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Radiation stimulates the expression of inflammatory mediators known to increase cancer cell invasion. Therefore, it is important to determine whether anti-inflammatory drugs can prevent this adverse effect of radiation. Since cyclooxygenase-2 (COX-2) is a central player in the inflammatory response, we performed studies to determine whether the COX-2 inhibitor NS-398 can reduce the radiation enhancement of cancer cell invasion. Thighs of Balb/c mice treated with NS-398 were irradiated with either daily fractions of 7.5 Gy for five consecutive days or a single 30 Gy dose prior to subcutaneous injection of nonirradiated MC7-L1 mammary cancer cells. Five weeks later, tumor invasion, blood vessel permeability and interstitial volumes were assessed using magnetic resonance imaging (MRI). Matrix metalloproteinase-2 (MMP-2) was measured in tissues by zymography at 21 days postirradiation. Cancer cell invasion in the mouse thighs was increased by 12-fold after fractionated irradiations (5 × 7.5 Gy) and by 17-fold after a single 30 Gy dose of radiation. This stimulation of cancer cell invasion was accompanied by a significant increase in the interstitial volume and a higher level of the protease MMP-2. NS-398 treatment largely prevented the stimulation of cancer cell invasion, which was associated with a reduction in interstitial volume in the irradiated thighs and a complete suppression of MMP-2 stimulation. In conclusion, this animal model using MC7-L1 cells demonstrates that radiation-induced cancer cell invasion can be largely prevented with the COX-2 inhibitor NS-398.

Following removal of the primary breast tumour by conservative surgery, patients may still have additional malignant foci scattered throughout the breast. Radiation treatments are not designed to eliminate all these residual cancer cells. Rather, the radiation dose is calculated to optimise long-term results with minimal complications. In a tumour, cancer cells are surrounded by a basement membrane, which plays an important role in the regulation of gene expression. Using an invasion chamber, we have shown that irradiation before cell plating of a reconstituted basement membrane (Matrigel; Becton Dickinson, Bedford, MA, USA) increased the invasiveness of the breast cancer cells MDA-MB-231. This radiation enhancement of invasion was associated with the upregulation of the pro-invasive gene matrix metalloproteinase (MMP)-2. The expression of membrane type 1 matrix metalloproteinase (MT1-MMP) and tissue inhibitor of metalloproteinase-2 (TIMP), which are required to activate the MMP-2, were also increased. Confirming the role of MMP-2 and MT1-MMP, radiation enhancement of cancer cell invasion was prevented by an MMP-2 inhibitor and an anti-MT1-MMP antibody. This study also demonstrated that radiation can potentially enhance the invasion ability by inducing the release of pro-invasive factors stored in the Matrigel. Conversely, no enhancement of invasiveness was observed with the low metastatic cell line MCF-7. This lack of invasiveness correlated with the absence of the MMP-2 activator MT1-MMP in the MCF-7 cells. Radiotherapy is an efficient modality to treat breast cancer which could be further improved by inhibiting the pro-invasive gene upregulated by radiation.

Treatment of breast tumours frequently involves irradiating the whole breast to reach malignant microfoci scattered throughout the breast. In this study, we determined whether irradiation of normal tissues could increase the invasiveness of breast cancer cells in a mouse model.Non-irradiated MC7-L1 mouse mammary carcinoma cells were injected subcutaneously in irradiated and non-irradiated thighs of Balb/c mice. The invasion volume, tumour volume, blood vessel permeability and interstitial volumes were monitored by magnetic resonance imaging (MRI). Slices of normal tissue invaded by cancer cells were examined by histology. Activity of matrix metalloproteinase -2 and -9 (MMP -2 and -9) in healthy and irradiated tissues was determined, and the proliferation index of the invading cancer cells was evaluated.Three weeks after irradiation, enhancement of MC7-L1 cells invasiveness in irradiated thighs was already detected by MRI. The tumour invasion volume continued to extend 28- to 37-fold compared to the non-irradiated implantation site for the following three weeks, and it was associated with an increase of MMP-2 and -9 activities in healthy tissues. The interstitial volume associated with invading cancer cells was significantly larger in the pre-irradiated sites; while the blood vessels permeability was not altered. Cancer cells invading the healthy tissues were proliferating at a lower rate compared to non-invading cancer cells.Implantation of non-irradiated mammary cancer cells in previously irradiated normal tissue enhances the invasive capacity of the mammary cancer cells and is associated with an increased activity of MMP-2 and -9 in the irradiated normal tissue.

