The broad, long-range objective of this proposal is to improve the prognosis for patients with hepatocellular carcinoma (HCC). HCC is a major global burden of morbidity and mortality and its incidence in the US has tripled over the past 30 years. Locoregional thermal ablative therapies are important treatment options for early-mid stage HCC, achieving short-term outcomes similar to surgery with less morbidity. However, high tumor recurrence rates after treatment of larger HCCs (up to 75% at 5 years) limit their applicability and overall survival remains poor for these patients. Of significant concern, there is evidence that thermal ablation of HCC may induce further malignant progression. Development of therapeutic strategies for improving the efficacy of thermal ablation and ultimately patient prognosis will require a greater understanding of the molecular mechanisms regulating thermal resistance, recurrence and tumor progression. We have identified a critical role for heat stress induced MET and EGFR receptor tyrosine kinase (RTK) mediated PI3K-AKT survival signaling in HCC thermal resistance and progression and are especially excited about the observation that inhibition of the PI3K-AKT-mTOR pathway thermosensitizes HCC and accelerates heat stress induced cell killing.
The specific aims of this proposal are: 1) To determine mechanisms of heat stress induced MET/EGFR-PI3K-AKT signaling regulating HCC molecular thermoresistance;2) To determine mechanisms of thermal ablation induced tumor progression;3) To modulate HCC sensitivity to thermal ablation by PI3K-AKT-mTOR inhibition. We will use a combination of cellular and molecular methods, novel imaging techniques and in vitro, in vivo and patient-based approaches to systematically investigative the mechanistic role of the novel heat stress induced MET/EGFR-PI3K-AKT axis in HCC thermoresistance and tumor progression. Successful completion of these studies will increase our understanding of the mechanisms of molecular thermal ablation induced resistance and tumor progression and provide a strong scientific framework for translating a mechanism- based combination ablative therapy for HCC to early stage clinical trials. Overall, this proposal is potentially of high impac given lack of effective long-term treatments for HCC. The findings from this research will also likely be generalizable to other solid organ malignancies treated with thermal ablation because of the known dysregulation of RTKs, PI3K-AKT pathway, and growth factors in other tumors.

Public Health Relevance

Liver cancer is a leading cause of death from cancer worldwide and has become three times more common in the US over the past 30 years. Current medication and interventional therapies used to treat liver cancer are not very effective. Therefore, there is a vital need to develop combination therapies to more effectively treat all individuals afflicted with this debilitating illness. This research should provide important information that can be used to translate new liver cancer therapies to patients.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
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Radiation Therapeutics and Biology Study Section (RTB)
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Wong, Rosemary S
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Mayo Clinic, Rochester
United States
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Jondal, Danielle E; Thompson, Scott M; Butters, Kim A et al. (2018) Heat Stress and Hepatic Laser Thermal Ablation Induce Hepatocellular Carcinoma Growth: Role of PI3K/mTOR/AKT Signaling. Radiology 288:730-738
Thompson, Scott M; Jondal, Danielle E; Butters, Kim A et al. (2018) Heat stress and thermal ablation induce local expression of nerve growth factor inducible (VGF) in hepatocytes and hepatocellular carcinoma: pre-clinical and clinical studies. Gene Expr :
Kinsman, Kristin A; White, Mariah L; Mynderse, Lance A et al. (2018) Whole-Gland Prostate Cancer Cryoablation with Magnetic Resonance Imaging Guidance: One-Year Follow-Up. Cardiovasc Intervent Radiol 41:344-349
Thompson, Scott M; Jondal, Danielle E; Butters, Kim A et al. (2018) Heat stress induced, ligand-independent MET and EGFR signalling in hepatocellular carcinoma. Int J Hyperthermia 34:812-823
Woodrum, David A; Kawashima, Akira; Gorny, Krzysztof R et al. (2016) Targeted prostate biopsy and MR-guided therapy for prostate cancer. Abdom Radiol (NY) 41:877-88
Thompson, Scott M; Callstrom, Matthew R; McKusick, Michael A et al. (2015) Initial Results of Image-Guided Percutaneous Ablation as Second-Line Treatment for Symptomatic Vascular Anomalies. Cardiovasc Intervent Radiol 38:1171-8
Thompson, Scott M; Callstrom, Matthew R; Knudsen, Bruce et al. (2013) AS30D model of hepatocellular carcinoma: tumorigenicity and preliminary characterization by imaging, histopathology, and immunohistochemistry. Cardiovasc Intervent Radiol 36:198-203
Thompson, Scott M; Callstrom, Matthew R; Knudsen, Bruce E et al. (2013) Molecular bioluminescence imaging as a noninvasive tool for monitoring tumor growth and therapeutic response to MRI-guided laser ablation in a rat model of hepatocellular carcinoma. Invest Radiol 48:413-21
Thompson, Scott M; Callstrom, Matthew R; Knudsen, Bruce et al. (2012) Development and preliminary testing of a translational model of hepatocellular carcinoma for MR imaging and interventional oncologic investigations. J Vasc Interv Radiol 23:385-95
Thompson, Scott M; Ramirez-Giraldo, Juan C; Knudsen, Bruce et al. (2011) Porcine ex vivo liver phantom for dynamic contrast-enhanced computed tomography: development and initial results. Invest Radiol 46:586-93