Dabrafenib, alone or in combination with trametinib, in BRAF V600–mutated pediatric Langerhans cell histiocytosis

Langerhans cell histiocytosis (LCH) is a rare, heterogenous, neoplastic disorder primarily affecting children. BRAF mutations have been reported in >50% of patients with LCH. The selective BRAF inhibitor, dabrafenib, in combination with the MEK1/2 inhibitor, trametinib, has been approved in select BRAF V600–mutant solid tumors. Two open-label phase 1/2 studies were conducted in pediatric patients with BRAF V600–mutant, recurrent/refractory malignancies treated with dabrafenib monotherapy (CDRB436A2102; NCT01677741) or dabrafenib plus trametinib (CTMT212X2101; NCT02124772). The primary objectives of both studies were to determine safe and tolerable doses that achieve similar exposure to the approved doses for adults. Secondary objectives included safety, tolerability, and preliminary antitumor activity. Thirteen and 12 patients with BRAF V600–mutant LCH received dabrafenib monotherapy and in combination with trametinib, respectively. Investigator-assessed objective response rates per Histiocyte Society criteria were 76.9% (95% confidence interval [CI], 46.2-95.0) and 58.3% (95% CI, 27.7-84.8) in the monotherapy and combination studies, respectively. More than 90% of responses were ongoing at study completion. The most common treatment-related adverse events (AEs) were vomiting and increased blood creatinine with monotherapy and pyrexia, diarrhea, dry skin, decreased neutrophil count, and vomiting with combination therapy. Two patients each discontinued treatment with monotherapy and combination therapy because of AEs. Overall, dabrafenib monotherapy or in combination with trametinib demonstrated clinical efficacy and manageable toxicity in relapsed/refractory BRAF V600–mutant pediatric LCH, with most responses ongoing. Safety was consistent with that reported in other pediatric and adult conditions treated with dabrafenib plus trametinib

Efficacy and Safety of Trametinib Monotherapy or in Combination With Dabrafenib in Pediatric BRAF V600–Mutant Low-Grade Glioma

PURPOSE: BRAF V600 mutations occur in many childhood cancers, including approximately 20% of low-grade gliomas (LGGs). Here, we describe a phase I/II study establishing pediatric dosing and pharmacokinetics of trametinib with or without dabrafenib, as well as efficacy and safety in a disease-specific cohort with BRAF V600–mutant LGG; other cohorts will be reported elsewhere. METHODS: This is a four-part, phase I/II study (ClinicalTrials.gov identifier: NCT02124772 ) in patients age < 18 years with relapsed/refractory malignancies: trametinib monotherapy dose finding (part A) and disease-specific expansion (part B), and dabrafenib + trametinib dose finding (part C) and disease-specific expansion (part D). The primary objective assessed in all patients in parts A and C was to determine pediatric dosing on the basis of steady-state pharmacokinetics. Disease-specific efficacy and safety (across parts A-D) were secondary objectives. RESULTS: Overall, 139 patients received trametinib (n = 91) or dabrafenib + trametinib (n = 48). Trametinib dose-limiting toxicities in > 1 patient (part A) included mucosal inflammation (n = 3) and hyponatremia (n = 2). There were no dose-limiting toxicities with combination therapy (part C). The recommended phase II dose of trametinib, with or without dabrafenib, was 0.032 mg/kg once daily for patients age < 6 years and 0.025 mg/kg once daily for patients age ≥ 6 years; dabrafenib dosing in the combination was as previously identified for monotherapy. In 49 patients with BRAF V600–mutant glioma (LGG, n = 47) across all four study parts, independently assessed objective response rates were 15% (95% CI, 1.9 to 45.4) for monotherapy (n = 13) and 25% (95% CI, 12.1 to 42.2) for combination (n = 36). Adverse event–related treatment discontinuations were more common with monotherapy (54% v 22%). CONCLUSION: The trial design provided efficient evaluation of pediatric dosing, safety, and efficacy of single-agent and combination targeted therapy. Age-based and weight-based dosing of trametinib with or without dabrafenib achieved target concentrations with manageable safety and demonstrated clinical efficacy and tolerability in BRAF V600–mutant LGG

RAB7 Controls Melanoma Progression by Exploiting a Lineage-Specific Wiring of the Endolysosomal Pathway

