Marcia V. Fournier

High-sensitivity array analysis of gene expression for the early detection of disseminated breast tumor cells in peripheral blood

Early detection is an effective means of reducing cancer mortality. Here, we describe a highly sensitive high-throughput screen that can identify panels of markers for the early detection of solid tumor cells disseminated in peripheral blood. The method is a two-step combination of differential display and high-sensitivity cDNA arrays. In a primary screen, differential display identified 170 candidate marker genes differentially expressed between breast tumor cells and normal breast epithelial cells. In a secondary screen, high-sensitivity arrays assessed expression levels of these genes in 48 blood samples, 22 from healthy volunteers and 26 from breast cancer patients. Cluster analysis identified a group of 12 genes that were elevated in the blood of cancer patients. Permutation analysis of individual genes defined five core genes (P ≤ 0.05, permax test). As a group, the 12 genes generally distinguished accurately between healthy volunteers and patients with breast cancer. Mean expression levels of the 12 genes were elevated in 77% (10 of 13) untreated invasive cancer patients, whereas cluster analysis correctly classified volunteers and patients (P = 0.0022, Fishers exact test). Quantitative real-time PCR confirmed array results and indicated that the sensitivity of the assay (1:2 × 108 transcripts) was sufficient to detect disseminated solid tumor cells in blood. Expression-based blood assays developed with the screening approach described here have the potential to detect and classify solid tumor cells originating from virtually any primary site in the body.

Interaction of E-cadherin and PTEN Regulates Morphogenesis and Growth Arrest in Human Mammary Epithelial Cells

Phosphatase and tensin homologue deleted on chromosome 10 (PTEN) is a dual-function phosphatase with tumor suppressor function compromised in a wide spectrum of cancers. Because tissue polarity and architecture are crucial modulators of normal and malignant behavior, we postulated that PTEN may play a role in maintenance of tissue integrity. We used two nonmalignant human mammary epithelial cell lines that form polarized, growth-arrested structures (acini) when cultured in three-dimensional laminin-rich extracellular matrix gels (lrECM). As acini begin to form, PTEN accumulates both in the cytoplasm and at cell-cell contacts where it colocalizes with the E-cadherin/beta-catenin complex. Reduction of PTEN levels by shRNA in lrECM prevents formation of organized breast acini and disrupts growth arrest. Importantly, disruption of acinar polarity and cell-cell contact by E-cadherin function-blocking antibodies reduces endogenous PTEN protein levels and inhibits its accumulation at cell-cell contacts. Conversely, in Skbr-3 breast cancer cells lacking endogenous E-cadherin expression, exogenous introduction of E-cadherin gene causes induction of PTEN expression and its accumulation at sites of cell interactions. These studies provide evidence that E-cadherin regulates both the PTEN protein levels and its recruitment to cell-cell junctions in three-dimensional lrECM, indicating a dynamic reciprocity between architectural integrity and the levels and localization of PTEN. This interaction thus seems to be a critical integrator of proliferative and morphogenetic signaling in breast epithelial cells.

Inhibition of vimentin or B1 integrin reverts morphology of prostate tumor cells grown in laminin-rich extracellular matrix gels and reduces tumor growth in vivo

