The use of biosimilar medicines in oncology - position statement of the Brazilian Society of Clinical Oncology (SBOC)

A biosimilar is a biologic product that is similar to a reference biopharmaceutical product, the manufacturing process of which hinders the ability to identically replicate the structure of the original product, and therefore, it cannot be described as an absolute equivalent of the original medication. The currently available technology does not allow for an accurate copy of complex molecules, but it does allow the replication of similar molecules with the same activity. As biosimilars are about to be introduced in oncology practice, these must be evaluated through evidence-based medicine. This manuscript is a position paper, where the Brazilian Society of Clinical Oncology (SBOC) aims to describe pertinent issues regarding the approval and use of biosimilars in oncology. As a working group on behalf of SBOC, we discuss aspects related to definition, labeling/nomenclature, extrapolation, interchangeability, switching, automatic substitution, clinical standards on safety and efficacy, and the potential impact on financial burden in healthcare. We take a stand in favor of the introduction of biosimilars, as they offer a viable, safe, and cost-effective alternative to the biopharmaceutical products currently used in cancer. We hope this document can provide valuable information to support therapeutic decisions that maximize the clinical benefit for the thousands of cancer patients in Brazil and can contribute to expedite the introduction of this new drug class in clinical practice. We expect the conveyed information to serve as a basis for further discussion in Latin America, this being the first position paper issued by a Latin American Oncology Society.

35 years of the Brazilian Journal of Medical and Biological Research

The authors pay homage to the three founders of the Brazilian Journal of Medical and Biological Research Profs. Lewis Joel Greene, Sérgio Henrique Ferreira and Eduardo Moacyr Krieger for their vision and commitment to divulge the scientific production of developing countries.

Hyperthermia increases the metastatic potential of murine melanoma

Hyperthemia, either alone or combined with radio-, immuno- or chemotherapy, can control tumor growth, but its effect on metastasis is still controversial. In the present study, we investigated the influence of hyperthermia on the metastatic potential of B16-F10 murine melanoma cells. Incubation of melanoma cells at 43 degrees Celsius for 30 min led to a significant decrease in cell viability. About half of the cells survived the acute exposure to heat. These thermoresistant cells displayed a longer lag phase as compared to control unheated B16-F10 melanoma cells. Other parameters of cell growth such as doubling time and saturation density were equivalent in both control and thermoresistant cells. Both control and treated cells were adherent, but thermoresistant cells failed to spread during the first 48 h after heat exposure. B16-F10 cells colonize the lungs of C57BL/6J mice when injected intravenously; the number of lung colonies is a measure of the metastatic potential of injected cells. Median values of 22, 10.5 and 31 colonies per injected mouse were observed for control cells, cells heated to 43 degrees Celsius for 30 min and thermoresistant cells, respectively, with statistically significant differences between groups (Mann-Whitney test, P<0.02). Thus, despite its cytotoxic action, heat exposure induced the acquisition of a more metastatic phenotype in a subpopulation of B16-F10 cells.

Laminin-binding proteins in EJ-ras-transformed fibroblasts

Malignant transformation is accompanied by changes in cell-matrix interations. Upon transfection with EJ-ras oncogene, transformed fibroblasts, acquired a migratory phenotype towards laminin-1. The increase in integrin expression was responsible for the migratory activity of transformed fibroblasts. In addition alpha(6)beta(1) integrins, both galectin-3 and an unidentified laminin-binding polypeptide had their expression pattern altered upon transformation. Here, we review these two classes of laminin-binding proteins and their possible roles in cell-laminin interactions.

The thymic nurse cell complex: an in vitro model for extracellular matrix-mediated intrathymic T cell migration

