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Old 02-02-2013, 10:21 PM   #1
Lani
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mechanism of natural switch crucial to spread of metastatic breast cancer identified

and metformin seems to help block it



Cornell bioengineers discover the natural switch that controls spread of breast cancer cells

ITHACA, N.Y. – With a desire to inhibit metastasis, Cornell biomedical engineers have found the natural switch between the body's inflammatory response and how malignant breast cancer cells use the bloodstream to spread. (PLOS ONE, Jan. 23, 2013)

Pro-inflammatory signaling molecules in blood called cytokines constitute a "switch" that induces the mechanism by which breast cancer cells "roll" and adhere to the blood vessel surface. The cancer cells eventually stick to the vessel and infiltrate it.

The laboratory of Michael R. King, Cornell professor of biomedical engineering has developed a flow chamber that mimics an inflamed endothelium (the blood vessel wall) and has used this to investigate the metastatic cascade.

In understanding the adhesive behavior of a particularly metastatic cell line, King and Yue Geng, graduate student in the field of biomedical engineering, discovered unexpectedly that these cells were unable to interact with selectins (receptor sites on the endothelium) – a key step in the metastatic cascade. This mechanism is identical to how white blood cells infiltrate blood vessels to reach the site of inflammation.

Cancer has long been associated with inflammation – the body's natural defense mechanism – and now the researchers have demonstrated a definitive link. They found that the presence of pro-inflammatory molecules – the cytokines IL-6 and TNF-alpha – enable the malignant, hormone therapy-resistant breast cancer cells used in the study to adhere to the endothelial wall, leading to metastasis.

Before the cancer has spread, tumor cells first encounter IL-6 and TNF-alpha in the primary tumor's microenvironment. These cytokines induce proliferation and aggregation of cancer cells, triggering other cancer cells to secrete more cytokines, resulting in a positive feedback loop.

The bioengineers went on to design several different cell culture setups to culture cancer cells with human plasma, IL-6 and TNF-alpha to test their hypotheses that inflammatory molecules in blood may induce adhesion capability. All of them promoted breast cancer cell metastatic behavior.

To confirm the results, the scientists used more sophisticated, real-life 3-D tumor spheroids, which are more physiologically accurate. In fact, the spheroid tumor cells exhibited the most significant increase in the interaction between the cancer cells and the blood vessel. They also treated some of the samples with a known anti-inflammatory drug called Metformin, which blocks IL-6, and they found that these samples were not able to metastasize – further accentuating their results.

Improving cancer treatment to fight metastasis via the bloodstream will depend on undoing this roll-and-stick mechanism of cancer cells, Geng says. The Cornell research could form the basis for immunotherapies to block the ligand-selectin binding of cancer cells, by first counteracting the inflammatory cytokines that, it seems, set the whole process in motion.

###

The paper, "Phenotypic switch in blood: effects of pro-inflammatory cytokines on breast cancer cell aggregation and adhesion," appears online Jan. 23, 2013 in the open-access, peer-reviewed journal PLOS ONE. The paper's first author is Geng and the senior author is King. Co-authors include Jong-Wei Hsu, Cornell post-doctoral researcher; Cornell graduate students Siddarth Chandrasekaran and Andrew D. Hughes; and undergraduate student Mishka Gidwani.

The National Cancer Institute via the Center on the Microenvironment and Metastasis, and a National Science Foundation Graduate Research Fellowship, funded the research.
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Old 02-03-2013, 01:33 AM   #2
Joanne S
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Re: mechanism of natural switch crucial to spread of metastatic breast cancer identif

Wow- What a humongous finding!!! I wonder what the next step will be?
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Aug06...Dx Age 50, IDC Left Breast, 6+/16 lymph nodes, Stg 3, ER+/PR+/HER2+
Sep06-Jan07...Mediport. Chemo: AC x 4, T x 4
Dec06-Nov07...Herceptin
Feb12,2007...Surg MRM Left & SM Right, reconstruct w/expanders
Mar07-Jun07...Saline Exp
Jun07...Start Tamoxifen
Jun07-Aug07...Rad x 25
Jun07-Oct07...Persistent fevers-unknown origin
Jun07-Nov07...PT for Severe PMPS & Capsular Contracture
Nov07...Surg Capsulectomy, Gel Implants, PMPS pain gone instantly.
Feb08...NED 1st CANCERVERSARY!!!!!
Feb08...2 months post surgery Caps Cont again :(
Mar08...Stop Tamoxifen. Start Arimidex.
Apr08...Sudden high fever, Hosp ICU 10 days, staph infect, emerg surg, implants removed. Outpt IVantibiotics Daily x 6 weeks
Feb11...NED 5th CANCERVERSARY!!!!!
Feb12...NED 6th CANCERVERSARY!!!!!
Aug12...Spotting. Surg=D&C
Sep12...STAGE IV = RARE BC METS TO UTERUS ILC ER+/PR+/HER2-Negative) (Different BC than originally diagnosed = IDC ER+/PR+/HER2+).
Sep12...Stop Arimidex. Start Afinitor & Aromasin.
Jan13...MRI = no progression no reduction
Apr13...Progression. Stop Afinitor & Aromasin.
Apr13...Start Chemo: Taxol & Carboplatin.
Nov13...Scans & Pelvic 95+% Reduction. Nueropathy>Stop chemo start Fareston.
Jan14...PET scan = no progression stable.
May14...Pelvic > Bleeding & cramps. TMs up.
May14...PET scan = uterine progression :(
May14...Stop Fareston. Start Chemo: Xeloda.