Prostate epithelial cells grown embedded in laminin-rich extracellular matrix (lrECM) undergo morphological changes that closely resemble their architecture in vivo. In this study, growth characteristics of three human prostate epithelial sublines derived from the same cellular lineage, but displaying different tumorigenic and metastatic properties in vivo, were assessed in three-dimensional (3D) lrECM gels. M12, a highly tumorigenic and metastatic subline, was derived from the parental prostate epithelial P69 cell line by selection in nude mice and found to contain a deletion of 19p-q13.1. The stable reintroduction of an intact human chromosome 19 into M12 resulted in a poorly tumorigenic subline, designated F6. When embedded in lrECM gels, the nontumorigenic P69 line produced acini with clearly defined lumena. Immunostaining with antibodies to {beta}-catenin, E-cadherin or {alpha}6-, {beta}4- and {beta}1-integrins showed polarization typical of glandular epithelium. In contrast, the metastatic M12 subline produced highly disorganized cells with no evidence of polarization. The F6 subline reverted to acini-like structures exhibiting basal polarity marked with integrins. Reducing either vimentin levels via siRNA interference or {beta}1-integrin expression by the addition of the blocking antibody, AIIB2, reorganized the M12 subline into forming polarized acini. The loss of vimentin significantly reduced M12-Vim tumor growth when assessed by subcutaneous injection in athymic mice. Thus, tumorigenicity in vivo correlated with disorganized growth in 3D lrECM gels. These studies suggest that the levels of vimentin and {beta}1-integrin play a key role in the homeostasis of the normal acini in prostate and that their dysregulation may lead to tumorigenesis.Prostate epithelial cells grown embedded in laminin-rich extracellular matrix (lrECM) undergo morphologic changes that closely resemble their architecture in vivo. In this study, growth characteristics of three human prostate epithelial sublines derived from the same cellular lineage, but displaying different tumorigenic and metastatic properties in vivo, were assessed in three-dimensional lrECM gels. M12, a highly tumorigenic and metastatic subline, was derived from the immortalized, prostate epithelial P69 cell line by selection in athymic, nude mice and found to contain a deletion of 19p-q13.1. The stable reintroduction of an intact human chromosome 19 into M12 resulted in a poorly tumorigenic subline, designated F6. When embedded in lrECM gels, the parental, nontumorigenic P69 line produced acini with clearly defined lumena. Immunostaining with antibodies to β-catenin, E-cadherin, or α6 and β1 integrins showed polarization typical of glandular epithelium. In contrast, the metastatic M12 subline produced highly disorganized cells with no evidence of polarization. The F6 subline reverted to acini-like structures exhibiting basal polarity marked with integrins. Reducing either vimentin levels via small interfering RNA interference or the expression of α6 and β1integrins by the addition of blocking antibodies, reorganized the M12 subline into forming polarized acini. The loss of vimentin significantly reduced M12-Vim tumor growth when assessed by s.c. injection in athymic mice. Thus, tumorigenicity in vivo correlated with disorganized growth in three-dimensional lrECM gels. These studies suggest that the levels of vimentin and β1 integrin play a key role in the homeostasis of the normal acinus in prostate and that their dysregulation may lead to tumorigenesis. [Mol Cancer Ther 2009;8(3):499–508]

Nongenomic Mechanisms of PTEN Regulation

A large amount of data supports the view that PTEN is a bona fide tumor suppressor gene. However, recent evidence suggests that derailment of cellular localization and expression levels of functional nonmutated PTEN is a determining force in inducing abnormal cellular and tissue outcomes. As the cellular mechanisms that regulate normal PTEN enzymatic activity resolve, it is evident that deregulation of these mechanisms can alter cellular processes and tissue architecture and ultimately lead to oncogenic transformation. Here we discuss PTEN ubiquitination, PTEN complex formation with components of the adherens junction, PTEN nuclear localization, and microRNA regulation of PTEN as essential regulatory mechanisms that determine PTEN function independent of gene mutations and epigenetic events.

A Need for Basic Research on Fluid-Based Early Detection Biomarkers

Cancer continues to be a major cause of mortality despite decades of effort and expense. The problem reviewed here is that before many cancers are discovered they have already progressed to become drug resistant or metastatic. Biomarkers found in blood or other body fluids could supplement current clinical indicators to permit earlier detection and thereby reduce cancer mortality.

A strategy to identify genes associated with circulating solid tumor cell survival in peripheral blood.

Efforts in metastasis research have centered on the phenotypic and genetic differences between primary site and metastatic site tumors. However, genes that may be used as molecular markers of metastasis in circulating tumor cells remain unidentified. Genes regulating the dissemination and survival of solid tumor cells in the blood, as well as their adaptation to new environments, could be candidates for unique metastatic tumor markers. Differential display (DD) was conducted to compare the blood of tumor-free individuals with the blood of patients with lung, breast, and colon cancers. Twenty-one up-expressed genes in the tumor patient blood samples but none in the tumor-free donor blood samples were identified. Nine of these samples were isolated, amplified, and directly sequenced. A gene AB-1 homologous to a Bcl-2 family member, which might function as an apoptosis inhibitor, was identified. The overexpression of an apoptosis inhibitor in blood from patients with metastatic tumors might be correlated with the capability of solid tumor cells to survive in peripheral blood. This is the first demonstration of the usefulness of comparing control and patient blood samples by DD to find novel potential genetic markers identifying metastasis in the blood.

