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  • 1
    Online Resource
    Online Resource
    S. Karger AG ; 2017
    In:  Breast Care Vol. 12, No. 1 ( 2017), p. 20-27
    In: Breast Care, S. Karger AG, Vol. 12, No. 1 ( 2017), p. 20-27
    Abstract: Triple-negative breast cancer (TNBC) is a molecularly diverse grouping with poor prognosis for which chemotherapy remains the foundation of treatment. The molecular heterogeneity of the disease rationalizes its diverse biological behavior and differential response to treatment. Estimates of up to 20% of patients diagnosed have germline mutations in DNA-damage repair-pathway genes, namely BRCA1 and 2, and this can be used to select patients likely to respond to platinums and/or inhibitors of poly(ADP-ribose) polymerase (PARP). Similar strategies can be utilized in other subtypes of TNBC that have ‘BRCA-like' tumor biology due to the presence of mutations in alternate DNA-damage repair genes. The diverse biological behavior of TNBC and its variable response to chemotherapy were largely decoded following genotyping studies that enabled the identification of distinct molecular subtypes, such that the biological and genetic heterogeneity of the disease could be understood. This subsequently enabled the identification of therapeutic ‘vulnerabilities' for each subtype that encompass biological processes including proliferation, DNA repair, apoptosis, angiogenesis, immune modulation, and invasion and metastasis. To expedite the development of therapies for high-risk, early-stage breast cancer, we have adopted novel trial designs and re-defined endpoints as surrogates of clinical outcomes. The purpose of this review is to highlight the current standard and experimental treatment options for TNBC.
    Type of Medium: Online Resource
    ISSN: 1661-3791 , 1661-3805
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2017
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    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 67, No. 23 ( 2007-12-01), p. 11300-11308
    Abstract: Lung cancer is a genetically heterogeneous disease characterized by the acquisition of somatic mutations in numerous protein kinases, including components of the rat sarcoma viral oncogene homolog (RAS) and AKT signaling cascades. These pathways intersect at various points, rendering this network highly redundant and suggesting that combined mitogen-activated protein/extracellular signal-regulated kinase (MEK) and mammalian target of rapamycin (mTOR) inhibition may be a promising drug combination that can overcome its intrinsic plasticity. The MEK inhibitors, CI-1040 or PD0325901, in combination with the mTOR inhibitor, rapamycin, or its analogue AP23573, exhibited dose-dependent synergism in human lung cancer cell lines that was associated with suppression of proliferation rather than enhancement of cell death. Concurrent suppression of MEK and mTOR inhibited ribosomal biogenesis by 40% within 24 h and was associated with a decreased polysome/monosome ratio that is indicative of reduced protein translation efficiency. Furthermore, the combination of PD0325901 and rapamycin was significantly superior to either drug alone or PD0325901 at the maximum tolerated dose in nude mice bearing human lung tumor xenografts or heterotransplants. Except for a PTEN mutant, all tumor models had sustained tumor regressions and minimal toxicity. These data (a) provide evidence that both pathways converge on factors that regulate translation initiation and (b) support therapeutic strategies in lung cancer that simultaneously suppress the RAS and AKT signaling network. [Cancer Res 2007;67(23):11300–8]
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2007
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  • 3
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 14, No. 7_Supplement ( 2015-07-01), p. A35-A35
    Abstract: Background: Activated MAPK and PI3K/AKT/mTOR pathway signaling are associated with poor prognosis in triple negative Breast cancer (TNBC). Therefore, suppression of both arms of the MAPK/PI3K/AKT/mTOR network is a promising strategy for targeting TNBC. Here we explore the anti-tumor effects of combinations of MEK inhibitor with PI3K, AKT, or mTOR inhibitors with a focus on cell fate and biomarker development in two major subtypes of TNBC, basal-like and mesenchymal. Methods: Combinations of a MEK inhibitor with a PI3K inhibitor, AKT inhibitor, dual mTORC 1/2 inhibitor, or rapalog were evaluated in TNBC cell lines and an orthotopically implanted patient-derived xenograft (PDX) model of TNBC. We utilized reverse-phase protein array (RPPA) and quantitative real-time PCR to interrogate the signaling architecture and transcriptional activity of the treated cell lines. Results: All combinations synergistically suppress the growth of basal-like and mesenchymal TNBC models. RPPA confirms that all combinations suppress common network targets including pERK Th202/T204, pPRAS40 T246, pS6rp S235/236, and p4E-BP1 S65 in all cell lines. Notably, however, comparable repression of MAPK/PI3K/AKT/mTOR signaling produces distinct