Although common cancer hallmarks are well established, lineage-restricted oncogenes remain less understood. Here, we report an inherent dependency of melanoma cells on the small GTPase RAB7, identified within a lysosomal gene cluster that distinguishes this malignancy from over 35 tumor types. Analyses in human cells, clinical specimens, and mouse models demonstrated that RAB7 is an early-induced melanoma driver whose levels can be tuned to favor tumor invasion, ultimately defining metastatic risk. Importantly, RAB7 levels and function were independent of MITF, the best-characterized melanocyte lineage-specific transcription factor. Instead, we describe the neuroectodermal master modulator SOX10 and the oncogene MYC as RAB7 regulators. These results reveal a unique wiring of the lysosomal pathway that melanomas exploit to foster tumor progression.M.S.S. is funded by Projects SAF2011-28317 and Consolider RNAREG from the Spanish Ministry of Economy and Innovation, R01CA125017 from the NIH, and a Team Science Award by the Melanoma Research Foundation. J.L.R.-P. and P.O.-R. are funded by grants FIS 11/025685 and FIS 11/1759, respectively, from the Spanish Ministry of Health. J.L.R.-P. was also supported by grant FMM-2008-106 of Fundación Mutua Madrileña, and P.O.-R. by Red Tematica de Investigacion Cooperativa en Cancer. D.A.-C. and E.P.-G. are recipients of Scientists in Training predoctoral fellowships from the Spanish Ministry of Science and Innovation. M.C. and P.K. are funded by predoctoral fellowships of Fundación La Caixa. E.R.-F. is the recipient of a postdoctoral fellowship from Fundación Científica de la Asociación Española Contra el Cáncer, and J.A.J. and H.-W.W. are funded by the American Cancer Society (RSG-12-076-01-LIB)

Identification and characterization of LIN-9 regulated genes in the human system - The role of LIN-9 in the regulation of the cell cycle

Das humane LIN-9 wurde zuerst als pRB-interagierendes Protein beschrieben und spielt eine Rolle als Tumorsuppressor im Kontext des pRB-Signalweges. Über die molekulare Funktion von LIN-9 ist jedoch wenig bekannt. Die Homologe von LIN-9 in D. melanogaster und in C. elegans, sind an der transkriptionellen Regulation verschiedener Genen beteiligt. Dies und die Tatsache, dass LIN-9 mit pRB in der Aktivierung differenzierungspezifischer Gene kooperiert, ließ vermuten, dass humanes LIN-9 einen bedeutenden Einfluss auf die transkriptionelle Regulation von Genen haben könnte. Primäres Ziel dieser Arbeit war daher die Identifizierung LIN-9 regulierter Gene. Dazu sollte mit Hilfe von cDNA-Microarray Analysen, das Genexpressionsprofil LIN-9 depletierter primärer humaner Fibroblasten (BJ ET Zellen) im Vergleich zu Kontrollzellen untersucht werden. Hierfür wurde zunächst ein RNAi-basierendes System etabliert, um die posttranskriptionelle Expression von LIN-9 in BJ-ET Zellen effizient zu reprimieren. Auf dem Ergebnis der cDNA-Microarray Analysen aufbauende Untersuchungen sollten Aufschluss über die molekularbiologische Funktion von LIN-9 geben. In dieser Arbeit konnte erstmals gezeigt werden, dass der Verlust von LIN-9 zu einer verminderten Expression einer Gruppe G2/M-spezifischer Gene führt, deren Produkte für den Eintritt in die Mitose benötigt werden. Bekannt war, dass ein Teil dieser Gene durch den Transkriptionsfaktor B-MYB koreguliert wird. Zudem konnten Untersuchungen in unserem Labor eine Interaktion von LIN-9 und B-MYB auf Proteinebene, sowie die Bindung beider Proteine an die Promotoren der LIN-9 regulierten G2/M-Gene nachweisen. Dies lässt vermuten, dass LIN-9 und B-MYB gemeinsam die Expression der G2/M-Gene kontrollieren. Die verminderte Expression von G2/M-Genen in LIN-9 bzw. B-MYB depletierten Zellen geht mit einer Reihe phänotypischer Veränderungen einher, wie einer deutlich verlangsamten Proliferation und einer Akkumulation der Zellen in der G2/M-Phase. Mit Hilfe eines Durchflusszytometers erstellte Zellzykluskinetiken ergaben, dass die Progression LIN-9 bzw. B-MYB depletierter Fibroblasten von der S-Phase durch die G2/M-Phase und in die nächste G1-Phase deutlich verzögert ist. Es konnte weder ein Arrest dieser Zellen in der Mitose noch eine veränderte Länge der S-Phase nach LIN-9 oder B-MYB Depletion festgestellt werden. Daher ist die verlangsamte Zellzyklusprogression nach LIN-9 bzw. B-MYB Verlust höchstwahrscheinlich auf einen Defekt in der späten G2-Phase zurückzuführen, welcher in einem verzögerten Eintritt in die Mitose resultiert. In D. melanogaster und in C. elegans sind die Homologe von LIN-9 und B-MYB zusammen, als Bestandteile hoch konservierter RB/E2F-Komplexe, an der Regulation von Genen entscheidend beteiligt. Daher liegt es nahe, dass im humanen System LIN-9 und B MYB ebenfalls Bestandteile eines ähnlichen Komplexes sind und dadurch die Aktivierung der LIN 9 abhängigen G2/M-Gene vermitteln. Die Tatsache, dass LIN-9 sowohl als Tumorsuppressor, als auch als positiver Regulator des Zellzyklus fungiert, lässt vermuten, dass LIN-9 zu einer stetig größer werdenden Gruppe von Proteinen gehört, welche in Abhängigkeit vom zellulären und genetischen Kontext sowohl tumorsuppressive als auch onkogene Funktionen besitzen.The human LIN-9 Protein was first identified as a novel pRB-interacting Protein which acts as a tumorsuppressor in context of the pRB-pathway. But the molecular function of LIN-9 is poorly unterstood. The homologs of LIN-9 in D. melanogaster and C. elegans are required for the transcriptional regulation of different genes. This and the fact, that LIN 9 cooperates with pRB in the activation of differentiation specific genes let to the hypothesis, that human LIN-9 could play an important role in the transcriptional regulation of genes. Thus, the primary goal of this thesis was to identify genes which are regulated by LIN-9. For that purpose, the genexpression profiles of LIN-9 depelted primary human fibroblasts (BJ ET cells) in comparison to control cells should be analyzed by a cDNA-microarray approach. Therefor an RNAi-based system was established, that efficiently represses the posttranscriptional expression of LIN-9 in BJ-ET cells. Based on the outcome of the cDNA microarray analysis, further studies should provide more informations about the molecular function of LIN-9. It was possible to show, that the loss of LIN-9 leads to a reduced expression of a cluster of G2/M-specific genes, whose products are required for timely entry into mitosis. It was known, that some of these genes are coregulated by the transcriptionfactor B-MYB. Moreover, studies in our lab account for the interaction of LIN-9 and B-MYB on protein level and the binding of both proteins to the promotors of LIN-9 regulated G2/M-genes. The reduced expression of these genes is accompanied by phenotypically changes, such as strongly impaired proliferation and an accumulation of these cells in the G2/M-Phase. Cell cycle kinetics generated by flowcytometry revealed that the progression of LIN-9 or B MYB depleted cells from S-phase to G2/M-phase and into the next G1-Phase is significantly delayed. Depletion of LIN-9 or B-MYB results neither in an arrest in mitosis nor in a significantly changed S-phase length of these cells. This indicates that the slowed progression is most likely due to a defect in the late G2-phase, which results in a delayed entry into mitosis. The homologs of LIN-9 and B-MYB in D. melanogaster and C. elegans act together as subunits of highly conserved RB/E2F-complexes in the regulation of genes. This let to the suggestion, that LIN-9 and B-MYB are also components of a similar complex in humans and thereby mediate the activation of LIN-9 regulated G2/M-genes. Because LIN-9 acts as a tumorsuppressor in the pRB-pathway as well as an positive regulator of the cell cycle, it seems that LIN-9 belongs to an increasing group of proteins, which function as context dependent tumorsuppressors and oncogenes

