Molecular tailoring of chemotherapy with novel imaging techniques

December 01, 2004

(Philadelphia, PA) - Researchers at the Abramson Cancer Center of the University of Pennsylvania are applying a host of imaging techniques to develop better ways to look noninvasively at the molecular characteristics of tumors. The experiments, now in human cell cultures and mouse models, are aimed at better forecasting early response to chemotherapy so that treatment choices can be adjusted.

"Right now in cancer therapy, with the exception of relatively uncommon examples of cancers for which we have tumor markers, we don't have reliable ways of predicting who is going to respond early on to chemotherapy," says Wafik El-Deiry, MD, PhD, Associate Professor, Departments of Medicine, Genetics, and Pharmacology. "Currently cancer patients get their chemo and you can't tell if they're responding for several weeks. We need to have tests that will tell us if patients are going to respond to the chemo or the radiation soon after it's first given, and whether these responses are going to last."

Two recent papers in Cancer Biology & Therapy and Cancer Research describe the work of the El-Deiry laboratory. One approach is to use a molecular beacon, a molecule that can be activated within cells due to a specific context, such as in this case, the response to chemotherapy. The beacon recognizes a characteristic change in chemo-treated tumor cells, physically opens up and fluoresces, which can then be measured. "The beacon goes right into the living cell and if it opens up, emitting fluorescence, we can detect the glow," says El-Deiry. Human lung-cancer cells were treated with the chemotherapeutic agent doxorubicin (Adriamycin), which causes cellular DNA damage. Doxorubicin works through the tumor suppressor protein p53, which ultimately kills many types of cancer cells. "We engineered a molecular beacon to detect expression of a gene called p21, that is turned on directly by p53 when cells are exposed to Doxorubicin," says El-Deiry.

The cells that were exposed to Doxorubicin activated the p53-responsive molecular-beacon tag and emitted a strong fluorescence. From this El-Deiry and colleagues hope to develop a scan that could detect a patient's likely reaction to certain chemotherapies: Strong fluorescence equals a good response to the chemotherapy. They hope to make what he refers to as a "beacon cocktail" that can predict response by monitoring multiple genes simultaneously as well as additional intracellular events in the process of cell death.

In another study El-Deiry and colleagues combine imaging techniques and a mouse model for colon cancer. "In this research, we're combining two very powerful emerging technologies," says El-Deiry. "This is the first example, to my knowledge, of the use of inducible gene silencing and non-invasive bioluminescence imaging in a mouse model for cancer." Gene silencing is a technique that allows researchers to control the expression of any gene in a given cell by introducing small RNA sequences targeting the gene of interest. Inducible refers to the ability to control whether or not the silencing RNA is expressed in the cell so that investigators can compare gene activity to tumor growth, as El-Deiry did in this study. This approach allows researchers to regulate gene expression by what they feed the mice. In this study, the KILLER/DR5 receptor, another protein that responds to chemotherapy by killing cancer cells, is silenced in colon tumors in the mice.

They also labeled the cells with a reporter gene called firefly luciferase, which gives off light. "The use of a reporter like firefly luciferase marks the tumor cells so we can see them by another imaging technique," explains El-Deiry. "Fireflies that we see in the evening carry out the same chemical reaction with their own luciferase protein to give off the light." The imager detects the light and captures its intensity to provide a measurement of the size of the tumor.

"The bioluminescence imaging technology has provided a breakthrough that allows scientists to examine the size of a tumor in living mice with high sensitivity," says El-Deiry. "Since the reporter gene is always on and only in the tumor cell, it's essentially measuring tumor volume. Using the reporter gene along with the KILLER/DR5 silencer, we show for the first time that when we turn off KILLER/DR5, we get bigger tumors."

While the beacon or beacon cocktails have the potential to be used in the clinic to detect mutations in cancer cells or the activation of genes that predict therapeutic response, the major advance with the bioluminescence imaging is in accelerating preclinical drug development. The gene silencing allows precise molecular characterization of targets that are relevant for therapeutic response while the imaging allows non-invasive assessment of drug activity towards implanted tumors. This approach saves time and money because it is possible to see the effects of drugs in living mice without sacrificing them and it also requires fewer mice in experiments.

Because the KILLER/DR5 receptor is involved in the process of cell death by chemotherapy, El-Deiry is also gaining insight into which drugs use it and which drugs work by other mechanisms. "This is important because to maximize tumor killing and to attempt to bypass or reverse resistance to chemotherapy, we need to harness all the ways cancer cells can be killed," he says.

