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1 A Disclosure of conflicts of interest 1. Employment or Leadership Position None 2. Advisory Role or Expert Testimony None 3. Stock Ownership None 4. Patent, Copyright, Licensing None 5. Honoraria None 6. Financing of Scientific Research None 7. Other Financial Relationships DGHO-JCLS-Promotionsstipendium 8. Immaterial Conflicts of Interest None

2 Annual Meeting of the German, Austrian and Swiss Associations of Hematology and Medical Oncology October 2 nd, 2017, Stuttgart, Germany A The pathophysiologic role of JunB in multiple myeloma: focus on angiogenesis Stefano Malvestiti Department of Medical Oncology National Center for Tumor Diseases (NCT), Heidelberg, Germany

3 Outlines Background Aims of the project Results Conclusions

4 Background Aims of the project Results Conclusions AP-1 JUN: c-jun, JunB, JunD FOS: c-fos, FosB, Fra1, Fra2 ATF: ATFa, ATF2, ATF3, ATF4, B-ATF MAF: c-maf,mafa, MAFB, NRL, MAFF/G/K 1. Shaulian E, Karin M. AP-1 as a regulator of cell life and death. NCB. May 2002; 4: Eferl R, Wagner EF. AP-1: a double-edged sword in tumorigenesis. Nat Rev Cancer. 2003; 3(11): F Fan et al. The AP-1 transcription factor JunB is essential for multiple myeloma cell proliferation and drug resistance in the bone marrow microenvironment. Leukemia. 2016; 6:1-12

5 Background Aims of the project Results Conclusions Secretion IL-6 SDF-1α, HGF, TNF-β, TNF- α, TGF- β Proliferation Drug-resistance Survival Secretion Adhesion

6 Background Aims of the project Results Conclusions Secretion IL-6 SDF-1α, HGF, TNF-β, TNF- α, TGF- β Proliferation Drug-resistance Survival Secretion Adhesion Angiogenic factors Angiogenesis EC migration Tubuli formation

7 Background Aims of the project Results Conclusions To delineate the role of JunB in BM angiogenesis using in vitro and in vivo models of human MM in the BM microenvironment 1. To identify the JunB-dependent production and secretion of angiogenic factors in MM cells within the BM microenvironment 2. To determine the functional interrelation of JunB, IL-6 and other GFs associated with BM angiogenesis 3. To assess the functional effect of JunB regulation on BM angiogenesis.

8 Background Aims of the project Results (Aim1) Conclusions Aim 1: JunB-dependent production of angiogenic factors in MM cells. JunB MM ADM, IGF-1, PlGF, VEGF, VEGFB Correlation?

9 log 2 median-centered intensity log 2 median-centered intensity log 2 median-centered intensity log 2 median-centered intensity Background Aims of the project Results (Aim 1) Conclusions Correlation between JunB and ADM, IGF-1, PlGF, VEGF and VEGFB expression profiles A NPC (22) MGUS (44) SMM (12) B 5 ANGPT1 FGF2 4 VEGF 3 IGF-1 2 VEGFB ADM 1 PlGF 0-1 C C NPC (5) MGUS (11) MM (133) D 0,8 0,6 0,4 0,2 0 ANGPT2 ANGPT1 PlGF VEGFB VEGF IGF-1 ADM Zahn et al. Blood. 2009; Agnelli et al. Genes Chromosomes Cancer

10 Background Aims of the project Results (Aim 2) Conclusions Aim2: Functional interrelation of JunB, IL-6 and other cytokines associated with BM angiogenesis IL-6 JunB MM ADM, IGF-1, PlGF, VEGF, VEGFB Dependency?

11 Branching points (fold of control) Expression (Fold of control) Background Aims of the project Results (Aim 1) Conclusions JunB dependent expression of IGF-1, PlGF, VEGF and VEGFB in BMSC: TetR-shJunB/MM cells co-culture systems A 4 3 * BMSC:shJunB * ** * VEGF VEGFB 2 1 IGF-1 0 Doxycycline VEGF - + VEGFB IGF-1+ PLGF - + PlGF B - Doxycycline + Doxycycline C * 3,5 3 2,5 2 1,5 1 0,5 0 - Doxycycline * p-value < 0.05 ** p-value < Doxycycline

