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New Findings Clarify How Kidney Cancer Spreads to Distant Organs

“By Eva Kiesler, PhD, Science Writer/Editor | Wednesday, December 19, 2012″

“Metastasis, the process by which some tumors spread from their site of origin to other body parts, accounts for more than nine out of ten cancer-related deaths. But scientists still know relatively little about the genes and biological processes that cause metastasis to occur — information that potentially could translate into new ways to stop cancers from reaching advanced or terminal stages.

Now a Memorial Sloan-Kettering research team has shed light on the mechanisms by which kidney cancer metastasizes to distant organs, including the lungs, bone, and brain. Published in the journal Nature Medicine in December, the findings point to potential therapeutic strategies to control the spread of the disease. The study also offers scientific insights that could advance metastasis research in other cancer types.

Focusing on Kidney Cancer

The research was led by cancer biologist Joan Massagué, Chair of the Sloan-Kettering Institute’s Cancer Biology and Genetics Program and Director of the Metastasis Research Center. In recent years, his laboratory has uncovered basic causes of metastasis in a number of cancer types, including breast and lung cancers.

“In this study, we focused on clear cell renal cell carcinoma, the most common subtype of kidney cancer, for which there is an urgent need for more-effective therapies,” says postdoctoral fellow Sakari Vanharanta, the first author of the Nature Medicine report. “The metastatic form of this disease is almost always incurable.”

In the vast majority of patients, clear cell renal cell carcinoma (ccRCC) tumors carry DNA changes in a gene called VHL. These mutations have been shown to cause the formation of primary kidney tumors, but they do not necessarily lead to metastasis. Until recently, researchers did not know what makes some renal cell carcinoma cells capable of forming secondary tumors in distant organs.

New Potential Drug Targets

In the recent study, the team addressed this question by performing experiments in mouse models and cell lines, and by analyzing biological and clinical data from more than 700 patients with ccRCC, whose tumors had been analyzed in large-scale cancer genomics projects.

They discovered that two genes called CYTIP and CXCR4 are activated in metastatic tumor cells but inactive in non-metastatic cells. Their experiments suggest that the activation of the two genes might be essential for the spread of kidney cancer.

CXCR4 has been linked to metastasis before in this and other tumor types, including breast cancer,” Dr. Vanharanta says. “Now, our study shows that blocking CXCR4 function with a drug called plerixafor can reduce kidney cancer metastasis in mice.” Plerixafor (MozobilTM) is currently used to stimulate blood stem cells in some cancer patients treated by bone marrow transplantation.

The researchers plan to investigate further whether CXCR4 and CYTIP, and other genes identified in the study, might offer new targets for the development of more-effective drugs for kidney cancer.

Exploring the Epigenetics of Metastasis

In addition, the investigators explored the mechanisms by which the CXCR4 and CYTIP genes are switched on in kidney cancer cells to incite metastasis. Their study revealed that the genes undergo a series of epigenetic changes — modifications in the proteins that package a cell’s DNA and regulate genes.

Unlike gene mutations, which alter a cell’s genetic code, epigenetic changes leave the DNA sequence unaffected. Nevertheless, such changes can influence a cell’s behavior by switching individual genes on or off.

Epigenetic modifications are commonly seen in many types of cancer and have recently been associated with more-advanced disease. However, little is known about the specific genes and mechanisms by which tumor cells may reconfigure their epigenetic makeup, causing a person’s disease to progress and establish itself in new organs.

“Our study has demonstrated with clear examples how epigenetic alterations can lead to the activation of metastasis-inducing genes,” Dr. Vanharanta notes. “This is a conceptual advancement that is likely to help us understand how metastasis occurs in kidney cancer as well as in other cancer types.” ” -article from Memorial Sloan-Kettering Cancer Center

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New Technique Could Make Cell-Based Immune Therapies for Cancer Safer and More Effective

“By Julie Grisham, MS, Science Writer/Editor | Tuesday, December 18, 2012

A team from Memorial Sloan-Kettering has reported a new technique that could allow the development of more-specific, cell-based immune therapies for cancer. These types of treatments — which make use of patients’ own immune cells that have been enhanced in the laboratory — have shown some early success in the treatment of blood cancers including certain types of leukemia.

For most cancers, however, cell-based therapies have been harder to develop, in large part because it has been difficult for investigators to train immune cells to attack cancer cells without damaging normal, healthy cells in the body.

“We are getting better at working with patients’ immune cells and enhancing them so that we can get a powerful immunological response against cancer,” says Michel Sadelain, Director of Memorial Sloan-Kettering’s Center for Cell Engineering, who led the study. “The dilemma now is that we are concerned with limiting these responses and making them as targeted as possible to avoid potentially harmful side effects. This new study helps us move toward that goal.”

