Targeting lipid metabolism in cancer metastasis

This review delves into the most recent research on the metabolic adaptability of cancer cells and examines how their metabolic functions can impact their progression into metastatic forms. We emphasize the growing significance of lipid metabolism and dietary lipids within the tumor microenvironment, underscoring their influence on tumor progression. Additionally, we present an outline of the interplay between metabolic processes and the epigenome of cancer cells, underscoring the importance regarding the metastatic process. Lastly, we examine the potential of targeting metabolism as a therapeutic approach in combating cancer progression, shedding light on innovative drugs/targets currently undergoing preclinical evaluation.

Abstract PO-029: Pancreatic cancer-associated cachexia as a 3-stage systemic disease with changes in body composition, tissue-specific wasting across time and alterations in glucose metabolism

Pancreatic ductal adenocarcinoma (PDAC) is a devastating disease that rapidly deteriorates the organism resulting in <10% 5-years survival in humans. Cancer-associated cachexia (CAC) is a multi-organ complex syndrome that accompanies PDAC in 85% of the cases. CAC is often characterized by the loss of body weight, including loss of muscle and fat tissues. Chronic inflammation, myokines and adipokines (released from muscle and fat, respectively), together with few recent tumor-derived factors, have been shown to collectively induce some of the metabolic changes in peripheral tissues that lead to wasting. Those include the synthesis of acute phase proteins in the liver, lipolysis and browning of the white adipose tissues (WAT), and protein degradation in the skeletal muscle. However, how these changes affect systemic metabolism, such as amino-acid utilization for liver gluconeogenesis, the systemic consequences of increased free fatty acids from lipolysis and their final destination for b-oxidation, or the rewiring of glucose metabolism, are processes not fully understood during cachexia. Here we established a 3-stage model of cachexia progression, including pre-, early- and late-CAC stages, in a doxycycline inducible murine model of PDAC (p48(Cre/+);tetKRAS(LSL/+);p53(fl/fl)), in both genders. We have monitored body weight loss, changes in body composition using DEXA scan, food intake and survival, across time since the start of doxycycline administration (i.e. tumor initiation). We have submitted these mice to metabolic cages aiming to distinguish in which of the 3 stages fat consumption starts, as well as monitored the weight of 8 tissue types (pancreas, liver, iWAT, eWAT, brown adipose tissue, quadriceps, gastrocnemius and soleus) over time. Overall, we have defined pre-CAC as “weight-gaining stage, before body weight peaks”, early-CAC as <10% and late-CAC as >10% of body weight loss, together with specific changes in body composition in each stage, food intake only happening at the very end stage, while all non-tumoral tissues present significant reduced weight at early stages. We have performed metabolomics and lipidomics in all peripheral tissues, aiming to identify changes that occur not only at early- but also at the pre-CAC stages, when pancreatic tumors already weighed more than double of the normal pancreas. In addition, glucose tolerance test analyses showed that tumor-bearing mice cleared the glucose more rapidly than control mice, even at pre-CAC stages, opening new avenues to continue studying glucose metabolism in the periphery such as increased liver gluconeogenesis and peripheral insulin resistance. Together, these results allowed us to establish a murine model to study cachexia in 3 stages, similar to what happens in humans. Furthermore, metabolomic data from the peripheral tissues, tumor interstitial fluid (TIF) and plasma, will allow us to identify the metabolic landscape of the entire organism throughout the progression of the disease, and potentially propose new therapeutic windows to target or prevent wasting in cancer.

Citation Format: Blanca Majem, Insia Naqvi, Courtney Dennis, Lucas Dailey, Clary B. Clish, Nada Kalaany. Pancreatic cancer-associated cachexia as a 3-stage systemic disease with changes in body composition, tissue-specific wasting across time and alterations in glucose metabolism [abstract]. In: Proceedings of the AACR Virtual Special Conference on Pancreatic Cancer; 2021 Sep 29-30. Philadelphia (PA): AACR; Cancer Res 2021;81(22 Suppl):Abstract nr PO-029.

