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PDF file - 167K, Different probes for the same gene vary within and across microarray platforms

Purpose: Epithelial–mesenchymal transition (EMT) has been associated with metastatic spread and EGF receptor (EGFR) inhibitor resistance. We developed and validated a robust 76-gene EMT signature using gene expression profiles from four platforms using non–small cell lung carcinoma (NSCLC) cell lines and patients treated in the Biomarker-Integrated Approaches of Targeted Therapy for Lung Cancer Elimination (BATTLE) study.Experimental Design: We conducted an integrated gene expression, proteomic, and drug response analysis using cell lines and tumors from patients with NSCLC. A 76-gene EMT signature was developed and validated using gene expression profiles from four microarray platforms of NSCLC cell lines and patients treated in the BATTLE study, and potential therapeutic targets associated with EMT were identified.Results: Compared with epithelial cells, mesenchymal cells showed significantly greater resistance to EGFR and PI3K/Akt pathway inhibitors, independent of EGFR mutation status, but more sensitivity to certain chemotherapies. Mesenchymal cells also expressed increased levels of the receptor tyrosine kinase Axl and showed a trend toward greater sensitivity to the Axl inhibitor SGI-7079, whereas the combination of SGI-7079 with erlotinib reversed erlotinib resistance in mesenchymal lines expressing Axl and in a xenograft model of mesenchymal NSCLC. In patients with NSCLC, the EMT signature predicted 8-week disease control in patients receiving erlotinib but not other therapies.Conclusion: We have developed a robust EMT signature that predicts resistance to EGFR and PI3K/Akt inhibitors, highlights different patterns of drug responsiveness for epithelial and mesenchymal cells, and identifies Axl as a potential therapeutic target for overcoming EGFR inhibitor resistance associated with the mesenchymal phenotype. Clin Cancer Res; 19(1); 279–90. ©2012 AACR.

Supplementary Figure S3. Pathway annotation for HNSCC super-groups. Each horizontal bar graph represents enriched pathways in different subtypes. The number at the end of bar is the total number of genes in a pathway. Percentage of genes in the dataset that overlap with the pathway are shown in grey colour of the bar. The trend line represents the -log(p-value).

PDF file - 66K, CDH1 probes vary in their accuracy and dynamic range

Supplementary Figure S2. Workflow of training HNSCC subtypes and consensus clustering of three training datasets. (A) Workflow of the procedure to identify and validate HNSCC subtypes (B) Consensus clustering in three training datasets identifies five HNC subtypes that differ across platforms. Consensus index matrix for k=5, cumulative distribution function (CDF) for k=2 to k=10 and relative change in area under the CDF curve for k=2 to k=10 are shown. From top to bottom are Agilent (n=134), Illumina (n=131), and Affymetrix (n=106) cohorts.

Purpose: Current classification of head and neck squamous cell carcinomas (HNSCC) based on anatomic site and stage fails to capture biologic heterogeneity or adequately inform treatment.Experimental Design: Here, we use gene expression-based consensus clustering, copy number profiling, and human papillomavirus (HPV) status on a clinically homogenous cohort of 134 locoregionally advanced HNSCCs with 44% HPV+ tumors together with additional cohorts, which in total comprise 938 tumors, to identify HNSCC subtypes and discover several subtype-specific, translationally relevant characteristics.Results: We identified five subtypes of HNSCC, including two biologically distinct HPV subtypes. One HPV+ and one HPV− subtype show a prominent immune and mesenchymal phenotype. Prominent tumor infiltration with CD8+ lymphocytes characterizes this inflamed/mesenchymal subtype, independent of HPV status. Compared with other subtypes, the two HPV subtypes show low expression and no copy number events for EGFR/HER ligands. In contrast, the basal subtype is uniquely characterized by a prominent EGFR/HER signaling phenotype, negative HPV-status, as well as strong hypoxic differentiation not seen in other subtypes.Conclusion: Our five-subtype classification provides a comprehensive overview of HPV+ as well as HPV− HNSCC biology with significant translational implications for biomarker development and personalized care for patients with HNSCC. Clin Cancer Res; 21(4); 870–81. ©2014 AACR.

