JP2018509899A - ガンを処置及び予後予測するための新たな方法 - Google Patents
ガンを処置及び予後予測するための新たな方法 Download PDFInfo
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Abstract
Description
本発明は、ガンを患っている患者の生存時間の予後を決定するためのin vitro方法であって、i)前記患者由来のサンプル中のDNMT3A/ISGF3γ対の発現レベルを決定すること、ii)前記発現レベルを所定の基準値と比較すること、及びiii)発現レベルが所定の基準値よりも低い場合には予後良好を提供し、発現レベルが所定の基準値よりも高い場合には予後不良を提供することからなる工程を含むin vitro方法に関する。
ガン細胞では、DNAメチル化パターンが異常であることが多い。したがって、遺伝子間領域の低メチル化が起こり、転位因子の活性化及びゲノム不安定性の増加を介して腫瘍形成をもたらし得る。遺伝子プロモーターの局所的低メチル化は、ガン遺伝子発現を促進し得る一方、遺伝子プロモーターの局所的高メチル化は、ガン細胞における腫瘍抑制機能の喪失につながり得る。この最後の点に基づいて、DNAメチル化によってサイレンシングされた腫瘍サプレッサー遺伝子(TSG)を活性化することを目的に、薬物開発は、DNAメチル化阻害剤に焦点を当てている。しかし、特異性がなければ、DNMT阻害剤は、TSGだけではなくガン遺伝子及び転位因子の脱メチル化も促進し得る。したがって、非特異的DNMT阻害剤の使用は、抗腫瘍形成的又は腫瘍形成促進的であり得る。その上、この最後の点は、いくつかの論文で例証されている。実際、文献では、5−アザ−2’−デオキシシチジン処置(非特異的DNMT阻害剤)は、非侵襲性乳ガン細胞株MCF−7細胞及びZR−75−1の侵襲性を増加させ、転移促進遺伝子を劇的に誘導したことが報告されている[Chik F et al., 2011]。5−アザ−2’−デオキシシチジン処置はまた、星状細胞からの神経膠腫のインデューサーとして、及び神経膠腫細胞の腫瘍形成特性のエンハンサーとして報告されている。それにもかかわらず、5−アザ−2’−デオキシシチジンは、骨髄異形成症候群の処置について、Food and Drug Administration of the United Statesによって承認されており、患者の生存率について、有意だが通常は一過性の改善を示す。この疑う余地のない臨床的有用性にもかかわらず、非特異的DNMT阻害剤の使用の二重効果は、特異的DNMT阻害剤の開発の根拠を提供する。加えて、特異的DNMT阻害剤はまた、特定のDNMTの異常な機能性を有する腫瘍をターゲティングすることを可能にし得る。特異的DNMT阻害剤の開発はまた、非特異的DNMT阻害剤の使用に関連するオフターゲット効果を減少させ得る。
予後予測方法
本発明の第1態様は、ガンを患っている患者の生存時間の予後を決定するためのin vitro方法であって、i)前記患者由来のサンプル中のDNMT3A/ISGF3γ対の発現レベルを決定すること、ii)前記発現レベルを所定の基準値と比較すること、及びiii)発現レベルが所定の基準値よりも低い場合には予後良好を提供し、発現レベルが所定の基準値よりも高い場合には予後不良を提供することからなる工程を含むin vitro方法に関する。
本発明の第2の態様は、ガンの治療及び予防において使用するための、DNMT3A/ISGF3γアンタゴニストである化合物又はDNMT3A/ISGF3γ遺伝子発現阻害剤である化合物に関する。
(i)DNMT3A/ISGF3γを発現する細胞、組織サンプル又は生物を提供して、DNMT3A/ISGF3γ対を提供する工程、
(ii)候補化合物、例えば小有機分子、内部抗体、ペプチド又はポリペプチドを提供する工程、
(iii)DNMT3A/ISGF3γの活性を測定する工程、
(iv)及び、DNMT3A/ISGF3γを遮断し、DNMT3A/ISGF3γの作用を遮断し、又はDNMT3A/ISGF3γ発現を阻害する候補化合物を積極的に選択する工程
を含む方法に関する。
P1:配列番号:1:RPMPRLTFQAGDPYYI
P1mut:配列番号:2:RPMPRLTAQAGAPYYI
本発明の別の目的は、ガンの治療及び予防において使用するための治療用組成物であって、本発明の化合物を含む治療用組成物に関する。
患者の特徴。
外科的切除の日から死亡まで、全生存を測定した。各腫瘍の悪性度では、本研究に含まれる患者全員が、同様の管理及び同様の処置(GBMのためのテモゾロミド(TMZ)を含む)を受けた。フランスの法律及びFrench National Committee of Ethicの勧告にしたがって、患者の資料及び記録(診断、年齢、性別、死亡日、カルノフスキー・パフォーマンス・スコア(KPS))を秘密厳守で使用した。