Aurora Borealis (Bora), Which Promotes Plk1 Activation by Aurora A, Has an Oncogenic Role in Ovarian Cancer

Identifying novel actionable factors that critically contribute to tumorigenesis is essential in ovarian cancer, an aggressive and disseminative tumor, with limited therapeutic options available. Here we show that Aurora Borealis (BORA), a mitotic protein that plays a key role in activating the master mitotic kinase polo-like kinase 1 (PLK1), has an oncogenic role in ovarian cancer. Gain and loss of function assays on mouse models and ex vivo patient-derived ascites cultures revealed an oncogenic role of BORA in tumor development and a transcriptome-analysis in clinically representative models depicted BORA's role in survival, dissemination and inflammatory cancer related-pathways. Importantly, combinatory treatments of FDA-approved inhibitors against oncogenic downstream effectors of BORA displayed synergistic effect in ovarian cancer models, offering promising therapeutic value. Altogether, our findings uncovered for the first time a critical role of BORA in the viability of human cancer cells providing potential novel therapeutic opportunities for ovarian cancer management.

Exploiting metabolic vulnerabilities of Non small cell lung carcinoma

Lung cancer is the main cause of cancer death worldwide. Non-Small Cell Lung Carcinoma (NSCLC) is the most common subtype of lung cancer, and the prognosis of NSCLC patients in advanced stages is still very poor. Given the need for new therapies, the metabolism of NSCLC has been widely studied in the past two decades to identify vulnerabilities that could be translated into novel anti-metabolic therapeutic approaches. A number of studies have highlighted the role of glucose and mitochondrial metabolism in the development of NSCLC. The metabolic properties of lung tumors have been characterized in detail in vivo, and they include high glucose and lactate use and high heterogeneity regarding the use of nutrients and mitochondrial pathways. This heterogeneity has also been observed in patients infused with labeled nutrients. We will summarize here the knowledge about the use of amino acids, fatty acids and carbohydrates in NSCLC that could lead to new combination treatments.

Characterization of Human Salivary Extracellular RNA by Next-generation Sequencing

BACKGROUND

It was recently discovered that abundant and stable extracellular RNA (exRNA) species exist in bodily fluids. Saliva is an emerging biofluid for biomarker development for noninvasive detection and screening of local and systemic diseases. Use of RNA-Sequencing (RNA-Seq) to profile exRNA is rapidly growing; however, no single preparation and analysis protocol can be used for all biofluids. Specifically, RNA-Seq of saliva is particularly challenging owing to high abundance of bacterial contents and low abundance of salivary exRNA. Given the laborious procedures needed for RNA-Seq library construction, sequencing, data storage, and data analysis, saliva-specific and optimized protocols are essential.

METHODS

We compared different RNA isolation methods and library construction kits for long and small RNA sequencing. The role of ribosomal RNA (rRNA) depletion also was evaluated.

RESULTS

The miRNeasy Micro Kit (Qiagen) showed the highest total RNA yield (70.8 ng/mL cell-free saliva) and best small RNA recovery, and the NEBNext library preparation kits resulted in the highest number of detected human genes [5649-6813 at 1 reads per kilobase RNA per million mapped (RPKM)] and small RNAs [482-696 microRNAs (miRNAs) and 190-214 other small RNAs]. The proportion of human RNA-Seq reads was much higher in rRNA-depleted saliva samples (41%) than in samples without rRNA depletion (14%). In addition, the transfer RNA (tRNA)-derived RNA fragments (tRFs), a novel class of small RNAs, were highly abundant in human saliva, specifically tRF-4 (4%) and tRF-5 (15.25%).

CONCLUSIONS

Our results may help in selection of the best adapted methods of RNA isolation and small and long RNA library constructions for salivary exRNA studies.

Human salivary microRNAs in Cancer

Circulating microRNAs (miRNAs) have emerged as excellent candidates for cancer biomarkers. Several recent studies have highlighted the potential use of saliva for the identification of miRNAs as novel biomarkers, which represents a great opportunity to improve diagnosis and monitor general health and disease. This review summarises the mechanisms of miRNAs deregulation in cancer, the value of targeting them with a therapeutic intention and the evidence of the potential clinical use of miRNAs expressed in saliva for the detection of different cancer types. We also provide a comprehensive review of the different methods for normalising the levels of specific miRNAs present in saliva, as this is a critical step in their analysis, and the challenge to validate salivary miRNAs as a reality to manage cancer patients.