12 Expression (fold of control) Background Aims of the project Results (Aim 2) Conclusions Doxycycline-induced JunB knockdown in TetR-shJunB/MM cells downregulates expression of IGF-1, PlGF and VEGF TetR-shJunB/MM + IL-6 + doxy XJunB JunB - doxy * 5 4,5 * 4 3,5 * 3 2,5 ** 2 1,5 1 0,5 0 Doxycycline VEGF - + VEGFB - + ADM - + IGF PLGF - + * p-value < 0.05 **p-value < 0.01

13 Background Aims of the project Results (Aim 2) Conclusions 4-OHT- induced JunB activity in JunB-ER/MM but not IRES-GFP/MM cells A B **p-value < 0.01 F Fan et al. Leukemia. 2016

14 Expression (fold of control) Background Aims of the project Results (Aim 2) Conclusions Tamoxifen-induced JunB activation in JunB-ER/MM cells induces expression of IGF-1, PlGF, VEGF and VEGFB JunB-ER * * * OHT VEGF - + VEGFB - + ADM - + IGF PLGF - + * * p-value < 0.05

15 Background Aims of the project Results (Aim 3) Conclusions Aim3: Functional effect of JunB activity on BM angiogenesis. IL-6 JunB MM Angiogenesis?

16 EC migration (% of negative control) Background Aims of the project Results (Aim 3) Conclusions Doxycycline-induced JunB downregulation in TetR-shJunB/MM cells inhibits EC migration * Untreated + IL-6 - Doxycycline + - IL-6 Doxy+ Doxycycline + IL-6 + Doxycycline Time (h) * p-value < 0.01

17 EC migration (% of negative control) Background Aims of the project Results (Aim 3) Conclusions 4-OHT- induced JunB activation in JunB-ER/MM cells stimulates EC migration * Untreated - 4-OHT + 4-OHT Time (h) * p-value < 0.01

18 Branching points (fold of control) Cell viability (fold of control) Background Aims of the project Results (Aim 3) Conclusions Inhibition of vascular tubuli formation upon doxycyclineinduced JunB knockdown in TetR-shJunB/MM cells A - Doxycycline + Doxycycline B ** Angiogenesis C 1,4 Survival ns 3 2,5 2 1,5 1 0,5 0 1,2 1 0,8 0,6 - Doxycycline + Doxycycline ** p-value < 0.01

19 F Fan et al. Leukemia Background Aims of the project Results (Aim 3) Conclusions In vivo evidence of JunB-mediated angiogenesis TetR-SCR TetR-shJunB TetR-SCR TetR-shJunB ** p-value < 0.01

20 CD31 Ki67 H&E Absolute number of vessels / 10x magnification field JunB Background Aims of the project Results (Aim 3) Conclusions A In vivo evidence of JunB-mediated angiogenesis TetR-SCR TetR-shJunB B CD31 CD31 *** x10 x40 x10 x x10 x40 x10 x x10 x40 x10 x40 TetR-SCR TetR-shJunB *** p-value < x10 x40 x10 x40

21 Summary Correlation? Background Aims of the project Results Conclusions Dependency? Angiogenesis? Secretion IL-6 SDF-1α, HGF, TNF-β, TNF- α, TGF- β Proliferation Drug-resistance Survival Secretion Adhesion ADM, IGF-1, PlGF, VEGF, VEGFB Angiogenesis EC migration Tubuli formation

22 Acknowledgements German Cancer Research Center (DKFZ) and Department of Medical Oncology, National Center for Tumor Diseases (NCT) and University of Heidelberg, Heidelberg, Germany AG Podar: Muhammad Hasan Bashari Fengjuan Fan Sonia Vallet Klaus Podar AG Jäger: Lea Schröder Rosa Eurich Inka Zörnig Dirk Jäger All other members of the Department of Medical Oncology Thank you! NCT and University of Heidelberg, Department of Internal Medicine V, Heidelberg, Germany Anja Seckinger Dirk Hose Hartmut Goldschmidt Genes Development and Disease Group, Spanish National Cancer Research Centre (CNIO), Madrid, Spain Latifa Bakiri Erwin F. Wagner Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA. USA Martin Sattler Karl Landsteiner University, Krems an der Donau, Austria Martin Pecherstorfer Universitá Magna Grecia di Catanzaro, Catanzaro, Italy. Eugenio Morelli Pierfrancesco Tassone

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