“As Targeted as Possible”

The treatment approach, known as adoptive cell transfer (ACT), involves engineering an immune cell called a T cell. Also called T lymphocytes, T cells are a type of white blood cell. They work by recognizing specific antigens — proteins on the surfaces of invading cells — and mounting an immune response against these invaders.

In the ACT process, T cells are removed from a patient and a gene is added to allow the T cells to recognize a certain antigen on the surface of a cancer cell. The enhanced T cells are grown in the laboratory and then infused back into the patient to seek out and attack cancer cells.

Cancer cells overproduce certain antigens, which can help T cells to recognize them, but those same antigens are often found in lower levels on healthy cells. “There are very few antigens, if any, that are found only on cancer cells,” Dr. Sadelain explains. This means that T cells engineered to recognize a certain antigen could attack normal cells that have that same antigen as well.

“Now we are bringing in a completely new concept,” he adds. “If there is no single unique antigen that is found on the surface of the cancer cell we want to target, we instead create T cells that recognize two different antigens found on the tumor cell — a signature that will be unique to that type of cancer — and only attack cells with both antigens, sparing the normal cells that express either antigen alone.”

Balanced Signaling

The new technique makes use of two kinds of receptors: chimeric antigen receptors (CARs), which allow T cells to target antigens on the surface of a tumor cell, and chimeric costimulatory receptors (CCRs), which allow T cells to recognize a second antigen.

The CAR and the CCR work together through a process known as balanced signaling, in which the presence of either antigen on its own is not enough to trigger the immune response. Only tumor cells that carry both antigens will be targeted.

In the study, which was published online December 16 in Nature Biotechnology, the team created T cells that carried receptors for two antigens found in prostate cancer cells: a CAR for an antigen called PSMA and a CCR for an antigen called PSCA. The investigators then generated mouse models of prostate cancer and infused the mice with the engineered cells. They found that the T cells attacked only tumors that carried both antigens.

“We are the first to test this concept and show that it works,” Dr. Sadelain concludes. “We plan to develop clinical trials based on this approach, although we have not yet decided whether the first study will be a trial for prostate cancer or for a different type of cancer using two other antigens. Ultimately, our goal is to create targeted immunotherapies that are both potent and safe for patients.”” – article from Memorial Sloan-Kettering

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Vitamin D can help infection-prone patients avoid respiratory tract infection

“Treating infection-prone patients over a 12-month period with high doses of vitamin D reduces their risk of developing respiratory tract infection – and consequently their antibiotic requirement. This according to a new study by researchers at Karolinska Institutet and Karolinska University Hospital published in the online scientific journal BMJ Open.

“Our research can have important implications for patients with recurrent infections or a compromised immune defence, such as a lack of antibodies, and can also help to prevent the emerging resistance to antibiotics that come from overuse,” says Peter Bergman, researcher at Karolinska Institutet’s Department of Laboratory Medicine and doctor at Karolinska University Hospital’s Immunodeficiency Unit. “On the other hand, there doesnt seem to be anything to support the idea that vitamin D would help otherwise healthy people with normal, temporary respiratory tract infections.”

Vitamin D is synthesised in the skin through exposure to sunlight and obtained through certain foods. In Sweden there is a seasonal variation in vitamin D in the blood, the trough coming during the darker half of the year. Studies have shown that low levels of vitamin D can increase the risk of infection, and it has long been known that the vitamin can also activate the immune defence.

For the present study now published in BMJ Open the researchers examined whether treatment with vitamin D can prevent and relieve respiratory tract infections in particularly infection-prone patients. All the 140 participants from the Immunodeficiency Unit had symptoms of disease in their respiratory tracts for at least 42 days prior to the study. The patients were randomly divided into two groups, one of which received vitamin D in relatively high doses, the other a placebo. They were also asked to keep a diary recording their state of health every day during the year-long study period.

The results show that symptoms of respiratory tract infection declined by almost a quarter and the use of antibiotics by almost half. Vitamin D treatment was also tolerated well by all patients and gave no serious side-effects.

The effect of vitamin D on respiratory tract infection is controversial, and a major study from New Zeeland published recently in the scientific journal JAMA found that it did not reduce the incidence or severity of viral respiratory tract infections. However, the present study differs from the former in several important respects, which could explain their different results. The JAMA study examined a group of healthy people with initially normal levels of vitamin D in the blood, and used bolus dose administration (i.e. large doses on fewer occasions), which is thought to be less effective that daily doses.

“However, the most important difference is probably due to the fact that our participants had much lower initial levels of vitamin D than those in the New Zealand study,” says Dr Anna-Carin Norlin, doctoral student and co-lead author of the study along with Dr Bergman. “There is evidence from previous studies that vitamin D supplements are only effective in patients who fall well below the recommended level, which also suggests that it would be wise to check the vitamin D levels of patients with recurrent infections.”

The study was financed by Karolinska Institutet, the Stockholm County Council and the Swedish Foundation for Strategic Research (SSF).

