1
|
Ding K, Chen F, Priedigkeit N, Brown DD, Weiss K, Watters R, Levine KM, Heim T, Li W, Hooda J, Lucas PC, Atkinson JM, Oesterreich S, Lee AV. Single cell heterogeneity and evolution of breast cancer bone metastasis and organoids reveals therapeutic targets for precision medicine. Ann Oncol 2022; 33:1085-1088. [PMID: 35764274 PMCID: PMC10007959 DOI: 10.1016/j.annonc.2022.06.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 05/04/2022] [Accepted: 06/17/2022] [Indexed: 11/26/2022] Open
Affiliation(s)
- K Ding
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, USA; Integrative Systems Biology Program, University of Pittsburgh, Pittsburgh, USA
| | - F Chen
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Tsinghua University, Beijing, China
| | - N Priedigkeit
- Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, USA
| | - D D Brown
- Institute for Precision Medicine, University of Pittsburgh and UPMC, Pittsburgh, USA
| | - K Weiss
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, USA; Musculoskeletal Oncology Laboratory, University of Pittsburgh, Pittsburgh, USA
| | - R Watters
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, USA; Musculoskeletal Oncology Laboratory, University of Pittsburgh, Pittsburgh, USA
| | - K M Levine
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA
| | - T Heim
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, USA; Musculoskeletal Oncology Laboratory, University of Pittsburgh, Pittsburgh, USA
| | - W Li
- Department of Orthopedic Surgery, University of Pittsburgh, Pittsburgh, USA
| | - J Hooda
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, USA
| | - P C Lucas
- Department of Pathology, University of Pittsburgh, Pittsburgh, USA
| | - J M Atkinson
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, USA; Institute for Precision Medicine, University of Pittsburgh and UPMC, Pittsburgh, USA
| | - S Oesterreich
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, USA.
| | - A V Lee
- Women's Cancer Research Center, UPMC Hillman Cancer Center, Magee-Womens Research Institute, Pittsburgh, USA; Department of Pharmacology and Chemical Biology, University of Pittsburgh, Pittsburgh, USA; Institute for Precision Medicine, University of Pittsburgh and UPMC, Pittsburgh, USA.
| |
Collapse
|
2
|
Levine KM, Ding K, Priedigkeit N, Sikora MJ, Tasdemir N, Zhu L, Tseng GC, Jankowitz RC, Dabbs DJ, McAuliffe PF, Lee AV, Oesterreich S. Abstract P5-04-21: FGFR4 is a novel druggable target for recurrent ER-positive breast cancers. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p5-04-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Breast cancer recurrence is a major clinical problem for estrogen receptor positive (ER+) disease, even decades after initial surgery. These long-term recurrences are a challenge for invasive ductal carcinoma (IDC), and are particularly frequent for the histological subtype of invasive lobular carcinoma (ILC). To study the long-term endocrine resistance seen in ILC patients, our lab recently generated six long-term estrogen deprivation (LTED) models of ILC cells and performed RNA-Sequencing to identify differentially expressed genes that ostensibly allow these cells to grow in the absence of estrogen. We overlapped these results with a previously published microarray dataset of tamoxifen-resistant cells, and found that FGFR4 is the most consistently overexpressed gene in the setting of acquired resistance to endocrine therapy in ILC cells. From a recent publication of RNA-Seq from other LTED models, FGFR4 RNA overexpression is also seen in all five IDC cell lines.
Hypothesis
FGFR4 is an important mediator of acquired endocrine resistance in breast cancer.
Methods
To study the role of FGFR4 in vitro, we used multiple shRNAs and specific small molecule inhibition for growth assays. To study the role of FGFR4 in de novo resistance to endocrine therapy, we collected 129 well curated ER+ ILC tumor specimens and performed gene expression analysis on the pre-treatment samples using a custom NanoString panel. To study the role of FGFR4 in acquired resistance, we collected over 50 pairs of primary-metastatic ER+ tumors and performed exon capture based RNA-Sequencing.
Results
FGFR4 inhibition decreases parental and LTED cell growth in classic 2D conditions and in colony formation assays. The LTED cells, with higher FGFR4 expression, are more sensitive to its inhibition. For the parental cells, combination FGFR4 and ER-targeting drugs results in synergistic decreases in growth. In our database of primary ILC clinical samples, increased expression of FGFR4 is predictive of shorter time to distant recurrence. Among primary-recurrent tumor pairs, FGFR4 is an outlier expression gain in 20/50 (40%), spanning all recurrence sites studied (i.e. local recurrences, and metastases to the brain, bone, ovaries, and GI tract). Finally, in analyzing large cohorts of metastatic tumors, there is a significant enrichment of hotspot FGFR4 mutations in tumors originating in the breast, with >2% of metastatic ILC tumors containing such a mutation.
Conclusion/Future studies
FGFR4 may play an important role in de novo resistance to endocrine therapy in ILC and acquired resistance in both ILC and IDC. Ongoing studies include overexpression of wild-type and FGFR4 hotspot mutations in ILC and IDC cell lines to determine growth and metastatic phenotypes.
Citation Format: Levine KM, Ding K, Priedigkeit N, Sikora MJ, Tasdemir N, Zhu L, Tseng GC, Jankowitz RC, Dabbs DJ, McAuliffe PF, Lee AV, Oesterreich S. FGFR4 is a novel druggable target for recurrent ER-positive breast cancers [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P5-04-21.
Collapse
Affiliation(s)
- KM Levine
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - K Ding
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - N Priedigkeit
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - MJ Sikora
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - N Tasdemir
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - L Zhu
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - GC Tseng
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - RC Jankowitz
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - DJ Dabbs
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - PF McAuliffe
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - AV Lee
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| | - S Oesterreich
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, Aurora, CO
| |
Collapse
|
3
|
Li Z, Bahreini A, Levine KM, Wang P, Tasdemir N, Montanez MA, Sundd P, Wallace CT, Watkins SC, Chu D, Park BH, Hou W, Mooring MS, Zhu L, Tseng GC, Carroll JS, Atkinson JM, Lee AV, Oesterreich S. Abstract P2-01-09: ESR1 mutations drive breast cancer metastasis by context-dependent alterations in adhesive and migratory properties. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p2-01-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Estrogen receptor alpha (ERα/ESR1) is mutated in 30-40% of endocrine resistant ER+ breast cancer. These mutations, primarily located in the ligand binding domain, are associated with worse outcome in patients, and preclinical studies have shown that they cause ligand independent growth. An open question is whether these mutations contribute to actual metastatic process, or merely endocrine resistance.
Methods: Using Y537S and D538G genome-edited MCF7 and T47D cells, 3D growth was assessed in ultralow attachment plates. Cell-cell adhesion was determined using calcein-labelled adhesion assay and quantitative microfluidic fluorescence microscope (qMFM). Collagen-based adhesion and spheroid invasion assays were used to test adhesive and invasive properties. Wound scratching, spheroid collective migration and Boyden chamber transwell assays were applied to monitor cell migratory phenotypes. Mutated ER cistromes were profiled using ChIP-sequencing. ESR1 mutations in clinical samples were characterized using ddPCR.
