de Groot Jolien S, van Diest Paul J, van Amersfoort Miranda, Vlug Eva J, Pan Xiaojuan, Ter Hoeve Natalie D, Rosing Hilde, Beijnen Jos H, Youssef Sameh A, de Bruin Alain, Jonkers Jos, van der Wall Elsken, Derksen Patrick W B
Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands.
Department of Pharmacy and Pharmacology, Netherlands Cancer Institute, Amsterdam, The Netherlands.
Oncotarget. 2017 Jun 15;8(37):60750-60763. doi: 10.18632/oncotarget.18490. eCollection 2017 Sep 22.
deficiency predisposes to the development of invasive breast cancer. In mutation carriers this risk can increase up to 80%. Currently, bilateral prophylactic mastectomy and prophylactic bilateral salpingo-oophorectomy are the only preventive, albeit radical invasive strategies to prevent breast cancer in BRCA mutation carriers. An alternative non-invasive way to prevent -associated breast cancer may be local prophylactic treatment via the nipple. Using a non-invasive intraductal (ID) preclinical intervention strategy, we explored the use of combined cisplatin and poly (ADP)-ribose polymerase 1 (PARP1) inhibition to prevent the development of hereditary breast cancer. We show that ID cisplatin and PARP-inhibition can successfully ablate mammary epithelial cells, and this approach attenuated tumor onset in a mouse model of Brca1-associated breast cancer from 153 to 239 days. Long-term carcinogenicity studies in 150 syngeneic wild-type mice demonstrated that tumor incidence was increased in the ID treated mammary glands by 6.3% due to systemic exposure to cisplatin. Although this was only evident in aged mice (median age = 649 days), we conclude that ID cisplatin treatment only presents a safe and feasible local prevention option if systemic exposure to the chemotherapy used can be avoided.
缺陷易引发浸润性乳腺癌。在突变携带者中,这种风险可增加高达80%。目前,双侧预防性乳房切除术和双侧预防性输卵管卵巢切除术是预防BRCA突变携带者患乳腺癌的仅有的预防性(尽管是根治性侵入性)策略。一种预防相关乳腺癌的非侵入性替代方法可能是通过乳头进行局部预防性治疗。我们采用非侵入性导管内(ID)临床前干预策略,探索联合使用顺铂和聚(ADP)-核糖聚合酶1(PARP1)抑制剂来预防遗传性乳腺癌的发生。我们发现,ID顺铂和PARP抑制可成功消除乳腺上皮细胞,并且这种方法使Brca1相关乳腺癌小鼠模型中的肿瘤发病时间从153天延长至239天。对150只同基因野生型小鼠进行的长期致癌性研究表明,由于全身暴露于顺铂,ID治疗的乳腺中肿瘤发生率增加了6.3%。尽管这仅在老年小鼠(中位年龄 = 649天)中明显,但我们得出结论,如果能够避免全身暴露于所用化疗药物,ID顺铂治疗仅提供一种安全可行的局部预防选择。