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PDF file - 50K, Mesenchymal lines are sensitive to Axl inhibition by SGI-7079

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PDF file - 214K, The EMT signature genes

Purpose: Mortality of patients with head and neck squamous cell carcinoma (HNSCC) is primarily driven by tumor cell radioresistance leading to locoregional recurrence (LRR). In this study, we use a classification of TP53 mutation (disruptive vs. nondisruptive) and examine impact on clinical outcomes and radiation sensitivity.Experimental Design: Seventy-four patients with HNSCC treated with surgery and postoperative radiation and 38 HNSCC cell lines were assembled; for each, TP53 was sequenced and the in vitro radioresistance measured using clonogenic assays. p53 protein expression was inhibited using short hairpin RNA (shRNA) and overexpressed using a retrovirus. Radiation-induced apoptosis, mitotic cell death, senescence, and reactive oxygen species (ROS) assays were carried out. The effect of the drug metformin on overcoming mutant p53-associated radiation resistance was examined in vitro as well as in vivo, using an orthotopic xenograft model.Results: Mutant TP53 alone was not predictive of LRR; however, disruptive TP53 mutation strongly predicted LRR (P = 0.03). Cell lines with disruptive mutations were significantly more radioresistant (P < 0.05). Expression of disruptive TP53 mutations significantly decreased radiation-induced senescence, as measured by SA-β-gal staining, p21 expression, and release of ROS. The mitochondrial agent metformin potentiated the effects of radiation in the presence of a disruptive TP53 mutation partially via senescence. Examination of our patient cohort showed that LRR was decreased in patients taking metformin.Conclusions: Disruptive TP53 mutations in HNSCC tumors predicts for LRR, because of increased radioresistance via the inhibition of senescence. Metformin can serve as a radiosensitizer for HNSCC with disruptive TP53, presaging the possibility of personalizing HNSCC treatment. Clin Cancer Res; 18(1); 290–300. ©2011 AACR.

PDF file - 71K, Percentage tumor volume compared to control, survival and therapeutic efficacy at days 17 and 38 post-treatment

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PDF file - 51K, EMT status of commonly mutated genes in NSCLC

Supplementary Table S2. Centroids of the 821 gene signature for the three super-groups

Supplementary Figure S4. Keratinization and differentiation in HNSCC subtypes. Samples in mesenchymal HPV subtype do not show keratinization and most of them are poorly differentiated. Conversely, most samples in basal subype are keratinizing and show moderate to well differentiation.

PDF file - 27K, SGI-7079 and erlotinib do not adversely affect animal body weight

PDF file - 96K, Structure of pyrrolopyrimidine AXL inhibitor SGI-7079

Supplementary Figure S1. Flowchart shows how OCT blocks of frozen tissue samples were obtained from the University of Chicago Head and Neck Cancer tissue bank.

Purpose: Radiotherapy plays an integral role in the treatment of head and neck squamous cell carcinoma (HNSCC). Although proteins involved in DNA repair may predict HNSCC response to radiotherapy, none has been validated in this context. We examined whether differential expression of double-strand DNA break (DSB) repair proteins in HNSCC, the chief mediators of DNA repair following irradiation, predict for treatment outcomes.Experimental Design: Archival HNSCC tumor specimens (n = 89) were assembled onto a tissue microarray and stained with antibodies raised against 38 biomarkers. The biomarker set was enriched for proteins involved in DSB repair, in addition to established mechanistic markers of radioresistance. Staining was correlated with treatment response and survival alongside established clinical and pathologic covariates. Results were validated in an independent intramural cohort (n = 34).Results: Ku80, a key mediator of DSB repair, correlated most closely with clinical outcomes. Ku80 was overexpressed in half of all tumors, and its expression was independent of all other covariates examined. Ku80 overexpression was an independent predictor for both locoregional failure and mortality following radiotherapy (P < 0.01). The predictive power of Ku80 overexpression was confined largely to HPV-negative HNSCC, where it conferred a nine-fold greater risk of death at two years.Conclusions: Ku80 overexpression is a common feature of HNSCC, and is a candidate DNA repair-related biomarker for radiation treatment failure and death, particularly in patients with high-risk HPV-negative disease. It is a promising, mechanistically rational biomarker to select individual HPV-negative HNSCC patients for strategies to intensify treatment. Clin Cancer Res; 17(7); 2035–43. ©2011 AACR.

