Nancy Krett

Expression of an Oncogenic BARD1 Splice Variant Impairs Homologous Recombination and Predicts Response to PARP-1 Inhibitor Therapy in Colon Cancer

BRCA1-associated RING domain protein 1 (BARD1) stabilizes BRCA1 protein by forming a heterodimeric RING-RING complex, and impacts function of BRCA1, including homologous recombination (HR) repair. Although colon cancer cells usually express wild type BRCA1, presence of an oncogenic BARD1 splice variant (SV) in select cancers may render BRCA1 dysfunctional and allow cells to become sensitive to HR targeting therapies. We previously reported association of loss of full-length (FL) BARD1 with poor prognosis in colon cancer as well as expression of various BARD1 SVs with unknown function. Here we show that loss of BARD1 function through the expression of a BARD1 SV, BARD1β, results in a more malignant phenotype with decreased RAD51 foci formation, reduced BRCA1 E3 ubiquitin ligase activity, and decreased nuclear BRCA1 protein localization. BARD1β sensitizes colon cancer cells to poly ADP ribose polymerase 1 (PARP-1) inhibition even in a FL BRCA1 background. These results suggest that expression of BARD1β may serve as a future biomarker to assess suitability of colon cancers for HR targeting with PARP-1 inhibitors in treatment of advanced colon cancer.

Activin signaling is an essential component of the TGF-β induced pro-metastatic phenotype in colorectal cancer

Advanced colorectal cancer (CRC) remains a critical health care challenge worldwide. Various TGF-β superfamily members are important in colorectal cancer metastasis, but their signaling effects and predictive value have only been assessed in isolation. Here, we examine cross-regulation and combined functions of the two most prominent TGF-β superfamily members activin and TGF-β in advanced colorectal cancer. In two clinical cohorts we observed by immune-based assay that combined serum and tissue activin and TGF-β ligand levels predicts outcome in CRC patients and is superior to single ligand assessment. While TGF-β growth suppression is independent of activin, TGF-β treatment leads to increased activin secretion in colon cancer cells and TGF-β induced cellular migration is dependent on activin, indicating pathway cross-regulation and functional interaction in vitro. mRNA expression of activin and TGF-β pathway members were queried in silico using the TCGA data set. Coordinated ligand and receptor expression is common in solid tumors for activin and TGF-β pathway members. In conclusion, activin and TGF-β are strongly connected signaling pathways that are important in advanced CRC. Assessing activin and TGF-β signaling as a unit yields important insights applicable to future diagnostic and therapeutic interventions.

NFkB is essential for activin-induced colorectal cancer migration via upregulation of PI3K-MDM2 pathway

Colorectal cancer (CRC) remains a common and deadly cancer due to metastatic disease. Activin and TGFB (TGFβ) signaling are growth suppressive pathways that exert non-canonical pro-metastatic effects late in CRC carcinogenesis. We have recently shown that activin downregulates p21 via ubiquitination and degradation associated with enhanced cellular migration independent of SMADs. To investigate the mechanism of metastatic activin signaling, we examined activated NFkB signaling and activin ligand expression in CRC patient samples and found a strong correlation. We hypothesize that activation of the E3 ubiquitin ligase MDM2 by NFkB leads to p21 degradation in response to activin treatment. To dissect the link between activin and pro-carcinogenic NFkB signaling and downstream targets, we found that activin but not TGFB induced activation of NFkB leading to increased MDM2 ubiquitin ligase via PI3K. Further, overexpression of wild type p65 NFkB increased MDM2 expression while the NFkB inhibitors NEMO-binding domain (NBD) and Bay11-7082 blocked the activin-induced increase in MDM2. In conclusion, in colon cancer cell migration, activin utilizes NFkB to induce MDM2 activity leading to the degradation of p21 in a PI3K dependent mechanism. This provides new mechanistic knowledge linking activin and NFkB signaling in advanced colon cancer which is applicable to targeted therapeutic interventions.