Results: Visual inspection of cells grown in suspension culture revealed more compressed multicellular spheroids in ESR1 mutant cells, indicative of increased cell-cell interactions. This observation was confirmed in both static and microfluidic conditions. This effect was more pronounced in MCF7 than T47D cells, correlating with increased expression of desmosome and gap junction genes. Pharmacological blockade of gap junctions decreased cell-cell adhesion. Decreased attachment and increased invasion to collagen were discerned in all mutant cell types. Further functional analysis identified alterations in the TIMP3-MMP axis causing these phenotypes. The cell-cell adhesion phenotypes were restricted to MCF7-Y537S/D538G and T47D-Y537S, whereas T47D-D538G cells showed significantly increased migration. A GSEA screen identified Wnt signaling as uniquely induced in this context, and combination treatment using the Wnt inhibitor LGK974 and Fulvestrant led to synergistic inhibition of migration. ChIP-seq identified mutation-specific cistromes with an overall increased ligand-independent ER binding. However, it did not reveal binding sites in any candidate metastases genes, suggesting secondary epigenetic mechanisms. The motif analysis revealed the enrichment of FOXA1 motifs in mutated ER cistromes except T47D-D538G cells. However, knockdown of FOXA1 induced significantly higher inhibition of T47D-D538G migration than Fulvestrant treatment alone, indicating a FOXA1-dominated mechanism. Collectively, these data show that ESR1 mutant cells gain metastatic properties, in addition to endocrine resistance. To prove this using clinical samples, we measured ESR1 mutations in a well-defined cohort of endocrine resistant local or distant recurrence. Significant enrichment of ESR1 mutations in distant (9/55) vs local (0/27) recurrences confirms critical role of mutant ERα in metastases.
Conclusion: Further analysis of context dependent changes in cell-cell adhesion and migration of ESR1 mutant cells might guide the design and development of drugs targeting ERα-mutant tumors, such as inhibitors of gap junction, FOXA1, MMP, and Wnt signaling pathways.
Disclosure: The authors declare no conflict of interest.
Citation Format: Li Z, Bahreini A, Levine KM, Wang P, Tasdemir N, Montanez MA, Sundd P, Wallace CT, Watkins SC, Chu D, Park BH, Hou W, Mooring MS, Zhu L, Tseng GC, Carroll JS, Atkinson JM, Lee AV, Oesterreich S. ESR1 mutations drive breast cancer metastasis by context-dependent alterations in adhesive and migratory properties [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P2-01-09.
Collapse
Affiliation(s)
- Z Li
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - A Bahreini
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - KM Levine
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - P Wang
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - N Tasdemir
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - MA Montanez
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - P Sundd
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - CT Wallace
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - SC Watkins
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - D Chu
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - BH Park
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - W Hou
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - MS Mooring
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - L Zhu
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - GC Tseng
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - JS Carroll
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - JM Atkinson
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - AV Lee
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| | - S Oesterreich
- University of Pittsburgh, Pittsburgh, PA; UPMC Hillman Cancer Center, Pittsburgh, PA; Tsinghua University, Pittsburgh, PA; Johns Hopkins University, Baltimore, MD; Cancer Research UK Cambridge Institute, Cambridge, United Kingdom
| |
Collapse
|
4
|
Schnitzler A, Lalli M, Levine K, Pease M, Lawson T, Rook M, Murrell J. Targeted optimization of chemically-defined medium for msc growth in bioreactors. Cytotherapy 2018. [DOI: 10.1016/j.jcyt.2018.02.135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
5
|
Oesterreich S, Li Z, Bahreini A, Wang P, Levine KM, Tasdemir N, Chu D, Park BH, Lee AV. Abstract PD8-08: ESR1 mutations confer novel metastatic functions in genome-edited breast cancer cell models. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd8-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Estrogen receptor alpha (ERα), encoded by the ESR1 gene, is expressed in approximately 70% of breast cancers. Recent studies conducted by us and others have shown that somatic mutations in ESR1 gene play a key role in conferring endocrine resistance in ER+ breast cancer. These hotspot mutations mainly occur on the ligand binding domain of ERα, leading to poor outcomes in 25-30% of patients with ER+ metastatic breast cancer in clinic. The mechanisms behind the potential enhanced metastasis of these mutations have become an urgent issue to be addressed, but they are not well understood due to a lack of ESR1 mutant models.
Methods: We generated and characterized genome-edited T47D and MCF7 breast cancer cell lines with the two most common ESR1 mutations (Y537S and D538G), using CRIPSR/Cas9 and rAAV systems respectively. Multiple clones for each mutant were sorted and the mutation frequencies were detected using digital droplet PCR (ddPCR). We subsequently performed an RNA-sequencing to deeply differentiate the gene expression patterns in these mutants. The growth of these pooled mutant-cells was determined in both 2D and 3D plates. The cell-matrix adhesions were measured based on ECM array, and 84-ECM adhesion related genes were further tested by qPCR array. IncuCyte real-time image system and boyden chamber transwell assays were used to monitor the cell migration and chemotaxis. Tail vein injection were performed on nude mice, and immunofluorescent staining of lung tissues with human specific cytokeratin 19 were utilized to evaluate in vivo metastatic capacities of the mutant cell models.
Results: We first identified the robust mutation frequencies at both RNA and DNA levels in our cell models. The RNA-seq exhibits multiple ligand-independent genes overlapping between either cell lines or mutants, which were further conformed by qPCR. We also found that both Y537S and D538G mutants present ligand-independent growth in 2D and 3D ultra-low attachment plates. Using wound-scratching assay, we observed significant higher migration rate in D538G mutant of T47D cell lines on both matrigel and type I collagen, indicating a cell-line and mutant-specific phenotype. We also detected lower attachment of both mutants on type I collagen in both cell lines, and our qPCR array revealed that alterations in the MMP pathways could be one of the major mechanism causing this phenotype. Finally, tail vein injection of T47D mutant-cells in nude mice derived more micrometatsatic spots in the lung tissues.
Conclusion: In sum, our study presents the first in-depth metastatic functional analysis of the biology of ESR1 mutations in genomic knock-in cell models, pointing out the enhanced migration and decreased cell-matrix adhesion as a potential novel gain-of-function of the Y537S and D538G mutant-cells in vitro and in vivo. These findings suggest the potential role of enhanced metastasis of these ESR1 mutations through remodeling of transcriptional profiles, shedding lights towards the development of efficient therapies of ESR1 mutant breast cancer.
Citation Format: Oesterreich S, Li Z, Bahreini A, Wang P, Levine KM, Tasdemir N, Chu D, Park BH, Lee AV. ESR1 mutations confer novel metastatic functions in genome-edited breast cancer cell models [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD8-08.
Collapse
Affiliation(s)
- S Oesterreich
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - Z Li
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - A Bahreini
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - P Wang
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - KM Levine
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - N Tasdemir
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - D Chu
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - BH Park
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| | - AV Lee
- Womens Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; School of Medicine, Tsinghua University, Beijing, China; The Sidney Kimmel Comprehensive Cancer Institute at Johns Hopkins, Baltimore, MD
| |
Collapse
|
6
|
Levine KM, Chen J, Sikora MJ, Tasdemir N, Priedigkeit N, Tseng GC, Puhalla SL, Jankowitz RC, Dabbs DJ, McAuliffe PF, Lee AV, Oesterreich S. Abstract PD4-09: Combination FGFR4 and ER-targeted therapy for invasive lobular carcinoma. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-pd4-09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Invasive Lobular Carcinoma (ILC) is an understudied subtype of breast cancer that requires novel therapies in the advanced setting. Distinctive properties of ILC include growth patterns, metastatic behavior, and receptor status (almost universally estrogen receptor (ER) positive). Our lab recently generated six long-term estrogen deprivation (LTED) models of ILC cells and performed RNA-Sequencing to identify differentially expressed genes compared to their parental cells cultured with estrogen. We overlapped these results with a previously published microarray dataset and found that FGFR4 is the most consistently overexpressed gene in the setting of acquired resistance to endocrine therapy in ILC cells.
Hypothesis
FGFR4 is an important mediator of resistance to endocrine therapy in ILC.
Methods
To study the role of FGFR4 in vitro, we used multiple shRNAs and specific small molecule inhibition for growth assays of ILC cells. To study the role of FGFR4 in de novo resistance to endocrine therapy, we collected 129 well curated ER+ ILC tumor specimens and performed gene expression analysis on the pre-treatment samples using a custom NanoString panel. To study the role of FGFR4 in acquired resistance, we collected over 50 pairs of primary-metastatic ER+ tumors and performed exon capture based RNA-Sequencing.
