis depression or anxiety was associated with receipt of treatment or survival. Results A greater proportion of patients with PC experienced depression or anxiety in the year preceding diagnosis than the overall frequency in controls (4.6% vs. 2.6%, p  = 0.005) based on ICD codes. Patients with PC exhibited signs of prodromal depression or anxiety based on ICD codes, clinical documentation of psychiatric symptoms, or initiation of new psychiatric medications more often than controls (20.7% vs. 6.7%, p   〈  0.001). Prediagnosis depression or anxiety was associated with a reduced likelihood of receiving chemotherapy (OR = 0.58, p  = 0.04). There was an associated decrease in overall survival among patients with metastatic disease who experienced depression or anxiety before PC diagnosis (HR = 1.32, p  = 0.04). Conclusions The frequency of depression or anxiety among patients with PC was higher than the general population. Prediagnosis psychiatric symptoms were associated with reduced chemotherapy utilization and worse overall survival. Thus, timely identification and treatment of these symptoms may improve outcomes.
    Type of Medium: Online Resource
    ISSN: 1057-9249 , 1099-1611
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2022
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  • 6
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    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Research Vol. 82, No. 12_Supplement ( 2022-06-15), p. 1476-1476
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 12_Supplement ( 2022-06-15), p. 1476-1476
    Abstract: Purpose: To verify the stability and reliability of circulating microRNA (miRNA) profiles in plasma and serum under different processing and storage conditions for the optimization of future biomarker analyses. Background: Development of blood-based early cancer detection methods have become increasingly popular in recent years. RNA profiles have been investigated; however, obtaining reliable RNA data has been a challenge due to rapid degradation by RNases. miRNAs are short non-coding regulatory RNAs that are more stable as they are complexed with proteins or packaged in exosomes. Thus, circulating miRNA profiles have the potential to serve as a diagnostic test for cancer. Optimization of collection protocols is a crucial next step for widespread use. Methods: Whole blood was drawn after Institutional Review Board approval. Blood was processed into either plasma or serum aliquots. The samples were stored at different temperatures (0 or 25°C) for varying periods of time (0-24 hours). miRNA was extracted using a Qiagen miRNeasy Serum/Plasma kit. Changes in profiles were assessed with RT-qPCR using a previously established panel of consistently expressed miRNAs (miR15b, miR16, miR21, miR24, miR223). Values were compared using two-tailed t-tests and values are presented as mean ± standard deviation. Results: Mean Cq values were similar at 0 and 24 hours when serum was stored on ice, suggesting negligible miRNA degradation: miR15b (29.6±0.5 vs 29.8±0.4, p=0.11), miR16 (23.5±0.8 vs 23.3±1.0, p=0.55), miR21 (28.6±0.5 vs 28.9±0.6, p=0.17), miR24 (27.4±0.7 vs 27.0±0.5, p=0.09), and miR223 (22.9±0.5 vs 22.9±0.7, p=0.90). There was similar stability over time for 60% of tested miRNAs when serum was left at room temperature: miR15b (30.3±0.7 vs 30.7±0.9, p=0.22), miR16 (23.9±0.7 vs 24.3±1.0, p=0.28), and miR21 (30.0±0.6 vs 29.9±0.6, p=0.38). Two of the miRNAs demonstrated a statistically significant increase in mean Cq after 24 hours: miR24 (27.6±0.7 vs 28.2±0.7, p=0.03) and miR223 (23.4±0.4 vs 24.6±0.6, p= & lt;0.01). In general, these trends were similar when plasma was collected, as compared to serum, at both room temperature and on ice. miRNA profiles collected from serum were overall like those obtained from plasma. Conclusions: These data confirm and expand upon past reports demonstrating the remarkable stability of miRNA. Even in suboptimal processing conditions (i.e., room temperature for 24 hours), the miRNA profile is remarkably consistent. Although blood processing and transport times may vary between institutions, our data suggest these discrepancies may not affect the efficacy of miRNA as a blood biomarker. We plan to validate our findings using bulk small RNA sequencing, which we hypothesize will similarly demonstrate minimal changes in the entire miRNA landscape in different conditions. We will then utilize our institutional biorepository to identify potentially unique miRNA profiles present in patients with cancer. Citation Format: Erryk S. Katayama, Jonathan J. Hue, Mehrdad Zarei, Hallie J. Graor, Omid Hajihassani, Ali Vaziri-Gohar, Jordan M. Winter. Stability of circulating microRNA for plasma and serum biomarker studies [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1476.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 7
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    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Research Vol. 82, No. 12_Supplement ( 2022-06-15), p. 2321-2321
