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Lung Cancer: The Breathtaking Battle of TKIs and EGFR Mutants Bobby Hodges, Elizabeth Ross, Natalie Simak, Keith Solvang and Eliot Vildaver

Bobby Hodges, Elizabeth Ross, Natalie Simak, Keith Solvang and Eliot Vildaver

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Bobby Hodges, Elizabeth Ross, Natalie Simak, Keith Solvang and Eliot Vildaver Slide 2 Diseased Genome Hospital http:// blogs.usask.ca/medical_education/archive/ElksRehabFront%2520Door.jpg Slide 3 http://1.bp.blogspot.com/_HI2mCx5P3H0/SLlEQoHj8AI/AAAAAAAAA8Q/My7tf78TNc8/s320/hospital-bed-786282.jpg Slide 4 http://img.quamut.com/chart/9471/02_healthy_sick_x-ray.jpg Slide 5 http://www.cardiothoracicsurgery.org/content/2/1/16/figure/F1?highres=y Slide 6 What Is Lung Cancer? Types Risks PredispositionMutations EGFR Other proteins Angiogenesis VEGF Your Treatment Plan http://www.freefoto.com/images/21/16/21_16_2---Single-Carriageway-Road_web.jpg Slide 7 http://www.odec.ca/projects/2005/thog5n0/public_html/Tumour.gif Slide 8 http://www.icowman.com/uploadfiles/2007072409225175.jpg Slide 9 NON SMALL CELL Squamous cell carcinoma Adenocarcinoma Large-cell carcinoma SMALL CELL Bronchi Grows rapidly Spreads quickly http://images.google.com/imgres?imgurl=http://www.dkimages.com/discover/previews/852/202230 38.JPG http://images.google.com/imgres?imgurl=http://upload.wikimedia.org/ Lynch et al., (2004) Slide 10 http://www.taconichills.k12.ny.us/webquests/noncomdisease/lungcancerpic.jpg Slide 11 This year approximately 200,000 people will be diagnosed with lung cancer NSCLC accounts for 80% of all lung cancers http://www.cdc.gov/cancer/lung/statistics/ http://seo2.0.onreact.com/wp-content/uploads/2008/09/you-re-not-alone.jpg Slide 12 http://medicineworld.org/cancer/lung/http://images.google.com/ Slide 13 While there is no known cure as of right now, there ARE options! http://dspace.mit.edu Imatinib Gefinitib Cisplatin http://dspace.mit.edu Slide 14 CisplatinImatinib Gefitinib EGF ERBB2 EGFR Nucleus P Protein Cascade Slide 15 P P EGF ERBB2 EGFR PI3K AKT P P MET P VEGF-A CisplatinImatinib Gefitinib Nucleus Protein Cascade PDGFR Protein Cascade Slide 16 http://rosenblumtv.files.wordpress.com http://www.pharmgkb.org http://academic.evergreen.edu Slide 17 Compact structures of DNA Contains thousands of genes Centromere Chromatid Genes http://staff.jccc.net/PDECELL/celldivision/chromosome1.gif Slide 18 Single variation in nucleotide base pairs Alleles are a result of SNPs within gene sequence SNPs are the basis for lung cancer susceptibility http://www.dnalandmarks.com/english/pictures/what_are_snps.jpg Slide 19 Variation across genomes Genotype cases along with controls Find roles that genes play in disease Large sample sizes http://www.blog.speculist.com/archives/dna2two Slide 20 Centromere p-arm q-arm 6 Regions Away Region 5q6 5 http://images.google.com/ Slide 21 http://upload.wikimedia.org/ Slide 22 Nicotine binds and stimulates acetylcholine ion channel-linked in neurons http://www.jyi.org/articleimages/88/originals/img0.jpg Slide 23 (Hung et al., 2008) Slide 24 (Thorgeirson et al., 2008) Slide 25 Cancerous Growth http://images.google.com/i Slide 26 (McKay et al., 2008) Slide 27 P P EGF ERBB2 EGFR PI3K AKT P P MET P VEGF-A CisplatinImatinib Gefitinib Nucleus Protein Cascade PDGFR Protein Cascade Slide 28 How Do Cells Proliferate? Slide 29 EGFR P EGF Proliferation Survival Apoptosis ERBB2 Nucleus EGFR P Protein Cascade ERBB2 Slide 30 How Can This Lead to Cancer? Slide 31 ERBB2 EGFR Nucleus Proliferation P Protein Cascade Slide 32 (Chen et al., 2006) Slide 33 EGFR ATPTKI ATP binding cleft on the kinase Tyrosine Kinase domain Slide 34 (Chen et al., 2006) Slide 35 What About the Proteins in the Signaling Pathway? Slide 36 (Pedersen et al., 2005) Slide 37 Slide 38 (Chen et al., 2006) Slide 39 P P EGF ERBB2 EGFR PI3K AKT P P MET P VEGF-A CisplatinImatinib Gefitinib Nucleus Protein Cascade PDGFR Protein Cascade Slide 40 What Are the Roles of Proteins Associated with Lung