Results
FGFR4 inhibition decreases parental and LTED ILC cell growth in classic 2D conditions, in the setting of ultra-low attachment, and in colony formation assays. The LTED cells, with higher FGFR4 expression, are more sensitive to its inhibition. For the parental cells, combination FGFR4 and ER-targeting drugs results in synergistic decreases in growth. In our database of primary ILC clinical samples, increased expression of FGFR4 is predictive of shorter time to distant recurrence. For our collection of 50 paired, primary-metastatic ER+ tissues, FGFR4 expression increases on average >2.5 fold in the metastatic setting, with large gains even in ductal carcinoma cases. Finally, in analyzing recently published cohorts of metastatic tumors, there is a significant enrichment of hotspot FGFR4 mutations in tumors originating in the breast, with >2% of metastatic ILC tumors containing such a mutation.
Conclusion
FGFR4 may play an important role in both acquired and de novo resistance to endocrine therapy in ILC.
Citation Format: Levine KM, Chen J, Sikora MJ, Tasdemir N, Priedigkeit N, Tseng GC, Puhalla SL, Jankowitz RC, Dabbs DJ, McAuliffe PF, Lee AV, Oesterreich S. Combination FGFR4 and ER-targeted therapy for invasive lobular carcinoma [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr PD4-09.
Collapse
Affiliation(s)
- KM Levine
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - J Chen
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - MJ Sikora
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - N Tasdemir
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - N Priedigkeit
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - GC Tseng
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - SL Puhalla
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - RC Jankowitz
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - DJ Dabbs
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - PF McAuliffe
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - AV Lee
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| | - S Oesterreich
- University of Pittsburgh, Pittsburgh, PA; University of Colorado Denver, Denver, CO
| |
Collapse
|
7
|
Jankowitz RC, Sreekumar S, Levine KM, Meier C, Sikora MJ, Basudan A, Boone D, Dabbs DJ, Jacobsen B, Lee AV, Oesterreich S. Abstract P4-05-02: Differential regulation of ER protein-turnover in invasive lobular carcinoma cells. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-05-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Invasive lobular breast carcinoma (ILC) accounts for 10-15% of breast cancers diagnosed annually. ILCs are more likely to be positive (90-95%) for ER compared to IDC (60-70%), and there is some evidence that endocrine treatment response might be different in patients with IDC vs ILC. We asked the question whether there were differences in ER protein steady state levels, and/or turn-over rates.
Methods: We utilized TCGA dataset to compare ESR1 mRNA and ER protein levels between ER+ ILC (n=137) and IDC (n=554). ER H-scores and ESR1 mRNA levels were analyzed from patients with ER+ ILC (n=143) and IDC (n=877) seen at UPMC Magee Women's Hospital. Correlation analysis with Pearson's (r) and Spearman's rank order coefficient (ρ) was used to study the relationship between mRNA and protein levels. Basal and ligand induced ESR1 mRNA and ER protein expression and turn-over were determined in a panel of estrogen responsive ER+ IDC (MCF-7, T47D and ZR75-1) and ILC (BCK-4, MDA-MB-134 VI (MM134), SUM44PE) cell lines to identify potential mechanisms that can contribute to differential expression of ERα protein.
Results: TCGA database analysis revealed significantly lower ESR1 mRNA and ER protein levels in ER+ ILC compared to IDC tumors. Analysis of data from our Magee hospital showed similar ER IHC H-scores for ER+ ILCs and IDCs despite having significantly lower ESR1 mRNA in ILC. In both the study sets, the correlation between ER mRNA and protein levels were found to be significantly weaker in ER+ ILC than IDC suggesting subtype specific increased synthesis and/or stability of the receptor protein. ILC cell lines MM134 and SUM44 have increased levels of ER protein compared to IDC cell lines. Estradiol decreased the levels and half-life of ER protein in all IDC cell lines tested. In MM134 and SUM44PE ILC cell lines, estradiol decreased the rate of degradation of ER and increased its half-life. In MM134 cells, treatment with estradiol induced a dose- and time-dependent increase in ER, which is associated with a sustained level of elevated phosphorylation at Ser 118.
Conclusions and ongoing/future studies: The estradiol-induced ER protein stability in a subset of ILC cell lines suggest a possible mechanism leading to weaker ER mRNA-protein correlation in ILC tumors. We currently do not know if and how this observation might be linked to antiestrogen response in ILC. We have recently initiated a TBCRC-supported trial in which we will compare the effect of different endocrine therapies in patients with ILC. Access to pre and post therapy samples will provide the opportunity to study ER levels and its downstream signaling as a function of antiestrogen treatment.
Citation Format: Jankowitz RC, Sreekumar S, Levine KM, Meier C, Sikora MJ, Basudan A, Boone D, Dabbs DJ, Jacobsen B, Lee AV, Oesterreich S. Differential regulation of ER protein-turnover in invasive lobular carcinoma cells [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-05-02.
Collapse
Affiliation(s)
- RC Jankowitz
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Sreekumar
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - KM Levine
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - C Meier
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - MJ Sikora
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - A Basudan
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - D Boone
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - DJ Dabbs
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - B Jacobsen
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - AV Lee
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Oesterreich
- Women's Cancer Research Center, University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; Techniche University, Dresden, Germany; Anschutz Medical Campus, University of Colorado, Denver, CO; University of Pittsburgh School of Medicine, Pittsburgh, PA
| |
Collapse
|
8
|
Levine KM, Du T, Zhu L, Tasdemir N, Lee AV, Van Houten B, Tseng GC, Oesterreich S. Abstract P1-03-03: Invasive lobular carcinoma and invasive ductal carcinoma differ in immune response, translation efficiency and metabolic rate. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-03-03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background
Invasive lobular carcinoma (ILC) is the second most common histological subtype of breast cancer after invasive ductal carcinoma (IDC). ILC differs from IDC in pathologic, molecular, and clinical features. ILC tumors are most often characterized as luminal A by PAM50 analysis, suggestive of an indolent disease. Yet, when matched for receptor status and tumor grade, patients with ILC tend to have worse long-term outcomes than patients with IDC. The main distinguishing molecular feature of ILC is the loss of functional E-cadherin, and yet, beyond that loss, the mechanisms underlying the differences between ILC and IDC are largely unknown. We examined the RNA expression profiles of ILC and IDC tumors to assess if there may be underlying vulnerabilities of ILC tumors to novel therapeutic strategies.
Methods
Differential expression analysis was performed on 159 luminal A (LumA) ILC tumors versus 311 LumA IDC tumors from The Cancer Genome Atlas (TCGA). The METABRIC cohort (65 LumA ILC and 533 LumA IDC) was used as a validation dataset. Pathway enrichment analysis was performed to identify potential differences in biological processes, and these potential differences were then tested in a series of in vitro experiments, using 3 ER+ ILC (MDA-MB-134VI, SUM44PE, and MDA-MB-330) and 3 ER+ IDC (MCF7, T47D, and ZR75.1) cell lines.
Results
Pathway analysis led to the identification of three main signaling differences between LumA ILC and LumA IDC: immune regulation, translation, and metabolism. A series of immune pathways, including Immunological Synapse, Biocarta IL17 pathway, and Response to Wounding were up-regulated in ILC tumors. We examined specific cell type markers, and found that ILC tumors have a higher activity of nearly all immune cell types, including CD4+ T cells, CD8+ T cells, B cells, NK cells, dendritic cells, M1 macrophages, and M2 macrophages. These results were surprising, since ILC tumors have a lower incidence of stromal inflammation, as defined by H&E staining, suggesting a unique immune regulatory mechanism in ILC.