E-cadherin: A determinant molecule associated with ovarian cancer progression, dissemination and aggressiveness

Ovarian cancer (OC) is the fifth cancer death cause in women worldwide. The malignant nature of this disease stems from its unique dissemination pattern. Epithelial-to-mesenchymal transition (EMT) has been reported in OC and downregulation of Epithelial cadherin (E-cadherin) is a hallmark of this process. However, findings on the relationship between E-cadherin levels and OC progression, dissemination and aggressiveness are controversial. In this study, the evaluation of E-cadherin expression in an OC tissue microarray revealed its prognostic value to discriminate between advanced- and early-stage tumors, as well as serous tumors from other histologies. Moreover, E-cadherin, Neural cadherin (N-cadherin), cytokeratins and vimentin expression was assessed in TOV-112, SKOV-3, OAW-42 and OV-90 OC cell lines grown in monolayers and under anchorage-independent conditions to mimic ovarian tumor cell dissemination, and results were associated with cell aggressiveness. According to these EMT-related markers, cell lines were classified as mesenchymal (M; TOV-112), intermediate mesenchymal (IM; SKOV-3), intermediate epithelial (IE; OAW-42) and epithelial (E; OV-90). M- and IM-cells depicted the highest migration capacity when grown in monolayers, and aggregates derived from M- and IM-cell lines showed lower cell death, higher adhesion to extracellular matrices and higher invasion capacity than E- and IE-aggregates. The analysis of E-cadherin, N-cadherin, cytokeratin 19 and vimentin mRNA levels in 20 advanced-stage high-grade serous human OC ascites showed an IM phenotype in all cases, characterized by higher proportions of N- to E-cadherin and vimentin to cytokeratin 19. In particular, higher E-cadherin mRNA levels were associated with cancer antigen 125 levels more than 500 U/mL and platinum-free intervals less than 6 months. Altogether, E-cadherin expression levels were found relevant for the assessment of OC progression and aggressiveness.

E-cadherin: A determinant molecule associated with ovarian cancer progression, dissemination and aggressiveness

Ovarian cancer (OC) is the fifth cancer death cause in women worldwide. The malignant nature of this disease stems from its unique dissemination pattern. Epithelial-to-mesenchymal transition (EMT) has been reported in OC and downregulation of Epithelial cadherin (E-cadherin) is a hallmark of this process. However, findings on the relationship between E-cadherin levels and OC progression, dissemination and aggressiveness are controversial. In this study, the evaluation of E-cadherin expression in an OC tissue microarray revealed its prognostic value to discriminate between advanced- and early-stage tumors, as well as serous tumors from other histologies. Moreover, E-cadherin, Neural cadherin (N-cadherin), cytokeratins and vimentin expression was assessed in TOV-112, SKOV-3, OAW-42 and OV-90 OC cell lines grown in monolayers and under anchorage-independent conditions to mimic ovarian tumor cell dissemination, and results were associated with cell aggressiveness. According to these EMT-related markers, cell lines were classified as mesenchymal (M; TOV-112), intermediate mesenchymal (IM; SKOV-3), intermediate epithelial (IE; OAW-42) and epithelial (E; OV-90). M- and IM-cells depicted the highest migration capacity when grown in monolayers, and aggregates derived from M- and IM-cell lines showed lower cell death, higher adhesion to extracellular matrices and higher invasion capacity than E- and IE-aggregates. The analysis of E-cadherin, N-cadherin, cytokeratin 19 and vimentin mRNA levels in 20 advanced-stage high-grade serous human OC ascites showed an IM phenotype in all cases, characterized by higher proportions of N- to E-cadherin and vimentin to cytokeratin 19. In particular, higher E-cadherin mRNA levels were associated with cancer antigen 125 levels more than 500 U/mL and platinum-free intervals less than 6 months. Altogether, E-cadherin expression levels were found relevant for the assessment of OC progression and aggressiveness.