Publication:  Bergman P*, Norlin AC*, Hansen S, Rekha RS, Agerberth B, Björkhem-Bergman L, Ekström L, Lindh JD, Andersson J (*equal contribution)

Vitamin D3 supplementation in patients with frequent respiratory tract infections – a randomized and double blind intervention study

BMJ Open, online 13 December 2012″ – article from the Karolinska Institutet

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Scripps Research Institute Scientists Identify Molecules in the Ear that Convert Sound into Brain Signals

The work suggests new gene therapy approach to some forms of deafness”

La Jolla, CA – December 6, 2012 – For scientists who study the genetics of hearing and deafness, finding the exact genetic machinery in the inner ear that responds to sound waves and converts them into electrical impulses, the language of the brain, has been something of a holy grail.

Now this quest has come to fruition. Scientists at The Scripps Research Institute (TSRI) in La Jolla, CA, have identified a critical component of this ear-to-brain conversion—a protein called TMHS. This protein is a component of the so-called mechanotransduction channels in the ear, which convert the signals from mechanical sound waves into electrical impulses transmitted to the nervous system.

“Scientists have been trying for decades to identify the proteins that form mechanotransduction channels,” said Ulrich Mueller, PhD, a professor in the Department of Cell Biology and director of the Dorris Neuroscience Center at TSRI who led the new study, described in the December 7, 2012 issue of the journal Cell.

Not only have the scientists finally found a key protein in this process, but the work also suggests a promising new approach toward gene therapy. In the laboratory, the scientists were able to place functional TMHS into the sensory cells for sound perception of newborn deaf mice, restoring their function. “In some forms of human deafness, there may be a way to stick these genes back in and fix the cells after birth,” said Mueller.

TMHS appears to be the direct link between the spring-like mechanism in the inner ear that responds to sound and the machinery that shoots electrical signals to the brain. When the protein is missing in mice, these signals are not sent to their brains and they cannot perceive sound.

Specific genetic forms of this protein have previously been found in people with common inherited forms of deafness, and this discovery would seem to be the first explanation for how these genetic variations account for hearing loss.

Many Different Structures

The physical basis for hearing and mechanotransduction involves receptor cells deep in the ear that collect vibrations and convert them into electrical signals that run along nerve fibers to areas in the brain where they are interpreted as sound.

This basic mechanism evolved far back in time, and structures nearly identical to the modern human inner ear have been found in the fossilized remains of dinosaurs that died 120 million years ago. Essentially all mammals today share the same form of inner ear.

What happens in hearing is that mechanical vibration waves traveling from a sound source hit the outer ear, propagate down the ear canal into the middle ear and strike the eardrum. The vibrating eardrum moves a set of delicate bones that communicate the vibrations to a fluid-filled spiral in the inner ear known as the cochlea. When the bones move, they compress a membrane on one side of the cochlea and cause the fluid inside to move.

Inside the cochlea are specialized “hair” cells that have symmetric arrays of extensions known as stereocilia protruding out from their surface. The movement of the fluid inside the cochlea causes the stereocilia to move, and this movement causes proteins known as ion channels to open. The opening of these channels is a signal monitored by sensory neurons surrounding the hair cells, and when those neurons sense some threshold level of stimulation, they fire, communicating electrical signals to the auditory cortex of the brain.

Because hearing involves so many different structures, there are hundreds and hundreds of underlying genes involved—and many ways in which it can be disrupted.

Hair cells form in the inner ear canal long before birth, and people must live with a limited number of them. They never propagate throughout life, and many if not most forms of deafness are associated with defects in hair cells that ultimately lead to their loss. Many genetic forms of deafness emerge when hair cells lack the ability to transduce sound waves into electric signals.

Over the years, Mueller and other scientists have identified dozens of genes linked to hearing loss—some from genetic studies involving deaf people and others from studies in mice, which have inner ears that are remarkably similar to humans.

A Clearer Picture

What has been lacking, however, is a complete mechanistic picture. Scientists have known many of the genes implicated in deafness, but not how they account for the various forms of hearing loss. With the discovery of the relevance of TMHS, however, the picture is becoming clearer.

TMHS turns out to play a role in a molecular complex called the tip link, which several years ago was discovered to cap the stereocilia protruding out of hair cells. These tip links connect the tops of neighboring stereocilia, bundling them together, and when they are missing the hair cells become splayed apart.

But the tip links do more than just maintain the structure of these bundles. They also house some of the machinery crucial for hearing—the proteins that physically receive the force of a sound wave and transduce it into electrical impulses by regulating the activity of ion channels. Previously, Mueller’s laboratory identified the molecules that form the tip links, but the ion channels and the molecules that connect the tip link to the ion channels remained elusive. For years, scientists have eagerly sought the exact identity of the proteins responsible for this process, said Mueller.