Next, we examined the translational regulation in ILC vs IDC tumors by comparing RNA expression and protein quantities as determined by RPPA analysis. ILC tumors have a lower protein:RNA ratio, suggesting a lower translation efficiency. This was reflected in the RPPA data by lower protein expression of eIF4G, ribosome protein S6 (S6) and p70-S6K in ILC tumors. Phosphorylation of 4E-BP1 (Ser65), eEF2, S6 (Ser235/236, Ser240/244), and mTOR (Ser2448) were also significantly lower in LumA ILCs. This lower translation efficiency was then validated in cell lines by O-propargyl-puromycin treatment.
Finally, the pathway analysis suggested lower rates of metabolism in lobular tumors. Comparative studies of OXPHOS and glycolysis with a Seahorse analyzer confirmed this finding.
Conclusions
ILC tumors have a higher immune activity than IDC tumors, even with lower rates of stromal inflammation, suggesting a potential for differential response to immunotherapy. The lower rates of translation and metabolism, which are general identifiers of tumor dormancy, could enable ILC to escape from cytotoxic therapies, and may play an important role in the late recurrence of ILC.
Citation Format: Levine KM, Du T, Zhu L, Tasdemir N, Lee AV, Van Houten B, Tseng GC, Oesterreich S. Invasive lobular carcinoma and invasive ductal carcinoma differ in immune response, translation efficiency and metabolic rate [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P1-03-03.
Collapse
Affiliation(s)
- KM Levine
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - T Du
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - L Zhu
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - N Tasdemir
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - AV Lee
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - B Van Houten
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - GC Tseng
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| | - S Oesterreich
- University of Pittsburgh, Pittsburgh, PA; Tsinghua University, Beijing, China
| |
Collapse
|
9
|
Healy E, Mendel E, Walston S, Levine K, Mashaly H, Zhang Z, Bourekas E, Raval R, Palmer J, Blakaj D. Local Control Assessment of Spine Metastases after Post-operative Stereotactic Radiosurgery Following Limited Versus Extensive Spine Surgery: A Retrospective Review. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
10
|
Sreekumar S, Levine K, Sikora MJ, Boone D, Dabbs DJ, Lee AV, Jankowitz RC, Oesterreich S. Abstract P3-04-02: Differential turnover of estrogen receptor alpha in invasive lobular carcinoma. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p3-04-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Invasive lobular carcinoma (ILC) accounts for 10-15% of invasive breast cancers diagnosed annually. There is increasing evidence that endocrine treatment response might differ between Invasive Ductal Carcinoma (IDC) and ILC, and that patients with ILC have worse long-term survival when other prognostic factors are taken into account. One such factor is ER status, which is more likely to be positive in ILC (90-95%) compared to IDC (60-70%). There are few studies that have directly compared mRNA and protein levels between ER+ ILC and ER+ IDC.
Hypothesis: Differences in ER protein steady state levels, and/or turn-over rates contribute to differences in endocrine treatment response between patients with ILC vs IDC.
Methods: We utilized publicly available TCGA data to compare ER mRNA and protein levels between ER+ ILC (n=184) and IDC (n=534). Correlation analysis with Spearman's rank order coefficient (ρ) was used to study the relationship between mRNA and protein levels. METABRIC data were analyzed to compare ER mRNA levels between ER+ ILC (n=130) and IDC (n=1152). ER H-scores and mRNA levels were also analyzed from patients with ER+ ILC (n=180) and IDC (n=1183) seen at our local UPMC Magee Womens Hospital. Finally, ER mRNA and total protein levels, and RNA and protein turn-over rates were determined in 2 IDC and 2 ILC breast cancer cell lines, using qRT-PCR and immunoblots analysis.
Results: Analysis of ESR1 gene expression in the TCGA database revealed significantly lower levels of ER mRNA (Mann-Whitney, p<.0005) in ER+ ILC compared to IDC, whereas ER protein levels were similar in the two histological subtypes. The correlation between ER mRNA and protein levels is weaker in ER+ ILC (ρ=0.60) compared to ER+ IDC (ρ=0.69) tumors, though not statistically significant. The weaker correlation between mRNA and protein expression in ILC is more clear when analyzing all 130 RNA and protein pairs with available RRPA data, (ILC median ρ=0.28; IDC median ρ=0.34, p<.0005). In the METABRIC dataset, ESR1 mRNA levels were also found to be lower in ER+ ILC tumor samples compared to IDCs (Mann-Whitney, p<0.005). In concordance with these observations, the study of patients seen at our local hospital showed similar ER IHC H-scores for ER+ ILCs (H-score = 244) and IDCs (H Score = 248), despite there being significantly lower ESR1 mRNA in ILC (p<0.005). Finally, our in vitro data showed that rate of estrogen-mediated turn-over of ER protein was significantly lower in the ILC cell lines compared to the IDC cell lines, which might explain the lack of lower ER protein levels despite lower ER mRNA levels. We are currently confirming these findings in additional cell lines, and deciphering the mechanisms through the study of ER ubiquitin-modification and proteasome machinery comparing ILC and IDC.
Conclusion: We have provided functional and in silico data that collectively suggest altered ER protein turn-over in ILC compared to IDC. We are currently testing if and how this affects sensitivity of ILC cells to SERDs, and underlying mechanisms.
Citation Format: Sreekumar S, Levine K, Sikora MJ, Boone D, Dabbs DJ, Lee AV, Jankowitz RC, Oesterreich S. Differential turnover of estrogen receptor alpha in invasive lobular carcinoma [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P3-04-02.
Collapse
Affiliation(s)
- S Sreekumar
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - K Levine
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - MJ Sikora
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - D Boone
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - DJ Dabbs
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - AV Lee
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - RC Jankowitz
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| | - S Oesterreich
- Womens Cancer Research Center, University of Pittsburgh Cancer Institute, Pittsburgh, PA; University of Pittsburgh, Pittsburgh, PA; University of Pittsburgh School of Medicine, Pittsburgh, PA
| |
Collapse
|
11
|
Gotimer K, Griffiths C, Jimenez E, Musa F, Villella J, Levine K, Chan K, Chalas E. Impact of Universal Screening Recommendation on Genetic Testing in Patients with Epithelial Ovarian, Fallopian Tube and Peritoneal Cancers. Gynecol Oncol 2016. [DOI: 10.1016/j.ygyno.2016.08.314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
12
|
Oesterreich S, Katz TA, Logan G, Levine K, Nagle A, Huo Z, Tseng GC, Rui H, Lee AV, Butler LM. Abstract PD2-08: Potential role of prolactin signaling in development and growth of the lobular subtype of breast cancer. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-pd2-08] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Invasive lobular carcinoma (ILC) is the eighth most frequently diagnosed cancer in any organ, and accounts for 8-11% of breast cancer. This histological subtype is characterized by loss of E-cadherin, and favorable prognostic factors, such as low Ki67 and high rates of ER/PR-positive tumors. Only recently is the lobular subtype gaining recognition as a distinct disease, displaying a unique growth pattern, unique molecular changes in addition to loss of E-cadherin, and evidence for late recurrences and reduced response to targeted endocrine therapy. It is widely accepted that a late age at first full term birth (FFTB) increases a women's risk for breast cancer. Interestingly, several published epidemiological studies have shown that the increased risk after a late age at FFTB is preferential for the lobular subtype of breast cancer compared to the ductal subtype. We therefore hypothesized that pregnancy hormones like prolactin play an integral role in the development and progression of ILC. Interrogation of the Cancer Genome Atlas (TCGA) data revealed a high expression of milk protein genes as well as prolactin signaling molecules, specifically Stat5a and Stat5b in lobular carcinomas compared to ductal carcinomas. We developed a lactation score including 7 milk protein genes and found that in the TCGA data set ILC tumors have a significantly higher lactation score than IDC tumors. Additionally, we found that ILC cell lines express increased prolactin receptor mRNA and protein levels compared to IDC cell lines. Prolactin treatment in ILC and IDC cells reveals divergent signaling pathways - prolactin stimulates ERK activation in IDC but not ILC cells. We are currently further delineating the prolactin signaling pathways, and resulting phenotypes, comparing ILC and IDC cells. We expect these experiments to move the field forward by establishing a relationship between prolactin and lobular carcinoma.