Supplementary Figures S1-S3; Supplementary Tables S1-S4.

Supplemental Materials and Legend. Supplemental Experimental Procedures: Determination of HPV status; Gene expression profiling; Copy number aberration (CNA) experiment; Copy number aberration (CNA) analysis; Published Data Set Collection and Integration; Unsupervised Discovery of Gene Expression-Based Subtypes and Derivation of Gene Signatures; Validation of HNSCC Classification; Single Sample Gene Set Enrichment Analysis (ssGSEA); Pathway Analysis; Survival Analysis; Immunohistochemistry and Immunofluorescence. Supplementary Figure Legends. Supplementary Table S1. Data set source and group allocation Supplementary Table S3. Significant copy number gain and loss in the discovery set (101 samples and 75 genes). Supplementary Table S4. Significant copy number gain and loss in the validation set (55 samples and 72 genes) Supplementary Table S5. Significant copy number alterations per subtype.

Supplementary Table 2 from Gene Expression Profiles Identify Epithelial-to-Mesenchymal Transition and Activation of Nuclear Factor-κB Signaling as Characteristics of a High-risk Head and Neck Squamous Cell Carcinoma

Supplementary Table 1 from Gene Expression Profiles Identify Epithelial-to-Mesenchymal Transition and Activation of Nuclear Factor-κB Signaling as Characteristics of a High-risk Head and Neck Squamous Cell Carcinoma

Gene expression signatures generated from DNA microarray analyses have shown promise as predictive biomarkers of clinical outcome. In this study, we determined a high-risk signature for disease recurrence using formalin-fixed head and neck squamous cell carcinoma (HNSCC) tumors and compared the results with an independent data set obtained from fresh frozen tumors. We also showed that genes involved in epithelial-to-mesenchymal transition (EMT) and nuclear factor-κB (NF-κB) signaling deregulation are the most prominent molecular characteristics of the high-risk tumors. Gene expression was determined in 40 samples, including 34 formalin-fixed tissues and 6 matched frozen tissues, from 29 HNSCC patients. A 75-gene list predictive of disease recurrence was determined by training on the formalin-fixed tumor data set and tested on data from the independent frozen tumor set from 60 HNSCC patients. The difference in recurrence-free survival (RFS) between the high-risk versus low-risk groups in the training and test sets was statistically significant (P = 0.002 and 0.03, respectively, log-rank test). In addition, the gene expression data was interrogated using Gene Set Enrichment Analysis to determine biological significance. The most significant sets of genes enriched in the high-risk tumors were genes involving EMT, NF-κB activation, and cell adhesion. In conclusion, global gene expression analysis is feasible using formalin-fixed tissue. The 75-gene list can be used as a prognostic biomarker of recurrence, and our data suggest that the molecular determinants of EMT and NF-κB activation can be targeted as the novel therapy in the identified high-risk patients. (Cancer Res 2006; 66(16): 8210-8)

Purpose: Mortality of patients with head and neck squamous cell carcinoma (HNSCC) is primarily driven by tumor cell radioresistance leading to locoregional recurrence (LRR). In this study, we use a classification of TP53 mutation (disruptive vs. nondisruptive) and examine impact on clinical outcomes and radiation sensitivity. Experimental Design: Seventy-four patients with HNSCC treated with surgery and postoperative radiation and 38 HNSCC cell lines were assembled; for each, TP53 was sequenced and the in vitro radioresistance measured using clonogenic assays. p53 protein expression was inhibited using short hairpin RNA (shRNA) and overexpressed using a retrovirus. Radiation-induced apoptosis, mitotic cell death, senescence, and reactive oxygen species (ROS) assays were carried out. The effect of the drug metformin on overcoming mutant p53-associated radiation resistance was examined in vitro as well as in vivo, using an orthotopic xenograft model. Results: Mutant TP53 alone was not predictive of LRR; however, disruptive TP53 mutation strongly predicted LRR (P = 0.03). Cell lines with disruptive mutations were significantly more radioresistant (P < 0.05). Expression of disruptive TP53 mutations significantly decreased radiation-induced senescence, as measured by SA-β-gal staining, p21 expression, and release of ROS. The mitochondrial agent metformin potentiated the effects of radiation in the presence of a disruptive TP53 mutation partially via senescence. Examination of our patient cohort showed that LRR was decreased in patients taking metformin. Conclusions: Disruptive TP53 mutations in HNSCC tumors predicts for LRR, because of increased radioresistance via the inhibition of senescence. Metformin can serve as a radiosensitizer for HNSCC with disruptive TP53, presaging the possibility of personalizing HNSCC treatment. Clin Cancer Res; 18(1); 290–300. ©2011 AACR.