For women with early stage breast cancer, the primary tumour is removed by conservative surgery. However, malignant microfoci are often scattered in the breast. To eliminate these cells radiotherapy is designed to irradiate the whole breast. But the dose is not calculated to eliminate all residual cancer cells but rather to optimize long-term results with minimal complications to normal tissues such as fibrosis. These complications are mainly caused by the induction of an inflammation, associated with the upregulation of the cyclooxygenase-2 (COX-2). Furthermore the inhibition of COX-2 decreases matrix metalloproteinases (MMPs) expression, such as MMP-2 and MMP-9, both playing a central role in breast cancer cell invasion. The aim of this study is to further improve radiotherapy of breast cancer by preventing radiation-enhancement dermatitis and breast cancer cell invasion with the administration of NS-398, a COX-2 specific inhibitor. Female Balb/c mice were irradiated on a healthy thigh followed by the s.c. injection of MC7-L1 mammary cancer cells. NS-398 was injected i.p. before and after irradiation. Controls without irradiation and without cancer cells were also performed. For 3 and 6 weeks the degree of skin inflammation was scored and cancer cell invasion was monitored by contrast-enhanced magnetic resonance imaging. Tumors and surrounding tissues were subsequently removed and processed for histological analysis and zymography. We have shown that radiation actually enhances the invasiveness of breast cancer cells. MC7-L1 cells grown mainly under the skin in non irradiated thighs but invaded into the muscle fibers in irradiated thighs. These patterns were distinct 4 weeks after irradiation, but more pronounced on the 6th week. The calculated apparent invasion tumor volume was significantly greater in irradiated thighs. The activity of MMP-2 and -9 were enhanced in muscle and skin after irradiation. Our preliminary results with the COX-2 inhibitor NS-398 demonstrated an improvement of skin tolerance and a decrease of the invasion marker MMP-2 in the irradiated area. The NS-398 seemed also to reduce cancer cells proliferation and invasion. Our promising preliminary data showed that the NS-398, a specific COX-2 inhibitor, might improve the efficacy of radiotherapy for breast cancer by preventing radiation-induced dermatitis and radiation-enhancement of cancer cell invasion.

In malignant breast cancer, estrogen metabolism is altered, favoring the accumulation of hydroxyestradiols, which can generate free radicals. These reactive species can activate matrix metalloproteinases (MMPs), which in turn can hydrolyze the proteins of the extracellular matrix (ECM) that act as a barrier to tumor cell passage. The aim of this study was to determine whether reactive oxygen species generated by 4-hydroxyestradiol (4-OHE(2)) can activate MMP-2 and then enhance the invasiveness of breast cancer cells MDA-MB-231 in vitro. Enzymatic assay and gel zymography demonstrated that 4-OHE(2) at a concentration as low as 10(-8) M led to the conversion of proMMP-2 to active MMP-2. Activation of proMMP-2 by 4-OHE(2) was inhibited by the Cu,Zn-SOD supporting the involvement of the free radical superoxide anion (O(2)(*-)). Using invasion chambers coated with matrigel (artificial ECM), 4-OHE(2) (10(-8) M) enhanced the invasiveness of MDA-MB-231 breast cancer cells by 3-fold. The addition of Cu,Zn-SOD reduced the invasiveness of MDA-MB-231 cells by more than 2-fold, supporting the involvement of O(2)(*-) generated by 4-OHE(2). Addition of an MMP-2 inhibitor completely inhibited the enhancement of invasiveness induced by 4-OHE(2), which demonstrates the importance of activating MMP-2 by 4-OHE(2). On the other hand, estradiol, which does not have a catechol structure, did not generate free radicals, and it could not activate proMMP-2 or enhance the invasiveness of beast cancer cells. Although these data need to be confirmed in an animal model, this study suggests that the accumulation of 4-OHE(2) in breast tumors could enhance the invasiveness of breast cancer cells.

Breast cancer patients frequently develop metastases. This process requires the degradation of extracellular matrix proteins which act as a barrier to tumour cell passage. These proteins can be degraded by proteases, mainly the matrix metalloproteinases (MMPs). MMP-2 and -9 which are frequently detected in breast cancer tissues. ProMMPs are released from cancer cells, and their activation is considered to be a crucial step in metastases development. In breast cancer, estrogen metabolism is altered favouring the accumulation of 2- and 4-hydroxyestradiol (2- and 4-OHE(2)). These estradiol metabolites can generate free radicals. Since reactive species are known activators of proMMPs, this study was designed to determine if the free radicals generated by 2- and 4-OHE(2) can activate proMMP-2 and -9. Activation of MMPs by hydroxyestradiol was determined by monitoring the cleavage of a fluorogenic peptide and by zymography analysis. Both estradiol metabolites activated the MMP-2 and -9. 4-OHE(2) was a more potent activator than 2-OHE(2), which reflects its higher capacity to generate free radicals. ProMMPs activation was mainly mediated through O(2)*-, although the free radical HO* also activated the proMMPs but to a lesser extent. ProMMPs activation was not observed with estrogens that cannot generate free radicals, i.e. estradiol, estrone, 2- and 4-methoxyestradiol, and 16alpha-hydroxyestrone. These results demonstrate that 2- and 4-OHE(2) at a concentration as low as 10(-8)M can activate the proMMP-2 and -9 and might play an important role in the invasion of breast cancer cells.