E-cadherin: A determinant molecule associated with ovarian cancer progression, dissemination and aggressiveness

Ovarian cancer (OC) is the fifth cancer death cause in women worldwide. The malignant nature of this disease stems from its unique dissemination pattern. Epithelial-to-mesenchymal transition (EMT) has been reported in OC and downregulation of Epithelial cadherin (E-cadherin) is a hallmark of this process. However, findings on the relationship between E-cadherin levels and OC progression, dissemination and aggressiveness are controversial. In this study, the evaluation of E-cadherin expression in an OC tissue microarray revealed its prognostic value to discriminate between advanced- and early-stage tumors, as well as serous tumors from other histologies. Moreover, E-cadherin, Neural cadherin (N-cadherin), cytokeratins and vimentin expression was assessed in TOV-112, SKOV-3, OAW-42 and OV-90 OC cell lines grown in monolayers and under anchorage-independent conditions to mimic ovarian tumor cell dissemination, and results were associated with cell aggressiveness. According to these EMT-related markers, cell lines were classified as mesenchymal (M; TOV-112), intermediate mesenchymal (IM; SKOV-3), intermediate epithelial (IE; OAW-42) and epithelial (E; OV-90). M- and IM-cells depicted the highest migration capacity when grown in monolayers, and aggregates derived from M- and IM-cell lines showed lower cell death, higher adhesion to extracellular matrices and higher invasion capacity than E- and IE-aggregates. The analysis of E-cadherin, N-cadherin, cytokeratin 19 and vimentin mRNA levels in 20 advanced-stage high-grade serous human OC ascites showed an IM phenotype in all cases, characterized by higher proportions of N- to E-cadherin and vimentin to cytokeratin 19. In particular, higher E-cadherin mRNA levels were associated with cancer antigen 125 levels more than 500 U/mL and platinum-free intervals less than 6 months. Altogether, E-cadherin expression levels were found relevant for the assessment of OC progression and aggressiveness.

Meeting report: discussions and preliminary findings on extracellular RNA measurement methods from laboratories in the NIH Extracellular RNA Communication Consortium

Extracellular RNAs (exRNAs) have been identified in all tested biofluids and have been associated with a variety of extracellular vesicles, ribonucleoprotein complexes and lipoprotein complexes. Much of the interest in exRNAs lies in the fact that they may serve as signalling molecules between cells, their potential to serve as biomarkers for prediction and diagnosis of disease and the possibility that exRNAs or the extracellular particles that carry them might be used for therapeutic purposes. Among the most significant bottlenecks to progress in this field is the lack of robust and standardized methods for collection and processing of biofluids, separation of different types of exRNA-containing particles and isolation and analysis of exRNAs. The Sample and Assay Standards Working Group of the Extracellular RNA Communication Consortium is a group of laboratories funded by the U.S. National Institutes of Health to develop such methods. In our first joint endeavour, we held a series of conference calls and in-person meetings to survey the methods used among our members, placed them in the context of the current literature and used our findings to identify areas in which the identification of robust methodologies would promote rapid advancements in the exRNA field.

Abstract 4093: Cadherin “switch” and ovarian cancer: Studies using in vitro models and patient samples

Ovarian cancer (OC) is the 5th leading cause of cancer deaths in women worldwide due to late symptoms and its diagnosis at advanced stages. Epithelial to mesenchymal transition (EMT) is an important step in cancer invasion/metastasis and downregulation of Epithelial cadherin (Ecad) is a critical feature of this process. Ecad expression was evaluated in 100 OC tissue sections, finding a decreased Ecad signal along tumor stage, with highest expression in stage I/II (no invasive) and lowest in stage IV (invasive) tumors. These results are in agreement with previous reports showing reduced Ecad expression in correlation with poor prognosis in OC patients. In some cases, Ecad downregulation is accompanied by increased Neural cadherin (Ncad) expression and acquisition of migratory/mesenchymal features. Although this cadherin “switch” has been reported in OC, current data is inconclusive. Expression of Ecad, Ncad and other EMT markers was studied in 4 OC cell lines and according to their levels they were classified as epithelial (OV90), intermediate epithelial (OAW42), intermediate mesenchymal (SKOV3) and mesenchymal (TOV112) cells. The mechanisms underlying regulation of Ecad levels were evaluated by assessing expression of its transcriptional repressors Twist, Snail, Slug, Zeb1. Migration properties were also studied, being significantly higher in TOV112 and SKOV3 cells. It has been proposed that OC cells shed from the primary tumor aggregate as spheroids in the ascites, maintain cellular contacts and survive in suspension. To mimic ovarian tumor cell dissemination through the ascites and to evaluate the role of the cadherin “switch” in this process, cell lines were grown under anchorage-independent conditions. The aggregates number/area was analyzed, being the SKOV3 spheroids the most compacted. When Ecad, Ncad and EMT markers expression was determined similar findings were obtained when spheroids were compared to monolayers, suggesting an intrinsic cell gene expression pattern rather than a response to a cell culture growth condition. The OC spheroids survival was assessed by estimating cell death, finding a positive correlation between high Ncad levels and cell aggregates with low% cell death. Spheroid adhesion/dissemination in extracellular matrices and 3D-spheroid matrigel assays were done to assess invasion at a secondary site. Spheroids from cells with mesenchymal/intermediate mesenchymal phenotypes adhered to extracellular matrices and invaded more than cells with intermediate epithelial/epithelial phenotypes. Finally, Ecad/Ncad expression studies done on primary cultures derived from tumor and ascitic cells from patients with OC revealed a diminished Ecad and a higher Ncad expression in ascitic cells compared to primary tumor cells. Altogether, the data here presented reveals an association between OC cell aggressiveness and a mesenchymal-like molecular profile; and it depends on the expression of Ecad and Ncad markers.