fates in basal-like and mesenchymal subtypes. Basal-like cell lines preferentially undergo delayed cell death with surviving cells displaying profound growth arrest. In contrast, mesenchymal cell lines respond with uniform quiescence exhibiting little or no cell death. Transcriptional analysis corroborates these phenotypic effects demonstrating differential modulation of genes regulating apoptosis and proliferation in basal-like versus mesenchymal cell lines. Drug treated mesenchymal cells exhibit transcriptional ‘reprogramming’ of epithelial-mesenchymal status as evidenced by reduced mesenchymal gene expression inferring potential effects on invasion and metastasis. In a PDX model of basal-like TNBC that is paclitaxel resistant, early and sustained suppression of tumor growth was achieved by treating once daily with the MEK inhibitor, GDC-0973, in combination with either the PI3K inhibitor, GDC-0941, or the rapalog, Temsirolimus. Concurrent dosing on this intense schedule was associated with some toxicity that could likely be diminished with dose modifications. Conclusions: These data highlight the therapeutic potential of combined MEK and PI3K/AKT/mTOR inhibition in chemo-resistant TNBC. Importantly, they demonstrate innate differences in the response of basal-like and mesenchymal subtypes of TNBC to these combinations, supporting the concept that molecular subtype will be an important predictor of response both in this setting and for other targeted therapies. The combination of GDC-0973 and GDC-0941 performed particularly well in a taxane resistant PDX model and deserves further evaluation in clinical trials for the treatment of TNBC. Citation Format: Sarah J. Schweber, Alicia Rodriguez-Gabin, Jinghang Zhang, Valerie Calvert, Huiping Liu, Emanuel M. Petricoin, III, Eleni Andreopoulou, Susan Band Horwitz, Hayley M. McDaid. Proteomic and transcriptional profiling reveal differential responses to combined MEK and PI3K-mTOR network inhibition in basal-like and mesenchymal subtypes of triple negative breast cancer. [abstract]. In: Proceedings of the AACR Special Conference: Targeting the PI3K-mTOR Network in Cancer; Sep 14-17, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(7 Suppl):Abstract nr A35.
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2015
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  • 4
    In: Clinical Breast Cancer, Elsevier BV, Vol. 13, No. 2 ( 2013-4), p. 103-108
    Type of Medium: Online Resource
    ISSN: 1526-8209
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2013
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  • 5
    Online Resource
    Online Resource
    Impact Journals, LLC ; 2011
    In:  Oncotarget Vol. 2, No. 1-2 ( 2011-02-28), p. 89-98
    In: Oncotarget, Impact Journals, LLC, Vol. 2, No. 1-2 ( 2011-02-28), p. 89-98
    Type of Medium: Online Resource
    ISSN: 1949-2553
    URL: Issue
    Language: English
    Publisher: Impact Journals, LLC
    Publication Date: 2011
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  • 6
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2011
    In:  Cancer Research Vol. 71, No. 8_Supplement ( 2011-04-15), p. 5472-5472
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 71, No. 8_Supplement ( 2011-04-15), p. 5472-5472
    Abstract: The MAPK-RAS-PI3K signaling network is oncogenic in many human malignancies. The plasticity of cancer cell ‘circuitry’ is an important consideration in the rational design of drug combinations, particularly those targeting this signaling network. Therapies directed at MEK, a downstream RAS effector, have been in various stages of clinical development and shown to exhibit single-agent activity in RAF-mutant tumors. However, there is significant redundancy in the MAPK-PI3K pathway that mediates acute resistance to drugs that target either axis of this network, therefore the optimal use for MEK inhibitors will be in combination. We have previously demonstrated that the combination of MEK and mTOR inhibitors is synergistic in a broad range of tumor cell lines and xenofrafts and mechanistically this is mediated via potent suppression of cap-dependent translation. To better define which cohort of patients would best benefit from this combination modality, we have evaluated the efficacy of MEK and rapalog combinations in TSC2 defective cells. The TSC1/2 complex integrates AKT/mTOR and MAPK circuitry and normally inhibits mTOR via Rheb. However disruption of the TSC complex occurs by mutational inactivation, LOH and inactivating phosphorylation via various kinases, including ERK. Loss of TSC2 function hyperactivates mTOR signaling and confers increased sensitivity to mTOR-directed therapies, including rapalogs. In spite of the known participation of MAPK signaling in TSC function, pharmacological inhibitors of MAPK or other components have not been evaluated in TSC2 null tumors. Cells defective in TSC2 had increased sensitivity to both single agent MEK or rapalog therapies, relative to TSC2 WT cells, and had a much more synergistic interaction that was associated with potent dephosphorylation of the translational repressor, 4E-BP1. Synergy was associated with autophagy induction in TSC2 null cells followed by profound growth arrest that did not respond to growth factor stimulation. Cells with intact TSC2 function did not undergo autophagy after combined MEK and rapalog-inhibitor treatment and did not exhibit the same degree of growth arrest. Bioenergetic profiling indicated that TSC2 null cells had increased levels of oxygen consumption relative to WT cells, indicating changes in metabolic output associated with mTOR activation. In conclusion, these data support the use of combined MEK and rapalog-inhibitor therapy in tumors with defective TSC2 signaling. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5472. doi:10.1158/1538-7445.AM2011-5472
