I. Nm23. The PI discovered the first metastasis suppressor gene, Nm23. Basic and translational research has investigated the role of Nm23 in the regulation of tumor metastasis. Eleven transfection studies have documented that overexpression of Nm23 in various tumor cell lines resulted in a 50-90% decrease in tumor metastatic potential in vivo. The mechanism of Nm23 suppression of metastasis is likely complex. Previous work has demonstrated a histidine protein kinase activity for Nm23 and identified Ksr and disruption of the Erk signaling pathway as substrates. Another potential mechanism of action of Nm23 is through binding to other proteins. This project asked, in an unbiased manner, which proteins bind to a Flag tagged Nm23-H1 and -M1 in vitro and in vivo. A previously undisclosed interaction of Nm23 and gelsolin has been validated. Nm23 interaction with Gelsolin has been demonstrated to retard Gelsolin depolymerization of actin and enhancement of metastasis in vivo in two model systems. The data offer an additional potential mechanistic explanation for Nm23's anti-metastatic effects. II. LPAR1 studies. One of the potential avenues to drug a suppressor gene is to identify inverse correlates of its expression. The lysophosphatidic acid receptor (LPA1, LPAR1), a G-protein coupled receptor for the serum lysophosphatidic acid (LPA) was found to be inversely related to Nm23 expression in cell lines, human breast tumors, and knock-out animal tissues. Forced re-expression of LPA1 overcame Nm23 suppression of tumor cell motility in vitro and metastasis in vivo. We hypothesized that an inhibitor of LPA1 would act as a metastasis suppressor and have preclinically validated Debio 0719. Administration of 0719 to animals injected into the mammary fat pad with murine 4T1 cells had no effect on primary tumor size. After surgical removal of the primary tumor, metastasis in the lymph nodes, lungs and liver was quantified 10 weeks post-injection. 0719 induced a significant suppression of metastasis in all sites. Other 4T1 experiments demonstrated that shRNA down-regulation of LPA1 also prevented metastasis, and is the mechanism of action of 0719. Treatment with 0719 only after mammary fat pad removal, akin to adjuvant therapy, was also metastasis suppressive. Confirmatory experiments showed a non-significant effect of 0719 on MDA-MB-231T human breast tumor growth in the mammary fat pad, but a significant inhibition of lung colonization after tail vein injection. When animals injected with MDA-MB-231T cells were treated with 0719 and the drug was removed, death ensued. Analysis of tissue from vehicle and 0719 treated animals showed that: (1) proliferation measured by Ki67 staining was high and equivalent in primary tumors treated with vehicle or 0719, but was reduced in lung and liver metastases treated with 0719; (2) similar trends were observed in pErk staining. The data indicate that 0719 induced site specific dormancy in metastasis, a novel indication for a drug to date. The mechanism of metastatic dormancy is under investigation. These data, to our knowledge, represent the first drug candidate to induce metastatic dormancy. III. Current efforts aim to translate this finding to the clinic. We completed a M-CRADA with Sanofi to use their compound SAR10082, an orally available LPA1 inhibitor under development for fibrosis, in similar preclinical models. The SAR100842 compound potently suppressed tumor cell motility to LPA or fetal calf serum in vitro. In vivo tests of SAR100842 on metastasis and metastatic dormancy will be reported. As this pathway was linked to fibrosis, we have also asked if fibrosis accompanies metastasis in model systems and if SAR100842 reduces fibrosis? In collaboration with Lalage Wakefiled and Jeff Green, we have stained metastases from multiple model systems of triple-negative breast cancer for fibrosis and found them to be focally positive. Recently, results of phase III trials of two new compounds foridiopathic pulmonary fibrosis, Nintednib and Pirfenidone. Since the SAR100842 compound would now have to be superior to these drugs, we are testing all three drugs for effects on fibrosis in metastasis, effects on metastasis and effects on metastatic dormancy.
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