3-D culture of BRAF- and KRAS-mutated Erdheim-Chester. disease tissues: impact of kinase inhibitors
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1 3-D culture of BRAF- and KRAS-mutated Erdheim-Chester disease tissues: impact of kinase inhibitors Marina Ferrarini, MD Division of Experimental Oncology San Raffaele Scientific Institute, Milano 5 th Annual ECD Medical Symposium New York, NY October 26, 216
2 A unifying disease model for ECD BRAF V6E p16 Ink4a Cavalli et al, 214 C. Doglioni
3 vemurafenib treatment in Erdheim-Chester disease
4 vemurafenib in Erdheim-Chester disease: unsolved issues BRAF V6E is a targetable oncogene in ECD, however: not all ECD patients bear the BRAF V6E mutation or known targetable mutations vemurafenib treatment mostly results in partial clinical responses in ECD patients vemurafenib treatment is often associated with severe side effects and relapses upon treatment discontinuation
5 RCCS TM bioreactor preserves architecture of normal and cancer tissues Dynamic condition D2-4 Skin Bone Marrow RCC D2-4 vwb/dapi Static condition 2 weeks Ferrarini et al, 213
6 Effects of vemurafenib on BRAF-mutated melanoma cells cells x day 3 LM16 vem (6 µμ) % PI LM16 LM16R % PI day 6 LM16R vem (µm) tr (nm) perk Ki-67 p16 LM16 Vem pg/ml pg/ml Vem LM16R 3 IL-1β IL-6 TNF-α CCL2 CCL4 4 CXCL8 TGF-β
7 Cytokine- and BRAF-inhibitors affect cytokine release from ECD tissues ECD 1 M/46-year-old xanthelasma ECD 2 F/5-year-old xanthelasma ECD 3 F/69-year-old pleural lesion TNF-α VEM IFX IL-8 IL-6 IL-1β stnf-rii stnf-ri pg/ml ng/ml pg/ml pg/ml ng/ml pg/ml pg/ml ng/ml pg/ml CCL4 CCL pg/ml pg/ml pg/ml VEM in vivo
8 Vemurafenib affects cytokine production but not histiocyte viability CD68 CD68 perk TNF-α Caspase 3 vem
9 BRAF-mutation and metabolism in ECD histiocytes ECD ECD HepG2
10 Effects of vemurafenib on BRAF-mutated ECD histiocytes: metabolism lactate (mm/l) TCM Skin ECD1 ECD1 Vem ECD2 ECD2 Vem ECD3 ECD3 Vem vem
11 trametinib inhibits cyto-chemokine release by KRAS-mutated histiocytes in vitro and ex-vivo Patient 4 BRAFwt, KRAS G12V xanthelasma IL-1β (pg/ml) TNF-α (pg/ml) tr days 6 3 ECD histiocytes ,6% 26,48% ECD monocytes CCL-2 (pg/ml) 4 2 CCL-4 (pg/ml) 2 1 tr CD14 FL5 Log CD days ,7%,76% FL1 Log perk ECD HM trametinib - + perk Erk perk/erk.46.6 pakt Akt pakt/akt perk ECD HM Red Oil IL-1β, TNF-α (pg/ml) IL-6 (ng/ml) IL-1 IL-6 TNF CCL2 (ng/ml) CCL4 (pg/ml) CCL2 CCL4 Tr
12 trametinib CD perk 12 lactate (mm/l) 8 4 TCM skin tr Glucose (mg/dl) ph 3 TCM skin tr 6 tr trametinib ECD - + βactin /βactin.37.7
13 Conclusions 3-D dynamic culture in bioreactor of ECD tissues is suitable for drug testing vemurafenib and trametinib affect cytokine and chemokine production but not viability of ECD histiocytes in short-term culture kinase inhibitors counteract the up-regulated aerobic glycolysis in BRAFmutated and KRAS-mutated ECD histiocytes The technology can be further exploited as a novel tool to investigate ECD pathophysiology and also to identify mechanisms of action of BRAF/MEK inhibitors on ECD histiocytes for future combination therapies
14 Acknowledgements Daniela Belloni Silvia Heltai Elisabetta Ferrero Marina Ferrarini Division of Experimental Oncology San Raffaele Scientific Institute, Milano Giulia Cangi Claudio Doglioni Pathology Unit San Raffaele Scientific Institute, Milano Giulio Cavalli Alvise Berti Corrado Campochiaro Lorenzo Dagna Unit of Medicine and Clinical Immunology San Raffaele Scientific Institute, Milano Cristina Colarossi Antonella Stoppacciaro University La Sapienza, Rome Monica Rodolfo Licia Rivoltini Istituto Nazionale Tumori, Milano Barbara Vergani Antonello Villa Consorzio MIA University of Milano-Bicocca Riccardo Biavasco Eugenio Montini SR-Tiget San Raffaele Scientific Institute, Milano Kathy Brewer ECD Global Alliance, DeRidder, LA
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17 Vemurafenib affects cytokine production but not histiocyte viability CD68 Caspase 3 p16 Ink4a perk TNF-α vem
18 Effects of vemurafenib on BRAF-mutated ECD histiocytes: metabolism 25 2 Glucose (mg/dl) vem lactate (mm/l) TCM Skin ECD1 ECD1 Vem ECD2 ECD2 Vem ECD3 ECD3 Vem TCM LM16 LM16 Vem
19 trametinib CD68 perk lactate (mm/l) 8 4 Glucose (mg/dl) ph TCM skin tr TCM skin tr tr trametinib ECD - + βactin Casp-3 /βactin.37.7
20 CD68 Caspase 3 TNF-α p16 Ink4a β-galactosidase vem ECD3 Glucose (mg/dl) HepG2 8 6 vem lactate (mm/l) 4 2 TCM Skin ECD ECD Vem
21 Patient 4 BRAFwt, KRAS G12V xanthelasma IL-1β (pg/ml) TNF-α (pg/ml) tr days ,6% 26,48% trametinib perk ECD - + HM vem LM CCL-2 (pg/ml) CCL-4 (pg/ml) tr days CD14 FL5 Log ,7%,76% FL1 Log perk Erk perk/erk.46.6 pakt Akt pakt/akt IL-1β, TNF-α (pg/ml) IL-6 (ng/ml) IL-1 IL-6 TNF CCL2 (ng/ml) CCL4 (pg/ml) CCL2 CCL4 Tr
22 Effects of vemurafenib on BRAF-mutated ECD histiocytes: metabolism 25 Glucose (mg/dl) vem lactate (mm/l) TCM Skin ECD1 ECD1 Vem ECD2 ECD2 Vem ECD3 ECD3 Vem
23 BRAF-mutation and metabolism in ECD histiocytes ECD ECD3 1 5 CD HepG2
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