Citation Format: Oesterreich S, Katz TA, Logan G, Levine K, Nagle A, Huo Z, Tseng GC, Rui H, Lee AV, Butler LM. Potential role of prolactin signaling in development and growth of the lobular subtype of breast cancer. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD2-08.
Collapse
Affiliation(s)
- S Oesterreich
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - TA Katz
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - G Logan
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - K Levine
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - A Nagle
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - Z Huo
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - GC Tseng
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - H Rui
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - AV Lee
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| | - LM Butler
- Univeristy of Pittsburgh Cancer Institute, Pittburgh, PA; University of Pittsburgh, Pittsburgh, PA; Univesity of Pittsburgh, Pittsburgh, PA; Kimmel Cancer Center, Philadelphia, PA
| |
Collapse
|
13
|
Check J, Wilson C, Levine K, Cohen R, Corley D. Improved implantation and live delivered pregnancy rates following transfer of embryos derived from donor oocytes by single injection of leuprolide in mid-luteal phase. CLIN EXP OBSTET GYN 2015. [DOI: 10.12891/ceog1966.2015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
|
14
|
Check JH, Wilson C, Levine K, Cohen R, Corley D. Improved implantation and live delivered pregnancy rates following transfer of embryos derived from donor oocytes by single injection of leuprolide in mid-luteal phase. CLIN EXP OBSTET GYN 2015; 42:429-430. [PMID: 26411205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
PURPOSE To determine if the use of a single injection of one-mg leuprolide acetate in mid-luteal phase can increase pregnancy rates in donor oocyte recipients. MATERIALS AND METHODS Prospective study where couples were made aware of a study using the gonadotropin releasing hormone agonist (GnRHa) triptorelin that in the mid-luteal phase found improved pregnancy rates following embryo transfer in donor oocyte recipients. They were given the option of a single one-mg injection of the GnRHa leuprolide acetate. Pregnancy outcome was compared according to whether leuprolide was given or not. Also compared were the average first serum beta-hCG level in those who conceived according to taking leuprolide or not. RESULTS Chi-square analysis showed a significantly higher clinical and live delivered pregnancy rate (63.9% and 52.8%) in those supplementing with leuprolide than those who did not (39.5% and 32.9%). Similarly implantation rates were significantly higher (44.2% vs. 25.2%). The average first serum beta-hCG level for those conceiving and taking leuprolide was 294 mIU/mL vs. 325 mIU/mL for those who did not. CONCLUSIONS Similar to triptorelin the mid-luteal injection of leuprolide acetate improves pregnancy outcome in donor oocyte recipients.
Collapse
|
15
|
Lewis J, Williams R, Levine K, Kalilani L, Clark R. FACTORS INFLUENCING THE IMPACT OF MENOPAUSE ON QUALITY OF LIFE IN A US POPULATION-BASED STUDY. Maturitas 2009. [DOI: 10.1016/s0378-5122(09)70413-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
16
|
Affiliation(s)
- E K Cloherty
- Department of Biochemistry and Molecular Pharmacology, UMass Medical School, 55 Lake Avenue North, Worcester, Massachusetts 01655, USA
| | | | | | | |
Collapse
|
17
|
Abstract
Williams syndrome is a genetic disorder resulting in a variety of medical and developmental features, one of which is a frequent outward presentation of substantial happiness. In this paper we describe the unique expression of happiness in people with Williams syndrome, with several anecdotes and a frame by frame conversational analysis. We then discuss this happiness in the context of other dimensions of the impact of Williams syndrome, especially anxiety. We conclude with a discussion of the role of genetics in emotions.
Collapse
Affiliation(s)
- K Levine
- Building Blocks, Peabody, Massachusetts 01960, USA
| | | |
Collapse
|
18
|
|
19
|
Cross FR, Levine K. Genetic analysis of the relationship between activation loop phosphorylation and cyclin binding in the activation of the Saccharomyces cerevisiae Cdc28p cyclin-dependent kinase. Genetics 2000; 154:1549-59. [PMID: 10747052 PMCID: PMC1461042 DOI: 10.1093/genetics/154.4.1549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We showed recently that a screen for mutant CDC28 with improved binding to a defective Cln2p G1 cyclin yielded a spectrum of mutations similar to those yielded by a screen for intragenic suppressors of the requirement for activation loop phosphorylation (T169E suppressors). Recombination among these mutations yielded CDC28 mutants that bypassed the G1 cyclin requirement. Here we analyze further the interrelationship between T169E suppression, interaction with defective cyclin, and G1 cyclin bypass. DNA shuffling of mutations from the various screens and recombination onto a T169E-encoding 3' end yielded CDC28 mutants with strong T169E suppression. Some of the strongest T169E suppressors could suppress the defective Cln2p G1 cyclin even while retaining T169E. The strong T169E suppressors did not exhibit bypass of the G1 cyclin requirement but did so when T169E was reverted to T. These results suggested that for these mutants, activation loop phosphorylation and cyclin binding might be alternative means of activation rather than independent requirements for activation (as with wild type). These results suggest mechanistic overlap between the conformational shift induced by cyclin binding and that induced by activation loop phosphorylation. This conclusion was supported by analysis of suppressors of a mutation in the Cdk phosphothreonine-binding pocket created by cyclin binding.
Collapse
Affiliation(s)
- F R Cross
- The Rockefeller University, New York, NY 10021, USA.
| | | |
Collapse
|
20
|
Levine KM. The shift to palliative care. New model can improve quality of life in long-term care. Contemp Longterm Care 2000; 23:27. [PMID: 11066601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
|
21
|
Abstract
Glycine is a nonessential amino acid that serves as both an inhibitory and an excitatory neurotransmitter. Hyperglycinaemia occurs in non-ketotic hyperglycinaemia, a primary defect in the glycine cleavage pathway, and as a secondary feature of several inborn errors of organic acid metabolism. However, specifically low levels of glycine have never been reported. Here we report a child with complementation group C xeroderma pigmentosum (XP) characterized by a splice donor mutation in the XPC gene, multiple skin cancers and specific and persistent hypoglycinaemia. He has cognitive delay, lack of speech, autistic features, hyperactivity and hypotonia, all unexplained by the diagnosis of XP group C, a non-neurological form of the disease. Treatment with oral glycine has improved his hyperactivity. Specific hypoglycinaemia could indicate a metabolic disorder producing neurological dysfunction. Whether it is related to or coincidental with the XP is unclear.
Collapse
Affiliation(s)
- E J Quackenbush
- Division of Genetics, Children's Hospital, Boston, Massachusetts 02115, USA
| | | | | | | | | | | | | |
Collapse
|
22
|
Abstract
To identify cyclin-dependent kinase mutants with relaxed cyclin requirements, CDC28 alleles were selected that could rescue a yeast strain expressing as its only CLN G1 cyclin a mutant Cln2p (K129A,E183A) that is defective for Cdc28p binding. Rescue of this strain by mutant CDC28 was dependent upon the mutant cln2-KAEA, but additional mutagenesis and DNA shuffling yielded multiply mutant CDC28-BYC alleles (bypass of CLNs) that could support highly efficient cell cycle initiation in the complete absence of CLN genes. By gel filtration chromatography, one of the mutant Cdc28 proteins exhibited kinase activity associated with cyclin-free monomer. Thus, the mutants' CLN bypass activity might result from constitutive, cyclin-independent activity, suggesting that Cdk targeting by cyclins is not required for cell cycle initiation.
