New Target For Fight Against Common Type Of Breast Cancer: Brk
Editor's ChoiceMain Category: Breast Cancer
Also Included In: Cancer / Oncology; Biology / Biochemistry
Article Date: 27 Aug 2008 - 3:00 PDT
A new promising enzyme target for a specific type of breast cancer, Brk, has been identified in research published on August 21, 2008 in the Proceedings of the National Academy of Sciences (PNAS.)
In a specific subset of breast cancer patients, the tumor cells produce high levels of the protein ErbB2 (also called HER2) which pushes the cells to proliferate without limit, a characteristic common of all cancers. Approximately one in four patients are in this group, and their clinical prognoses are considerably worse than other patients. While Herceptin and Lapatinib, concomitantly administered with other chemotherapic agents, have improved the prognosis for many of these patients, there is significant potential for development in this area. In particular, they are able to suppress ErbB2, but are not effective against all tumors that secrete it. Additionally, when patients' tumors do respond, they usually become resistant over time.
According to the authors of this study, led by Professor Senthil Muthuswamy, Ph.D of the Cold Spring Harbor Laboratories, this suggested that another element might factor into the progression of these tumors. "The limited success of existing therapy suggested to us that factors besides ErbB2, or proteins that collude with ErbB2, might nullify the effects of Herceptin and Lapatinib," explained Dr. Muthuswamy.
ErbB2 is a type of molecule known as a receptor tyrosine kinases. Implicated in many cancers, these molecules reside on the surface of the cell and detect cues in the surrounding environment which signal the cells to proliferate. In breast cancers, this over-production or ErbB2 in breast cancers are due to a gene mutation resulting in multiple copies of the gene.
Brk is another protein that undergoes this sort of amplification due to multiple copies of its gene in the genome. This study focused on the potential link with Brk, which was previously shown to be over-produced in many types of cancers, including two-thirds of all breast cancers. By analyzing the genomes of several breast cancer patients helped showed an association between ErbB2 and Brk. To do this, they forced the production of both agents in the same cells, and noting the way they worked together, to see if they were over-produced in tandem.
The team examined tissue from more than two hundred patients for variations in the genome that could lead to multiple copies of both genes. In these samples, both proteins were amplified abnormally. Re-analyzing for the proteins themselves, rather than the genes, also indicated that the proteins were also over-expressed and thus in higher concentrations in the patients' cells. This indicates that both might play an important role in the development of this type of cancer, and thus should both be targetted. "Our results might explain why the strategy of using ErbB2 inhibitors alone to treat breast cancers has fallen short," said Dr. Muthuswamy. "These findings may also suggest a way to treat patients with advanced ErbB2-positive tumors and those who've developed resistance to ErbB2 inhibitors -- an idea that we're eager to test."
In further experimentation, it became clear to the team that Brk was not able, in isolation, to induce cancerous proilferation, and instead enhanced the proliferation of cells also expressing ErbB2 by accelerating their entrance into the cell cycle. According to Dr. Muthuswamy, it may be useful to think of these proteins as factors in driving a car: "If ErbB2 is the accelerator that makes the car move, Brk helps shift the gear to gain more speed."
Thus, Brk helps these tumors become virulent. Additionally, the team was able to implicate Brk in the drug-resistant properties of some of these tumors. This indicates, once again, that both must be targeted in future therapies. According to Muthuswamy: "We might need to hit ErbB2-expressing cancers with drugs against both ErbB2 and Brk."
Brk might also be targeted in isolation. The scientists believe this to be a reasonable strategy because Brk influence appears to be specific to these cancer cells. "Brk does not promote the proliferation of normal cells, and its expression in normal tissues is restricted to non-proliferating cells." Thus, many side effects that could be caused by other drugs, which target less specific chemicals, or are in higher levels in the cells.
Finally, Brk might have use in dianosing breast cancer. "We also think that Brk would be an ideal clinical marker than could be used to provide both a diagnosis and prognosis for breast cancer," states Dr. Muthuswamy.