Laennec Hospital (Nantes/Saint-Herblain, France)の脳神経外科サービスから入手した新鮮な脳腫瘍組織を採取し、切除後30分以内に加工した。臨床プロトコールはフランスの倫理法によって承認され、被験者全員からインフォームド・コンセントを得た。以前に記載されている技術にしたがって、機械的解離後に、初代培養腫瘍細胞を得た。簡潔に言えば、腫瘍組織を1〜5mm3切片に切断し、10%FBS及び抗生物質を含むDMEMを含む60mm2組織培養皿にプレーティングした。加えて同時に、細分化した腫瘍切片を、PBS中で200U/mlコラゲナーゼI(Sigma, France)及び500U/ml DNaseI(Sigma, France)と共に、激しく一定撹拌しながら37℃で1時間インキュベーションした。単一細胞懸濁液を70 mm cell strainer (BD Falcon, France)でろ過し、PBSで洗浄し、DMEM−10%FBSに懸濁した。続いて、コンフルエントになったら細胞培養物を1:2に分割し、3〜5継代前に実験を行った。
細胞を、カバースリップ上で24時間培養した。次いで、細胞を、4%パラホルムアルデヒドPBS溶液(pH7.4)を用いて室温で15分間固定した。透過処理を、0.5%Triton X−100を含有するPBSを用いて室温で20分間実施する。製造業者の説明書(Olink Bioscience, Sweden)にしたがって、ブロッキング、染色、ハイブリダイゼーション、ライゲーション、増幅及び検出工程を行った。全てのインキュベーションを湿度チャンバー内で実施した。増幅及び検出工程を暗室で実施した。ApoTomeモジュール(X63及び開放値1.4)を備えるAxiovert 200M microscopy system (Zeiss, Le Pecq, France)を使用することによって、蛍光を可視化した。DAPIを含むProLong Gold antifade reagent (Life Technologies, France)を使用することによって、調製物をマウントした。構造化照明顕微鏡法で、画像取得を行った。デコンボリューション(3.5 Huygens Essential software (SVI))後、Amira.4.1.1 programを使用することによって、3D図を得た。最後に、www.cb.uu.se/~amin/BlobFinderからダウンロード可能なフリーウェア「BlobFinder」を使用することによって、画像を分析した。したがって、核を自動的に同定することができるので、本発明者らは、核1個当たりのいずれかのシグナル数を得た。
MultiPep peptide synthesizer (Intavis AG, Cologne, Germany)を使用して、ペプチドを、400nmol/cm2のローディング容量でAmino-PEG500-UC540膜上にスポットした。合成後、膜を乾燥させ、次いで、95%トリフルオロ酢酸、3%トリイソプロピル、2%H2Oを含有するカクテルで1時間切断することによって、キャッピングされた側鎖を脱保護した。トリフルオロ酢酸を除去し、膜をジクロロメタンでリンスし、続いてジメチルホルムアルデヒドでリンスし、次いでエタノールでリンスした。膜を飽和させてから、検討リコンビナントタンパク質と共に室温で2時間インキュベーションした。その後、それを3回洗浄し、蛍光色素にカップリングされた抗体を使用して、陽性ペプチドを明らかにした。Typhoon (GE Healthcare, France)を使用して、蛍光を決定した。スポットしたペプチドに対する検討リコンビナントタンパク質の結合強度を、ImageJソフトウェアを使用した定量によって決定し、配列特異的な正規化単位に変換した。所定のアミノ酸をカバーする各ペプチドについて得られた強度を加え、ペプチドの数で割った。
GST/His Tagged-Protein Interaction Pull-Down Kits (Thermo Scientific, France)を使用することによって、プルダウンアッセイを実施した。簡潔に言えば、ベイトタンパク質100μgを、穏やかに混合しながら4℃で1時間インキュベーションしてカラム上に固定化した。洗浄後、プレイタンパク質1μgを、回転プラットホーム上で穏やかに揺動運動させながら4℃で1時間かけて追加した。洗浄及び溶出後、SDS−PAGE及びウエスタンブロット法によって、「ベイト−プレイ」の相互作用を分析した。検討ペプチドを37℃で1時間プレインキュベーションすることによって、競合プルダウン実験を行った。
