Summer Cancer Research Experience for High School Students from Historically Marginalized Populations in Kansas City

The Accelerate Cancer Education (ACE) summer research program at The University of Kansas Cancer Center (KUCC) is a six-week, cancer-focused, summer research experience for high school students from historically marginalized populations in the Kansas City metropolitan area. Cancer affects all populations and continues to be the second leading cause of death in the United States, and a large number of disparities impact racial and ethnic minorities, including increased cancer incidence and mortality. Critically, strategies to bolster diversity, equity, inclusion, and accessibility are needed to address persistent cancer disparities. The ACE program offers an educational opportunity for a population of students who otherwise would not have easy access onto a medical center campus to make connections with cancer physicians and researchers and provides a vital response to the need for a more diverse and expansive oncology workforce. Students grow their technical, social, and professional skills and develop self-efficacy and long-lasting connections that help them matriculate and persist through post-secondary education. Developed in 2018, the ACE program has trained 37 high school junior and senior students. This article describes the need for and how we successfully developed and implemented the ACE program.

OPTIK: a database for understanding catchment areas to guide mobilization of cancer center assets

An increasingly diversified demographic landscape in rural and urban America warrants the attention of The University of Kansas Cancer Center (KU Cancer Center) researchers, clinicians, outreach staff and administrators as the institution assesses ways to reach its expansive, bi-state catchment area. Within the counties of the KU Cancer Center catchment area, patient level and public health data are available and categorized by varying geographic regional boundaries. Multiple data sources and different data collection processes complicate summarizing catchment area data. A curated data warehouse that retrieves and structures the data, with a common denominator, can support meaningful use of the data in a standard and consistent format. The KU Cancer Center built a data warehouse to Organize and Prioritize Trends to Inform KU Cancer Center (OPTIK), which functions to streamline the process of synthesizing data regarding Kansas and Missouri demographics, cancer risk factors and incidence and mortality rates. OPTIK standardizes these diverse data sources to enable analyses of the cancer burden at local, regional and national levels while upholding a strict standard of patient privacy. The OPTIK database enables researchers to use available data and create heat maps and other visualizations to aid in funding proposals, presentations and research activities. Furthermore, using knowledge provided by OPTIK, the KU Cancer Center is able to prioritize action items for research and outreach and more effectively communicate the impact of those efforts.

Abstract PS7-44: Energetics and lifestyle in inherited syndromes (ELLIE'S study)

Background: US women have a 1 in 8 lifetime chance of developing breast cancer (BC), with an estimated 10% resulting from a hereditary BC gene mutation. Individuals with mutations in genes such as BRCA1 and BRCA2 have an increased risk of breast and ovarian cancer, as well as other types of cancers. At present, there are more than a dozen other hereditary cancer related genetic mutations that have an associated moderate to high risk of developing cancer. Along with an ability to identify and characterize risk in individuals with a hereditary cancer mutation, there is a need to study modifiable factors such as dietary intake and physical activity in relation to an individual’s risk for cancer.

Obesity and poor physical fitness are independently associated with an increased risk of BC and recurrence. There is a paucity of data on the impact of BMI, obesity, and physical activity on primary and recurrent BC in genetic mutation carriers. Women with a moderate penetrance gene mutation are at a high risk for BC and yet are likely to have an impact from modifiable risk factors. The impact of obesity, diet, and physical activity on BC risk and outcomes needs to be further characterized in genetic mutation carriers.

Methods: A short REDCap electronic survey was disseminated on social media and through our advocate partner Facing our Risk of Cancer Empowered (FORCE). Eligible participants include males or females, ≥18 years with a hereditary cancer genetic mutation. The survey includes questions regarding personal health, weight, height, metabolic risk factors, reproductive history as well as personal and/or family history of cancer and gene mutation status. In addition, includes a standardized assessment for diet (14-Item Mediterranean Diet Tool) and physical activity (IPAQ and modifiable PAQ). The first 1000 participants are compensated for their time with a $10 e-card. The survey is available in English and Spanish. The Spanish version was developed in collaboration with JUNTOS Kansas City.

Objectives: To establish a cohort and describe obesity rates, physical activity, metabolic factors, and nutrition in a cohort of individuals that have an increased risk of cancer due to a hereditary cancer genetic mutation.

Results: A total of N = 1,117 surveys have been completed as of June 30, 2020. Of them, 61.2% were removed from final analysis due to incomplete surveys, internet bots, and multiple single-user entries. A total N = 443 surveys have been verified and included in this analysis. Demographics: 98.6% female (n= 437), 94.4% white (n = 418) and median age 46 (range 19 – 77 yrs). Mutations represented in the cohort include: BRCA2 (39.0%), BRCA1 (29.1%), CHEK2 (13.1%), and ATM (5.9%) and < 5%: PALB2, RAD51D, and TP53. Median BMI 24.9 ± 6.06 stdv. BMI 25 to < 30: 26.4% (n = 117). BMI 30 or > 30: 23.47% (n = 104). 61.3% responders are currently trying to lose weight. Attempts at weight loss: No attempts: n = 60 (13.5%), at least 1: n = 55 (12.4%), 2-5: n = 211 (47.6%), 6 or more: n = 117 (26.4%). Limitations to exercise include motivation (26.9%), time (23.5%), not liking exercise (15.6%), and lack of gym memberships (12.4%). 74.9% (n = 332) responded that they are interested in participating in future studies. The Spanish survey was made available 3/3/2020, no responses to date.

