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1. A gene expression-based classifier for HER2-low breast cancer

Author

Serena Di Cosimo, Sara Pizzamiglio, Chiara Maura Ciniselli, Valeria Duroni, Vera Cappelletti, Loris De Cecco, Cinzia De Marco, Marco Silvestri, Maria Carmen De Santis, Andrea Vingiani, Biagio Paolini, Rosaria Orlandi, Marilena Valeria Iorio, Giancarlo Pruneri, and Paolo Verderio

Subjects
Medicine, Science
Abstract

Abstract In clinical trials evaluating antibody-conjugated drugs (ADCs), HER2-low breast cancer is defined through protein immunohistochemistry scoring (IHC) 1+ or 2+ without gene amplification. However, in daily practice, the accuracy of IHC is compromised by inter-observer variability. Herein, we aimed to identify HER2-low breast cancer primary tumors by leveraging gene expression profiling. A discovery approach was applied to gene expression profile of institutional INT1 (n = 125) and INT2 (n = 84) datasets. We identified differentially expressed genes (DEGs) in each specific HER2 IHC category 0, 1+, 2+ and 3+. Principal Component Analysis was used to generate a HER2-low signature whose performance was evaluated in the independent INT3 (n = 95), and in the publicly available TCGA and GSE81538 datasets. The association between the HER2-low signature and HER2 IHC categories was evaluated by Kruskal–Wallis test with post hoc pair-wise comparisons. The HER2-low signature discriminatory capability was assessed by estimating the area under the receiver operating characteristic curve (AUC). Gene Ontology and KEGG analyses were performed to evaluate the HER2-low signature genes functional enrichment. A HER2-low signature was computed based on HER2 IHC category-specific DEGs. The twenty genes included in the signature were significantly enriched with lipid and steroid metabolism pathways, peptidase regulation, and humoral immune response. The HER2-low signature values showed a bell-shaped distribution across IHC categories (low values in 0 and 3+; high values in 1+ and 2+), effectively distinguishing HER2-low from 0 (p

Published
2024
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2. A combination of extracellular matrix‐ and interferon‐associated signatures identifies high‐grade breast cancers with poor prognosis

Author

Mara Lecchi, Paolo Verderio, Vera Cappelletti, Francesca De Santis, Biagio Paolini, Melissa Monica, Sabina Sangaletti, Serenella Maria Pupa, Marilena Valeria Iorio, Giulia Bianchi, Massimiliano Gennaro, Giovanni Fucà, Filippo De Braud, Elda Tagliabue, and Massimo Di Nicola

Subjects
gene signature, high‐grade breast cancer, prognostic marker, tumor microenvironment, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Breast cancer (BC) is a heterogeneous disease in which the tumor microenvironment (TME) seems to impact the clinical outcome. Here, we investigated whether a combination of gene expression signatures relating to both the structural and immune TME aspects can help predict prognosis in women with high‐grade BC (HGBC). Thus, we focused on a combined molecular biomarker variable that involved extracellular matrix (ECM)‐associated gene expression (ECM3 signature) and interferon (IFN)‐associated metagene (IFN metagene) expression. In 97 chemo‐naive HGBCs from the METABRIC dataset, the dichotomous ECM3/IFN (dECIF) variable identified a group of high‐risk patients (ECM3+/IFN− vs other; hazard ratio = 3.2, 95% confidence interval: 1.5–6.7). Notably, ECM3+/IFN− tumors showed low tumor‐infiltrating lymphocytes, high levels of CD33‐positive cells, absence of PD‐1 expression, or low expression of PD‐L1, as suggested by immune profiles and immune‐histochemical analysis on an independent cohort of 131 HGBCs. To make our results transferable to clinical use, we refined the dECIF biomarker using reduced ECM3 and IFN signatures; notably, the prognostic value of this reduced dECIF was comparable to that of the original dECIF. After validation in a new BC cohort, reduced dECIF was translated into a robust qPCR classifier for real‐world clinical use.

Published
2021
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3. The PDGFRβ/ERK1/2 pathway regulates CDCP1 expression in triple-negative breast cancer

Author

Luca Forte, Federica Turdo, Cristina Ghirelli, Piera Aiello, Patrizia Casalini, Marilena Valeria Iorio, Elvira D’Ippolito, Patrizia Gasparini, Roberto Agresti, Beatrice Belmonte, Gabriella Sozzi, Lucia Sfondrini, Elda Tagliabue, Manuela Campiglio, and Francesca Bianchi

Subjects
TNBC, CDCP1, PDGFRβ, FISH, ERK1/2, PDGF-BB, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, RC254-282
Abstract