簡潔に言えば、ドデシル硫酸ナトリウム−ポリアクリルアミドゲル電気泳動によって、タンパク質をサイズ分画した。タンパク質をニトロセルロース又はPVDF膜上に転写した。SNAP i.(商標)Protein Detection System (Millipore, France)を使用することによって、飽和及びブロッティングを行った。ECL(商標)(Amersham Biosciences, France)及び/又はSuperSignal west femto Maximum Sensitivity (Thermo Scientific, France)化学発光試薬を使用して、タンパク質の検出を実施した。FusionX7 Imager (Fisher Scientific, France)を使用して、タンパク質の検出を実施した。
エレクトロポレーションのために、NLS配列をペプチドに追加した。指数増殖期中に、細胞をトリプシン処理によって回収し、元の培地に再懸濁した。それらをPBS、pH7.2(0.14M NaCl、2mM KCl、8mM Na2HPO4及び1.5mM NaH2PO4)で洗浄し、細胞0.6×106個/mlの濃度で元の培養培地に再懸濁した。次に、細胞懸濁液0.8mlをペプチド(50μg/ml)と混合し、室温で10分間放置し、disposable 0.4 cm Bio-Rad electroporation cuvette (Bio-Rad, France)に追加した。等容量のDMSOを、コントロール(未処置とも称される)として使用するためのペプチドを含まない細胞懸濁液に追加した。最初に、蛍光色素lucifer yellow (Sigma, France)の取り込みによるフローサイトメトリーによって、各細胞株のエレクトロポレーション効率を決定した。Gene-Pulser (Bio-Rad, France)で細胞を1パルスに暴露して、エレクトロポレーションを行った。以下のパラメータを使用した:キュベットギャップ0.4cm、電圧0.3kV、時定数35ミリ秒及びコンデンサ960μF。エレクトロポレーション後、細胞を、室温で10分間放置することによって回収し、次いで、エレクトロポレーションチャンバーから取り出し、PBSで2回洗浄し、元の培養培地2mlに再懸濁した。
QiaAmp DNA mini Kit (Qiagen, France)を使用することによって、DNAを抽出した。次に、製造業者の説明書にしたがってMethylamp Global DNA methylation Quantification kit (Euromedex-Epigentek, France)を使用して、5−メチルシトシンの存在を定量することによって、グローバルDNAメチル化を推定した。
トリパンブルー染色0.4%及びCountess(登録商標)Automated Cell Counter (Life Technologies, France)を使用することによって、細胞死の割合を評価した。以前に記載されているように、テモゾロミド(25μM)及び放射線照射(2Gy)を使用して、細胞死を誘導した。
Doubling Time Online Calculator website (Roth V. 2006, http://www.doubling-time.com/compute.php)を使用し、103個の細胞の増殖を120時間にわたってカウントすることによって、倍加時間(すなわち、量のサイズが2倍になるために必要な時間)を計算した。Countess(登録商標)Automated Cell Counter (Life Technologies, France)を使用して、細胞数を120時間にわたって24時間ごとに決定した。
スクラッチ技術を使用して、細胞遊走アッセイを実施した。細胞を80〜90%で6ウェルプレートにプレーティングし、(細胞増殖の影響を排除するために)10μg/mlマイトマイシンC(Sigma, Farnce)で2時間処理した。次いで、細胞をスクラッチした。顕微鏡検査によって、細胞遊走をモニタリングした。各サンプルについて取得した画像を定量的に分析した。各画像について、スクラッチの一方の側と他方の側との間の距離を測定した。時間0から最後の時点(24時間)までの画像を比較することによって、本発明者らは、測定した距離に基づいて各スクラッチ閉鎖の距離を得る。
全ての手順は、製造業者の説明書(QCM 24-Well Collagen-Based Cell Invasion Assay, Millipore, France)にしたがっていた。簡潔に言えば、2×105個の細胞を含有する無血清培地200μlを浸潤チャンバーに播種し、完全培地500μlを含有する24ウェルプレートに入れた。37℃で72時間インキュベーションした後、チャンバーから培地を除去し、チャンバーを染色溶液中に室温で20分間置くことによって、細胞を染色した。チャンバーの上面から、非浸潤細胞を慎重に除去した。染色されたチャンバーを、抽出バッファー200μlを含有するクリーンウェルに室温で15分間挿入した。チャンバーから抽出した染色溶液100μlを96ウェルプレートに移し、分光光度計を用いて光学密度を560nmで測定した。