In their new study, Mueller and his colleagues showed that TMHS is one of the lynchpins of this process, where it is a subunit of the ion channel that directly binds to the tip link. When the TMHS protein is missing, otherwise completely normal hair cells lose their ability to send electrical signals.

The scientists demonstrated this using a laboratory technique that emulates hearing with cells in the test tube. Vibrations deflected off the cells mimic sound, and the cells can be probed to see if they can transduce the vibrations in electrical signals—as they would in the body if the cells were then trying to send signals to the brain. What they showed is that without TMHS, this ability disappears.

“We can now start to understand how organisms convert mechanical signals to electrical signals, which are the language of the brain,”̈said Mueller.

In addition to Mueller, the article “TMHS is an Integral Component of the Mechanotransduction Machinery of Cochlear Hair Cells” is authored by Wei Xiong (first author), Nicolas Grillet, Heather M. Elledge, Thomas F.J. Wagner, Bo Zhao, Kenneth R. Johnson and Piotr Kazmierczak.

This work was funded with support from the National Institutes of Health (DC005965, DC007704), the Dorris Neuroscience Center, the Skaggs Institute for Chemical Biology and the Bundy Foundation.” – article from The Scripps Research Institute

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Achilles’ heel of pathogenic bacteria discovered

Max Planck researchers find promising new target for antibiotics

“Multidrug-resistant bacteria remain a major concern for hospitals and nursing homes worldwide. Propagation of bacterial resistance is alarming and makes the search for new antimicrobials increasingly urgent. Scientists at the Max Planck Institute for Biophysical Chemistry in Göttingen have now identified a potential new target to fight bacteria: the factor EF-P. EF-P plays a crucial role in the production of proteins that are essential for the virulence of EHEC or salmonellae. The researchers’ findings suggest that drugs blocking EF-P would impair the fitness of pathogenic bacteria and might lead to a new generation of specific antibiotics that allow to combat infections caused by drug-resistant pathogens.

Bacteria in hospitals can pose a major risk to patients: According to estimates of the Robert Koch Institute in Berlin, up to 600,000 people in Germany alone contract a bacterial infection there every year; 15,000 of them die from the infection. A growing number of these cases are caused by multidrug-resistant pathogens – bacteria that have become resistant to most common antibiotics. Experts have long been warning that new antibiotics cannot be provided quickly enough to fight such pathogens.

Scientists working with Marina Rodnina, head of the Physical Biochemistry Department at the Max Planck Institute for Biophysical Chemistry, have now discovered a promising target for a new generation of antibiotics: a bacterial protein called elongation factor P (EF-P). Intestinal bacteria such as Escherichia coli (E. coli) or salmonellae lacking EF-P are less fit and not as virulent as usually. So far, however, the exact function of EF-P has remained unclear.

Structural studies by Nobel Prize laureate Tom Steitz from Yale University showed how EF-P binds to the cell’s protein factories, the ribosomes. Ribosomes assemble proteins from the individual building blocks – the amino acids – according to the blueprints stored in the genes. “The results of the Yale group suggested that EF-P should influence protein production in bacteria. However, we knew that most proteins can be synthesized without EF-P,” says Marina Rodnina. “Thus, the intriguing question for us was: Have we overlooked proteins that can only be produced with the help of EF-P? And if so: What are these proteins?

With these ideas in mind, the young scientists Lili Dörfel and Ingo Wohlgemuth set out searching for the “needle in the haystack”. They systematically looked for amino acid sequences in proteins that could be formed only with EF-P – and found the pattern: Proteins containing more than two consecutive residues of the amino acid proline could only be manufactured efficiently in the presence of EF-P. “Proline-rich proteins are not only important for growth of bacteria, they also form dangerous weapons that salmonellae or the enterohaemorrhagic E. coli bacterium EHEC use to attack human cells,” explains Wohlgemuth. Approximately 270 of the total 4,000 E. coli proteins contain this type of amino acid pattern. “Our results show that EF-P is actually an important auxiliary factor in the production of such proteins. Furthermore, this factor has been found in all bacteria studied to date,” says the scientist.

Protein production, besides cell wall synthesis and replication of the genetic material, is a major target for common antimicrobials. The growing number of multidrug-resistant bacterial strains makes the search for new therapeutics all the more urgent. “A factor similar to EF-P is indeed present in human cells as well, but it differs in a number of important features from its bacterial counterpart. Therefore, EF-P represents a promising new target for fighting multidrug-resistant pathogens without inhibiting the protein production in our own cells,” explains Rodnina. The Max Planck researchers in Göttingen hope that EF-P – and the proteins that regulate its activity in the bacterial cell – could be targets for a new generation of very specific, potent antibiotics.” – the Max Planck Institute

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A new door opens in colon cancer

“By Leah Eisenstadt, Broad Communications, December 13th, 2012

Colon cancer is one of the leading causes of cancer-related death in the United States. Risk factors for the disease are varied and include factors such as advanced age and diet, but most cases share something crucial that scientists hope can usher in new treatments. In nearly all cases, the DNA in colon tumors harbors mutations in a key intracellular process or “pathway,” leading to the buildup of proteins that drive uncontrolled growth of cells.

