The evolution of cancer genomic medicine in Japan and the role of the National Cancer Center Japan

The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.

Skeletal muscle as a molecular and cellular biomarker of disease progression in amyotrophic lateral sclerosis:a narrative review

Amyotrophic lateral sclerosis is a fatal multisystemic neurodegenerative disease with motor neurons being a primary target.Although progressive weakness is a hallmark feature of amyotrophic lateral sclerosis,there is considerable heterogeneity,including clinical presentation,progression,and the underlying triggers for disease initiation.Based on longitudinal studies with families harboring amyotrophic lateral sclerosis-associated gene mutations,it has become apparent that overt disease is preceded by a prodromal phase,possibly in years,where compensatory mechanisms delay symptom onset.Since 85-90%of amyotrophic lateral sclerosis is sporadic,there is a strong need for identifying biomarkers that can detect this prodromal phase as motor neurons have limited capacity for regeneration.Current Food and Drug Administration-approved therapies work by slowing the degenerative process and are most effective early in the disease.Skeletal muscle,including the neuromuscular junction,manifests abnormalities at the earliest stages of the disease,before motor neuron loss,making it a promising source for identifying biomarkers of the prodromal phase.The accessibility of muscle through biopsy provides a lens into the distal motor system at earlier stages and in real time.The advent of“omics”technology has led to the identification of numerous dysregulated molecules in amyotrophic lateral sclerosis muscle,ranging from coding and non-coding RNAs to proteins and metabolites.This technology has opened the door for identifying biomarkers of disease activity and providing insight into disease mechanisms.A major challenge is correlating the myriad of dysregulated molecules with clinical or histological progression and understanding their relevance to presymptomatic phases of disease.There are two major goals of this review.The first is to summarize some of the biomarkers identified in human amyotrophic lateral sclerosis muscle that have a clinicopathological correlation with disease activity,evidence of a similar dysregulation in the SOD1G93A mouse during presymptomatic stages,and evidence of progressive change during disease progression.The second goal is to review the molecular pathways these biomarkers reflect and their potential role in mitigating or promoting disease progression,and as such,their potential as therapeutic targets in amyotrophic lateral sclerosis.

Mapping the metabolic responses to oxaliplatin-based chemotherapy with in vivo spatiotemporal metabolomics

Adjuvant chemotherapy improves the survival outlook for patients undergoing operations for lung metastases caused by colorectal cancer (CRC). However, a multidisciplinary approach that evaluates several factors related to patient and tumor characteristics is necessary for managing chemotherapy treatment in metastatic CRC patients with lung disease, as such factors dictate the timing and drug regimen, which may affect treatment response and prognosis. In this study, we explore the potential of spatial metabolomics for evaluating metabolic phenotypes and therapy outcomes during the local delivery of the anticancer drug, oxaliplatin, to the lung. 12 male Yorkshire pigs underwent a 3 h left lung in vivo lung perfusion (IVLP) with various doses of oxaliplatin (7.5, 10, 20, 40, and 80 mg/L), which were administered to the perfusion circuit reservoir as a bolus. Biocompatible solid-phase microextraction (SPME) microprobes were combined with global metabolite profiling to obtain spatiotemporal information about the activity of the drug, determine toxic doses that exceed therapeutic efficacy, and conduct a mechanistic exploration of associated lung injury. Mild and subclinical lung injury was observed at 40 mg/L of oxaliplatin, and significant compromise of the hemodynamic lung function was found at 80 mg/L. This result was associated with massive alterations in metabolic patterns of lung tissue and perfusate, resulting in a total of 139 discriminant compounds. Uncontrolled inflammatory response, abnormalities in energy metabolism, and mitochondrial dysfunction next to accelerated kynurenine and aldosterone production were recognized as distinct features of dysregulated metabolipidome. Spatial pharmacometabolomics may be a promising tool for identifying pathological responses to chemotherapy.