Experimental Design for Gene Expression Analysis

More and more, array platforms are being used to assess gene expression in a wide range of biological and clinical models. Technologies using arrays have proven to be reliable and affordable for most of the scientific community worldwide. By typing microarrays or proteomics into a search engine such as PubMed, thousands of references can be viewed. Nevertheless, almost everyone in life science research has a story to tell about array experiments that were expensive, did not generate reproducible data, or generated meaningless data. Because considerable resources are required for any experiment using arrays, it is desirable to evaluate the best method and the best design to ask a certain question. Multiple levels of technical problems, such as sample preparation, array spotting, signal acquisition, dye intensity bias, normalization, or sample-contamination, can generate inconsistent results or misleading conclusions. Technical recommendations that offer alternatives and solutions for the most common problems have been discussed extensively in previous work. Less often discussed is the experimental design. A poor design can make array data analysis difficult, even if there are no technical problems. This chapter focuses on experimental design choices in terms of controls such as replicates and comparisons for microarray and proteomics. It also covers data validation and provides examples of studies using diverse experimental designs. The overall emphasis is on design efficiency. Though perhaps obvious, we also emphasize that design choices should be made so that biological questions are answered by clear data analysis.

Abstract 405: A novel panel of 325 biomarkers is part of a large interconnected network representing multiple cell signaling pathways and allowing development of predictive tests for oncology drugs

Background: We developed an algorithm based on the gene expression of tumor biopsies to identify the best combination of biomarkers to reliably predict a patient’s response to relevant cancer treatments. This algorithm is derived from 325 genes whose expression showed significant changes during differentiation of non-malignant human mammary epithelial cells cultured in laminin-rich extracellular matrix. Of these 325 genes, 251 are novel and not present in 9 other cancer based gene expression panels such as FoundationOne or PAM50. These differentiated cells formed multicellular structures with defined lumens and tight junctions and with specific localizations of cadherin and integrins. In contrast, cells from breast cancers displayed a general loss of structure. Previous work showed that different sets of these 325 biomarkers accurately predicted overall breast cancer patients9 survival or response to neoadjuvant therapy in multiple independent studies. Objective: Predict cell-signaling pathways, drug associations, and disease associations for the 325 biomarkers (BA325) in contrast to other cancer gene panels. Methods and Results: The Qiagen Ingenuity program was used to identify pathways and disease states containing significant overlap with BA325. Multiple cell signaling pathways including cell proliferation, migration, invasion, and metabolism were found in BA325, while most other cancer biomarker panels were highly concentrated in cell proliferation. Examples of significant pathway associations relevant for oncology drug discovery and targeted treatments include Cell Cycle Control of Chromosomal Replication (p=8.1E-14), Polo-like-kinase and HSP90 complex (p=6.3E-07), G2/M DNA Damage Checkpoint (p=6.4E-07), Integrin Signaling (p=3E-05), Integrin Linked Kinase Signaling (p=4.51E-05), BRCA1 DNA Damage Response (p=1.75E-04), Estrogen Mediated S-phase entry (p=4.24E-04), Regulation of Actin Based Motility by RHO (p=4.55E-04), Adherins Junction Remodeling (p=5.6E-04), Actin Cytoskeleton Signaling (p=7.25E-04), Mismatch Repair (p=1.6E-03), RAN Signaling (p=1.64E-03), Protein Ubiquitination (p=1.78E-03) and Cholesterol Biosynthesis (p=4.8E-03). This wide coverage of cellular signaling pathways provides an advantage in developing predictive tests for treatments targeting highly complex cell signaling networks. Surprisingly, even though the BA325 panel was obtained during non-malignant differentiation, the most significant disease state associated with these genes was mammary tumor, demonstrating the validity of this approach to probe breast cancer biology. Conclusion: This analysis demonstrates that the BA325 panel is useful both in understanding non-malignant mammary epithelial differentiation and breast cancer tumors. Citation Format: Edward C. Goodwin, Said Attiya, Marcia Fournier. A novel panel of 325 biomarkers is part of a large interconnected network representing multiple cell signaling pathways and allowing development of predictive tests for oncology drugs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 405. doi:10.1158/1538-7445.AM2017-405