Purpose: Radiotherapy plays an integral role in the treatment of head and neck squamous cell carcinoma (HNSCC). Although proteins involved in DNA repair may predict HNSCC response to radiotherapy, none has been validated in this context. We examined whether differential expression of double-strand DNA break (DSB) repair proteins in HNSCC, the chief mediators of DNA repair following irradiation, predict for treatment outcomes. Experimental Design: Archival HNSCC tumor specimens (n = 89) were assembled onto a tissue microarray and stained with antibodies raised against 38 biomarkers. The biomarker set was enriched for proteins involved in DSB repair, in addition to established mechanistic markers of radioresistance. Staining was correlated with treatment response and survival alongside established clinical and pathologic covariates. Results were validated in an independent intramural cohort (n = 34). Results: Ku80, a key mediator of DSB repair, correlated most closely with clinical outcomes. Ku80 was overexpressed in half of all tumors, and its expression was independent of all other covariates examined. Ku80 overexpression was an independent predictor for both locoregional failure and mortality following radiotherapy (P < 0.01). The predictive power of Ku80 overexpression was confined largely to HPV-negative HNSCC, where it conferred a nine-fold greater risk of death at two years. Conclusions: Ku80 overexpression is a common feature of HNSCC, and is a candidate DNA repair-related biomarker for radiation treatment failure and death, particularly in patients with high-risk HPV-negative disease. It is a promising, mechanistically rational biomarker to select individual HPV-negative HNSCC patients for strategies to intensify treatment. Clin Cancer Res; 17(7); 2035–43. ©2011 AACR.

Human papillomavirus (HPV) type 16 is a major cause of oropharyngeal carcinoma (OPC). P16INK4A has been suggested to be a reliable surrogate marker of HPV-associated OPC with 100% sensitivity and about 80% specificity. Increasing data showed tumor HPV positivity or p16 expression was strongly associated with significantly better prognosis in patients with OPC. As a tumor suppressor gene, p16 has biological functions including regulation of cell cycle progression at the G1/S boundary, angiogenesis, cell senescence, tumor invasion, cell spreading, apoptosis and anoikis. The present study was undertaken to assess the role of p16 in regulating tumor radioresponse and the underlying mechanisms in OPC cell lines. OPC cell lines HN-5 (HPV and p16 negative) and UMSCC-47 (HPV and p16 positive) were used. P16 overexpressing HN-5 cells and shRNA p16 knockdown UMSCC-47 cells were generated using lentivirus vectors. Treatment endpoint was clonogenic cell survival (CSA) determined 10-12 days (for HN5) or 17-20 days (for UMSCC-47) after exposing the cells to 2-10 Gy single doses of γ-radiation (IR). Compared with the control (scramble) cells, p16-overexpressing HN5 cells had significantly higher radiosensitivity (by a factor of 1.56 at 0.1 cell survival fraction); whereas, p16-knockingdown UMSCC-47 cells had less radiosensitivity (by a factor of 1.23 at 0.1 cell survival fraction). Overexpressing P16 in HN-5 cells significantly prolonged the presence of radiation-induced double-strand breaks detected on the basis of 53BP1 foci at 24h after 4 Gy IR. To directly gauge damaged DNA, an alkaline comet assay to detect both single- and double-strand DNA breaks was performed. P16 overexpressing HN-5 cells exhibited a 2.09-fold increase in the comet ‘tail moment’ 48 hours after IR. This finding was supported by increased expression of 53BP1 analyzed by Western blot. In conclusion, other than being a robust surrogate marker for tumor control and survival outcome, our findings demonstrated that p16 also functions as a potent radiation sensitizer. The major underlying mechanism of p16 regulating radiosensitivity is by inhibition of DNA damage repair. Citation Format: Li Wang, Peijing Zhang, David P Molkentine, Hailong Piao, Chunyan Chen, Jessica M Molkentine, Jinsong Zhang, David R Valdecanas, Heath Skinner, Thomas A Buchholz, Junjie Chen, Li Ma, Kathy A Mason, Kie-kian Ang, Raymond E Meyn. P16INK4A, a surrogate marker of HPV infection and prognosis for head and neck cancer, delays DNA damage repair and enhances radiation response. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 4895. doi:10.1158/1538-7445.AM2014-4895