Conclusion: Individuals harboring a hereditary cancer genetic mutation are interested and willing to participate in research focused on lifestyle modifications and association with cancer risk. Rates of being overweight or obese are high and many have made multiple attempts at weight loss and find common barriers to exercise. Social media is a feasible platform to recruit to a lifestyle research project in a rare population. Additional steps to limit internet trolls, bots, and repetitive responses are necessary but did not impede recruitment. Further effort and collaboration are needed to expand the survey to underrepresented minorities.

Citation Format: Lauren E Nye, Kendra Cruz, Sue Friedman, Diane Rose, Christie Befort, Debra K Sullivan, Jill M Hamilton-Reeves, Lisa M Harlan-Williams, Fariba Behbod, Jo Wick, Melinda Irwin, Jennifer Klemp. Energetics and lifestyle in inherited syndromes (ELLIE'S study) [abstract]. In: Proceedings of the 2020 San Antonio Breast Cancer Virtual Symposium; 2020 Dec 8-11; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2021;81(4 Suppl):Abstract nr PS7-44.

BRCA1-No Matter How You Splice It

BRCA1 (breast cancer 1, early onset), a well-known breast cancer susceptibility gene, is a highly alternatively spliced gene. BRCA1 alternative splicing may serve as an alternative regulatory mechanism for the inactivation of the BRCA1 gene in both hereditary and sporadic breast cancers, and other BRCA1-associated cancers. The alternative transcripts of BRCA1 can mimic known functions, possess unique functions compared with the full-length BRCA1 transcript, and in some cases, appear to function in opposition to full-length BRCA1 In this review, we will summarize the functional "naturally occurring" alternative splicing transcripts of BRCA1 and then discuss the latest next-generation sequencing-based detection methods and techniques to detect alternative BRCA1 splicing patterns and their potential use in cancer diagnosis, prognosis, and therapy.

The role of BRCA1 and BRCA2 in prostate cancer

The familial aggregation of prostate cancer and breast cancer has been observed for almost half a century and about 85% of the inherited breast cancer can be linked to germ-line mutations of BRCA1 (breast cancer 1, early onset) and BRCA2. In this review, we are mainly focusing on the contribution of BRCA1/2 sequence variations to prostate cancer risk and disease progression. We will discuss the biological functions of BRCA1/2 and BRCA1/2-related signaling pathways in prostate cancer biology. The majority of studies supporting the link between BRCA1/2 mutations and prostate cancer are from populations with a high frequency of mutations, such as Ashkenazi Jewish, Icelandic, and U.K. population. BRCA1 can directly interact with the androgen receptor (AR) and Janus kinase (JAK), and can differentially regulate insulin-like growth factor 1 receptor (IGF-IR) expression in an AR-dependent manner. BRCA2 homeostasis in prostate cancer cells has been found to be critical in determining cell fates during prostate cancer progression. This review may be helpful for medical professionals and prostate cancer patients when discussing prostate cancer risks, treatment and prognosis.

Abstract 494: Identification and characterization of novel kinases that regulate BRCA1 expression and function

Transcriptional and functional regulation of breast cancer susceptibility gene 1 (BRCA1) in the pathogenesis of sporadic breast cancers is poorly understood. About 90% of all breast cancers are considered sporadic, and 30-40% of these cases exhibit decreased expression of BRCA1 in the absence of mutations at its genetic locus. Loss of BRCA1 accelerates growth of tumor cells, while expression of BRCA1 leads to growth arrest and apoptosis. These observations support further examination of regulatory pathways of BRCA1 to restore its expression and function.

To identify potential regulators of BRCA1, we developed a functional assay based on the role of BRCA1 in DNA damage repair. BRCA1 acts as a central scaffold that assembles a complex of repair proteins to sites of double-strand breaks (DSBs) following exposure to ionizing radiation (IR). Immunostaining for BRCA1 reveals these repair sites as punctate ionizing radiation-induced foci (IRIF). The ability of BRCA1 to localize to DSBs depends on both its expression and phosphorylation status. We evaluated the effect of siRNAs against kinases on BRCA1 IRIF formation because 1) phosphorylation of BRCA1 regulates many of its functions, 2) bioinformatics provides BRCA1 phosphorylation sites where the kinase involved is unknown, and 3) kinases play key roles in signaling pathways to influence gene expression or phosphorylation status. A number of kinases were identified that affected the ability of BRCA1 to form IRIF. However, the mechanism of kinase influence is unclear. Secondary siRNA screening assays have validated the kinase hits and lead kinases have been selected for further characterization. We are currently determining whether the effects of the lead kinases on BRCA1 are at the transcriptional or post-translational level and how these changes affect the ability of BRCA1 to repair DSBs by homologous recombination, to regulate the G2/M cell cycle checkpoint, and to modulate expression of downstream genes. Additionally, we are elucidating the signaling pathways that explain how the lead kinases regulate BRCA1. Once completed, we will have identified and characterized the role of the lead kinases on BRCA1 expression and function. This knowledge can translate into a novel therapy for BRCA1-related sporadic breast cancers.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 494.