Mission of the National Cancer Center Hospital in Japan to promote clinical trials for precision medicine

Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。

Current and future trends in whole genome sequencing in cancer

Cancer remains a formidable global health challenge affecting millions of lives annually.For decades,conventional cancer treatments used a one-size-fits-all approach,overlooking the intricate genetic variations that drive tumors.The emergence of cancer genomics has ushered in a new era of personalized and targeted cancer therapies.The Human Genome Project,which was launched in 1990 and completed in 2003。

Resilience to structural and molecular changes in excitatory synapses in the hippocampus contributes to cognitive function recovery in Tg2576 mice

Plaques of amyloid-β(Aβ)and neurofibrillary tangles are the main pathological characteristics of Alzheimer’s disease(AD).However,some older adult people with AD pathological hallmarks can retain cognitive function.Unraveling the factors that lead to this cognitive resilience to AD offers promising prospects for identifying new therapeutic targets.Our hypothesis focuses on the contribution of resilience to changes in excitatory synapses at the structural and molecular levels,which may underlie healthy cognitive performance in aged AD animals.Utilizing the Morris Water Maze test,we selected resilient(asymptomatic)and cognitively impaired aged Tg2576 mice.While the enzyme-linked immunosorbent assay showed similar levels of Aβ42 in both experimental groups,western blot analysis revealed differences in tau pathology in the pre-synaptic supernatant fraction.To further investigate the density of synapses in the hippocampus of 16-18 month-old Tg2576 mice,we employed stereological and electron microscopic methods.Our findings indicated a decrease in the density of excitatory synapses in the stratum radiatum of the hippocampal CA1 in cognitively impaired Tg2576 mice compared with age-matched resilient Tg2576 and non-transgenic controls.Intriguingly,through quantitative immunoelectron microscopy in the hippocampus of impaired and resilient Tg2576 transgenic AD mice,we uncovered differences in the subcellular localization of glutamate receptors.Specifically,the density of GluA1,GluA2/3,and mGlu5 in spines and dendritic shafts of CA1 pyramidal cells in impaired Tg2576 mice was significantly reduced compared with age-matched resilient Tg2576 and non-transgenic controls.Notably,the density of GluA2/3 in resilient Tg2576 mice was significantly increased in spines but not in dendritic shafts compared with impaired Tg2576 and non-transgenic mice.These subcellular findings strongly support the hypothesis that dendritic spine plasticity and synaptic machinery in the hippocampus play crucial roles in the mechanisms of cognitive resilience in Tg2576 mice.

Dual ligand-targeted Pluronic P123 polymeric micelles enhance the therapeutic effect of breast cancer with bone metastases

Bone metastasis secondary to breast cancer negatively impacts patient quality of life and survival.The treatment of bone metastases is challenging since many anticancer drugs are not effectively delivered to the bone to exert a therapeutic effect.To improve the treatment efficacy,we developed Pluronic P123(P123)-based polymeric micelles dually decorated with alendronate(ALN)and cancer-specific phage protein DMPGTVLP(DP-8)for targeted drug delivery to breast cancer bone metastases.Doxorubicin(DOX)was selected as the anticancer drug and was encapsulated into the hydrophobic core of the micelles with a high drug loading capacity(3.44%).The DOX-loaded polymeric micelles were spherical,123 nm in diameter on average,and exhibited a narrow size distribution.The in vitro experiments demonstrated that a pH decrease from 7.4 to 5.0 markedly accelerated DOX release.The micelles were well internalized by cultured breast cancer cells and the cell death rate of micelle-treated breast cancer cells was increased compared to that of free DOX-treated cells.Rapid binding of the micelles to hydroxyapatite(HA)microparticles indicated their high affinity for bone.P123-ALN/DP-8@DOX inhibited tumor growth and reduced bone resorption in a 3D cancer bone metastasis model.In vivo experiments using a breast cancer bone metastasis nude model demonstrated increased accumulation of the micelles in the tumor region and considerable antitumor activity with no organ-specific histological damage and minimal systemic toxicity.In conclusion,our study provided strong evidence that these pH-sensitive dual ligand-targeted polymeric micelles may be a successful treatment strategy for breast cancer bone metastasis.