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
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  • 7
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 65, No. 7 ( 2005-04-01), p. 2854-2860
    Abstract: Taxol may contribute to intrinsic chemoresistance by activating the mitogen-activated protein kinase kinase (MEK)/extracellular signal-regulated kinase (ERK) cytoprotective pathway in human cancer cell lines and tumors. We have previously shown additivity between Taxol and the MEK inhibitor, U0126 in human cancer cell lines. Here, the combination of Taxol with an orally bioavailable MEK inhibitor, CI-1040, was evaluated in human lung tumors heterotransplanted into nude mice. Unlike xenograft models that are derived from cells with multiple genetic alterations due to prolonged passage, heterotransplanted tumor models are more clinically relevant. Combined treatment with both drugs resulted in inhibition of tumor growth in all models and tumor regressions in three of four models tested, supporting our previous observation that Taxol's efficacy is potentiated by MEK inhibition. Concurrent administration was superior to intermittent dosing. Pharmacodynamic assessments of tumors indicated that suppression of MEK was associated with induction of S473 phosphorylated Akt and reduced proliferation in the combination groups relative to single agents, in addition to suppression of fibroblast growth factor–mediated angiogenesis and reduced expression of vascular endothelial growth factor. These findings are significant and indicate that this combination may have broad therapeutic applications in a diverse range of lung tumors with different intrinsic chemosensitivities.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2005
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  • 8
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2010
    In:  Clinical Cancer Research Vol. 16, No. 14_Supplement ( 2010-07-15), p. IA2-2-IA2-2
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 16, No. 14_Supplement ( 2010-07-15), p. IA2-2-IA2-2
    Abstract: Cytotoxic chemotherapy has formed the backbone of cancer treatment for decades. The clinical use of such agents was established using dosing strategies that favored efficacy (optimal tumor regression) coupled with minimal toxicity. Conceptually, little regard was given to mechanisms governing survival circuitry, or the genetic alterations in a given tumor, which we now appreciate, are important prognosticators of clinical response for both cytotoxic drugs and therapies that target aberrant signaling pathways involved in cancer pathogenesis. Pharmacogenomic profiling is focused on characterizing genetic changes in tumor cells that drive malignant growth and render cells ‘addicted’ to certain pathways for survival and growth. By identifying these genes and the pathways in which they participate, one can devise therapeutic strategies to disable them. An underappreciated fact in cancer therapeutics is that cancer cells respond to and counteract the effects of any drugs that threaten their survival. Signaling pathways have evolved with innate adaptive abilities to form a regulatory circuitry via positive and negative feedback. These adaptive properties present in normal cells are exploited further in cancer genomes due to their genomic instability and the resulting plasticity. The MAPK-RAS-PI3K signaling network is oncogenic in many human malignancies, including NSCLC, though somatic mutations in PI3K are rare in this disease. Efforts to therapeutically target MAPK dysfunction have been focused on RAF and RAS, since their high frequency of mutations in human tumors renders these druggable targets (activating point mutations in K-RAS occur in approximately 30% of lung adenocarcinomas). Therapeutic strategies to inhibit oncogenic RAS alone have not been successful since these have focused on disrupting effectors downstream of the canonical RAS pathway, without perturbing other RAS effectors. One such RAS- binding protein is type I PI3K, which is required for RAS-driven tumorigenesis: therefore, the PI3K / mTOR component is an important target in RAS-mutant tumors. Therapies directed at MEK, a downstream RAS effector, have been in therapeutic development and shown to exhibit optimal singleagent activity in RAF-mutant tumors. However, the enthusiasm for their clinical