Increased Frequency of KRAS Mutations in African Americans Compared with Caucasians in Sporadic Colorectal Cancer

OBJECTIVES: The basis for over‐representation of colorectal cancer (CRC) in African‐American (AA) populations compared with Caucasians are multifactorial and complex. Understanding the mechanisms for this racial disparity is critical for delivery of better care. Several studies have investigated sporadic CRC for differences in somatic mutations between AAs and Caucasians, but owing to small study sizes and conflicting results to date, no definitive conclusions have been reached. METHODS: Here, we present the first systematic literature review and meta‐analysis investigating the mutational differences in sporadic CRC between AAs and Caucasians focused on frequent driver mutations (APC,TP53, KRAS,PI3CA, FBXW7,SMAD4, and BRAF). Publication inclusion criteria comprised sporadic CRC, human subjects, English language, information on ethnicity (AA, Caucasian, or both), total subject number >20, and information on mutation frequencies. RESULTS: We identified 6,234 publications. Meta‐analysis for APC, TP54, FBXW7, or SMAD4 was not possible owing to paucity of data. KRAS mutations were statistically less frequent in non‐Hispanic Whites when compared with AAs (odds ratio, 0.640; 95% confidence interval (CI): 0.5342–0.7666; P=0.0001), while the mutational differences observed in BRAF and PI3CA did not reach statistical significance. CONCLUSIONS: Here, we report the mutational patterns for KRAS, BRAF, and PI3CA in sporadic CRC of AAs and Caucasians in a systematic meta‐analysis of previously published data. We identified an increase in KRAS mutations in sporadic CRC in AAs, which may contribute to worse prognosis and increased mortality of CRC in AAs. Future studies investigating health‐care disparities in CRC in AAs should control for KRAS mutational frequency.

Activin in acute pancreatitis: Potential risk-stratifying marker and novel therapeutic target

Acute Pancreatitis is a substantial health care challenge with increasing incidence. Patients who develop severe disease have considerable mortality. Currently, no reliable predictive marker to identify patients at risk for severe disease exists. Treatment is limited to rehydration and supporting care suggesting an urgent need to develop novel approaches to improve standard care. Activin is a critical modulator of inflammatory responses, but has not been assessed in pancreatitis. Here, we demonstrate that serum activin is elevated and strongly correlates with disease severity in two established murine models of acute pancreatitis induced by either cerulein or IL-12 + IL-18. Furthermore, in mice, inhibition of activin conveys survival benefits in pancreatitis. In addition, serum activin levels were measured from a retrospective clinical cohort of pancreatitis patients and high activin levels in patients at admission are predictive of worse outcomes, indicated by longer overall hospital and intensive care unit stays. Taken together, activin is a novel candidate as a clinical marker to identify those acute pancreatitis patients with severe disease who would benefit from aggressive treatment and activin may be a therapeutic target in severe acute pancreatitis.

Activin in Acute Pancreatitis: Potential Risk-Stratifying Marker and Novel Therapeutic Target

Acute Pancreatitis is a substantial health care challenge with increasing incidence. Patients who develop severe disease have considerable mortality. Currently, no reliable predictive marker to identify patients at risk for severe disease exists. Treatment is limited to rehydration and supporting care suggesting an urgent need to develop novel approaches to improve standard care. Activin is a critical modulator of inflammatory responses, but has not been assessed in pancreatitis. Here, we demonstrate that serum activin is elevated and strongly correlates with disease severity in two established murine models of acute pancreatitis induced by either cerulein or IL-12 + IL-18. Furthermore, in mice, inhibition of activin conveys survival benefits in pancreatitis. In addition, serum activin levels were measured from a retrospective clinical cohort of pancreatitis patients and high activin levels in patients at admission are predictive of worse outcomes, indicated by longer overall hospital and intensive care unit stays. Taken together, activin is a novel candidate as a clinical marker to identify those acute pancreatitis patients with severe disease who would benefit from aggressive treatment and activin may be a therapeutic target in severe acute pancreatitis.

Abstract B40: Mutations in KRAS are increased in sporadic colon cancers of African Americans compared to Non-Hispanic Whites