Brk is coamplified with ErbB2 to promote proliferation in breast cancer
Bin Xiang, Kiranam Chatti, Haoqun Qiu, B. Lakshmi, Alexander Krasnitz, Jim Hicks, Min Yu, W. Todd Miller, and Senthil K. Muthuswamy.
Proceedings of the National Academy of Sciences, August 21, 2008
doi: 10.1073/pnas.0805009105
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About Cold Spring Harbor Labs:
CSHL is a private, non-profit research and education institution dedicated to exploring molecular biology and genetics in order to advance the understanding and ability to diagnose and treat cancers, neurological diseases, and other causes of human suffering. For more information, please visit http://www.cshl.edu .
Written by Anna Sophia McKenney
Copyright: Medical News Today
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Receptor And Enzyme Identification
posted by Gregory D. Pawelski on 27 Aug 2008 at 7:25 amTargeted drugs are based on a variety of biological mechanisms (pathways) that essentially stop cancer from spreading. They interfere with specific molecules (receptors and enzymes inside and outside a cancer cell) involved in carcinogenesis (the process by which normal cells become cancer cells) and tumor growth.
The most common targets on the outside of a cancer cell are receptors, which are proteins that help relay chemical messages. Many targets on the inside of a cell are enzymes, which are proteins that help speed up chemical reactions in the body.
By focusing on these molecular and cellular changes, targeted cancer drugs go after the "target" in these cells, rather than just all cells. In other words, they focus on molecular and cellular changes that are specific to cancer.
Because many cancer cells use similar pathways, the same drug could be used to treat one person's breast cancer and another person's lung cancer, as long as each tumor contained similar targets. This is why many of these treatments are being used in a variety of cancer types.
Although targeted therapy is appealing, it is more complex than meets the eye. Cancer cells often have many mutations in many different pathways, so even if one route is shut down by a targeted treatment, the cancer cell may be able to use other routes.
In other words, cancer cells have "backup systems" that allow them to survive. The result is that the drug does not shrink the tumor as expected. One approach to this problem is to target multiple pathways in a cancer cell.
There has been a continuous parade of new targeted small and large molecule therapies that will continue to be introduced into the market virtually blind. Most of them have been developed for use in solid tumors but some have also emerged for hematological malignancies. These targeted drugs mostly need to be combined with active chemotherapy to provide any benefit and the need for predictive tests for individualized therapy selection has increased.
Multi-targeted drugs can be well-predicted by measuring the effect of the drugs on the "function" (is the cell being killed regardless of the mechansim) of live cells, as opposed to a "target" (does the cell express a particular target the the drug is supposed to be attacking).
While a "target" assay tells you whether or not to give "one" drug, a "functional" assay can find other compounds and combinations and can recommend them from the one assay.
Functional profiling can discriminate between the activity of different “targeted” drugs and identify situations in which it is advantageous to combine the “targeted” drugs with other types of cancer drugs. Because these new “smart” drugs will work for “some” but not “all” cancer patients who receive them, functional profiling can accurately identify patients who would benefit from treatment with molecularly-targeted anti-cancer therapies.
The study of cell function analysis tells us that even when the disease is the same type, different patients' tumor respond differently to the same agents. A large molecule targeted drug may be more beneficial to some patients than a small molecule targeted drug (sometimes not).
Whatever the percentage of patients benefit from these drugs, the point is, targeted drugs are not for everybody. Pre-tests can help identify the individual cancer patient the drug works extremely well for, or it can tell that the drug is resistant. It is important to "personalize" cancer treatment, and this can be accomplished by testing the tumor first.
The ordinary trial system will not suffice if we are to encourage new drugs for restricted numbers of patients. More and more physicians and patients are turning to individualized therapies to treat cancers. Without individualized testing the efficacy of these drugs, it's difficult to determine which drugs are best for patients who don't respond to standard therapies.
Literature Citation:
Eur J Clin Invest 37 (suppl. 1):60, 2007
J Intern Med 2008; 264: 275-287
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