Purpose: Targeting signaling pathways that are implicated in cancer cell resistance to therapy are being investigated to improve therapy outcome. One of the receptor tyrosine kinases, c-Met (Met) is frequently overexpressed in many cancer types including non small cell lung cancers (NSCLCs) and head and neck squamous cell carcinomas (HNSCCs) and is associated with resistance to radiation. EMD1214063 is a small molecule inhibitor that suppresses the kinase activity of Met. The current study investigated the potential of EMD1214063 (provided by EMD Serono Merck Inc) in enhancing cancer cell sensitivity to radiation. Materials and Methods: Three NSCLC lines (A549, H460 and H1993) and three HNSCC lines (FaDu, HN-5 and UMSCC-1) with different levels of Met protein were used for the study. The effects of EMD1214063 on Met expression, cell viability, migration and cell radiosensitivity were assessed. Various scheduling effect on the magnitude of increased cell radiosensitivity was evaluated. 53BP1 foci formation was assayed for DNA repair kinetics. In vivo tumor growth delay assays on two NSCLCs and two HNSCCs generated in mice were performed to test the efficacy of EMD1214063 on tumor growth and tumor response to radiation. Results: NSCLC lines expressed higher levels of Met than HNSCC lines. EMD1214063 reduced survival of NSCLC lines markedly and had a minimal effect on HNSCC lines in vitro. Western blots showed three major Met protein bands with molecular weights of about 145 kDa, 60 kDa and 45 kDa. Radiation increased the expression levels of the 145 kDa and 60 kDa fragments of Met in a dose dependent manner. EMD1214063 suppressed the radiation-induced expression of Met and prolonged the presence of 53BP1 foci. It potently enhanced the radiosensitivity of A549, H1993, HN-5 and FaDu but not that of H460 and UMSCC-1. The enhancement factors at the survival fraction of 0.5 ranged from 1.11 to 2.24, with H1993 being the most responsive cell line. In vivo data showed lack of single agent activity of EMD1214063 on the growth of tumor xenografts tested (A549, H460 and FaDu). However, it showed a schedule dependent effect in enhancing A549 tumor xenograft response to radiation: a marked enhancement was observed only when EMD1214063 was given concurrently with fractionated doses of radiation. In vivo studies on other tumor types are ongoing. Conclusions: This study demonstrated that EMD1214063 reduced viability and migration of NSCLC cells and it selectively enhanced radiosensitivity of cells that express higher levels of basal or induced Met and the underlying mechanism may be inhibition of DNA repair. In vivo study data showed EMD1214063 induced a schedule dependent enhancement of tumor response to radiation in a NSCLC line. These data warrant further in vivo investigations aiming at taking best regimens to the clinic testing. This study is being supported by EMD Serono Merck via an independent medical grant. Citation Format: Uma Raju, David P. Molkentine, Jessica M. Molkentine, David N. Valdecanas, K Kian Ang. Targeting Met signaling to overcome human cancer cell resistance to radiation. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 4435. doi:10.1158/1538-7445.AM2013-4435