小胶质细胞在卒中中的作用

小胶质细胞在缺血后的炎症反应和受损组织的清除中扮演关键角色,它们对缺血引起的干扰反应迅速,致力于恢复失去的稳态。然而,被修改的环境,包括离子失衡、关键的神经元-小胶质细胞相互作用的中断、去极化传播以及来自坏死神经元的危险信号的产生,诱导了小胶质细胞的形态和表型转变。这导致它们表现为促炎表型并增加吞噬活动。从缺血后的第3天开始,巨噬细胞渗透到坏死组织核心,而小胶质细胞则在病灶周边聚集。此外,炎症促使代谢转向有利于糖酵解、戊糖磷酸途径和脂质合成。这些转变与吞噬脂质的摄入相结合,促进了脂滴生成、合成代谢,并使小胶质细胞增殖。增殖的小胶质细胞释放营养因子,有助于神经保护和修复。然而,一些小胶质细胞持续积累脂质,并转变为功能失调且可能有害的泡沫细胞。研究还表明,有些小胶质细胞要么清除凋亡细胞能力的受损,要么消除突触、活神经元或内皮细胞。然而,阐明被吞噬细胞的生存能力、局部环境特征、组织损伤程度和时间序列将是至关重要的。缺血为小胶质细胞提供了丰富多样的、依赖于区域和损伤的刺激,随着时间演变导致出现不同的小胶质细胞表型,包括表现为促炎性或功能失调特征的细胞,以及显示出促进修复功能的细胞。准确分析小胶质细胞表型,以及更精确地了解相关的缺血后组织条件,是对卒中进行针对性干预的必要步骤。

Amyloid-beta pathology-induced nanoscale synaptic disruption:the case of the GABA_B-GIRK assembly

Alzheimer's disease (AD) is characterized by an imbalance between excitatory and inhibitory brain networks,leading to aberrant homeostatic synaptic plasticity.AD has progressively been recognized as syna ptopathy and syna ptic dysfunction has been identified as a key component of its pathogenesis (Schirinzi et al.,2020).Syna ptic dysfunction is believed to precede synapse loss,a primary biological correlate of cognitive decline in AD,inevita bly associated with neuronal death.

The NORE1A/RASSF5 Tumor Suppressor Forms a Complex with GSK-3β to Regulate β-Catenin

NORE1A (RASSF5) is a tumor suppressor of the RASSF family that is often down-regulated in human tumors. NORE1A has multiple roles in controlling cellular homeostasis, one of them being regulating levels of β-catenin by binding and modulating the ubiquitin ligase substrate recognition factor β-TrCP. β-catenin is a major executor of the Wnt pathway. The ubiquitin SCF-β-TrCP ligase complex acts on a phospho-degron site in β-catenin that can be phosphorylated by GSK-3β. We now show that in addition to binding β-TrCP, NORE1A also promotes the phosphorylation of the β-catenin phospho-degron by complexing with the kinase GSK-3β. Indeed, NORE1A enhances the formation of a GSK-3β/β-TrCP complex. A structural mutant of NORE1A that retains β-TrCP binding but will no longer interact with GSK-3β inhibits the β-catenin degrading action of NORE1A. The GSK-3β interaction with NORE1A plays an important role in the biology of NORE1A as a GSK-3β inhibitor blocks NORE1A induced senescence. Thus, we identify a new role for the tumor suppressor NORE1A: The regulation of GSK-3β. GSK-3β has many other substrates including multiple transcription factors and co-activators such as p53 and the Hippo component TAZ. The work implies that NORE1A may be able to influence all of them via this new kinase scaffolding interaction.

Genomic medicine in clinical practice:national genomic medicine program in Japan

Cancer statistics in Japan Cancer is the most common cause of death in Japan based on Statistics 2021~1.Since statistics were first gathered,infectious diseases,such as tuberculosis,and cerebrovascular disease have been the main causes of death in Japan.Cancer surpassed cerebrovascular disease as the main cause of death in 1981,and the number of cancer deaths has increased.Approximately 38,000 people died of cancer in 2021.The National Cancer Center(NCC)reported that the 5-year survival rate for patients with cancer was improving(62%for males and 66.9%for females)in a population-based cancer registry.

Molecular genetics and targeted therapeutics in biliary tractcarcinoma

The primary malignancies of the biliary tract, cholangio-carcinoma and gallbladder cancer, often present at an advanced stage and are marginally sensitive to radiation and chemotherapy. Accumulating evidence indicates that molecularly targeted agents may provide new hope for improving treatment response in biliary tract carcinoma(BTC). In this article, we provide a critical review of the pathogenesis and genetic abnormalities of biliary tract neoplasms, in addition to discussing the current and emerging targeted therapeutics in BTC. Genetic studies of biliary tumors have identified the growth factors and receptors as well as their downstream signaling pathways that control the growth and survival of biliary epithelia. Target-specific monoclonal antibodies and small molecules inhibitors directed against the signaling pathways that drive BTC growth and invasion have been developed. Numerous clinical trials designed to test these agents as either monotherapy or in combination with conventional chemotherapy have been completed or are currently underway. Research focusing on understanding the molecular basis of biliary tumorigenesis will continue to identify for targeted therapy the key mutations that drive growth and invasion of biliary neoplasms. Additional strategies that have emerged for treating this malignant disease include targeting the epigenetic alterations of BTC and immunotherapy. By integrating targeted therapy with molecular profiles of biliary tumor, we hope to provide precision treatment for patients with malignant diseases of the biliary tract.