Citation Format: Marina Rosso, Blanca Majem, Laura Devis, Lara Lapyckyj, Marta Llauradó, Lucía Lanau, María Florencia Abascal, María Laura Matos, María José Besso, Josep Castellví, Jose Luís Sanchez-Iglesias, Asunción Pérez-Benavente, Antonio Gil-Moreno, Jaume Reventós, Marina Rigau, Mónica Vazquez-Levin. Cadherin “switch” and ovarian cancer: Studies using in vitro models and patient samples. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 4093. doi:10.1158/1538-7445.AM2015-4093

Non-coding RNAs in saliva: emerging biomarkers for molecular diagnostics

Saliva is a complex body fluid that comprises secretions from the major and minor salivary glands, which are extensively supplied by blood. Therefore, molecules such as proteins, DNA, RNA, etc., present in plasma could be also present in saliva. Many studies have reported that saliva body fluid can be useful for discriminating several oral diseases, but also systemic diseases including cancer. Most of these studies revealed messenger RNA (mRNA) and proteomic biomarker signatures rather than specific non-coding RNA (ncRNA) profiles. NcRNAs are emerging as new regulators of diverse biological functions, playing an important role in oncogenesis and tumor progression. Indeed, the small size of these molecules makes them very stable in different body fluids and not as susceptible as mRNAs to degradation by ribonucleases (RNases). Therefore, the development of a non-invasive salivary test, based on ncRNAs profiles, could have a significant applicability to clinical practice, not only by reducing the cost of the health system, but also by benefitting the patient. Here, we summarize the current status and clinical implications of the ncRNAs present in human saliva as a source of biological information.

MicroRNAs as prognostic markers in ovarian cancer

Ovarian cancer (OC) is the most lethal gynecological malignancy among women. Over 70% of women with OC are diagnosed in advanced stages and most of these cases are incurable. Although most patients respond well to primary chemotherapy, tumors become resistant to treatment. Mechanisms of chemoresistance in cancer cells may be associated with mutational events and/or alterations of gene expression through epigenetic events. Although focusing on known genes has already yielded new information, previously unknown non-coding RNAs, such as microRNAs (miRNAs), also lead insight into the biology of chemoresistance. In this review we summarize the current evidence examining the role of miRNAs as biomarkers of response and survival to therapy in OC. Beside their clinical implications, we also discuss important differences between studies that may have limited their use as clinical biomarkers and suggest new approaches.

Abstract B15: Unveiling the mechanism of ovarian cancer dissemination through a comparative study among primary tumors, ascites and metastases

Introduction & Objectives: Epithelial ovarian cancer (OC) is the most lethal gynecological malignancy and the fifth cause of cancer deaths in women in the western world. Largely asymptomatic, OC is frequently detected at late stage (75-80%). Five-year survival rate for women with advanced stage disease is less than 20%, while the cure rate is almost 90% when are diagnosed at early stages. Epithelial OC metastasizes by direct extension from the ovary seeding the cells into the peritoneal wall and to neighbouring organs. Our aim is to study the OC dissemination comparing human paired ovarian primary tumors, ascites and metastases.