The thymus is a primary lymphoid organ in wich bone narrow-derived T cell precursors undergo a complex maturation process in the context of the thymic microenvironment, represented by non-lymphoid cells and extracellular matrix (ECM) components. The thymic epithelial cells are the major cellular component of the thymic microenvironment, and influence different aspects of thymocyte differentiation, via cell-cell interactions and secretion of soluble factors, such as thymic hormones. The thymic nurse cell (TNC) complexes are multicellular lymphoepithelial structures formed by one thymic epithelial cell harboring 2-200 thymocytes, primary bearing the CD4/CD8 double-positive phenotype. TNCs probably create a special microenvironment for thymocyte differentiation and/or proliferation, with thymocytes being exposed to major histocompatibility complex (MHC) antigens and thymic hormones. Such differentiation parallels cell migration into and out of the complex. We showed the expression of ECM components and respective receptors by TNCs, and that interactions between the epithelial component of TNC and TNC-lymphocytes can be modulated by ECM components and respective receptors. Moreover, we demonstrated that intrinsic as well as extrinsic biological circuits can be involved in the control of such ECM-mediated thymic epithelial cell (TEC)/thymocyte interactions. For example, interferon-gamma can biphasically modulate the expression of ECM ligands and receptors by TEC, with results in corresponding modulation of their ability to interact with TNC-thymocytes. Additionally, hormones such as triiodothyronine, prolactin and growth hormone can influence the degree of these lymphocyte/epithelial cell adhesive interactions. Lastly, we recently furnished evidence for a de-adhesive mechanism within TNC aparently mediated by galectin 3 (an endogenous soluble beta-galactoside-binding lectin). Taken together, our data strongly indicate that thymic nurse cells can be regarded as an in vitro model for intrathymic T cell migration, particularly with respect to those events mediated by the extracellular matrix.

Morfometría de la diferenciación de células epiteliales mamarias en cultivo / Morphometric differentiation of mammary epithelial cells in culture

La diferenciación funcional del epitelio mamario requiere de hormonas específicas, factores de crecimiento y señales del medio ambiente celular. Estas últimas consisten en comunicación de sus células con la matriz extracelular e interacciones célula-célula, las cuales determinan un intrincado mecanismo que se traduce, finalmente, en eventos que conllevan a la secreción láctea. Células epiteliales mamarias de rata HC11, un subclon de la línea celular COMMA-1D de glándula mamaria en mitad de la preñez, fueron cultivadas en presencia de hormonas lactogénicas, insulina, dexametasona y prolactina y estimuladas con el factor de crecimiento epidérmico. En estas condiciones, las células se diferencian sintetizando ß caseína, demostrada mediante inmuno-blotting y filamentos intermediarios de citoqueratina, los cuales son evidenciados en micrografías electrónicas y con reacción inmuno-citoquímica con anticuerpos anticitoqueratina. Además, en estas células normales-proliferantes y diferenciales, fue realizado un estudio morfométrico, cuyos resultados correlacionan adecuadamente con los eventos morfológicos y bioquímicos observados en esta diferenciación del epitelio mamario de rata, en cultivo

Carbohydrate-binding proteins in cell-matrix interactions

1. Carbohydrate-dependent interactions have been more extensively studied during the last decade. Althought the roles of carbohydrates in cellular functions are still poorly understood, the finding of carbohydrate-binding proteins in animal cells opened a great number of perspectives. 2. Animal lectins are associated with tumor progression, playing a key role in neoplastic cell interactions with endothelial cells and extracellular matrix glycoproteins such as laminin. 3. Here, we review the role of animal lectins in the migrating phenotype of neoplastic cells and normal cells such as T-lymphocytes

Adhesion to laminin is down-regulated upon retinoic acid-induced F9 cell differentiation: a role for alpha6/beta1 integrin

F9 mouse teratocarcinoma cells have a high capacity to adhere to laminin and we identified alpha6/beta1 integrin as the principal laminin-binding protein present in these cells. F9 cells differentiated into parietal endoderm when monolayer cultures were treated with retinoic acid and dibutyryl cyclic AMP. In this process a decreased adherence to laminin was observed due to a lower expression of alpha6/beta1 integrin on the cell surface

Trypanosoma cruzi binds to laminin in a carbohydrate-independent way

The bindings of 125I-laminin to trypomastigotes is specific and 2-5 x 10**3 laminin-binding sites were calculated to be presented on the surface of a live trypomastigote. Anti-laminin antibodies were able to inhibit the invasion of cultured cells by trypomastigotes (62-75 per cent), suggesting that laminin may be involved in the adhesion of the parasite to host cells. By affinity chromatography, an 85-KDa glycoprotein was isolated (laminin-bindign glycoprotein, LBG) from trypomastigote lysates, but not from epimastigote lysates. It is suggested that at least fragment E8 (but not E1) from laminin could be involbed in the reaction which is independent of the carbohydrate moieties from both ligand and recepto. It is also shown that LBG is member of the Tc-85 family, previously shown to be related to the invasion process of the parasite