MicroRNA therapeutics:principles,expectations,and challenges

MicroRNAs(miRNAs) are a class of highly abundant non-coding RNA molecules that are involved in several biological processes.Many miRNAs are often deregulated in several diseases including cancer.There is substantial interest in exploiting miRNAs for therapeutic applications.In this editorial,we briefly review current advances in the use of miRNAs or antisense oligonucleotides(antagomirs) for such therapies.One of the key issues related to therapy using miRNAs is degradation of naked particles in vivo.To overcome this limitation,delivery systems for miRNA-based therapeutic agents have been developed,which hold tremendous potential for improving therapeutic outcome of cancer patients.

神经胶质细胞炎症反应的RNA调控及其作为中枢神经系统疾病治疗靶点的潜力

神经炎症的一个主要标志是小胶质细胞和星形胶质细胞的激活以及炎症介质(如IL-1β、TNF-α、iNOS和IL-6)的诱导。神经炎症会导致从急性中枢神经系统创伤到慢性神经退行性疾病等多种神经系统疾病的进展。mRNA稳定性的转录后调控途径和翻译效率是这些炎症介质表达的主要驱动因素。这一调节水平的一个共同元素以富含腺嘌呤和尿苷的元素(ARE)为中心,该元素存在于编码这些炎症介质的mRNA的3’非翻译区(UTR)中。(ARE)-结合蛋白(AUBPs)——如人类抗原R(HuR)、三四脯氨酸(TTP)和KH型剪接调节蛋白(KSRP)——是指导这些转录后通路的关键节点,可以促进(HuR)或抑制(TTP和KSRP)胶质细胞产生炎症介质。本综述将讨论ARE介导的RNA调节的基本概念及其对胶质细胞驱动的神经炎症性疾病的影响。还将讨论针对这种新的基因调控水平以达到治疗效果的策略,并对其治疗神经系统疾病潜力的初步研究进行回顾性分析。

Collagen matrix scaffolds:Future perspectives for the management of chronic liver diseases

Approximately 1.5 billion chronic liver disease(CLD)cases have been estimated worldwide,encompassing a wide range of liver damage severities.Moreover,liver disease causes approximately 1.75 million deaths per year.CLD is typically characterized by the silent and progressive deterioration of liver parenchyma due to an incessant inflammatory process,cell death,over deposition of extracellular matrix proteins,and dysregulated regeneration.Overall,these processes impair the correct function of this vital organ.Cirrhosis and liver cancer are the main complications of CLD,which accounts for 3.5%of all deaths worldwide.Liver transplantation is the optimal therapeutic option for advanced liver damage.The liver is one of the most common organs transplanted;however,only 10%of liver transplants are successful.In this context,regenerative medicine has made significant progress in the design of biomaterials,such as collagen matrix scaffolds,to address the limitations of organ transplantation(e.g.,low donation rates and biocompatibility).Thus,it remains crucial to continue with experimental and clinical studies to validate the use of collagen matrix scaffolds in liver disease.

Clues from a missense mutation of the adenosine A1 receptor gene associated with early-onset Parkinson’s disease

Parkinson’s disease (P D) is a com plex neu rodegenerative disorder for which ra re and common genetic variants contribute to disease risk,onset,and progression.The genetic contribution to PD can be classified mainly in,first,rare DNA variants that are highly penetrant and therefore causal,which are typically associated with monogenic PD;and second,more common risk polymorphic variants,which individually exert a small increase in the risk of the disease,which are usually identified in the most prevalent and apparently sporadic PD (Blauwendraat et al.,2020).