Material & Methods: Fresh ovarian primary tumor, ascites and peritoneal metastases from patients suffering advanced serous OC were collected at the surgery room and processed for further analysis. Formalin-fixed paraffin-embedded (FFPE) tissues were collected from the Pathology Department for further immunohistochemical analysis. Discovery phase: We determined the global gene expression profile of 5 fresh-paired samples (primary tumor, ascites and metastases) by microarray analysis. Validation phase: We analysed mRNA and protein levels from 10 unpaired fresh samples by RTqPCR and Western-blot, respectively. We further evaluated protein expression by immunohistochemistry from 10-paired tumor and metastasis FFPE-samples.

Results: GREM1 was shown to be upregulated in metastases versus ascites and in metastases versus primary tumors. FABP4 and INHBA were significantly overexpressed in metastases when compared to primary tumors. INHBA and FABP4 were validated at RNA and protein level, whereas GREM1 only at RNA level.

Conclusions: The present study highlights the role of previously unknown candidates in OC dissemination that might be used as tumor biomarkers, to clinically monitor the progression of the disease, or as target therapies, to block the OC dissemination.

Citation Format: Lucia Lanau, Marina Rigau, Blanca Majem, Tatiana Altadill, Josep Castellví, José-Luis Sánchez-Iglesias, Assumpció Pérez-Benavente, Silvia Cabrera, Angel García, Jordi Xercavins, Josep-Maria Del Campo, Antonio Gil-Moreno, Anna Ruiz, Jaume Reventós, Marta Llauradó. Unveiling the mechanism of ovarian cancer dissemination through a comparative study among primary tumors, ascites and metastases. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr B15.

Abstract A28: Analyses of FOXM1 isoforms in ovarian cancer

Introduction & Objectives: Epithelial ovarian cancer (OC) is the most lethal gynaecological malignancy and the fifth leading cause of cancer death in women in the Western world. Forkhead box M1 (FOXM1) transcription factor was already been described to be overexpressed in various malignancies, playing a key role in cell-cycle progression, chromosomal segregation and genomic stability, and oxidative stress. Moreover, it can also promote drug resistance to herceptin, paclitaxel and cisplatin in breast cancer cells. A recent report from our group has shown, for the first time, that FOXM1 is also overexpressed in OC, being associated with tumor grade. This result seem to indicate an interesting role of this molecule in the progression and resistance to therapy in OC. Our aim is to characterize FOXM1 isoforms in OC through the use of human tissue samples.

Material & Methods: Fresh ovarian primary tumors, ascites and peritoneal metastases from patients suffering advanced serous OC were collected from surgery room and processed for microarray analysis to detect FOXM1 expression levels. FOXM1 isoforms were analysed at mRNA expression level by using RTqPCR in a set of new frozen tissue samples.

Results: We found that FOXM1 overexpression is increased in OC peritoneal metastases. Now, we are characterizing the isoforms of FOXM1 in primary, ascites and metastatic tumors. Nevertheless, more samples need to be analysed in order to have conclusive results.

Conclusions: The present study highlights the role of FOXM1 isoforms in OC dissemination and pursues the idea to elucidate the biologic role of FOXM1 in OC tumorigenesis.

Citation Format: Tatiana Altadill, Marina Rigau, Blanca Majem, Lucia Lanau, Josep Castellví, Ángel García, Assumpció Pérez-Benavente, José Luis Sánchez, Silvia Cabrera, Jordi Xercavins, Josep Maria del Campo, Antonio Gil-Moreno, Marta Llauradó, Jaume Reventós. Analyses of FOXM1 isoforms in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A28.

Abstract A56: Identification of a micro RNA profile to predict response to therapy and improve patient survival in ovarian cancer

Introduction & Objectives: Ovarian cancer (OC) is the leading cause of death among gynecological malignancies in developed countries. The standard treatment is surgery plus platinum-paclitaxel (CP/TX) chemotherapy. Nevertheless, 70% of these patients are diagnosed in advanced stages, and, among those, 75% will recur, become resistant to therapies and die. We believe that an improvement in OC survival might be related with an early identification of those patients, since long survival (SV) is related to chemosensitivity. Our aim is to identify an expression profile of micro RNAs (miRNAs) associated with SV of patients with advanced OC.