Because disruptions in this pathway, known as the Wnt/beta-catenin pathway, are so ubiquitous in colon cancer and other cancers, it represents a promising target for developing therapeutics. However, scientists have so far been unsuccessful in targeting the pathway. Broad Institute senior associate member William Hahn, who is also an associate professor at the Dana–Farber Cancer Institute and Harvard Medical School, describes the situation as being stuck in a room with only one exit. Scientists thought that beta-catenin had only one partner protein, a transcription factor called TCF4, through which it worked to initiate and drive cancer. With no way to target TCF4, it was as though the single door to a potential new therapy remained locked.

A new door may now be open, thanks to an ambitious effort from researchers at the Broad Institute and Dana-Farber Cancer Institute. The work, led by Hahn and made possible by the Broad’s large-scale RNA interference and cell line resources, reveals an alternative pathway through which beta-catenin drives cancer, one that may be more amenable to therapeutic targeting. The findings appear online December 13 in the journal Cell and help suggest an expanded role for proteins like beta-catenin — that they may have more than one path in the cell and more than one role in cancer.

The new study was motivated not only by the desire for new therapeutic targets, but also by the need for a deeper understanding of beta-catenin’s workings in the cell. Recent genome sequencing studies, some completed at the Broad, revealed that beta-catenin’s traditional partner protein, TCF4, was actually missing or inactivated in more than a quarter of cases of colon cancer. The absence of this key partner suggested that beta-catenin had other partner proteins — indicating potential hidden pathways through which it worked to cause cancer.

To begin the hunt for a new pathway, the team set out to find genes that were essential to the survival of cancers driven by beta-catenin, representing its potential partners in the cell. They first classified 85 cell lines from the Broad-Novartis Cancer Cell Line Encyclopedia based on whether beta-catenin was activated (as it is in most colon cancers) or not. In parallel, they analyzed data on those cell lines from an RNA interference screen completed as part of the Cancer Program’s Project Achilles, which identified genes essential for the survival of cancer cells, the so-called “Achilles heels” of cancer.

The results pointed to genes that regulate a protein called YAP1, which controls the activity of other genes. Through extensive follow-up work in cellular and animal models, the team discovered a new complex of proteins that work together with beta-catenin to regulate the transcription, or activity, of genes that drive cancer. Further, they found that the new complex is regulated by YES1, an enzyme in the kinase family of proteins that have proven to be more amenable to therapeutic targeting than transcription factors. The team was even able to use a small molecule to inhibit YES1, blocking the activity of the complex and halting the growth of cancer cells.

“It’s a bit of a surprising finding because most of us thought that beta-catenin has one partner — TCF4 — that’s responsible for all its roles in cancer,” said Hahn. The new results help explain how cancer cells without a working TCF4 protein could still be cancerous. “By finding that there’s another set of partners that beta-catenin could have, it helps explain those findings and it may allow us to have an idea about how these complexes play different roles at different stages of tumor development.”

The discovery of beta-catenin’s new pathway was made possible by the Broad’s resources for large-scale, systematic exploration, in addition to informatics expertise. “We’ve been studying this pathway for twenty years, and we didn’t recognize that there was this other, very important component of it,” said Hahn. “It’s because we didn’t have the tools to do it until now.”

“This work demonstrates the power of Project Achilles and the advantage of using so many cell lines,” said Joseph Rosenbluh, first author on the study. “We could identify new things, simply because we have larger numbers than ever before.”

The findings reveal a new branch of the Wnt/beta-catenin pathway that’s likely important in development and cancer. In addition, targeting the pathway through the YES1 kinase may successfully prevent tumor growth in a large percentage of patients, if a safe and effective targeting therapy were developed. The team is currently looking into further studies of an existing drug that is FDA-approved for other conditions and that targets YES1. Finding a way to target the pathway could make a significant impact on the treatment of this disease, because it is altered in such a large proportion of cases. As Rosenbluh explained, “Finding a way to target beta-catenin will allow us to target all colon cancers.”

The work also demonstrates that systematic studies of the function of genes are a very good complement to those aimed at characterizing cancer genomes. “As genome sequencing in cancer and other conditions becomes cheaper and more routine, the emphasis must shift to the understanding of the function of genes,” Hahn said. “This is a good example of how we’re moving in parallel [to sequencing studies] to do that.”

The new pathway increases the complexity of beta-catenin’s role in the cell, but offers significant opportunities, too. “This complexity we’ve uncovered is probably going to get us closer to understanding how things really work,” said Hahn. “A new door has been opened that tells us there are many other ways we can understand this pathway, and that gives us new opportunities to think about intervening. YES1 is a really promising one, but it may be just the first of many things to come.”