Introduction: African Americans (AA) have a higher incidence and mortality of colorectal cancer (CRC) when compared to Non-Hispanic Whites (NHW) and tumors present at later stages. Possible underlying factors include differences in diet, access to care and demographic differences, as well as variances in racial disease-specific gene mutations. Understanding mechanisms for this racial disparity is critical to delivery of better care. Several studies have investigated sporadic CRC mutational somatic differences between AAs and NHWs, but due to small study sizes and conflicting results, no definitive conclusions have been reached. Mutations in KRAS, BRAF , and PI3CA occur frequently in sporadic CRC and are associated with a worse prognosis. Therefore we investigated the frequency of these gene mutations in AA versus NHW populations as a possible causative factor in racial disparity of CRC. Here, we present the first systematic literature review and meta-analysis investigating the mutational differences in sporadic CRC between AAs and NHWs. Methods: We searched the PubMed database with a query designed to identify publications reporting mutations in KRAS, BRAF and PI3CA in CRC. Inclusion criteria were sporadic CRC, human subjects, English language, information on ethnicity (AA, NHW or both), total subject number >20, and information on KRAS, BRAF or PI3CA mutation frequencies. Each study was evaluated by two investigators to confirm presence of study criteria. Results: Our search identified 6162 publication. Twelve studies met the inclusion criteria, detected mutations in AAs and NHWs, and had extractable data. Ten studies reported on KRAS (n=4529), 6 studies on BRAF (n=2063), and 3 studies on PI3CA (n=662). We did not observe a statistically significant difference in the frequency of PI3CA (odds ratio 0.870 CI 0.559-1.36 p=0.5396) or BRAF mutations (odds ratio 1.24 CI 0.689-2.25, p=0.4683) when comparing CRC in AAs versus NHWs. However, KRAS mutations were more frequent in CRC in AAs when compared to NHWs (odds ratio 0.634 CI 0.529 - 0.760, p=0.0001). Conclusion: Here, we report on the mutational patterns of KRAS, BRAF and PI3CA in sporadic CRC of AAs and NHWs in the first systematic meta-analysis on this topic of previously published data. For the first time, we identify an increase in KRAS mutations in sporadic CRC in AAs which may contribute to worse prognosis and increased mortality of CRC in AAs. Future studies investigating health care disparities in CRC in AAs should account for KRAS mutational frequency. Citation Format: Nancy L. Krett, Jonas Staudacher, Ahmer Khalid, Vadim Bul, Joseph Zeidan, Cemal Yazici, Barbara Jung. Mutations in KRAS are increased in sporadic colon cancers of African Americans compared to Non-Hispanic Whites. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr B40.

Abstract 42: The NF-κB/MDM2 pathway is engaged in activin/ PI3 kinase induced degradation of p21 in colon cancer cells

Introduction: The signaling pathways for activin and TGFβ are frequently disrupted in colorectal cancers (CRC) and these mutations are associated with metastatic disease. Understanding the cellular consequences wrought by mutations to these signaling pathways may provide opportunities for the development of new therapeutic approaches. Our lab has previously shown opposing effects on a downstream target of TGFβ and activin, namely the cyclin-dependent kinase (CDK) inhibitor p21. TGFβ induces SMAD4-dependent upregulation of p21, while activin downregulates p21 in a SMAD4-independent mechanism via ubiquitination and degradation allowing for enhanced cell migration. However, the mode of regulation leading to p21 degradation is not completely known. We hypothesize that regulation of the E3 ubiquitin ligase MDM2 by NF-κB is involved in p21 degradation. Here we explore the role of MDM2 in the regulation of p21 in response to activin and TGFβ treatment in FET CRC cells. Methods: Colon cancer cell lines were assessed for ligand-induced PI3K/NF-κB/MDM2/p21 pathway engagement. FET cells were transfected with increasing concentrations of either wild type p65 or a dominant-negative mutant of p65 and treated with activin or TGFβ prior to immunoblot analysis for IκB-alpha, MDM2 and p21. DNA-binding activity of NF-κB was assessed by electrophoretic mobility shift assay (EMSA). The requirement for NF-κB activation was determined through use of the selective inhibitor peptide NBD (NEMO-binding domain), and PI3 kinase activity was confirmed by inhibition with LY294002. Results: Because activin induces ubiquitination of p21, we investigated the potential involvement of MDM2 and further the regulation of MDM2 by NF-κB. NF-κB has been reported to regulate MDM2 through direct binding to an NF-κB binding site in the promoter of MDM2. Activin induced activation of NF-κB as measured by increased DNA binding activity to an NF-κB consensus-binding site as well as by a reduction in IκB-alpha protein. Furthermore, we found this regulation to be dependent on activation of PI3 kinase. Overexpression of wild type p65 plasmid but not dominant negative p65 was found to increase MDM2 expression while the NF-κB specific inhibitor NBD blocked the activin-induced increase in MDM2. By contrast, TGFβ treatment did not contribute to an increase in MDM2 levels via NF-κB pathway. Conclusions: Here, we provide evidence to indicate that in colon cancer cells, activin may be working through NF-κB to promote MDM2 activity leading to the degradation of p21 in a PI3 kinase dependent mechanism. Future experiments will explore if pharmaceutical intervention in this pathway can inhibit the metastatic activity of activin as a therapeutic approach for advanced colon cancer. Citation Format: Arundhati Jana, Seung Hyua Baik, Timothy Carroll, Ozkan Ozden, Nancy L. Krett, Barbara Jung. The NF-κB/MDM2 pathway is engaged in activin/ PI3 kinase induced degradation of p21 in colon cancer cells. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 42. doi:10.1158/1538-7445.AM2015-42