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Analysis of biomarkers in plasma-derived exosomal RNA in prostate cancer and application in combinatorial treatments targeting signal transduction of androgen receptor

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Academic year: 2021

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REPORT SULLE ATTIVITÀ SVOLTE

Corso di dottorato Scienze Cliniche e Traslazionali

Cognome Crucitta

Nome Stefania

Titolo della tesi

Analysis of biomarkers in plasma-derived exosomal RNA in prostate cancer and application in combinatorial treatments targeting signal transduction of androgen receptor

Progetto di ricerca

Castration resistant prostate cancer is an androgen-dependent tumor. The standard treatment targets androgen biosynthesis or the androgen receptor (AR). The 20-40% of patients have no response to these drugs or acquire secondary resistance. One of the possible reason of these events is the presence of AR splice variants (i.e AR-V7) as a mechanism of tumor adaptation to elude the killing effect of the treatment. For these reasons, the early detection of the AR-Vs could suggest the discontinuation of ineffective treatment and switch to alternative and more effective treatments. The aim of the study was the prospective assessment of the frequency of AR-Vs developing during treatment and its association with resistance to treatment. Due to the limitations of methods available for AR-V7 analysis, the identification of a reliable detection method may facilitate the use of this biomarker in clinical practice. In order to provide a reliable laboratory approach to AR-V7 assessment, the present study was conducted to:

- confirm the role of AR-V7 in prediction of resistance to hormonal therapy;

- develop a new methodological approach to reliably and easily assess AR-V7 by a digital droplet PCR in exosomal-derived RNA from plasma samples;

- provide new data to address the correlation between exosomal-derived AR-V7 RNA and resistance, being the translation CTC to exosomes not obvious.

Concerning in vitro study, activation of the PI3K/Akt/mTOR pathway has been strongly implicated in prostate cancer progression through interacting with other cell signaling pathways important

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for cellular survival, growth, and differentiation, including the AR signaling pathway. In vitro we tested the combined treatment of abiraterone (anti-AR pathway) and everolimus (mTOR inhibitor) in PCa cell lines.

During the training abroad (ERASMUS MC – Rotterdam - NL), my research focused on the detection of small RNAs associated with prostate cancer in liquid biopsies.

Attività formative previste dal corso di Dottorato

- Inglese accademico I “C1” aa 2015/2016 (votazione esame finale: good) - Inglese accademico II “C1+” aa 2016/2017 (votazione esame finale: very good) - Statistica (votazione finale: idonea)

Attività formative inerenti al corso di Dottorato

- Vincitrice Bando Erasmus 2015/2016 per borse di studio all’estero per un periodo di 2 mesi alla Erasmus University Medical Center - Rotterdam (NL). Durante il periodo all’estero è stata svolta una parte preliminare del mio progetto di dottorato, inerente all’ottimizzazione e alla valutazione di metodiche di laboratorio (qPCR e ddPCR) da utilizzare per la messa a punto del metodo di valutazione di biomarcatori predittivi di resistenza al trattamento su esosomi estratti dal plasma

- Vincitrice Bando Erasmus 2017/2018 per borse di studio all’estero per un periodo di 4 mesi alla Erasmus University Medical Center - Rotterdam (NL).

Durante il periodo all’estero è stata svolta una parte del progetto di dottorato, inerente alla prognosi e diagnosi nel tumore della prostata ed è stata messa a punto una metodica non invasiva per valutare miRNA su esosomi estratti dal plasma.

-Vincitrice di “Borsa di ricerca SIF per brevi periodi all’estero”, per il periodo svolto alla Erasmus University Medical Center - Rotterdam (NL). Titolo del progetto “Detection of small RNAs associated with prostate cancer in liquid biopsies”.

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Partecipazione a convegni di società scientifiche nazionali ed internazionali e seminari tenuti nel triennio

- Poster presenter al Congresso INTERNAZIONALE della European Society of Medical Oncology (ESMO) - ESMO 2018 – Monaco

Titolo del poster : “Expression of TK1 and CDK9 in plasma-derived exosomes is associated with clinical response to CDK4/6 inhibitors in breast cancer”

Dal 19-10-2018 al 23-10-2018

- Relatore al Convegno Monotematico della Società Italiana di Farmacologia (SIF), Napoli.