Other Broad researchers involved in this study include Deepak Nijhawan, Eric Schafer, Travis Zack, Xiaoxing Wang, Aviad Tsherniak, Anna Schinzel, Diane Shao, Steven Schumacher, Barbara Weir, Francisca Vazquez, Glenn Cowley, David Root, Jill Mesirov, and Rameen Beroukhim.

Paper(s) cited: Rosenbluh, et al. β-Catenin-Driven Cancers Require a YAP1 Transcriptional Complex for Survival and Tumorigenesis. Cell. Online December 13, 2012. DOI: 10.1016/j.cell.2012.11.026.” – article from the Broad Institute

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Delaying childbirth may reduce the risk of an aggressive form of breast cancer in younger women, study suggests

Waiting to have first child 15 years or more after starting menstruation reduces risk of triple-negative breast cancer by up to 60 percent

“Seattle – Dec. 12, 2012 – Younger women who wait at least 15 years after their first menstrual period to give birth to their first child may reduce their risk of an aggressive form of breast cancer by up to 60 percent, according to a Fred Hutchinson Cancer Research Center study. The findings, by Christopher I. Li, M.D., Ph.D., a member of the Public Health Sciences Division at Fred Hutch, are published online in Breast Cancer Research and Treatment.

“We found that the interval between menarche and age at first live birth is inversely associated with the risk of triple-negative breast cancer,” Li said. While relatively uncommon, triple-negative breast cancer is a particularly aggressive subtype of the disease that does not depend on hormones such as estrogen to grow and spread. This type of cancer, which accounts for only 10 percent to 20 percent of all breast cancers, does not express the genes for estrogen receptor (ER), progesterone receptor (PR) or HER2/neu and therefore does not respond to hormone-blocking drugs such as Tamoxifen.

The study by Li and colleagues in the Public Health Sciences and Human Biology divisions at Fred Hutch is the first to look at how the interval between first menstrual period and age at first birth is related to the risk of this particular type of breast cancer. It is also the first study to look at the relationship between reproductive factors and breast cancer risk among premenopausal women, who have a higher risk of triple-negative and HER2-overexpressing breast cancer than postmenopausal women.

The study also confirmed several previous studies that have suggested that breast-feeding confers a protective effect against triple-negative disease. “Breast-feeding is emerging as a potentially strong protective factor against one of the most aggressive forms of breast cancer,” Li said.

The mechanism by which breast-feeding and delaying childbirth reduces the risk of this form of breast cancer is unclear, Li said.

Previous research has shown, however, that the risk of the most common subtype of breast cancer, ER positive, is decreased among women who’ve had a full-term pregnancy and have breast-fed. The reason for this, researchers believe, is that the hormones of pregnancy induce certain changes in the cellular structure of the breast that seem to make the tissue less susceptible to this type of cancer.

The study has particular implications for African-American women, who experience disproportionately high rates of triple-negative disease. While the reason for this remains largely unknown, on a population level reproductive characteristics are known to vary by race, and compared to non-Hispanic white women, African-American women are more likely to start having children at a younger age and are less likely to breast-feed, Li said.

“Our observations that delayed childbearing and breast-feeding are protective against triple-negative breast cancer suggest that variations in reproductive histories by race may to some extent explain the higher rates of triple-negative disease in African-American women,” Li said.

The study involved more than 1,960 Seattle-area women between the ages of 20 and 44, 1,021 with a history of breast cancer and 941 without. Reproductive histories among women without a history of breast cancer were compared to those of women with ER-positive (781), triple-negative (180) and HER2-overexpressing (60) breast cancer.

“This is an observational study and also one of the first to focus on premenopausal breast cancer and so our results require confirmation and thus should be interpreted with some caution,” Li said.

The National Cancer Institute and the Department of Defense Breast Cancer Research Program funded the study.

Editor’s note: To obtain a copy of the Breast Cancer Research and Treatment paper, “Reproductive factors and risk of estrogen receptor positive, triple-negative, and HER2-neu overexpressing breast cancer among women 20-44 years of age,” visit http://www.springerlink.com/openurl.asp?genre=article&id=doi:10.1007/s10549-012-2365-1” – article from the Fred Hutchinson Cancer Research Center

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Single gene defect wipes out immunity

Gene knockout stops immune cell development

Researchers at the Wellcome Trust Sanger Institute have identified the key gene in ensuring that our immune defences develop infection-fighting cells. No cells of the adaptive immune system – key to attacking and destroying bacteria and other pathogens – develop in the absence of the gene Bcl11a.

The result will help to understand the human immune system and how it can fail in disease, as well as possibly allowing the development of functioning human immune systems in mice for research and development of treatments.

Our immune system has two arms: the adaptive and innate pathways. The adaptive immune system leads to infection- and cancer-fighting cells called B cells, T cells and NK cells: these all share a common ancestor, or lymphoid progenitor.