Abstract Background CDCP1, a transmembrane protein with tumor pro-metastatic activity, was recently identified as a prognostic marker in TNBC, the most aggressive breast cancer subtype still lacking an effective molecular targeted therapy. The mechanisms driving CDCP1 over-expression are not fully understood, although several stimuli derived from tumor microenvironment, such as factors present in Wound Healing Fluids (WHFs), reportedly increase CDCP1 levels. Methods The expression of CDCP1, PDGFRβ and ERK1/2cell was tested by Western blot after stimulation of MDA-MB-231 cells with PDGF-BB and, similarly, in presence or not of ERK1/2 inhibitor in a panel of TNBC cell lines. Knock-down of PDGFRβ was established in MDA-MB-231 cells to detect CDCP1 upon WHF treatment. Immunohistochemical staining was used to detect the expression of CDCP1 and PDGFRβ in TNBC clinical samples. Results We discovered that PDGF-BB-mediated activation of PDGFRβ increases CDCP1 protein expression through the downstream activation of ERK1/2. Inhibition of ERK1/2 activity reduced per se CDCP1 expression, evidence strengthening its role in CDCP1 expression regulation. Knock-down of PDGFRβ in TNBC cells impaired CDCP1 increase induced by WHF treatment, highlighting the role if this receptor as a central player of the WHF-mediated CDCP1 induction. A significant association between CDCP1 and PDGFRβ immunohistochemical staining was observed in TNBC specimens, independently of CDCP1 gene gain, thus corroborating the relevance of the PDGF-BB/PDGFRβ axis in the modulation of CDCP1 expression. Conclusion We have identified PDGF-BB/PDGFRβ–mediated pathway as a novel player in the regulation of CDCP1 in TNCBs through ERK1/2 activation. Our results provide the basis for the potential use of PDGFRβ and ERK1/2 inhibitors in targeting the aggressive features of CDCP1-positive TNBCs.

Published
2018
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4. Abstract P5-13-26: The future of HER2-positive breast cancer patients might be written in miRNAs: An exploratory analysis from the NeoALTTO study

Author

Marilena Valeria Iorio, Sara Pizzamiglio, Giulia Cosentino, Chiara M Ciniselli, Loris De Cecco, Alessandra Cataldo, Ilaria Plantamura, Tiziana Triulzi, Sarra El-abed, Yingbo Wang, Mohammed Bajji, Paolo Nuciforo, Jens Huober, Susan Ellard, David Rimm, Andrea Gombos, Mariagrazia Daidone, Paolo Verderio, Elda Tagliabue, and Serena Di Cosimo