Titolo della relazione: "eNOS polymorphisms are not associated with bevacizumab-related hypertension, but predict the clinical outcome in bevacizumab-treated breast cancer patients" Dal 26-09-2018 al 27-09-2018

- Relatore al XXI Seminario SIF per Dottorandi, Assegnisti di Ricerca, Post-dottorandi e Specializzandi, Bresso (MI).

Titolo della relazione: “Expression of TK1 and CDK9 in plasma-derived exosomes is associated with clinical response to CDK4/6 inhibitors in breast cancer”

Dal 19-09-2018 al 22-09-2018

- Poster presenter all’ Oncology Science Conference, patrocinato dall’Astrazeneca, svolto a Milano. Titolo del poster: “An in vitro study to assess the COoperation of EGFR Mutations in Promoting Actionable REsistance in NSCLC and explore new therapeutic Strategies”

Dal 21-05-2018 al 22-05-2018

- Relatore al Convegno Monotematico della Società Italiana di Farmacologia (SIF), Napoli

Titolo della relazione: “ L’espressione di TK1 su RNA esosomiale è biomarcatore di risposta clinica in pazienti con tumore alla mammella in trattamento con inibitori CDK4/6”

Dal 15-03-2018 al 16-03-2018

- Relatore al congresso ““Il carcinoma prostatico: novità diagnostiche e terapeutiche”, Livorno Titolo della relazione: ” AR-V7”

Il 19-12-2017

- Poster presenter al 38° Congresso Nazionale della Società Italiana di Farmacologia (SIF), Rimini. Titolo del poster : “Detection of AR-V7 in plasma-derived exosomal RNA in metastatic prostate cancer patients treated with first-line hormonal therapy

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- Poster Presenter alla IV Conferenza INTERNAZIONALE della European Society of Pharmacogenomics and Personalised Therapy (ESPT), Catania.

Titolo del poster: “Detection of AR-V7 in plasma-derived exosomal RNA in metastatic prostate cancer patients treated with first-line hormonal therapy

Dal 4-10-2017 al 7-10-2017

- Relatore al Congresso Internazionale dell’European association for Predictive Preventive and Personalised Medicine (EPMA), Malta

Titolo della relazione: “Monitoring of activating and resistance mutations in plasma samples of NSCLC patients treated with EGFR TKIs: the role of liquid biopsy”

Dal 14-09-2017 al 17-09-2017

- Poster presenter al XIX Seminario SIF Dottorandi e Assegnisti - Rimini,

Titolo del poster: “The detection of AR-V7 in plasma-derived exosomal RNA strongly predicts resistance to hormonal therapy in metastatic prostate cancer patients”

Dal 20-09-2016 al 22-09-2016

Riconoscimenti e premi ottenuti nel triennio

2017: Vincitrice di “Borsa per il miglior poster “ presentato durante il 38° Congresso Nazionale della Società Italiana di Farmacologia (SIF), Rimini.

2018: Vincitrice del travel grant ESO per partecipare alla conferenza “ESMO Preceptorship on Immuno-Oncology, Lugano (Svizzera), 4-5 Maggio 2018

Lavori pubblicati nel triennio

1) Del Re M, Citi V, Crucitta S, Rofi E, Belcari F, van Schaik R.H, Danesi R. Pharmacogenetics of CYP2D6 and tamoxifen therapy: light at the end of the tunnel? Pharmacol Res. 2016 Apr;107:398- 406

2) Femia AP, Luceri C, Lodovici M, Crucitta S, Caderni G. Gene Expression Profile of Colon Mucosa after Cytotoxic Insult in wt and Apc-Mutated Pirc Rats: Possible Relation to Resistance to Apoptosis during Carcinogenesis. Biomed Res Int. 2016;2016:1310342.