The team had shown earlier that Bcl11a was important for development of some immune cells in mouse embryos. In the new research they looked at the role of this gene in adult mice. They knocked out Bcl11a and looked at development of the immune system cells.

They were surprised to see that no cells of the adaptive system developed in the mice.

“This is the cornerstone of building an effective immune system,” says Dr Pentao Liu, who led the research. “It is perhaps the first time that anyone has found a single gene that is absolutely essential for development of cells of our entire adaptive immune system.

“With this new discovery, we can understand better how our immune system is built and begin to learn how we might repair it.”

The protein produced by Bcl11a controls the activity of other genes: it is part of a network of components that regulate cell development and the imbalance caused by a lack of Bcl11a leads to the death of the progenitor cells of the adaptive immune system. By contrast, overactivity of Bcl11a is known to cause lymphomas.

“This is the most important gene in the adaptive immune system,” says PhD student Yong Yu, who did the research while at the Wellcome Trust Sanger Institute. “Without it, there are no cells of this system, no antibodies to fight infection.

“We have begun to tease apart the networks that have to work in balance to give us a healthy immune system.”

One member of the Bcl11a network is a gene called p53, known to be important in controlling cell division and, when mutated, important in driving cancer development. If p53 also is inactivated in mice that lack Bcl11a, some cells of the immune system develop. Uncovering these interactions will drive a better understanding of disease of the immune system.

Mice that lack functional Bcl11a and hence lack a functional immune system could be important in studying human cells and human immune biology. By adding human disease cells to the immune-deficient mice, researchers could define the function of human genes in a humanised environment in order, for example, to examine the role of genes in transplant biology.

Bcl11a also has a role in development of oxygen-carrying red blood cells: in 2011, researchers showed that silencing Bcl11a in mice could reverse sickle-cell disease.

“Our discovery shows that Bcl11a has a central and essential role in the immune system, alongside its other functions,” continues Dr Liu. “It is work that our mouse models have driven. Understanding the complex interactions of networks of genes in this way will be essential for better understanding human disease and in finding better ways to diagnose and treat patients.

“We already see that Bcl11a is involved in lymphoma and anaemia. We can now look to see if it has a role in other human disease.” – article from The Wellcome Trust Sanger Institute

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New Small Molecule Inhibitor Could be a Safe and First-Line Treatment for Metastatic Breast Cancer

Results show that the drug could extend progression-free survival”

San Antonio, TX (December 7, 2012)—Previous research has shown that a family of genes, proteins and enzymes called the uPA system (for urokinase plasminogen activator) plays an active role in different facets of cancer’s biology, including tumor cell invasion, the spread of metastases, and the growth of a primary tumor.

Mesupron® is a new small molecule inhibitor, taken as a pill, that inhibits the uPA system. The results from a recent phase II clinical study suggest that the drug could be a safe and first-line treatment that extends progression-free survival for metastatic breast cancer patients, when combined with the chemotherapeutic drug Capecitabine. Results will be presented by Lori J. Goldstein, MD, Director of the Breast Evaluation Center at Fox Chase Cancer Center, at the 2012 CTRC-AACR San Antonio Breast Cancer Symposium on Friday, December 7, 2012.

The trial was designed based on the results of a Phase I study completed at Fox Chase, led by Dr. Goldstein, showing both the safety of the combination drug and some evidence of the drug’s benefit.

The study included 132 patients with metastatic breast cancer from 20 centers in five countries. In the trial, patients who took Mesupron combined with Capecitabine went without the return of disease for a median 8.3 months after the therapy. Patients who only took Capecitabine had a progression-free survival of 7.5 months.

“The combination of oral agents was convenient for and well tolerated by the patients,“ says Goldstein. “Plans for future studies are ongoing.”

The drug was developed by WILEX, a German pharmaceutical company that focuses on the development of small molecule inhibitors and other new targeted cancer drugs designed to give patients treatment options with fewer side effects than traditional chemotherapy. In the Phase II study, Goldstein and her collaborators also investigated the safety and efficacy of the drug, as well as the objective response rate—the patient population who had no sign of disease after a specific amount of time.

Nine percent of the patients who received only Capecitabine had a complete objective response after 24 weeks. The objective response rate among the patients taking the combination therapy was nearly twice that, at 17 percent.

The researchers also looked at different subgroups of participants to try to identify which patients might receive the most benefit from a combination therapy involving Mesupron. Among 109 Caucasian patients, the progression free survival was 7.5 months for patients who received Capecitabine alone, and 9.1 months for those who also received Mesupron.

The drug also showed a significant improvement for patients who had previously received treatment—before their disease became metastatic.

In the subgroup of patients (n=95) who received adjuvant chemotherapy following the primary diagnosis of breast cancer, progression free survival improved from 4.3 months in the Capecitabine alone group to 8.3 months in the Mesupron combination group.