The poly-(ADP-ribose) polymerase (PARP) inhibitor, MK-4827, is a novel potent, orally bioavailable PARP-1 and PARP-2 inhibitor currently in phase I clinical trials for cancer treatment. No preclinical data currently exist on the combination of MK-4827 with radiotherapy (XRT). We examined whether MK-4827 enhances radiosensitivity of a variety of human tumor xenografts of differing p53 status. Human lung cancer xenografts, Calu-6 (p53 null), A549 (p53 wild-type [wt]) and H-460 (p53 wt) and triple negative MDA-MB-231 human breast carcinoma xenografts were used. Tumor xenografts growing in the hind leg of nude mice were exposed to fractionated XRT at 8 mm (diameter). Fractionated XRT (2 Gy per fraction) was delivered for 7 (twice daily, 6 h in between) or 14 (once daily) consecutive days, total dose 28 Gy. MK-4827 was given by gavage once (50 mg/kg, 1 h before first XRT of the day) or twice daily (25 mg/kg, 1 h before each XRT of the day) starting when tumors were 6 mm diameter. Mice received (a) no treatment, (b) MK-4827, (c) XRT or (d) MK-4827 plus XRT. Tumor growth delay (TGD, days for tumors to grow from 8.0 mm to 12.0 mm) was the endpoint. Radiation enhancement factor (EF) was then calculated. MK-4827 alone had no effect on tumor growth for any of the tumors types. For p53 mutant Calu-6 xenografts TGD for untreated tumors was 13.2 ± 0.5 and for twice daily XRT was 30.9 ± 2.4 days. Combination of XRT for 7 days with MK-4827, 25mg/kg twice daily for 21 consecutive days, further extended TGD to 39.7 ± 2.0 days (EF 1.4) and 47.8 ± 4.0 days (EF 2.03) for MK-4827, 50mg/kg once daily. Maximum radiation enhancement was observed when MK-4827 was given at a dose of 50 mg/kg once daily. For XRT and MK-4827 given once daily, MK-4827 was continued until 2 days after completion of XRT, MK-4827 was found to be similarly effective and the EF was 1.7. For p53 wt H460and A459 xenografts, twice daily XRT and once daily MK-4827 was used. MK-4827 was continued until 2 days after completion of XRT. TGD for untreated H460 and A459 xenografts was 7.8 ± 0.5 and 33.2 ± 1.5 days respectively; whereas it was 15.6 ± 0.5 and 53.2 ± 3.1 days respectively for irradiated tumors. TGDs were further extended to 26.0 ± 3.5 days for H460 (EF 2.2) and 64.1 ± 4.2 days (EF 1.9) for A549 xenografts in MK-4827 plus XRT groups. Similarly, using MDA-MB-231 human breast carcinoma xenografts, the potency of combination treatment was greater than XRT alone showing essentially no local tumor regrowth until the occurrence of metastases. When MK-4827 was given as a single dose of 50 mg/kg and tumors were assayed for PAR, MK-4827 reduced PAR levels in tumors by 1 h after administration which persisted for up to 24 h. In conclusion, MK-4827 strongly enhanced the effect of radiation on a variety of human tumor xenografts irrespective of p53 status. The long lasting PARP inhibition (1-24h) potentially adds flexibility to future clinical trial design. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 1461. doi:1538-7445.AM2012-1461