Abstract 5065: A 22-gene signature predicts response to chemotherapy in a broad range of breast cancer subtypes

Statement of Purpose: To test the utility of a novel, multifaceted 22-gene signature to predict response to chemotherapy in different molecular subtypes of breast cancer. Background: Only 15-25% of breast cancer patients from all histopathological subtypes currently respond to primary chemotherapy with a complete pathological response (pCR) and there is currently no test in widespread clinical use to predict whether a patient will respond. Here we present results describing a 22-gene signature that can identify breast cancer patients who will respond to taxol-combination chemotherapy in a wide range of molecular subtypes. The signature was identified using a biology-driven approach. We hypothesized that genes involved in normal human mammary acinar morphogenesis represent biomarkers capable of stratifying breast cancers. Methods: To determine whether genes with differential expression during acinar morphogenesis predict response to chemotherapy, we have analyzed gene expression microarray results. Three preexisting microarray datasets were used. 1) The dataset of Fournier et al (Cancer Res, 2006. 66:7095) obtained from a time course of two different non-malignant human mammary epithelial cell types grown in a laminin-rich extracellular matrix culture (lrECM). 2) The dataset of Hess et al (J Clin Oncol, 2006. 24:4236) including 133 patients with stage I-III breast cancer obtained before primary taxol-combination chemotherapy (TFAC). 3) The dataset of Popovici et al (Breast Cancer Res, 2010. 12:R5) including 278 patient samples that overlaps with the previous dataset. The assignment of molecular subtype of tumor samples was performed using the intrinsic gene set of 300 genes (Hu et al., BMC Genomics, 2006.7:96). Results: The majority of genes (12 out 22) down regulated upon growth arrest and polarity formation during acinar morphogenesis in lrECM were significantly over expressed in patients who responded to chemotherapy with pCR (p Conclusions: This study is the first example of a single gene signature to predict chemotherapy response in different molecular subtypes of breast cancer. Its predictive value in ER-negative and basal-like breast cancers is notable. Patients identified as non-responsive have the potential to benefit from adding an alternative treatment early in their care or from improved quality of life in forgoing an ineffective treatment. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 5065. doi:10.1158/1538-7445.AM2011-5065

Abstract 1767: Gene expression signatures as predictors of chemotherapeutic response in breast cancer

Proceedings: AACR 101st Annual Meeting 2010‐‐ Apr 17‐21, 2010; Washington, DC The purpose of this study is to evaluate a novel 22-gene signature as a predictor of response to chemotherapy in breast cancer. The extent of residual viable tumor following chemotherapy is the most important predictor of long-term outcome in breast cancer. It is essential to identify patients who will not respond to chemotherapy to avoid ineffective therapies as well as unnecessary side effects. The rate of complete pathologic response to chemotherapy is relatively low, ranging from 3% to 27% of patients. Much work has been performed to predict chemotherapy responsiveness, but, as of yet, no test is effective and widely used in the clinic. Gene expression signatures are a multifaceted approach to characterizing disease states. They offer the potential to tailor a chemotherapy regimen to an individual patient. Here we compare the ability of multiple gene signatures, including the 70-gene prognostic signature (MammaPrint) and the 22-gene signature among others, to accurately predict response to multiple different regimens of primary chemotherapy in breast cancer. Predictive ability is compared in independent microarray datasets totaling approximately 157 breast cancer patients treated with primary chemotherapy. Sensitivity, specificity, and overall accuracy were evaluated by receiver operating characteristics (ROC) graphs, a technique for visualizing, organizing, and selecting classifiers based on their performance. Results show that the 22-gene signature accurately predicts response to multiple primary chemotherapies (p<0.05). Importantly, the 22-gene signature outperformed other signatures with highly significant p-values in all datasets tested. This signature potentially represents a clinically useful method to select a personalized chemotherapy regimen for breast cancer patients. 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 1767.