The drug has shown similar results in pancreatic cancer, extending progression free survival and boosting the objective response rate. “The data confirm the results of the pancreatic cancer trial reported in 2012. This proof of concept study shows the Mesupron may be of benefit in breast cancer as well as pancreatic cancer. Because the uPA system has been implicated in a range of solid tumors, the drug could well find application in a variety of indications,” says Paul Bevan, PhD, Head of R&D and Member of the Executive Management Board of WILEX.

In addition to Bevan, Goldstein’s collaborators include Nadia Harbeck from the University of Cologne in Germany, another coordinating investigator; and Carola Mala, S. Kastner, and S. Selder from WILEX.” – article from the Fox Chase Cancer Center

PacBio RS and 454 DNA sequencing at engencore.sc.edu


More than 3,000 epigenetic switches control daily liver cycles

Salk findings may help explain connections between dietary schedules and chronic disease

“La Jolla, CA—When it’s dark, and we start to fall asleep, most of us think we’re tired because our bodies need rest. Yet circadian rhythms affect our bodies not just on a global scale, but at the level of individual organs, and even genes.

Now, scientists at the Salk Institute have determined the specific genetic switches that sync liver activity to the circadian cycle. Their finding gives further insight into the mechanisms behind health-threatening conditions such as high blood sugar and high cholesterol.

“We know that genes in the liver turn on and off at different times of day and they’re involved in metabolizing substances such as fat and cholesterol,” says Satchidananda Panda, co-corresponding author on the paper and associate professor in Salk’s Regulatory Biology Laboratory. “To understand what turns those genes on or off, we had to find the switches.”

To their surprise, they discovered that among those switches was chromatin, the protein complex that tightly packages DNA in the cell nucleus. While chromatin is well known for the role it plays in controlling genes, it was not previously suspected of being affected by circadian cycles.

Panda and his colleagues, including Joseph R. Ecker, holder of the Salk International Council Chair in Genetics, report their results December 5, 2012 in Cell Metabolism.

Over the last ten years, scientists have begun to discover more about the relationship between circadian cycles and metabolism. Circadian cycles affect nearly every living organism, including plants, bacteria, insects and human beings.

“It’s been known since the early eighteenth century that plants kept in darkness still open their leaves in 24 hour cycles. Similarly, human volunteers also maintain circadian rhythms in dark rooms. Now we’re determining the regulatory processes that control those responses,” says Ecker, who was recently elected a fellow of the American Association for the Advancement of Science for his work on the genetics of plant and human cells.

Panda offers an example of human circadian influenced behavior that is painfully familiar to all parents of newborns: Why do infants wake up in the middle of the night? It isn’t because they aren’t yet “trained” to a regular schedule, but because their internal circadian clocks haven’t even developed.

“Once the clock is developed, the infant can naturally sleep through the night,” Panda says. “On the other end of the scale, older people with dementia have sleep problems because their biological clock has degenerated.”

In the case of humans and other vertebrates, a brain structure called the suprachiasmatic nucleus controls circadian responses. But there are also clocks throughout the body, including our visceral organs, that tell specific genes when to make the workhorse proteins that enable basic functions in our bodies, such as producing glucose for energy.

In the liver, genes that control the metabolism of fat and cholesterol turn on and off in sync with these clocks. But genes do not switch on and off by themselves. Their activity is regulated by the “epigenome,” a set of molecules that signal to the genes how many proteins they should make, and, most importantly from the circadian point of view, when they should be made.

“We know that when we eat determines when a particular gene turns on or off, for example, if we eat only at nighttime, a gene that should be turned on during the day will turn on at night,” Panda says.

For this reason, the epigenome is of particular interest for health, since we can control when we eat. An earlier study from Panda’s lab, published last May in Cell Metabolism, suggested that we should observe a 16-hour fast between our evening and morning meals.

“In response to natural cycles, our body has evolved to make glucose at nighttime,” Panda says. “But if on top of that you eat, you’re creating excess glucose and that damages organs, which leads to diabetes. It’s like over-charging a car battery. Bad things will happen.”

In short, while we can’t control what genes we’re born with, we do have some influence over what they do. Nevertheless, the interplay between genome and epigenome is extremely complex. Panda, Ecker and their colleagues, including the paper’s co-first authors Salk postdoctoral researchers, Christopher Vollmers and Robert J. Schmitz, did their studies in mice. In the mouse liver, they discovered more than 3,000 epigenomic elements, which regulate the circadian cycles of 14,492 genes. Comparing the mouse genome to the human genome, they find many of the same genes.

“Now that we know where the switches are, it brings us one step closer to understanding the mechanism of gene regulation,” says Panda, “For example, it helps us restrict our search for other factors to particular regions of the genome. In other words, at least we now know to search in Alaska, rather than Australia. But Alaska’s still a big place.”" – article from the Salk Institute for Biological Studies

PacBio RS and 454 DNA sequencing at engencore.sc.edu

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