application in lung cancer is moderated by the low prevalence of RAF mutations/amplifications in the disease and the appreciation that there is significant redundancy in the MAPK-PI3K pathway that mediates acute resistance to these agents. Therefore, like most targeted therapies, the optimal use for this drug will be in combination. The plasticity of cancer cell circuitry is an important consideration in the rational design of drug combinations, particularly those targeting this signaling network. By characterizing the mechanisms that RAS and RAF mutant cancer cells use to escape MEK-inhibitor therapy, one can use combinations of drugs that target addicted pathways and also prevent cancer cells activating secondary pathways to evade death. We have focused on strategies to counteract these mechanisms of resistance and exploit them therapeutically. An example of this is using MEK inhibitors with rapamycin, which is synergistic in a diverse range of NSCLC cell lines and xenograft models. We have identified proteins in the RAS-PI3K network that moderate the therapeutic response to the MEK-rapamycin combination. In addition, other combinations of MEK inhibitors with drugs that target the estrogen receptor and erbB receptor tyrosine kinases, respectively, will be discussed. Citation Information: Clin Cancer Res 2010;16(14 Suppl):IA2-2.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2010
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  • 9
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2016
    In:  Cancer Research Vol. 76, No. 14_Supplement ( 2016-07-15), p. LB-066-LB-066
    In: Cancer Research, American Association for Cancer Research (AACR), Vol. 76, No. 14_Supplement ( 2016-07-15), p. LB-066-LB-066
    Abstract: There is widespread interest in the relationship between aging and cancer, and the involvement of senescence in both processes. The accumulation of senescent cells imparts elevated risk of age-associated disease, including cancer; however, a continuing challenge in the field is the lack of senescence-specific biomarkers. Chemotherapy and radiotherapy are potent inducers of senescence, and the pro-inflammatory secretion of persistent senescent cells has been shown to propel tumor evolution and metastatic dissemination. Thus, there is a need to define how much senescence can be tolerated in tissue prior to physiologic dysfunction; however defining senescence ‘burden’ in aged tissue or cancer cannot be accurately determined with existing markers due to their redundancy. To address this shortcoming, we undertook a proteomic-based analysis to identify novel senescent biomarkers in K-Ras mutant non-small cell lung cancer (NSCLC). Importantly, quiescent cells were also included in the experimental design to enable the identification of proteins associated with general dormancy and not specific to senescence. Cell surface proteins from senescent, quiescent and asynchronous cancer cells were labeled with biotin, enriched and analyzed using tandem mass spectrometry. An average of 850 proteins were detected in each replicate, and 287 were unique to senescence. Gene ontology analysis of proteins detected in senescence indicated functions enriched for metabolism, DNA damage checkpoint integrity, membrane organization, wound healing and cytoskeletal remodeling; all consistent with a senescent phenotype. Data were filtered by strict criteria to derive a final list of 31 proteins unique to senescence. Initial validation of a subset of these for which specific commercial antibodies were available, was done by immunoblotting whole cell lysates and plasma membrane-enriched fractions. Some candidates had enriched expression in senescence; while others were increased in both senescence and quiescence and thus are more useful as dormancy markers. Additional validation by immunofluorescence was performed to deduce expression and localization of four senescent candidates. Novel patterns of localization were found whereby some candidates showed enrichment in structures resembling large vesicles and invadopodia-like extensions that connected with neighboring senescent cells. Lastly, immunohistochemical (IHC) analyses of formalin-fixed tissue obtained from chemotherapy-treated NSCLC patients revealed intense staining in enlarged cells with polymorphic nuclei, a characteristic of senescent cells. Thus, we have identified a unique cohort of senescence-specific biomarkers, some of which are amenable to IHC analyses. Ongoing studies will determine their utility as prognostic and predictive biomarkers of senescence tumor burden in NSCLC, with potential extrapolation to other malignancies and pathologies. Citation Format: Meagan Vogt, Chia-Ping H. Yang, Edward Nieves, Kenny Ye, Perry Cohen, Steven Keller, Hayley M. McDaid. Proteomic-based senescent biomarker identification and characterization in non-small cell lung cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr LB-066.
    Type of Medium: Online Resource
    ISSN: 0008-5472 , 1538-7445
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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