Cancer? http://www.taconichills.k12.ny.us/webquests/noncomdisease/lungcancerpic.jpg Slide 41 Recap Nucleus N-terminus C-terminus P Serine P Threonine Tyrosine P Leucine Lysine Alanine Slide 42 Slide 43 ERBB2 P PI3KSH2 Nucleus P Protein Cascade Change in Gene Expression Slide 44 Slide 45 (Rikova et al. 2007) Slide 46 Green and Blue circles =Proteins involved in cascade Red lines = Interactions Red circles =EGFR Receptor (Jones et al. 2006) Slide 47 No. protein receptors Affinity Threshold (nM) Affinity Threshold (nM) Affinity Threshold (nM) Slide 48 http://en.wikipedia.org/wiki/Proteins Slide 49 (Rikova et al. 2007) Slide 50 Chart configured from Table1 of Rikova et al. 2007 A mount of overphosphorylated protein in samples Slide 51 (Engelman et al., 2007) Slide 52 P P EGF ERBB2 EGFR PI3K AKT P P MET P VEGF-A CisplatinImatinib Gefitinib Nucleus Protein Cascade PDGFR Protein Cascade Slide 53 http://www.taconichills.k12.ny.us/webquests/noncomdisease/lungcancerpic.jpg Slide 54 http://www.researchvegf.com/researchvegf/multimedia/index.m#type-slides Slide 55 VEGF-A VEGFR Angiogenesis Tumors PDGF- PDGFR- Slide 56 P85- PIP 2 P P PTEN P PIP 3 P P P P110- PI3K AKT SH2 P P Endothelial Cell Slide 57 AKT P P P BAD MDM2 mTOR Growth, Translation Apoptosis p53 P Nucleus Slide 58 Cancer Cell Proto-Oncogene Oncogene Slide 59 (Chen et al., 2009) Slide 60 Giemsa-Stained Cells Slide 61 P85- PIP 2 P P PTEN P PIP 3 P P P P110- PI3K AKT SH2 P P VEGF-A VEGFR FLJ10540 Endothelial Cell Slide 62 http://www.medicinescomplete.com/mc/martindale/2007/images/MRT9229C001.gif Binds to ATP binding site of many enzymes: p-PDGFR- Inhibitor Reduced IFP, Hypoxia Decreased VEGF Expression Slide 63 http://www.medscape.com/pi/editorial/clinupdates/2000/583/art-tu02.fig04.jpg http://www.nature.com/nm/journal/v7/n9/images/nm0901-987-F1.gif Normal Tumor Slide 64 (Vlahovic et al. 2007) Slide 65 Vlahovic et al. 2007 Slide 66 http://onctalk.com/wp-content/uploads/2008/01/angiogenesis-summary.jpg Imatinib Slide 67 P P EGF ERBB2 EGFR PI3K AKT P P MET P VEGF-A CisplatinImatinib Gefitinib Protein Cascade PDGFR Protein Cascade Nucleus Slide 68 Dr. Vildaver Imatinib Dr. Ross Gefinitib Slide 69 (Rosenberg et al., 1969) Slide 70 Cisplatin Nucleus Simple Diffusion Pt NH 3 GG P73 C-Abl Cell Cycle Arrest & Apoptosis P53 HMG1 ? ? Slide 71 nucleus Pt Transporter protein Transporter protein Pt (Hall et al., 2007) Slide 72 crosslink nucleus Pt NH 3 Cell Cycle Arrest & Apoptosis G G 1,2-intrastrand d(GpG)adduct (Ohndorf et al., 1999) Slide 73 http://www.unc.edu/~shantanu/images/bkstcg_aacr07.png Slide 74 Pt-DNA Adduct Apoptosis HMGB P73P53 (Stross et al., 2002) Slide 75 (Ohndorf et al., 1999) * Nucleotides crosslinked Bold- nucleotides contacted by the protein Slide 76 (Ohndorf et al., 1999) Slide 77 Cisplatin Nucleus ? Simple Diffusion Pt NH 3 GG P73 C-Abl Cell Cycle Arrest & Apoptosis P53 HMG1 ? ? Slide 78 tyrosine kinase mismatch repair protein cisplatin homologue of p53 Tumor suppresor (Gong et al., 1999) Slide 79 P53 knockout= less sensitive to CDDP, survived better than wild type in lower concentrations of CDDP MLH1-/- & Abl= less sensitive to CDDP, survived better than wild type in lower concentrations of CDDP (Gong et al., 1999) Slide 80 Cisplatin Nucleus Simple Diffusion Pt NH 3 GG P73 Cell Cycle Arrest & Apoptosis P53 HMG1 ATM Transporter Proteins C-Abl P Slide 81 CisplatinImatinib Gefitinib EGF ERBB2 EGFR Nucleus P Protein Cascade Slide 82 P P EGF ERBB2 EGFR PI3K AKT P P MET P VEGF-A CisplatinImatinib Gefitinib Nucleus Protein Cascade PDGFR Protein Cascade Slide 83 http://immunodefence.com/ii/gefitinib.gif http://www.themesotheliomalibrary.com/cisplatin.jpg http://www.specialityformulations.com/pcat-gifs/products-small/imatinib.jpg Slide 84 New plasma membrane proteins have unique mechanisms and effects on NSCLC Gefitinib effectively inhibits particular EGFR mutants SiRNA could be used as a possible treatment for various mutated proteins Slide 85 How does cisplatin enter the nucleus? 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