Abstract 757: Identification and characterization of small molecule activators of BRCA1 expression

Breast cancer susceptibility gene 1 (BRCA1) has been intensely investigated in normal and cancerous cells and mutations in the BRCA1 gene have been found to account for half of the hereditary breast cancer cases. Although the role of BRCA1 in sporadic breast cancer is still uncertain, 30-40% of such cases show downregulation of BRCA1 expression. Because BRCA1 is a tumor suppressor gene, decreased expression of BRCA1 accelerates growth of mammary tumor cells, while increased expression leads to growth arrest and apoptosis. Furthermore, overexpression of BRCA1 in the murine mammary gland provides protection against mutagen-induced mammary neoplasia. In 2009, the American Cancer Society estimates that 254,650 new cases of invasive and in situ breast cancer will be diagnosed among women. Based on estimates of BRCA1 dysfunction in sporadic breast cancers, over 80,000 newly diagnosed malignancies would have decreased BRCA1 expression. Therefore, a novel prevention or therapeutic strategy targeting BRCA1 could have significant impact on incidence and/or survival.

We developed an MCF-7 breast cancer cell line containing stably integrated copies of a BRCA1 promoter-driven firefly luciferase reporter plasmid and screened over 100,000 compounds for their ability to increase BRCA1-firefly luciferase expression. Six hundred and sixty two compounds (hits) increased BRCA1-firefly luciferase activity greater than 2 standard deviations above the control, DMSO. Secondary dose-response BRCA1-firefly luciferase assays confirmed 27 of the top 32 hits as true active compounds. Potency and efficacy of the active compounds were characterized quantitatively as effective concentration (EC50) and area under the curve (AUC), respectively. Cell viability assays determined that the active compounds had little cytotoxic effects. Non-cytotoxic compounds that increased BRCA1-firefly luciferase activity in a dose-dependent manner with a potency (EC50) and efficacy (AUC) greater than or equal to that of genistein, the positive control, were selected to move forward as lead compounds. Thus far, several lead compounds have been identified. Western blot analysis indicates lead compound 17 increases endogenous BRCA1 expression. Furthermore, DNA foci formation assays indicate compound 17 enhances the ability of BRCA1 to localize to sites of ionizing radiation-induced DNA damage. Because BRCA1 appears to play a role as a growth inhibitor and tumor suppressor in adult breast tissues, identification and characterization of a plausible active compound that enhances BRCA1 expression could potentially translate into a novel prevention or therapeutic option for patients afflicted with breast cancer.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 757.

Abstract 1391: Inhibition of Hsp90 induces BRCA1 degradation and hypersensitivity to ionizing radiation

Cells expressing high levels of breast cancer susceptibility gene 1 (BRCA1) are resistant to ionizing radiation and alkylative chemotherapeutic agents. Ablation of BRCA1 expression in vitro and in vivo can enhance and/or restore sensitivity to these agents.

BRCA1 is a nuclear phosphoprotein that is critical for resolving double-strand DNA (dsDNA) breaks. Thus, its overexpression likely confers an advantage to cancerous cells targeted by anti-neoplastic agents that induce this form of DNA damage. In vitro evidence suggests that ablating BRCA1 expression may present a novel mechanism to enhance or restore radio- and chemosensitivity in refractory cancers. Like BRCA1, high expression of heat shock protein 90 (Hsp90) has been associated with resistance to radiotherapy and chemotherapy, though the mechanism(s) behind this phenotype are poorly characterized. Hsp90 is a cytoplasmic chaperone that is upregulated or exists in a hyperfunctional state in many human malignancies. Previous studies have demonstrated that Hsp90 regulates the assembly of several molecules involved in the homology-directed repair of dsDNA breaks, including BRCA2/FANCD1, FANCA, MRE11/RAD50/NBS1 (MRN), and RAD51. Using in vitro culture of breast, ovarian, and colorectal cancer cell lines, we demonstrate that inhibition of Hsp90 by the pharmacologic agent 17-allylamino-17-demethoxygeldanamycin (17-AAG), which is currently in clinical evaluation, targets BRCA1 for ubiquitylation and proteasome-mediated degradation. Furthermore, inhibition of Hsp90 and the subsequent loss of BRCA1 expression are associated with decreased repair of ionizing radiation-induced DNA damage and increased tumor cell death. Using lentiviral shRNA expression, we also demonstrate that loss of BRCA1 is epistatic to the ability of 17-AAG to sensitize cells to the effects of ionizing radiation, consistent with the central role of BRCA1 in assembling the dsDNA break repair machinery.

These results suggest that inhibition of Hsp90 using an existing therapeutic agent (17-AAG) may be an effective mechanism to transiently inhibit BRCA1 expression and improve or restore radio- and/or chemosensitivity in breast and ovarian cancers.

Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 1391.