PURPOSE: The combination of radiation with concurrent chemotherapy improves local-regional control and overall survival in patients with locally advanced head and neck squamous cell carcinoma (HNSCC). However, its acute and chronic toxicity have raised concerns and thereby prompted the search for more biologically sound therapeutic strategy, e.g., targeting receptor tyrosine kinases (RTKs) that are differentially expressed between tumors and normal tissues. The current study tested the therapeutic benefits of co-targeting two RTKs, namely, epidermal growth factor receptor (EGFR) by panitumumab (Pmab) and insulin-like growth factor receptor-1 (IGF-1R) by AMG479 to enhance tumor response to radiation. METHODS AND MATERIALS: A HNSCC model, FaDu, was used for assessing the effects of AMG479, and Pmab to improve tumor response to radiation by in vitro clonogenic cell survival assay and in vivo tumor growth delay assay. Various doses and administration scheduling of these agents relevant to radiation were tested. RESULTS: In vitro study showed that Pmab significantly enhanced the radiosensitivity of FaDu with an enhancement factor (EF) of 1.4 at 0.5 survival fraction. AMG479 given alone or concurrently with Pmab had no affects in normal (10% serum) culture media. In vivo xenograft studies showed that Pmab or AMG479 given as single agent enhanced the tumor response to fractionated radiation (2 Gy twice a day for 6 d) in a dose and schedule dependent manner. The maximum EF was 1.1 for AMG479 and 1.7 for Pmab. The effects of combining Pmab and AMG479 with radiation depended markedly on the scheduling. The best effects were achieved when (1) Pmab and AMG479 were given concurrently daily starting 4 d before radiation for a total of 15 days resulting in an EF of 3.0 or (2) Pmab and AMG479 were given sequentially commencing Pmab 4 d before radiation for 15 d and AMG479 after completion of radiation also for 15 d yielding an EF of 2.9. However, administering AMG479 before radiation followed by Pmab was much less effective (EF: 2.0). CONCLUSIONS: Our results showed Pmab enhanced FaDu response to radiation. AMG479 markedly increased tumor response when given together or following Pmab, in conjunction with radiation. These findings provide the rationale for clinical testing of the combination of Pmab and AMG479 for the treatment of HNSCC along with the most promising regimen of administration. Supported by Amgen Inc., Thousand Oaks, CA Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2507. doi:10.1158/1538-7445.AM2011-2507

Background: cSrc is often over-expressed in cancer cells including head and neck squamous cell carcinoma (HNSCC) and is implicated in promoting cell survival, proliferation, angiogenesis, cell adhesion and motility. Its role in tumor resistance to cytotoxic agents, such as radiation, is less clear. Present study investigated (1) the relationship between the level of activated cSrc expression and the degree of cell radioresistance and (2) the role of cSrc in the cellular response to radiation, using both in vitro and in vivo models. Materials and methods: Ten HNSCC lines (FaDu, HN-5, UMSCC-1, HN-30, MDA1386, UMSCC-17B, UMSCC-47, Sqccy-1, SN2 and PCI15B) were assessed for their sensitivity to ionizing radiation by clonogenic survival and for expression levels of active Src kinases using phospho-kinase antibody array kit (Proteome ProfilerTM, R&D Systems, Inc., Minneapolis, MN). cSrc expression levels were validated by Western blot. cSrc-siRNA was transfected by electroporation to suppress cSrc expression, after which the cells were assessed for radiosensitivity. We also tested the effect of dasatinib, an inhibitor of Src kinases, on in vitro cell radiosensitivity, and on the growth of tumor xenografts in nude mice. Results: HNSCC lines exhibited a wide range of both radiosensitivity and levels of phosphorylated Src family kinases. There was a highly positive correlation (r=0.883) between SF2 values (cell survival at 2 Gy) and the degree of basal phosphorylated cSrc kinase expression. As the latter increased the ability of cells to survive radiation, increased. Inhibition of cSrc expression by cSrc-siRNA in 2 cell lines tested (FaDu and UMSCC1) resulted in a significant increase in their radiosensitivity, suggesting a causal relationship between cSrc and cell radioresistance. Inhibition of cSrc by dasatinib also resulted in increase of radiosensitivity of 3 cell lines tested (FaDu, HN-5, UMSCC-1). Additionally, dasatinib enhanced in vivo tumor response to radiation as shown by a marked increase in radiation-induced growth delay of FaDu xenografts. Conclusions: Our data showed that (1) a strong correlation exists between the expression level of cSrc and cell radiosensitivity of HNSCCs, (2) inhibition of cSrc expression by siRNA can render tumor cells more radiosensitive, implicating a causal relationship between cSrc and radioresistance, and (3) dasatinib enhanced both the in vitro tumor cell radiosensitivity and in vivo tumor response to radiation. These results suggest that targeting cSrc signaling network may have potential to improve the efficacy of radiotherapy. Supported in part by Bristol-Myers Squibb Company Sponsored Agreement (PI: U. Raju), NIH PO-1 Grant CA-06294 (PI: KK. Ang) Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 488.