Collapse
Affiliation(s)
- K Levine
- Rockefeller University, New York, New York, USA
| | | | | | | | | |
Collapse
|
23
|
Abstract
OBJECTIVE To examine whether older HMO patients with depression are treated differently than younger patients in terms of diagnosis, treatment by specialty provider, and pharmacotherapy. DESIGN Chart-review, Cross sectional study. SETTING AND PARTICIPANTS Patients were selected from six HMOs in the United States who had one or more of five medical diagnoses: arthritis, asthma, otitis media, epigastric pain/ulcer, and hypertension, (n = 9143). From this group, chart diagnoses and pharmacy records were used to identify patients who also had a diagnosis of depression (n = 416) or who had a diagnosis of depression and/or treatment with antidepressant medication (n = 1286). MEASUREMENT Medical records and computerized service and pharmacy records were reviewed to obtain diagnoses, office visits by provider type, and psychiatric medication prescription counts. RESULTS Significant differences were found in treatment of depression for older versus younger patients. Although depression was identified at a similar rate for both groups, older patients received fewer mental health specialty visits and fewer prescriptions for SSRI antidepressants. Older patients with a diagnosis of depression were more likely to be treated with benzodiazepines (49.2% of older vs. 33.2% of younger) though they were less likely to receive long half-life benzodiazepines. CONCLUSIONS Psychotropic medication management is an important target for improving quality of care for older patients with depression in HMOs. Decreasing inefficient minor tranquilizer use and increasing use of newer antidepressant medications may lead to improved outcomes for older depressed adults.
Collapse
Affiliation(s)
- S J Bartels
- Dartmouth Medical School, New Hampshire, USA
| | | | | | | |
Collapse
|
24
|
Cross FR, Levine K. Molecular evolution allows bypass of the requirement for activation loop phosphorylation of the Cdc28 cyclin-dependent kinase. Mol Cell Biol 1998; 18:2923-31. [PMID: 9566911 PMCID: PMC110671 DOI: 10.1128/mcb.18.5.2923] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/1997] [Accepted: 02/23/1998] [Indexed: 02/07/2023] Open
Abstract
Many protein kinases are regulated by phosphorylation in the activation loop, which is required for enzymatic activity. Glutamic acid can substitute for phosphothreonine in some proteins activated by phosphorylation, but this substitution (T169E) at the site of activation loop phosphorylation in the Saccharomyces cerevisiae cyclin-dependent kinase (Cdk) Cdc28p blocks biological function and protein kinase activity. Using cycles of error-prone DNA amplification followed by selection for successively higher levels of function, we identified mutant versions of Cdc28p-T169E with high biological activity. The enzymatic and biological activity of the mutant Cdc28p was essentially normally regulated by cyclin, and the mutants supported normal cell cycle progression and regulation. Therefore, it is not a requirement for control of the yeast cell cycle that Cdc28p be cyclically phosphorylated and dephosphorylated. These CDC28 mutants allow viability in the absence of Cak1p, the essential kinase that phosphorylates Cdc28p-T169, demonstrating that T169 phosphorylation is the only essential function of Cak1p. Some growth defects remain in suppressed cak1 cdc28 strains carrying the mutant CDC28 genes, consistent with additional nonessential roles for CAK1.
Collapse
Affiliation(s)
- F R Cross
- The Rockefeller University, New York, New York 10021, USA.
| | | |
Collapse
|
25
|
Abstract
The Start transition in the budding yeast cell cycle is the point of most physiological regulation of cell cycle commitment. This transition is controlled by the CLN1,2,3 gene family. We review what is known about the regulation, inter-regulation and function of these genes in controlling the Start transition.
Collapse
Affiliation(s)
- K Levine
- Rockefeller University, New York, NY 10021, USA
| | | | | |
Collapse
|
26
|
Levine KM. Unpaid expert witnesses. N Engl J Med 1998; 338:1233; author reply 1233-4. [PMID: 9556403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
|
27
|
Levine K, Oehlen LJ, Cross FR. Isolation and characterization of new alleles of the cyclin-dependent kinase gene CDC28 with cyclin-specific functional and biochemical defects. Mol Cell Biol 1998; 18:290-302. [PMID: 9418876 PMCID: PMC121493 DOI: 10.1128/mcb.18.1.290] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/1997] [Accepted: 10/07/1997] [Indexed: 02/05/2023] Open
Abstract
The G1 cyclin Cln2 negatively regulates the mating-factor pathway. In a genetic screen to identify factors required for this regulation, we identified an allele of CDC28 (cdc28-csr1) that blocked this function of Cln2. Cln2 immunoprecipitated from cdc28-csr1 cells was completely defective in histone H1 kinase activity, due to defects in Cdc28 binding and activation by Cln2. In contrast, Clb2-associated H1 kinase and Cdc28 binding was normal in immunoprecipitates from these cells. cdc28-csr1 was significantly deficient in other aspects of genetic interaction with Cln2. The cdc28-csr1 mutation was determined to be Q188P, in the T loop distal to most of the probable Cdk-cyclin interaction regions. We performed random mutagenesis of CDC28 to identify additional alleles incapable of causing CLN2-dependent mating-factor resistance but capable of complementing cdc28 temperature-sensitive and null alleles. Two such mutants had highly defective Cln2-associated kinase, but, surprisingly, two other mutants had levels of Cln2-associated kinase near to wild-type levels. We performed a complementary screen for CDC28 mutants that could cause efficient Cln2-dependent mating-factor resistance but not complement a cdc28 null allele. Most such mutants were found to alter residues essential for kinase activity; the proteins had little or no associated kinase activity in bulk or in association with Cln2. Several of these mutants also functioned in another assay for CLN2-dependent function not involving the mating-factor pathway, complementing the temperature sensitivity of a cln1 cln3 cdc28-csr1 strain. These results could indicate that Cln2-Cdc28 kinase activity is not directly relevant to some CLN2-mediated functions. Mutants of this sort should be useful in differentiating the function of Cdc28 complexed with different cyclin regulatory subunits.
Collapse
Affiliation(s)
- K Levine
- The Rockefeller University, New York, New York 10021, USA
| | | | | |
Collapse
|
28
|
James R, Nguyen T, Arthur W, Levine K, Williams D. Hydrolase (β-Glucanase, α-Glucanase, and Protease) Activity in Ariolimax columbianus (Banana Slug) and Arion ater (Garden Slug). Comp Biochem Physiol B Biochem Mol Biol 1997. [DOI: 10.1016/s0305-0491(97)00058-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
29
|
Ben-Zion IZ, Levine K, Shiber A. [Capgras' syndrome]. Harefuah 1997; 133:188-90, 247. [PMID: 9461686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
We present 3 cases of Capgras' syndrome-a delusional disorder in which the patient believes that 1 (or more) of his acquaintances has been replaced by an imposter who appears as a double. 2 were schizophrenics and 1 had depression with psychotic features. This syndrome is rare in our practice, but we do not know if this is due to lack of awareness of the condition, or to the possibility that it is a culture-related syndrome. We suggest that although the syndrome has lost some of it's significance, it is still worth making the diagnosis because of the medical and psychological implications this condition carries.