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Old 02-03-2013, 07:56 AM   #3
rhondalea
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Re: mechanism of natural switch crucial to spread of metastatic breast cancer identif

The "next step" started long before the publication of this paper. I'm in this study:

http://clinicaltrials.gov/show/NCT01101438

This study just concluded:

http://onlinelibrary.wiley.com/doi/1...27706/abstract

If you go to clinicaltrials.gov, you will see that there are many more metformin studies.

The article Lani posted can be read in its entirety here:

http://www.plosone.org/article/info%...l.pone.0054959
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2/6/09 Core needle biopsy: negative; Mammos through 2010: no change
3/30/11 Pea-sized lump in left breast at site of prior biopsy; mammo negative, sonogram not so much
4/14/11 Core needle biopsy: negative for cancer
5/18/11 Excisional biopsy 1.2 cm tumor, LVI, positive margin; ER+60%,PR+20%,HER2/CEP17 5
6/15/11 BMX: Left DCIS & LH; Right ADH; SNB: 2/3 nodes: 1.4 cm and 1 mm; ALND L1&2: 0/10; Stage IIa, Grade 3
7/14/11 CT/Bone scans NED; MUGA 66%
7/19/11 Biweekly dd AC w/Neulasta; done 8/30/11
9/13/11 Transfusion (Hemoglobin 8.6); MUGA 64%
9/20/11 Start Taxol + Herceptin; Taxol done 12/6/2011; continue Herceptin until 9/4/2012
12/27/11 Radiation - 6 weeks; 2/27/2012 - DONE! Yayyyy!
2/29/12 Start Tamoxifen 20 mg/day; continue until 2/28/17
5/16/12 Start five-years Metformin trial
6/19/12 MUGA 61%
8/21/12 Brain MRI NED (head still hurts, brain still fogged)
9/4/12 Herceptin done!
9/6/12 Port out!
7/11/13 Aricept 5mg for cognitive impairment; increased to 10mg as of 8/23/13; back to 5mg 12/2013
5/2014 Add Namenda 7mg
9/2014 Stop Aricept and Namenda; Neuropsychological evaluation
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Old 02-03-2013, 10:39 AM   #4
'lizbeth
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Re: mechanism of natural switch crucial to spread of metastatic breast cancer identif

I have always suspected my Paget's had hijacked my immune system to develop and spread.
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Diagnosed 2007
Stage IIb Invasive Ductal Carcinoma, Pagets, 3 of 15 positive nodes

Traditional Treatment: Mastectomy and Axillary Node Dissection followed by Taxotere, 6 treatments and 1 year of Herceptin, no radiation
Former Chemo Ninja "Takizi Zukuchiri"

Additional treatments:
GP2 vaccine, San Antonio Med Ctr
Prescriptive Exercise for Cancer Patients
ENERGY Study, UCSD La Jolla

Reconstruction: TRAM flap, partial loss, Revision

The content of my posts are meant for informational purposes only. The medical information is intended for general information only and should not be used in any way to diagnose, treat, cure, or prevent disease
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Old 02-03-2013, 01:32 PM   #5
europa
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Re: mechanism of natural switch crucial to spread of metastatic breast cancer identif

Thank you! I'm on a Metformin trial. Other than a metallic taste in my mouth...it's an easy drug to tolerate
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DX 10/2011
PET Scan + MRI 10/2011
Lumpectomy 11/11/11
Stage 2B +++ ER+(10%), PR+(5%), HER2+++(1 positive node, 1 micromets to second node)
AC started 12/2011 ended 1/2012
Taxol + Herceptin weekly for 12 weeks ended 4/2012
30 zaps of radiation done 6/2012
Tamoxifen 6/2012
every 3 weeks of Herceptin for another year.
Metformin Trial 8/12
10/12 MRI- CLEAR
01/13 BRAIN MRI- CLEAR!
01/13 Neck MRI- CLEAR!
FINISHED HERCEPTIN 1/9/2013...Woot Woot
Starting Walter Reed Vaccine Trial 2/13
CT Scans + ultrasound of abdomen CLEAR-5/13
02/2015 through 11/2015 emergency D&Cs for Tamoxifen induced uterine polyps which caused uncontrollable hemorrhaging
12/2015 blood clot to left leg caused by Tamoxifen. No longer taking it. On Xarelto, a blood thinner
12/2015 Ablation to prevent hemorrhaging from potential issues with Tamoxifen residue in my system
1/2016 continuing journey without hormonal therapy. Reevaluating the option of a hysterectomy and oopherectomy.
4/1/2018 2mm stroke. Yes, stroke! No cause ever found but they believe it was a migraine that went bonkers and created a tiny clot. No deficits. I was back to normal with 24hrs. Now on baby aspirin for life.
7/27/2018 hysterectomy and oopherectomy
01/07/2019 Mastectomy and expanders put in
3/22/2019 Vtach, almost died. Cause unknown.
7/22/2019 New perky boobs put in
7/21/2020 Off of all drugs but a baby aspirin because of the stroke in 2018.


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