3) Del Re M, Biasco E, Crucitta S, Derosa L, Rofi E, Orlandini C, Miccoli M, Galli L, Falcone A, Jenster GW, van Schaik RH, Danesi R. The detection of androgen receptor splice variant 7 in plasma derived exosomal RNA strongly predicts resistance to hormonal therapy in metastatic prostate cancer patients. Eur Urol. 2017 Apr;71(4):680-687

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4) Del Re M, Restante G, Crucitta S, Rofi E, Danesi R. Pharmacogenetics and metabolism from science to implementation in clinical practice: the example of dihydropyrimidine dehydrogenase. Curr Pharm Des. 2017 Jan;23(14):2028-2034.

5) Del Re M, Fogli S, Derosa L, Massari F, De Souza P, Crucitta S, Bracarda S, Santini D, Danesi R. The role of drug-drug interactions in prostate cancer treatment: focus on abiraterone acetate/prednisone and enzalutamide. Cancer Treat Rev. 2017 Mar;55:71-82

6) Del Re M, Biasco E, Crucitta S, Derosa L, Rofi E, Orlandini C, Miccoli M, Galli L, Falcone A, Jester GW, van Schaik RH, Danesi R. Author's reply. The detection of AR-V7 in plasma-derived exosomal RNA strongly predicts resistance to hormonal therapy in metastatic prostate cancer patients. Eur. Urol. 2017. DOI:10.1016/j.eururo.2017.07.034

7) Del Re M, Rofi E, Restante G, Crucitta S, Arrigoni E, Fogli S, Di Maio M, Petrini I, Danesi R.

Implications of KRAS mutations in acquired resistance to treatment in NSCLC. Oncotarget. 2017;9(5):6630-6643

8) Del Re M, Arrigoni E, Restante G, Passaro A, Rofi E, Crucitta S, De Marinis F, Di Paolo A, Danesi R. Resistance to Tyrosine Kinase Inhibitors in Non-Small Cell Lung Cancer: The Role of Cancer Stem Cells. Stem Cells. 2018 Jan. doi: 10.1002/stem.2787

9) Arrigoni E, Del Re M, Galimberti S, Restante G, Rofi E, Crucitta S, Baratè C, Petrini M, Danesi R, Di Paolo A. Chronic myeloid leukemia: stem cell niche and response to pharmacologic treatment. Stem Cells Transl Med. 2018 Mar;7(3):305-314

10) Del Re M, Marconcini R, Pasquini G, Rofi E, Vivaldi C, Bloise F, Restante G, Arrigoni E, Caparello C, Bianco MG, Crucitta S, Petrini I, Vasile E, Falcone A, Danesi R. PD-L1 mRNA expression in

plasma-derived exosomes is associated with response to anti-PD-1 antibodies in melanoma and NSCLC. BJC 2018. doi:10.1038/bjc.2018.9

11) Del Re M1, Crucitta S1, Restante G, Rofi E, Arrigoni E, Biasco E, Sbrana A, Coppi E, Galli L, Bracarda S, Santini D, Danesi R. Pharmacogenetics of androgen signaling in prostate cancer: Focus on castration resistance and predictive biomarkers of response to treatment. Crit Rev Oncol Hematol. 2018 https://doi.org/10.1016/j.critrevonc.2018.03.002

12) Del Re M, Bordi P, Rofi E, Restante G, Valleggi S, Minari R, Crucitta S, Arrigoni E, Chella A, Morganti R, Tiseo M, Petrini I, Danesi R. The amount of activating EGFR mutations in circulating cell-free DNA is a marker to monitor osimertinib response. Br J Cancer. 2018 Nov;119(10):1252-1258. doi: 10.1038/s41416-018-0238-z.

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13) Rofi E, Vivaldi C, Del Re M, Arrigoni E, Crucitta S, Funel N, Fogli S, Vasile E, Musettini G, Fornaro L, Falcone A, Danesi R. The emerging role of liquid biopsy in diagnosis, prognosis and treatment monitoring of pancreatic cancer. Pharmacogenomics. 2018 Dec 6. doi: 10.2217/pgs-2018-0149.

Attività di tutoraggio

- Tutoraggio a studenti per tesi di laurea in Medicina e Chirurgia (1), Farmacia (1), per la realizzazione della parte sperimentale e scrittura della tesi

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