Collapse
Affiliation(s)
- I Z Ben-Zion
- Psychiatry Dept., Soroka Medical Center, Beer Sheba
| | | | | |
Collapse
|
30
|
Abstract
The three budding yeast CLN genes appear to be functionally redundant for cell cycle Start: any single CLN gene is sufficient to promote Start, while the cln1 cln2 cln3 triple mutant is Start defective and inviable. Both quantitative and apparently qualitative differences between CLN genes have been reported, but available data do not in general allow distinction between qualitative functional differences as opposed to simply quantitative differences in expression or function. To determine if there are intrinsic qualitative differences between Cln proteins, we compared CLN2, CLN3, and crippled (but still partially active) CLN2 genes in a range of assays that differentiate genetically between CLN2 and CLN3. The results suggest that different potencies of Cln2, Cln3, and Cln2 mutants in functional assays cannot be accounted for by a simple quantitative model for their action, since Cln3 is at least as active as Cln2 and much more active than the Cln2 mutants in driving Swi4/Swi6 cell cycle box (SCB)-regulated transcription and cell cycle initiation in cln1 cln2 cln3 bck2 strains, but Cln3 has little or no activity in other assays in which Cln2 and the Cln2 mutants function. Differences in Cln protein abundance are unlikely to account for these results. Cln3-associated kinase is therefore likely to have an intrinsic in vivo substrate specificity distinct from that of Cln2-associated kinase, despite their functional redundancy. Consistent with the idea that Cln3 may be the primary transcriptional activator of CLN1, CLN2, and other genes, the activation of CLN2 transcription was found to be sensitive to the gene dosage of CLN3 but not to the gene dosage of CLN2.
Collapse
Affiliation(s)
- K Levine
- The Rockefeller University, New York, New York 10021, USA
| | | | | |
Collapse
|
31
|
Abstract
The recent determination of the crystal structures of both cyclin A and the cyclin a-CDK2 complex provides new insight into the cyclin- dependent activation of cyclin-dependent protein kinases.
Collapse
Affiliation(s)
- K Levine
- Rockefeller University, New York, NY 10021, USA
| | | |
Collapse
|
32
|
Wharton RH, Levine K, Shane H, Emans SJ. Evaluations of children who have disclosed sexual abuse via facilitated communication. Arch Pediatr Adolesc Med 1995; 149:1288-9. [PMID: 7581774 DOI: 10.1001/archpedi.1995.02170240105030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
|
33
|
Levine K, Shane HC, Wharton RH. What if...: a plea to professionals to consider the risk-benefit ratio of facilitated communication. Ment Retard 1994; 32:300-4; discussion 314-7. [PMID: 7968563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- K Levine
- Speech-Language Pathology Services, Children's Hospital, Boston, MA 02115
| | | | | |
Collapse
|
34
|
Levine K, DeBlasio A, Miller WH. Molecular diagnosis and monitoring of acute promyelocytic leukemia treated with retinoic acid. Leukemia 1994; 8 Suppl 1:S116-20. [PMID: 8152276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The characteristic balanced 15;17 translocation, t(15;17), of acute promyelocytic leukemia (APL) fuses the retinoic acid receptor alpha (RAR alpha) gene on chromosome 17 to PML, a recently described gene of unknown function, on chromosome 15. It is this fusion gene and consequent fusion protein that is thought to be responsible for both the block in normal myelocyte differentiation as well as the dramatic in vitro and in vivo response to the differentiating effects of all-trans retinoic acid (RA). The t(15;17) also provides a genetic marker for the presence of leukemic cells. PML/RAR alpha fusion mRNA's can be detected by a reverse transcription polymerase chain reaction (RT-PCR) assay. Using this assay, at least three distinct patterns, differing in the 3' region of the PML breakpoint, can be identified. The detection of abnormal mRNA's by the RT-PCR assay has proven to be an important aid in the diagnosis of APL as well as the best predictor of an initial clinical response to RA. The results of an ongoing, longitudinal evaluation of patients with APL show that the RT-PCR assay may also be a useful indicator of minimal residual disease (MRD). Negative RT-PCR assays following completion of all therapy are associated with prolonged disease free survival, whereas persistence or return of a positive test is highly correlated with subsequent relapse. Further studies will determine whether patients who test positive may benefit from the introduction of additional antileukemic therapy.
Collapse
Affiliation(s)
- K Levine
- Memorial Sloan-Kettering Cancer Center, New York, NY 10021
| | | | | |
Collapse
|
35
|
Cross FR, Levine K. Vignettes: Raisons d'Être. Science 1994; 263:1164-5. [PMID: 17831635 DOI: 10.1126/science.263.5150.1164-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
36
|
Cross FR, Levine K. Growth and Division. Science 1994. [DOI: 10.1126/science.1164-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
|
37
|
|
38
|
Miller WH, Levine K, DeBlasio A, Frankel SR, Dmitrovsky E, Warrell RP. Detection of minimal residual disease in acute promyelocytic leukemia by a reverse transcription polymerase chain reaction assay for the PML/RAR-alpha fusion mRNA. Blood 1993; 82:1689-94. [PMID: 8400225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
The characteristic reciprocal translocation t(15;17) of acute promyelocytic leukemia (APL) disrupts the PML gene on chromosome 15 and the retinoic acid receptor-alpha (RAR-alpha) gene on chromosome 17. PML/RAR-alpha fusion mRNAs are then transcribed and can be detected by a newly described reverse transcription polymerase chain reaction (RT-PCR) assay. Using RT followed by nested PCR amplification for PML/RAR-alpha, we serially evaluated bone marrow aspirates from patients with APL who were treated with all-trans retinoic acid (RA) for induction, followed by all-trans RA as maintenance or cytotoxic drugs as consolidation. At diagnosis, PML/RAR-alpha mRNA was detected in all patients. After initial therapy with all-trans RA, the RT-PCR assay remained positive after induction of complete remission in 31 of 32 evaluable patients. Maintenance treatment by all-trans RA alone was associated with persistent assay positivity and subsequent clinical relapse in 13 of 13 patients. By contrast, the test became negative in 19 of 20 newly diagnosed patients who received consolidation chemotherapy; the 1 patient who remained positive relapsed at 12 months. Three of the 19 assay-negative patients later converted to positive and subsequently relapsed; the remaining 16 patients have remained RT-PCR negative in sustained first remission, with a median follow-up duration that exceeds 24 months (range, 12+ to 34+ months). Despite induction of complete remission in a high proportion of patients, all-trans RA rarely eradicates molecular evidence of disease in patients with APL; however, subsequent treatment with cytotoxic chemotherapy frequently converts the RT-PCR assay for PML/RAR-alpha to negative. Serial negative tests are associated with prolonged disease-free survival, whereas persistence of a positive test after treatment is highly correlated with subsequent relapse. This test identifies patients in remission at high risk for relapse who may benefit from additional antileukemic therapy.