培養細胞をトリプシン処理によって回収し、洗浄し、生理食塩水バッファーに再懸濁した。細胞懸濁液を、等容量のmatrigel matrix (Becton Dickinson, France)と共に2x106個の細胞を含むPBS 0.05mlとして、7/8週齢のヌードNMRI−nu雌性マウス(Janvier, France)の側腹部に皮下(s.c.)注射した。腫瘍確立の後、腫瘍内注射(it)によって、マウスをテモゾロミド及び/又はペプチドで処置した。腫瘍重量を求めるために、各腫瘍を外科的に摘出し、計量する。Institutional Animal Care and the French National Committee of Ethicsのガイドラインにしたがって、動物を使用した全ての実験手順を行った。
全ての実験を少なくともトリプケートで行った。スチューデントt検定を使用して、平均の差の有意性を計算した。カプラン・マイヤー法にしたがって生存曲線をプロットし、(例えば、対応する図に示されているように)コックス比例ハザード生存回帰分析によって比較した。ピアソン検定を使用して、2つのパラメータ間の相関の有意性を計算した。
高レベルのDNMT3A/ISGF3γ相互作用は、テモゾロミド/放射線照射誘導性細胞死に対する低レベルの感受性と相関する。
DNMT3AとDNMT3A結合タンパク質(D3ABP)との間の相互作用の存在が、その神経膠腫細胞がテモゾロミド/放射線照射処置に対して耐性表現型を有するGBM患者の亜集団の同定を可能にし得るかを決定するために、本発明者らは、患者由来の生検から31個の初代培養腫瘍細胞(PCTC)を確立した。次いで、これらのPCTCを使用して、特定のDNMT3A/D3A−BP相互作用の数とテモゾロミド/放射線照射誘導性(TMZ/IR誘導性)細胞死の割合との間の推定相関を評価した(データは示さず)。本発明者らなどがその存在を既に実証しているので[Fuks F et al., 2001及びHervouet E et al., 2009]、本発明者らの研究では、本発明者らは、DNMT3A/HDAC1、DNMT3A/AP2α、DNMT3A/GATA1及びDNMT3A/ISGF3γ相互作用に焦点を当てた。近接ライゲーションin situアッセイ(P−LISA)を使用して、目的の相互作用をモニタリングした。トリパンブルー法を使用することによって、TMZ/IR誘導性細胞死の割合を推定した(データは示さず)。目的のDNMT3A/D3A−BP相互作用の数及びTMZ/IR誘導性細胞死の割合を互いにプロットした(データは示さず)。ピアソン相関検定を使用した統計分析により、DNMT3A/ISGF3γ相互作用の数とTMZ/IR誘導性細胞死の割合との間においてのみ、有意な逆相関が示された(p=0.002)(データは示さず)。これらの結果により、DNMT3A/ISGF3γは、TMZ/IR処置に対する神経膠腫細胞の予後不良応答において重要な役割を果たし得ることが示唆された。
腫瘍生検に見られるDNMT3A/ISGF3γ相互作用レベルに基づいて、31人の患者を2つの群に分けた。15人の患者由来の腫瘍は、(DNMT3A/ISGF3γ相互作用の中央値12.5よりも高い)高レベルのDNMT3A/ISGF3γ相互作用を発現した一方、16人の患者は、12.5以下のDNMT3A/ISGF3γ相互作用を有していた。カプラン・マイヤー法によって全生存曲線を推定し、コックス比例ハザード生存回帰分析と比較した(図1)。その腫瘍が高レベルのDNMT3A/ISGF3γ相互作用を有していた患者と、その腫瘍が有していなかった者との間では、全生存について有意差が観察された(p=0.0092)。これらのデータは、高レベルのDNMT3A/ISGF3γ相互作用が予後不良因子であることを示している。
高レベルのDNMT3a/ISGF3γ相互作用は、テモゾロミド/放射線照射処置に対する予後不良応答に関連し、全生存の予後不良に関連していたという二重事実は、DNMT3A/ISGF3γ相互作用を治療ターゲットとして使用することができることを示唆している。
DNMT3A/ISGF3γ相互作用を阻害するように、P1を設計した。しかしながら、P1はまた、DNMT3とD3A−BPとの間に存在する他の相互作用に影響を与える可能性があった。この点を調査するために、本発明者らは、目的のDNMT3A/D3A−BP相互作用に対するP1の影響を分析した。本発明者らは、P1が、PCTC#1におけるDNMT3A/GATA1、DNMT3A/AP2γ及びDNMT3A/HDAC1相互作用の完全性に対して効果を有しないことを認めた。