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 12_Supplement ( 2022-06-15), p. 2321-2321
    Abstract: INTRODUCTION: Indolamine 2,3-dioxygenase 1 (IDO1) is upregulated in tumors. It facilitates catabolism of tryptophan to kynurenine and downstream metabolites, which are associated with psychiatric symptoms. To this point, 20% of patients at our institution developed psychiatric symptoms months before pancreatic cancer (PC) diagnosis. This proportion was threefold greater relative to non-cancer controls (6.7%), supplying indirect evidence of a biochemical link. Herein, we investigate IDO1 as a target in pancreatic cancer-associated depression. METHODS: Human and murine PC cells were used in vitro. Protein levels were assessed using western blotting and cell survival by PicoGreen. For in vivo studies, murine PC cells were injected into the pancreatic tail. Control mice underwent an acellular injection. Mice were treated with epacadostat (an IDO1 inhibitor), escitalopram, or vehicle. To evaluate depressive-like behavior, mice were subjected to the forced swim and tail suspension tests. The open field test was used to monitor mobility. Tumors were analyzed using western blotting and serum metabolites were assessed using LC-MS. RESULTS: Murine and human PC cells had undetectable basal IDO1 protein levels; however, there was a strong induction with interferon-gamma. There was a further increase in IDO1 with added epacadostat. Escitalopram had no effect on IDO1 levels. Epacadostat and escitalopram did not impact PC cell viability. Physical mobility of PC mice was similar to controls over the study period. PC mice were more immobile relative to controls during the forced swim (percent immobile: 16.0% v 8.2%, p & lt;0.001) and tail suspension (24.1% v 15.4%, p=0.003) tests. There was a 2.3-fold increase in serum kynurenine levels in PC mice relative to controls (p & lt;0.001).PC mice treated with epacadostat were less immobile relative to PC mice receiving vehicle in both the forced swim (3.2% v 6.6%, p=0.002) and tail suspension (25.0% v 39.3%, p=0.002) tests. Metabolomics demonstrated a 95% reduction in serum kynurenine levels in mice receiving epacadostat relative to vehicle (p & lt;0.001). Tumors of mice treated with epacadostat exhibited a compensatory upregulation of IDO1. Mice treated with escitalopram performed similarly to vehicle-treated mice on the forced swim (7.6%, p=0.85) and tail suspension (38.7%, p=0.77) tests, and kynurenine levels were similar. CONCLUSION: Mice with PC exhibit depressive-like behavior relative to control mice with an associated increase in kynurenine. Treatment with epacadostat improved depressive-like behavior and dramatically reduced kynurenine. These data provide evidence to trial epacadostat in patients battling pancreatic cancer-associated depression. Citation Format: Jonathan J. Hue, Hallie J. Graor, Mehrdad Zarei, Ali Vaziri-Gohar, Erryk S. Katayama, Karen Ji, Omid Hajihassani, Alexander W. Loftus, Luke D. Rothermel, Jordan M. Winter. IDO1 is a potential target to combat pancreatic cancer-associated depression [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2321.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 8
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 12_Supplement ( 2022-06-15), p. 3133-3133
    Abstract: Introduction: Pancreatic cancer (PC) is resistant to systemic therapies. This is at least in part due to the characteristically harsh tumor microenvironment which limits the delivery of systemic therapies and is not conducive to anti-tumor immune cell function. Unfortunately, development of novel therapeutics is arduous. Thus, identification of methods to augment the efficacy of existing therapeutics, such as immunotherapies, represents an attractive option. Herein, we attempt to sensitize PC to a colony stimulating factor 1 receptor (CSF1R) inhibitor by augmenting peripheral glucose levels. Methods Murine PC cells (KPC) and bone marrow derived macrophages were cultured in hypoglycemic (≤2.5mM) or hyperglycemic (25mM) conditions. Phenotypic (western blot, flow cytometry), metabolic (seahorse, LC-MS metabolomics), and cell survival (clonogenic assay) assays were performed. KPC cells were orthotopically injected into the pancreas of immunocompetent mice for survival studies. Mice were randomized to pexidartinib (a CSF1R inhibitor) or vehicle and received either normal water of 30% dextrose (D30). Results: In a co-culture experiment, tumor-supporting M2 macrophages increased KPC cell growth by 30%, whereas tumor-fighting M1 macrophages decreased KPC growth by 95%. M1 macrophages were poorly suited to survive in hypoglycemic conditions as compared to hyperglycemic conditions (relative survival: 38% vs 100%, p & lt;0.01). M2 macrophage survival was equivalent (93% vs 100%, p=0.39). When cultured in hypoglycemic conditions, M1 macrophages adopted an M2-like metabolic profile (i.e., increased TCA cycle metabolites and decreased glycolytic metabolites) assessed by both seahorse and LC-MS metabolomics. As