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F. Chen



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    P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P1.04-014 - Clinicopathologic Significance of Epithelio-Mesenchymal Transition in Human Lung Adenocarcinoma (ID 2321)

      09:30 - 09:30  |  Author(s): F. Chen

      • Abstract
      • Slides

      Background:
      Activation of Epithelial-Mesenchymal Transition (EMT) mechanisms in tumor cells is known to be associated with its invasive and metastatic properties. However, this hypothesis has not been fully elucidated from the point of detailed clinicopathological view using surgically resected clinical samples. We, hereby, examined the expression levels of EMT marker and analyzed the integrated data of clinicopathlogical information including background genetic alterations.

      Methods:
      Clinical samples were obtained from the 256 cases of resected lung adenocarcinoma which were consecutively operated from January 2001 to December 2007 in Kyoto University Hospital. Pathological stage distribution of the cases by TNM classification (WHO, 7th edition) was below: 1A: 132, 1B: 56, 2A: 22, 2B: 4, 3A: 26, 3B: 2, 4:14. Mean survival time of all the cases was 62 months, and 5-year survival rate was 75.3%. The distribution of predominant histlogical subtype by IASLC/ATS/ERS classification was AIS (9, 3.5 %), MIA (13, 5.1 %), lepidic (18, 7.0 %), acinar (32, 12.5 %), papillary (122, 47.6%), solid (44, 17.2 %), micropapillary (9, 3.5 %), mucinous (8, 3.1 %), others (1, 0.4 %). We performed immunohistochemical staining for the expression of E-cadherin and Vimentin on tissue microarrays of resected samples to assess the activation level of EMT. Then, we classified the cases with positive E-cadherin expression and negative for Vimentin as “null” activation of EMT mechanisms, called ‘Group N’, whereas loss of E-cadherin and positive for Vimentin as “full” activation, ‘Group F’, and, further, either loss of E-cadherin or positive Vimentin as “partial” activation, ‘Group P’. DNA samples were extracted from frozen surgical samples and the mutations for the hot-spot exons of EGFR, ALK, K-ras, and p53 were detected by SSCP or direct sequencing methods. Statistical analyses for survival were performed by Kaplan-Meirer curve and log-rank test. Categorical data were analyzed by Pearson’s test. P-values < 0.05 were considered to be statistically significant.

      Results:
      Histological subtypes were significantly associated with EMT activation level. Poorly differentiated tumors mainly comprising solid, micropapillary, and mucinous adenocarcinoma possessed highly activated EMT level, and vice versa. Group F showed the highest positivity both in local lymphatic/vascular invasion and lymph-node metastasis (35.7%/ 42.9%/ 46.3%, respectively), followed by group P and group N in order. Significant difference was found in 5-year disease-free/ overall survival rate among these 3 groups: group F, 46.9%/ 50.6%; group P, 64.9%/ 73.4%; group N, 74.9%/ 85.4%. Tumors harboring wild type EGFR or mutant p53 had tendency to acquire higher EMT activation level. Interestingly, p53 mutation rate significantly correlated with EMT activation level especially in mutant EGFR tumors, whereas no correlation in wild type EGFR ones. No significant correlation was shown between EMT activation level and the proportion of K-ras mutation or ALK fusion gene.

      Conclusion:
      Our results revealed that the activation of EMT mechanisms in human lung adenocarcinoma is significantly associated with histological subtypes and plays important roles in the tumor progression through its lymph-vascular local involvement leading to the node-metastasis. Among human lung adenocarcinomas harboring EGFR mutation, p53 alteration deeply correlates with EMT activation.

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    P2.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 234)

    • Event: WCLC 2015
    • Type: Poster
    • Track: Biology, Pathology, and Molecular Testing
    • Presentations: 1
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      P2.04-097 - Vinorelbine Resistance in Lung Cancer; Role of Focal Adhesion Signaling Pathways (ID 2569)

      09:30 - 09:30  |  Author(s): F. Chen

      • Abstract
      • Slides

      Background:
      Vinorelbine (VRB) combined with cisplatin is a widely used regimen for the treatment of non-small cell lung cancer, but their curative effect is unsatisfactory. The resistance to these drugs is the main cause of chemotherapeutic failure. Several factors are reported to be related with VRB resistance, however their validity remains controversial. In the present study, we compared the gene expression and protein phosphorylation between parental (P) and induced VRB resistant (VR) cell lines to elucidate candidate mechanisms for VRB resistance.

      Methods:
      First we established VR lung cancer cells (H1299) with the exposure to the graded increase in VRB concentration. Then, transcriptional changes were measured with DNA microarray and pathway analysis by comparing VR line to the parental. Protein expression and its activation in the candidate pathway were examined by western blot analysis. Cell viability about VRB and Src / ABCB1 inhibitors was assessed by ‘WST-8 assays’.

      Results:
      Half-maximum inhibitory concentration (IC50) of VR cells to VRB were 190 times higher than that of parental cells. VR cells had cross resistance to docetaxel and etoposide, but they did not have cross resistance to cisplatin. VR cells highly expressed ABC transporter (ABCB1: fold change = 13.4) and focal adhesion (FA) related genes, such as integrins and underlining molecules (ITGB3: fold change = 3.7, Src: fold change = 1.1). Western blot analysis confirmed the high expression of intergrin β1, β3 and the activation of the FA pathways including Src, and Akt in VR cells. VRB sensitivity in VR cells was recovered with ABCB1 inhibitor (tariquidar: TQD). Although single usage of Src inhibitor (dasatinib: DAS) did not show any effectiveness, TQD and DAS had synergistic effect on VRB sensitivity. VRB IC50 concomitant use with DMSO, DAS 50 nM, TQD 15 nM, and DAS 50 nM + TQD 15 nM were 1261 nM, 1125 nM, 466.5 nM, and 75.58 nM, respectively. Saracatinib (SAR), a dual inhibitor of Src and ABCB1, recovered VRB sensitivity (Fig.).Figure 1



      Conclusion:
      Indeed, ABCB1 is the main cause of VRB resistance and multi-drug resistance in lung cancer. Genome-wide gene expression analyses revealed another candidate, focal adhesion pathways, except for drug efflux in VRB resistance. Our results show the potential of Src inhibitor to overcome these drug resistance.

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