RAB7 counteracts PI3K-driven macropinocytosis activated at early stages of melanoma development.

Derailed endolysosomal trafficking is emerging as a widespread feature of aggressive neoplasms. However, the oncogenic signals that alter membrane homeostasis and their specific contribution to cancer progression remain unclear. Understanding the upstream drivers and downstream regulators of aberrant vesicular trafficking is distinctly important in melanoma. This disease is notorious for its inter- and intra-tumoral heterogeneity. Nevertheless, melanomas uniformly overexpress a cluster of endolysosomal genes, being particularly addicted to the membrane traffic regulator RAB7. Still, the underlying mechanisms and temporal determinants of this dependency have yet to be defined. Here we addressed these questions by combining electron microscopy, real time imaging and mechanistic analyses of vesicular trafficking in normal and malignant human melanocytic cells. This strategy revealed Class I PI3K as the key trigger of a hyperactive influx of macropinosomes that melanoma cells counteract via RAB7-mediated lysosomal degradation. In addition, gain- and loss-of-function in vitro studies followed by histopathological validation in clinical biopsies and genetically-engineered mouse models, traced back the requirement of RAB7 to the suppression of premature cellular senescence traits elicited in melanocytes by PI3K-inducing oncogenes. Together, these results provide new insight into the regulators and modes of action of RAB7, broadening the impact of endosomal fitness on melanoma development.M.S.S. is funded by grants from the Spanish Ministry of Economy and Innovation (projects SAF2011-28317; and Consolider RNAREG), and a Team Science Award by the Melanoma Research Alliance. J.L.R-P and P.O-R. are funded by grants FIS 14/1737 and FIS 14/01784, respectively, from the Spanish Ministry of Health. J.L.R-P was also supported by FMM-2008-106 of Fundacion Mutua Madrilena and P.O-R by the RTICC ("Red Tematica de Investigacion Cooperativa en Cancer"). J.P is funded by MCINN CIT-090100-2007-48/CIT-090000-2008-14 and MSSSI- ADE08-90038. D.A-C was a recipient for Scientists in Training Predoctoral Fellowships from the Spanish Ministry of Science and Innovation. P.K is funded by a predoctoral fellowship from Fundacion La Caixa and R.M-H from the Spanish Ministry of Economy. E.R-F. is the recipient of a postdoctoral fellowship from "Fundacion Cientifica de la Asociacion Espanola Contra el Cancer.S