The KILLER/DR5 receptor is engaged by a therapeutic agent currently being developed called TRAIL (Tumor necrosis factor-Related Apoptosis Inducing Ligand). TRAIL is produced normally by natural killer cells and controls tumor spread by binding to a tumor's death-inducing receptor KILLER/DR5. "However, in cancer patients with suppressed immunity and for reasons we still don't understand, there isn't enough TRAIL being produced or effectively delivered by the natural killer cells at the site of tumors and so tumors are not suppressed," says El-Deiry. "The hope is that if TRAIL is administered to patients alone or in combination with chemotherapy, this may in the clinic lead to some benefit." TRAIL looks promising in animal studies but clinical studies that are due to start in the next year or so will determine how toxic TRAIL is and begin to see whether it really works in cancer patients.
-end-
The work was funded by NIH grants including a multi-institutional Network for Translational Research in Optical Imaging imaging grant from the National Cancer Institute. The Network provides support for imaging resources to accelerate translational research on cancer.

This release and associated images can be found at: http://www.uphs.upenn.edu/news/News_Releases/nov04/ElDeiryLab.htm

The Abramson Cancer Center of the University of Pennsylvania was established in 1973 as a center of excellence in cancer research, patient care, education and outreach. Today, the Abramson Cancer Center ranks as one of the nation's best in cancer care, according to U.S. News & World Report, and is one of the top five in National Cancer Institute (NCI) funding. It is one of only 39 NCI-designated comprehensive cancer centers in the United States. Home to one of the largest clinical and research programs in the world, the Abramson Cancer Center of the University of Pennsylvania has 275 active cancer researchers and 250 Penn physicians involved in cancer prevention, diagnosis and treatment.

PENN Medicine is a $2.7 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System (created in 1993 as the nation's first integrated academic health system).

Penn's School of Medicine is ranked #3 in the nation for receipt of NIH research funds; and ranked #4 in the nation in U.S. News & World Report's most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three owned hospitals [Hospital of the University of Pennsylvania, which is consistently ranked one of the nation's few "Honor Roll" hospitals by U.S. News & World Report; Pennsylvania Hospital, the nation's first hospital; and Presbyterian Medical Center]; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.

University of Pennsylvania School of Medicine

Related Cancer Articles from Brightsurf:

New blood cancer treatment works by selectively interfering with cancer cell signalling
University of Alberta scientists have identified the mechanism of action behind a new type of precision cancer drug for blood cancers that is set for human trials, according to research published in Nature Communications.

UCI researchers uncover cancer cell vulnerabilities; may lead to better cancer therapies
A new University of California, Irvine-led study reveals a protein responsible for genetic changes resulting in a variety of cancers, may also be the key to more effective, targeted cancer therapy.

Breast cancer treatment costs highest among young women with metastic cancer
In a fight for their lives, young women, age 18-44, spend double the amount of older women to survive metastatic breast cancer, according to a large statewide study by the University of North Carolina at Chapel Hill.

Cancer mortality continues steady decline, driven by progress against lung cancer
The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017, the largest single-year drop in cancer mortality ever reported.

Stress in cervical cancer patients associated with higher risk of cancer-specific mortality
Psychological stress was associated with a higher risk of cancer-specific mortality in women diagnosed with cervical cancer.

Cancer-sniffing dogs 97% accurate in identifying lung cancer, according to study in JAOA
The next step will be to further fractionate the samples based on chemical and physical properties, presenting them back to the dogs until the specific biomarkers for each cancer are identified.

Moffitt Cancer Center researchers identify one way T cell function may fail in cancer
Moffitt Cancer Center researchers have discovered a mechanism by which one type of immune cell, CD8+ T cells, can become dysfunctional, impeding its ability to seek and kill cancer cells.

More cancer survivors, fewer cancer specialists point to challenge in meeting care needs
An aging population, a growing number of cancer survivors, and a projected shortage of cancer care providers will result in a challenge in delivering the care for cancer survivors in the United States if systemic changes are not made.

New cancer vaccine platform a potential tool for efficacious targeted cancer therapy
Researchers at the University of Helsinki have discovered a solution in the form of a cancer vaccine platform for improving the efficacy of oncolytic viruses used in cancer treatment.

American Cancer Society outlines blueprint for cancer control in the 21st century
The American Cancer Society is outlining its vision for cancer control in the decades ahead in a series of articles that forms the basis of a national cancer control plan.

Read More: Cancer News and Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.