次いで、本発明者らは、増殖レベル、浸潤、遊走及びアポトーシスの回避(又はより具体的には、治療処置によって誘導されるアポトーシスの感受性)を含むいくつかのガン特質/表現型に対するDNMT3A/ISGF3γ相互作用のP1誘導性破壊の影響を決定した。この目的のために、前記のように、細胞をP1及びTDFで処置した。
標準的な抗GBM処置は、化学療法剤としてテモゾロミドを使用するので、次に、本発明者らは、確立された腫瘍のスイスヌードマウスモデルにおける、P1ペプチドをTMZと合わせた処置の効果を調査した。この目的のために、(高レベルのDNMT3A/ISGF3γ相互作用を有する)2x106個の神経膠腫細胞を16匹のスイスヌードマウスに皮下注射した(図3A)。次に、腫瘍体積が100mm3になったら、4匹のマウスを無作為に処置せず、TMZ、TMZ+P1、TMZ+P1mut又はP1(それぞれT1及びT5と称される)で処置した。3週間の処置後、未処置マウスとTMZのみで処置したマウスとの間、及び未処置マウスとP1で処置したマウスとの間では、統計学的差が観察されなかったので(図3B)、本発明者らは、TMZ処置が、腫瘍成長を制限するために非効率的であったことを認めた。より興味深いことに、本発明者らは、TMZ+P1処置が腫瘍体積を減少させた一方、TMZ+P1mut処置は腫瘍成長を減少させるために非効率的であることを認めた。したがって、本発明者らのデータにより、P1とTMZとの併用は、腫瘍成長のTMZ誘導性減少を促進したことが示された。
Claims (13)
- ガンを患っている患者の生存時間の予後を決定するためのin vitro方法であって、i)前記患者由来のサンプル中のDNMT3A/ISGF3γ対の発現レベルを決定すること、ii)前記発現レベルを所定の基準値と比較すること、及びiii)発現レベルが所定の基準値よりも低い場合には予後良好を提供し、発現レベルが所定の基準値よりも高い場合には予後不良を提供することからなる工程を含む、in vitro方法。
- ガンを患っている患者であって、従来の処置で処置された患者の生存時間を予測するためのin vitro方法であって、i)前記患者由来のサンプル中のDNMT3A/ISGF3γ対の発現レベルを決定すること、ii)前記発現レベルを所定の基準値と比較すること、及びiii)発現レベルが所定の基準値よりも低い場合には予後良好を提供し、発現レベルが所定の基準値よりも高い場合には予後不良を提供することからなる工程を含む、in vitro方法。
- ガンを患っている患者であって、従来の処置で処置された患者の応答を予測するためのin vitro方法であって、i)前記患者由来のサンプル中のDNMT3A/ISGF3γ対の発現レベルを決定すること、ii)前記発現レベルを所定の基準値と比較すること、及びiii)発現レベルが所定の基準値よりも低い場合には応答良好を提供し、発現レベルが所定の基準値よりも高い場合には応答不良を提供することからなる工程を含む、in vitro方法。
- ガンが神経膠芽腫である、請求項1〜3に記載のin vitro方法。
- 従来の処置がテモゾロミド及び放射線である、請求項2〜4に記載のin vitro方法。
- ガンの治療及び予防において使用するための、DNMT3A/ISGF3γアンタゴニストである化合物又はDNMT3A/ISGF3γ遺伝子発現阻害剤である化合物。
- ガンの治療及び予防において同時使用、個別使用又は逐次使用するための複合調製物としての、i)DNMT3A/ISGF3γアンタゴニスト若しくはDNMT3A/ISGF3γ遺伝子発現阻害剤、及びii)化学療法剤、及びiii)放射線療法又は放射線療法剤。
- アミノ酸配列RPMPRLTFQAGDPYYI(配列番号:1)を含むペプチド又はその機能保存変異体。
- ガンの治療及び予防において使用するための、請求項8に記載のペプチド。
- 神経膠芽腫の治療及び予防において同時使用、個別使用又は逐次使用するための複合調製物としての、i)配列番号:1の配列又はその機能保存変異体の化合物、及びii)テモゾロミド、及びiii)放射線療法。
- ガンの治療及び予防において使用するための治療用組成物であって、薬学的に許容し得る賦形剤と共に請求項6に記載の化合物を含む、治療用組成物。
- それを必要とする被験体におけるガンの予防及び治療のための薬物として使用するための候補化合物をスクリーニングする方法であって、i)候補化合物を提供する工程、及びii)DNMT3A/ISGF3γを遮断又はアンタゴナイズする候補化合物を選択する工程を含む、方法。
- ガンを治療又は予防する方法であって、治療有効量のDNMT3A/ISGF3γアンタゴニストである化合物又はDNMT3A/ISGF3γ遺伝子発現阻害剤である化合物を、それを必要とする被験体に投与することを含む、方法。
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