Collapse
MESH Headings
- Antineoplastic Agents/therapeutic use
- Biomarkers, Tumor/analysis
- Bone Marrow/pathology
- Chromosomes, Human, Pair 15
- Chromosomes, Human, Pair 17
- Humans
- Leukemia, Promyelocytic, Acute/diagnosis
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Leukemia, Promyelocytic, Acute/pathology
- Longitudinal Studies
- Polymerase Chain Reaction/methods
- RNA, Messenger/analysis
- Receptors, Retinoic Acid/analysis
- Receptors, Retinoic Acid/biosynthesis
- Receptors, Retinoic Acid/genetics
- Recombinant Fusion Proteins/analysis
- Recombinant Fusion Proteins/biosynthesis
- Recombinant Fusion Proteins/genetics
- Remission Induction
- Retinoic Acid Receptor alpha
- Translocation, Genetic
- Tretinoin/therapeutic use
Collapse
Affiliation(s)
- W H Miller
- Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY
| | | | | | | | | | | |
Collapse
|
39
|
Miller WH, Kakizuka A, Frankel SR, Warrell RP, DeBlasio A, Levine K, Evans RM, Dmitrovsky E. Reverse transcription polymerase chain reaction for the rearranged retinoic acid receptor alpha clarifies diagnosis and detects minimal residual disease in acute promyelocytic leukemia. Proc Natl Acad Sci U S A 1992; 89:2694-8. [PMID: 1372989 PMCID: PMC48728 DOI: 10.1073/pnas.89.7.2694] [Citation(s) in RCA: 163] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The characteristic t(15;17) of acute promyelocytic leukemia (APL) fuses the retinoic acid receptor alpha (RAR-alpha) gene on chromosome 17 to a gene on chromosome 15 called PML, a putative transcription factor. This distinct translocation results in a fusion mRNA detected by Northern analysis. Two cDNAs have been isolated that differ in the extent of 3' PML nucleic acid sequence contained. This study describes a reverse transcription polymerase chain reaction (RT-PCR) assay for the PML/RAR-alpha fusion transcript, which amplifies PML/RAR-alpha mRNA from APL cells with either reported breakpoint. DNA sequencing of the predominant RT-PCR products from 6 patients showed identical RAR-alpha exonic breakpoints and two PML breakpoints. This RT-PCR assay was positive in leukemic cells from 30/30 APL patients with the molecular rearrangement confirmed by cytogenetics or Northern analysis. In leukemic cells of patients with a morphologic diagnosis of APL lacking the t(15;17) by routine cytogenetics, a positive RT-PCR assay predicted clinical response to all-trans-retinoic acid (RA) therapy. Dilutional studies with leukemic cells that express (NB4) or do not express (HL-60) a PML/RAR-alpha fusion mRNA reveal that this RT-PCR assay detects the transcript from as little as 50 pg of total RNA. In APL cells from 5/6 patients treated with RA alone, a complete response by clinical and cytogenetic criteria accompanied a persistently positive RT-PCR assay. This preceded relapse by 1-6 months. RT-PCR for PML/RAR-alpha mRNA provides a more-sensitive test for the t(15;17) than routine cytogenetics or Northern analysis. This molecular rearrangement detected by RT-PCR best defines this RA-responsive malignancy. The RT-PCR assay for the PML/RAR-alpha transcript yields important diagnostic and prognostic information in the management of APL patients.
Collapse
MESH Headings
- Base Sequence
- Blotting, Northern
- Carrier Proteins/genetics
- Chromosome Aberrations/diagnosis
- Chromosome Disorders
- Gene Expression
- Gene Rearrangement
- Humans
- Leukemia, Promyelocytic, Acute/diagnosis
- Leukemia, Promyelocytic, Acute/drug therapy
- Leukemia, Promyelocytic, Acute/genetics
- Molecular Sequence Data
- Oligodeoxyribonucleotides/chemistry
- Polymerase Chain Reaction
- Prognosis
- RNA, Messenger/genetics
- RNA-Directed DNA Polymerase/metabolism
- Receptors, Retinoic Acid
- Translocation, Genetic
- Tretinoin/therapeutic use
Collapse
Affiliation(s)
- W H Miller
- Laboratory of Molecular Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10021
| | | | | | | | | | | | | | | |
Collapse
|
40
|
Lamster IB, Oshrain RL, Celenti R, Levine K, Fine JB. Correlation analysis for clinical and gingival crevicular fluid parameters at anatomically related gingival sites. J Clin Periodontol 1991; 18:272-7. [PMID: 1713224 DOI: 10.1111/j.1600-051x.1991.tb00427.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
This study was designed to evaluate the relationship of certain clinical and biochemical measures of periodontal pathology at anatomically related gingival sites. The maxillary first molar--second bicuspid region was studied in patients with gingivitis and periodontitis. The mesiobuccal site on the first molar was compared to the mesiopalatal and direct buccal sites on the molar and the distobuccal site on the second bicuspid. Probing depth, attachment level, gingival index, gingival crevicular fluid (GCF) volume, and GCF levels of the lysosomal enzyme B-glucuronidase (BG), the cytoplasmic enzyme lactate dehydrogenase, IgG and the protease-inhibitor alpha-2-macroglobulin were studied. For the 3 anatomical pairs that were analyzed, the correlation coefficients for the GCF constituents were generally higher than the correlations for the clinical parameters. The mean correlations for the GCF constituents were higher for the periodontitis patients as compared to the gingivitis patients. For the periodontitis patients, BG activity was correlated at adjacent proximal sites, approached significance at adjacent papillary sites, but was not significantly correlated at adjacent facial-proximal sites. This data suggests that sampling of BG activity from a mesiobuccal site provides information about the anterior papillary unit. In contrast, IgG in GCF collected from the mesiobuccal site on the first molar was significantly correlated with the total IgG in the 3 other sites.(ABSTRACT TRUNCATED AT 250 WORDS)
Collapse
Affiliation(s)
- I B Lamster
- Division of Periodontics, School of Dental and Oral Surgery, Columbia University, New York
| | | | | | | | | |
Collapse
|
41
|
Langford HG, Schlundt D, Levine K. Sodium restriction in hypertension. Compr Ther 1984; 10:6-11. [PMID: 6488753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Hypertensive patients, treated or untreated, benefit from sodium restriction. Need for fewer drugs, less hypokalemia if thiazide-diuretic treated, and lower blood pressures should result from successful reduction of sodium intake. A planned program using behavior modification principles can help patients make the necessary changes in their eating habits. Monitoring blood pressure and urinary sodium excretion will give evidence of adherence to the diet.
Collapse
|
42
|
Rosenthal D, Levine K, Lamis PA, Stanton PE. A simplified approach for correction of bilateral renal and aortoiliac occlusive disease. J Cardiovasc Surg (Torino) 1983; 24:181-5. [PMID: 6841444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Aortorenal bypass procedures have utilized autogenous artery, vein, and synthetic materials in the surgical management of atherosclerotic renal artery occlusive disease. When concomitant bilateral renal artery and aortic occlusive disease is identified, transaortic bilateral renal artery endarterectomy and aortoiliac/femoral bypass grafting is a safe and simplified technique which does not share the attendant problem and technical difficulties of aortorenal bypass operations.
Collapse
|
43
|
Rosenthal D, Levine K, Stanton PE, Lamis PA. Femoropopliteal bypass: the preferred site for distal anastomosis. Surgery 1983; 93:1-4. [PMID: 6849179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
In many patients undergoing femoropopliteal bypass, an occluded superficial femoral artery may reconstitute at the adductor canal and the popliteal artery will be patent. For these patients, uncertainty exists as to whether the preferred site for the distal anastomosis is an above-knee (AK) or below-knee (BK) bypass graft. Operation is, therefore, often based on personal preference rather than fact. To evaluate this problem, we undertook a 6-year review of the cases of 90 patients who had femoropopliteal bypass to a patent popliteal artery. Seventy AK bypass grafts were performed: 20 with autogenous vein, 25 with Dacron, and 25 with polytetrafluoroethylene (PTFE). Based on the life table analysis method, the late patency rate was 70% for vein, 68% for PTFE, and 64% for Dacron. These results were compared against results in 25 patients who had BK femoropopliteal bypass with autogenous vein, in whom the late patency rate was 65%. There was no statistical difference between these groups (P less than 0.25). An AK femoropopliteal bypass with a prosthesis yielded long-term patency rates that were similar to those of AK or BK vein grafts. When the popliteal artery is patent and the distal anastomosis can be done proximal to the knee joint, a prosthetic graft should be used. A prosthetic graft will reduce operative time, shorten recuperation time, and spare the saphenous vein for use in the coronary or infrapopliteal vessels if the need arises.
Collapse
|
44
|
Abstract
Rapid spot-test screening of antischistosomal agents reveals that hycanthone is a potent frameshift mutagen while the closely related compound, miracil D, is nonmutagenic in Salmonella. Both hycanthone and miracil D are frameshift mutagens for T4 bacteriophage during growth in Escherichia coli.
Collapse
|