The AppA and PpsR Proteins from Rhodobacter sphaeroides Can Establish a Redox-Dependent Signal Chain but Fail To Transmit Blue-Light Signals in Other Bacteria▿

The AppA protein of Rhodobacter sphaeroides has the unique ability to sense and transmit redox and light signals. In response to decreasing oxygen tension, AppA antagonizes the transcriptional regulator PpsR, which represses the expression of photosynthesis genes, including the puc operon. This mechanism, which is based on direct protein-protein interaction, is prevented by blue-light absorption of the BLUF domain located in the N-terminal part of AppA. In order to test whether AppA and PpsR are sufficient to transmit redox and light signals, we expressed these proteins in three different bacterial species and monitored oxygen- and blue-light-dependent puc expression either directly or by using a luciferase-based reporter construct. The AppA/PpsR system could mediate redox-dependent gene expression in the alphaproteobacteria Rhodobacter capsulatus and Paracoccus denitrificans but not in the gammaproteobacterium Escherichia coli. Analysis of a prrA mutant strain of R. sphaeroides strongly suggests that light-dependent gene expression requires a balanced interplay of the AppA/PpsR system with the PrrA response regulator. Therefore, the AppA/PpsR system was unable to establish light signaling in other bacteria. Based on our data, we present a model for the interdependence of AppA/PpsR signaling and the PrrA transcriptional activator

Ripensando il "welfare"

Sommario: 1. "Welfare senza risorse: emergenza o sistema. - 2. Economia reale e finanza speculativa. - 3. Eurozona e crisi globale. - 4. Solidariet\ue0 sociale e solidariet\ue0 familiare. - 5. Persona e salute. - 6. Vecchiaia e pensioni. - 7. Occupazione e ammortizzatori sociali. - 8. Previdenza e assistenza. - 9. "Welfare" ed autosufficienza. - 10. Sicurezza sociale e cittadinanza

(+)-Naloxone, an opioid-inactive toll-like receptor 4 signaling inhibitor, reverses multiple models of chronic neuropathic pain in rats

UnlabelledPrevious work demonstrated that both the opioid antagonist (-)-naloxone and the non-opioid (+)-naloxone inhibit toll-like receptor 4 (TLR4) signaling and reverse neuropathic pain expressed shortly after chronic constriction injury. The present studies reveal that the TLR4 contributes to neuropathic pain in another major model (spinal nerve ligation) and to long established (2-4 months) neuropathic pain, not just to pain shortly after nerve damage. Additionally, analyses of plasma levels of (+)-naloxone after subcutaneous administration indicate that (+)-naloxone has comparable pharmacokinetics to (-)-naloxone with a relatively short half-life. This finding accounts for the rapid onset and short duration of allodynia reversal produced by subcutaneous (+)-naloxone. Given that toll-like receptor 2 (TLR2) has also recently been implicated in neuropathic pain, cell lines transfected with either TLR4 or TLR2, necessary co-signaling molecules, and a reporter gene were used to define whether (+)-naloxone effects could be accounted for by actions at TLR2 in addition to TLR4. (+)-Naloxone inhibited signaling by TLR4 but not TLR2. These studies provide evidence for broad involvement of TLR4 in neuropathic pain, both early after nerve damage and months later. Additional, they provide further support for the TLR4 inhibitor (+)-naloxone as a novel candidate for the treatment of neuropathic pain.PerspectiveThese studies demonstrated that (+)-naloxone, a systemically available, blood-brain barrier permeable, small molecule TLR4 inhibitor can reverse neuropathic pain in rats, even months after nerve injury. These findings suggest that (+)-naloxone, or similar compounds, be considered as a candidate novel, first-in-class treatment for neuropathic pain.Susannah S. Lewis, Lisa C. Loram, Mark R. Hutchinson, Chien-Ming Li, Yingning Zhang, Steven F. Maier, Yong Huang, Kenner C. Rice and Linda R. Watkin