华蟾素治疗肝癌、肺癌、胰腺癌的Ⅰ期临床研究:初步报道

背景与目的:华蟾素目前广泛应用于肿瘤的治疗中,由于在80年代上市,未进行临床Ⅰ期研究,无法确定其最大耐受剂量。因此本文旨在观察华蟾素治疗肝细胞癌、肺癌和胰腺癌的最大耐受剂量和不良反应,同时评价治疗疗效。方法:Ⅲ、Ⅳ期肝细胞癌、非小细胞肺癌和胰腺癌接受华蟾素治疗,采用静脉滴注,连续14 d,21 d为一疗程。如果没有出现剂量限制性毒性,治疗将持续2个疗程。剂量递增的方案为:10、20、40、60、90和120 m l/(m2.d)。结果:入组15例患者(每个剂量组为3例)中,11例为肝癌,2例胰腺癌和2例肺癌。第五剂量组结束时没有发现剂量限制性毒性(DLT)。其中14例患者可评价疗效,6例(42.9%)为SD,8例(57.1%)为PD。在第一剂量组中,1例肝癌患者肿瘤缩小20%并维持11个月。结论:本研究最高剂量达到常规剂量的8倍,尚未出现剂量限制性毒性。部分患者获得了肿瘤缩小或稳定的疗效。

Discovering genetic biomarkers for targeted cancer therapeutics with eXplainable Artificial Intelligence

High-Grade Serous Ovarian Cancer(HGSC)is the most prevalent and lethal form of gynecologic malignancies[1],accounting for 70%-80%of ovarian cancer fatalities.Despite decades of research,the overall survival rate for HGSC has remained largely unchanged[2],and patients with advanced stages of the disease have only a 41%chance of surviving beyond five years[3].

新型STAT3信号转导通路抑制剂WP1193在体外对脑肿瘤干细胞生物学特性影响的研究

背景与目的:恶性脑胶质母细胞瘤(glioblastoma Multiforme,GBM)是最常见的成人原发性脑肿瘤,预后仍不理想。近年来,肿瘤干细胞理论认为脑肿瘤干细胞是GBM进展及治疗耐受的主要原因,只有针对脑肿瘤干细胞的靶向治疗才能更加有效的治疗GBM。本研究旨在探讨新型STAT3信号转导通路抑制剂WP1193在体外对脑肿瘤干细胞生物学特性的影响。方法:从新鲜手术切除的GBM标本中,分离、培养及鉴定脑肿瘤干细胞。采用Western blot及RT-PCR法检测WP1193给药后,STAT3信号转导通路的变化。使用神经球形成实验评估WP1193对GBM干细胞形成神经球能力的影响。利用RT-PCR及流式细胞技术检测WP1193对CD133阳性细胞的影响。采用MTS及PI染色结合流式细胞技术检测WP1193对GBM干细胞增殖及细胞周期的影响。采用AnnexinV流式细胞术分析WP1193对GBM干细胞的凋亡诱导效应。结果:WP1193抑制GBM干细胞STAT3磷酸化及下游基因的表达。WP1193有效抑制GBM干细胞形成神经球的能力及增殖,并可将细胞阻滞于G1期。WP1193在体外通过改变Bax/Bcl-2比例诱导GBM干细胞凋亡。结论:WP1193通过抑制STAT3信号转导通路,有效的抑制GBM干细胞的增殖及形成神经球的能力,并能诱导凋亡。STAT3信号转导通路可作为GBM干细胞的治疗靶点。

STAT3信号转导通路抑制剂诱导胶质瘤干细胞产生自噬的研究

背景与目的:胶质瘤干细胞(glioma stem cell,GSC)在胶质瘤发展及治疗抗拒中发挥重要作用。我们以往的研究表明,新型STAT3信号转导通路抑制剂(STAT3 inhibitor,STI)WP1193能够诱导GSC产生细胞周期阻滞及凋亡。本研究旨在探讨STI是否能在体外诱导GSC产生自噬现象。方法:从手术切除的胶质母细胞瘤中分离及培养GSC。使用STI处理GSC。利用细胞计数法检测STI对GSC增殖的影响。使用Western blot检测自噬相关蛋白LC3的表达情况。吖啶橙染色后,利用荧光显微镜及流式细胞技术检测酸性自噬小体。使用透射电镜检测GSC中自噬小体。结果:STI剂量依赖性的抑制GSC的增殖。STI处理后,GSC中出现LC3表达的切换。STI处理后,GSC中出现自噬小体,且出现自噬小体细胞的比例增加。结论:STI能够在GSC中诱导自噬现象的产生。自噬在STI治疗中的意义及调节机制需要进一步的研究。