Material & Methods: Formalin-fixed paraffin-embedded (FFPE) primary tumor tissues from late stage (III/IV) OC patients were collected at the time of surgery for the study. All patients were treated with optimal surgery and standard chemotherapy (CP/TX; after surgery). Samples were divided into two groups; (a) patients with “long SV” (SV>10 years after diagnosis) and (b) patients with “short SV”. The identification of miRNAs associated with each profile of SV was performed using TaqMan Array MicroRNA microfluidic cards in 30 patients.

Results: The identification phase has shown that the majority of the miRNAs appeared to be down-regulated in the group of “short SV” versus the “long SV”. A validation phase in a new group of tumor tissue samples is ready to validate the promising miRNA candidates that seem to be associated with the resistant (short SV) and the sensitive (long SV) profiles.

Conclusions: The ability to identify markers associated with “long SV” in patients with advanced OC could allow transforming the impact of the disease through the reduction of chemotherapy treatments and the reduction of unnecessary health care costs. Moreover, it could permit the generation of knowledge applicable to the future development of new therapies for the “short SV” since they are supposed to be resistant to the therapy.

Citation Format: Marina Rigau, Blanca Majem, Tatiana Altadill, Lucia Lanau, José-Luis Sánchez-Iglesias, Josep Castellví, Assumpció Pérez-Benavente, Silvia Cabrera, Angel García, Jordi Xercavins, Francesc Alameda, Xavier Matias-Guiu, Antonio Gil-Moreno, Josep-Maria Del Campo, Marta Llauradó, Jaume Reventós. Identification of a micro RNA profile to predict response to therapy and improve patient survival in ovarian cancer. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: From Concept to Clinic; Sep 18-21, 2013; Miami, FL. Philadelphia (PA): AACR; Clin Cancer Res 2013;19(19 Suppl):Abstract nr A56.

Molecular bases of endometrial cancer: new roles for new actors in the diagnosis and the therapy of the disease

Endometrial carcinoma (EC) is the most commonly diagnosed gynecologic malignancy in the western world. The majority of these cancers are curable, but a subset about 15-20% of endometrial tumors exhibits an aggressive phenotype. Based on clinic-pathological and molecular characteristics, EC has been classified into two groups: Type I estrogen-dependent adenocarcinomas, which have a good prognosis and an endometrioid histology, and Type II or non-estrogen-dependent EC associated with poor prognosis and non-endometrioid histology. EC develops as a result of a stepwise accumulation of alterations that seem to be specific of each histological type. However, more knowledge is needed to better understand the differences in the biology and the clinical outcome of EC. We would like to highlight the need to explore new potential biomarkers of EC as a tool for the detection and monitoring of aggressive endometrial tumors that, at the same time, will allow us to develop novel and more selective molecular targeted therapies against EC.

A three-gene panel on urine increases PSA specificity in the detection of prostate cancer

BACKGROUND

Several studies have demonstrated the usefulness of monitoring an RNA transcript, such as PCA3, in post-prostate massage (PM) urine for increasing the specificity of prostate-specific antigen (PSA) in the detection of prostate cancer (PCa). However, a single marker may not necessarily reflect the multifactorial nature of PCa.

METHODS

We analyzed post-PM urine samples from 154 consecutive patients, who presented for prostate biopsies because of elevated serum PSA (>4 ng/ml) and/or abnormal digital rectal exam. We tested whether the putative PCa biomarkers PSMA, PSGR, and PCA3 could be detected by quantitative real-time PCR in post-PM urine sediment. We combined these findings to test if a combination of these biomarkers could improve the specificity of actual diagnosis. Afterwards, we specifically tested our model for clinical usefulness in the PSA diagnostic "gray zone" (4-10 ng/ml) on a target subset of 82 men with no prior biopsy.

RESULTS

By univariate analysis, we found that the PSMA, PSGR, and PCA3 scores were significant predictors of PCa. Using a multiplex model, the area under the multi receiver-operating characteristic curve was 0.74 versus 0.82 in the diagnostic "gray zone." Fixing the sensitivity at 96%, we obtained a specificity of 34% and 50% in the gray zone.

CONCLUSIONS

Taken together, these results provide a strategy for the development of a more accurate model for PCa diagnosis. In the future, a multiplexed, urine-based diagnostic test for PCa with a higher specificity, but the same sensitivity as the serum-PSA test, could be used to determine better which patients should undergo biopsy.