Subjects
Cancer Research, Oncology
Abstract

Importance. Neoadjuvant therapy with dual HER2 blockade improved pathological complete response (pCR) rate. Nevertheless, it would be desirable to identify patients exquisitely responsive to single agent trastuzumab to minimize or avoid overtreatment. Objective. To evaluate the predictive and prognostic value of basal primary tumor miRNA expression profile within the trastuzumab arm of the NeoALTTO study.Design, Setting and Participants. RNA samples from baseline biopsies were randomized into training (n =45) and testing (n =47) sets. After normalization, miRNAs associated with Event-free survival (EFS) and pCR were identified by univariate analysis. Multivariate models were implemented to generate specific signatures which were first confirmed, and then analyzed according to other clinical and pathological variables.Main outcomes and measures. Association between miRNA expression and pCR and/or EFS.Results. We identified a prognostic signature including hsa-miR-153-3p (HR 1.831, 95%CI: 1.34-2.50) and hsa-miR-219a-5p (HR 0.629, 95%CI: 0.50 - 0.78). For two additional miRNAs (miR-215-5p and miR-30c-2-3p), we found a statistically significant interaction term with pCR (p.interaction: 0.017 and 0.038, respectively). Besides, a two-miRNA signature was predictive of pCR (hsa-miR-31-3p, OR 0.70, 95%CI: 0.53 - 0.92, and hsa-miR-382-3p, OR: 1.39, 95%CI: 1.01 -1.91). Notably, the performance of this predictive miRNA signature resembled that of the genomic classifiers PAM50 and TRAR, and did not improve when the extended models were fitted.Conclusions and relevance. Analysis of primary tumor tissue miRNAs holds the potential of a parsimonious tool to identify patients with differential clinical outcomes after trastuzumab based neoadjuvant therapy. Trial registration. ClinicalTrials.gov Identifier: NCT00553358. Table 1.MiRNAs associated with EFS. Results of the univariate Cox regression model- training set.miRNAsHR95% CIhsa-miR-12000.671(0.512; 0.879)ahsa-miR-1238-3p0.669(0.543; 0.826)ahsa-miR-12650.839(0.705; 0.997)ahsa-miR-129-5p0.785(0.628; 0.980)ahsa-miR-153-3p1.412(1.026; 1.943)ahsa-miR-15390.826(0.697; 0.979)ahsa-miR-1908-5p0.796(0.648; 0.978)ahsa-miR-205-5p0.737(0.553; 0.982)hsa-miR-219a-5p0.787(0.627; 0.989)ahsa-miR-25-5p0.566(0.391; 0.819)ahsa-miR-3000.581(0.399; 0.845)ahsa-miR-382-3p0.791(0.636; 0.985)ahsa-miR-4920.774(0.635; 0.944)ahsa-miR-519a-3p0.834(0.696; 0.998)ahsa-miR-551b-5p0.666(0.452; 0.981)ahsa-miR-5830.727(0.549; 0.963)ahsa-miR-6001.373(1.03; 1.829)ahsa-miR-6260.819(0.673; 0.998)ahsa-miR-651-5p0.611(0.382; 0.977)hsa-miR-7610.845(0.721; 0.991)ahsa-miR-891b0.658(0.479; 0.904)ahsa-miR-92a-2-5p0.787(0.637; 0.971)ahsa-miR-937-3p0.748(0.578; 0.967)aHR, Hazard Ratio; CI, Confidence Intervala microRNAs retained its statistically significance (at 10%) also when normalized for the overall mean. Table 2.MiRNAs associated with pCR. Results of the univariate logistic model - training set.miRNAsOR95% CIhsa-miR-132-3p0.410(0.169; 0.991)ahsa-miR-23b-5p0.520(0.316; 0.856)ahsa-miR-31-3p0.566(0.351; 0.912)ahsa-miR-31-5p0.508(0.291; 0.887)ahsa-miR-330-3p0.501(0.251; 0.999)hsa-miR-34b-3p0.673(0.474; 0.956)ahsa-miR-382-3p1.392(1.006; 1.925)ahsa-miR-548j-5p1.702(1.090; 2.658)aOR, Odds Ratio; CI, Confidence Interval. a microRNAs retained its statistically significance (at 10%) also when normalized for the overall mean. 2 Citation Format: Marilena Valeria Iorio, Sara Pizzamiglio, Giulia Cosentino, Chiara M Ciniselli, Loris De Cecco, Alessandra Cataldo, Ilaria Plantamura, Tiziana Triulzi, Sarra El-abed, Yingbo Wang, Mohammed Bajji, Paolo Nuciforo, Jens Huober, Susan Ellard, David Rimm, Andrea Gombos, Mariagrazia Daidone, Paolo Verderio, Elda Tagliabue, Serena Di Cosimo. The future of HER2-positive breast cancer patients might be written in miRNAs: An exploratory analysis from the NeoALTTO study [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P5-13-26.

Published
2022
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5. HER2 signaling enhances 5'UTR-mediated translation of c-Myc mRNA

Author

Enrico, Galmozzi, Patrizia, Casalini, Marilena Valeria, Iorio, Barbara, Casati, Clelia, Olgiati, and Sylvie, Ménard

Subjects
Neuregulin-1, Genes, myc, Protein Serine-Threonine Kinases, Proto-Oncogene Proteins c-myc, Phosphatidylinositol 3-Kinases, Genes, Reporter, Cell Line, Tumor, Proto-Oncogene Proteins, Humans, RNA, Messenger, Cycloheximide, Enzyme Inhibitors, Luciferases, Promoter Regions, Genetic, Ovarian Neoplasms, Protein Synthesis Inhibitors, TOR Serine-Threonine Kinases, Carcinoma, Genes, erbB-2, Clone Cells, Androstadienes, Gene Expression Regulation, Neoplastic, Protein Biosynthesis, Dactinomycin, Female, 5' Untranslated Regions, Wortmannin, Protein Kinases, Proto-Oncogene Proteins c-akt, Signal Transduction
Abstract

The increased levels of c-Myc protein observed previously in an ovarian carcinoma cell line stably transfected to express HER2 has suggested a role for the HER2 pathway in c-Myc expression. Analysis of HER2-transfected cells stimulated with heregulin beta1 (HRG) revealed increased c-Myc protein levels but not a corresponding increase in c-Myc mRNA expression or any change in c-Myc protein half-life. Transfection of HER2-overexpressing cells with a construct containing the 5' untranslated region (5'UTR) of c-Myc mRNA originated from the P2 promoter and placed upstream of the Renilla luciferase gene, enhanced reporter expression upon stimulation with HRG. The HRG-mediated increase in reporter activity correlated with the HRG-mediated induction observed for c-Myc protein, identifying the P2-derived leader (P2L) of c-Myc mRNA as the cis-element involved in c-Myc translational induction. Both the increase in c-Myc protein levels and P2L-enhanced translational activity were inhibited by the PI3K inhibitor wortmannin. Together, these results demonstrate that HRG stimulation of HER2 overexpressing cells leads to enhanced c-Myc protein synthesis through activation of the PI3K/Akt/mTOR pathway and that the P2L of c-Myc mRNA is the element responsible for induction of c-Myc translation.

Published
2004

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