glucose concentrations decreased in culture media over time, protein levels of an M1 marker (inducible nitric oxide, iNOS) decreased and an M2 marker (arginase) appeared, suggesting a phenotypic switch. Pexidartinib augmented M1 iNOS protein levels and simultaneously decreased M2 arginase levels. On an in vitro flow cytometric analysis, the percentage of M2 macrophages (CD206+, CD301+, F480+, CD11b+) decreased as glucose concentrations were increased (33.7% vs 38.0%), and decreased further when pexidartinib was combined with hyperglycemia (20.5%). Mice treated with pexidartinib and D30 had improved median survival relative to mice receiving pexidartinib alone (median survival: 42 (IQR: 38, 52) vs 34 (IQR: 32, 38) days, p & lt;0.05) in two independent experiments. Of note, pexidartinib alone did not improve survival as compared to vehicle or D30. Conclusion: Higher glucose conditions promote M1 macrophage survival and function, while preventing the switch to an M2 phenotype. Also, higher peripheral glucose levels appear to sensitize PC to a CSF1R inhibitor. We plan to validate these findings using other immunotherapeutics (e.g., checkpoint inhibitors). Citation Format: Jonathan J. Hue, Mehrdad Zarei, Hallie J. Graor, Erryk S. Katayama, Omid Hajihassani, Alexander W. Loftus, Luke D. Rothermel, Ali Vaziri-Gohar, Jordan M. Winter. Glucose is important for macrophage metabolism and response to immunotherapy in a pancreatic cancer model [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3133.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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  • 9
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    Online Resource
    American Association for Cancer Research (AACR) ; 2022
    In:  Cancer Research Vol. 82, No. 12_Supplement ( 2022-06-15), p. 3038-3038
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 82, No. 12_Supplement ( 2022-06-15), p. 3038-3038
    Abstract: Introduction: Novel immunotherapies and targeted therapies have generated remarkable responses for patients with melanoma relative to historic treatments, but these responses are only seen in about 50% of patients. This suggests that treatment resistance is an ongoing challenge for a significant number of patients with melanoma, leaving an urgent need for improved therapeutic strategies. In our previous studies, we demonstrated that oxidative stress has an important role in drug resistance, and that wild type isocitrate dehydrogenase 1 (IDH1) is a major source of cytosolic NADPH that maintains redox homeostasis of cells under hypoxic and metabolic stress. This critical enzyme has not been thoroughly evaluated in melanoma. Herein, we explored the expression and function of IDH1 in human melanoma and the role of IDH1 in regulating melanoma metabolism. Methods: We evaluated IDH1 expression in primary and metastatic melanoma using The Cancer Genome Atlas (TCGA). We performed IDH1 knockdown by siRNA oligos, and evaluated cell viability by Trypan blue and PicoGreen assays under normal and nutrient-deprived conditions. Cellular reactive oxygen species (ROS) levels were determined by the DCFDA method. Metastatic activity of these cells was measured by transwell migration assays. In order to determine the impact of IDH1 in cellular metabolism, metabolomics profiling was performed by using LC-MS. These experiments were performed in A375 and SK-Mel 28 cell lines. Results: Analysis of TCGA data from melanoma samples showed IDH1 is highly overexpressed in primary and metastatic melanoma, and higher levels are associated with decreased progression-free survival in patients. Further, we validated that IDH1 is overexpressed in tumors by comparing normal skin tissue versus tumor samples by IHC and protein expression arrays. Silencing IDH1 impaired cell proliferation and migration (vs. control) in a nutrient-deprived microenvironment, but this effect was not seen in nutrient abundance. Metabolomics revealed that inhibiting IDH1 significantly decreased NADPH, α-ketoglutarate (αKG), and GSH levels with a corresponding increase in ROS levels and an impairment of mitochondrial function. In addition, silencing IDH1 sensitized melanoma cells to temozolomide (TMZ), a DNA-alkylating agent, as indicated by a decrease in relative cell survival compared with controls. Conclusion: IDH1 plays a critical role in tumorigenesis and chemoresistance in melanoma. Our data show that IDH1 inhibition sensitizes melanoma cells to TMZ therapy. Our study suggests that IDH1 is a potential target in melanoma as a monotherapy or in combination with existing chemotherapies. Citation Format: Mehrdad Zarei, Ali Vaziri-Gohar, Jonathan Hue, Omid Hajihassani, Erryk Katayama, Hallie Graor, Jordan Winter, Luke Rothermel. IDH1 facilitates melanoma cell survival under metabolic stress [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 3038.
    Type of Medium: Online Resource
    ISSN: 1538-7445
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2022
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