Matrix metalloproteinases participation in the metastatic process and their diagnostic and therapeutic applications in cancer.

Matrix metalloproteinases (MMPs) participate from the initial phases of cancer onset to the settlement of a metastatic niche in a second organ. Their role in cancer progression is related to their involvement in the extracellular matrix (ECM) degradation and in the regulation and processing of adhesion and cytoskeletal proteins, growth factors, chemokines and cytokines. MMPs participation in cancer progression makes them an attractive target for cancer therapy. MMPs have also been used for theranostic purposes in the detection of primary tumor and metastatic tissue in which a particular MMP is overexpressed, to follow up on therapy responses, and in the activation of cancer cytotoxic pro-drugs as part of nano-delivery-systems that increase drug concentration in a specific tumor target. Herein, we review MMPs molecular characteristics, their synthesis regulation and enzymatic activity, their participation in the metastatic process, and how their functions have been used to improve cancer treatment.

Differences in plasma MMPs and TIMPs protein expression and chemotherapy response in patients with tobacco- or wood-smoke-induced lung cancer.

BACKGROUND: One of the risk factors associated with lung cancer in never-smoker patients is wood smoke exposure (WS). However, information about its clinical and molecular characteristics remains scant. OBJECTIVE: This was to analyze--in plasma from patients with tobacco- or wood-smoke-induced lung cancer--whether the enzymatic activity and concentration of matrix metalloproteinases (MMPs) and tissue inhibitors of matrix metalloproteinases (TIMPs) differ, and to determine whether there was a correlation between these indicators of the metastatic potential and the first-line chemotherapy response. METHODS: Patients were classified according to lung cancer associated with: the smoking of tobacco (T), WS and where no association with a known risk factor (N) could be established. The gelatinase activity of plasma MMP was analyzed by radiolabeled substrate degradation and zymography assay. Protein expression of MMPs and TIMPs was evaluated by Western blot densitometry analysis. RESULTS: The 26.9% WS patients had a better response to therapy in comparison with the T group (OR = 4.9, 95% CI = 1.25-20.15; p = 0.019). The lowest gelatinase activity was observed in WS subjects, in comparison with T and N subjects (96.7 ± 15.9, 182.9 ± 31.5 and 163.3 ± 22.7 µg of degraded gelatin/mg of incubated plasma protein, respectively; p < 0.025); this enzymatic activity corresponded to MMP-2. The highest MMP-2, MMP-9, MT1-MMP and TIMP-1 plasma levels were observed in T subjects. CONCLUSION: Tobacco and wood smoke have different effects on MMP and TIMP synthesis and gelatinase activity, directly influencing lung cancer metastatic potential and chemotherapy response.

Primary adenoid cystic carcinoma of the tracheobronchial tree: A decade-long experience at a health centre in Mexico.

BACKGROUND: Mexico's National Institute of Respiratory Diseases (NIRD) is a third-level national reference center. Primary adenoid cystic carcinoma (PACC) is an uncommon neoplastic disorder; hence improvements in the description of this disease are needed. MATERIALS AND METHODS: This is a retrospective clinical study based on all consecutive patients with pathological diagnoses of PACC seen at the NIRD between January 1, 2000 and December 31, 2009. RESULTS: We identified 9 cases of PACC (67% female) out of a total of 2,634 patients with lung cancer seen during the period analyzed. The mean age of those 9 patients was 41 years (IQR 36-57), and the frequency of PACC at our center was 0.3%. It is important to note that 67% of those patients had a history of smoking and that 6 of the 9 had the antecedent of previous exposure to biomass fuel smoke. Baseline arterial blood gas analyses revealed a median of 61 mmHg for pO(2) and 28.5 mmHg for pCO(2). Median FVC was 78%, while FEV(1) was 77% with an FEV(1) /FVC ratio of 78. Death occurred in 56% of cases, and the median survival time was 17 months (IQR 6-26) after the initial diagnosis. CONCLUSIONS: The frequency of tracheobronchial PACC among patients with lung cancer was similar to that previously reported (0.3%). According to our results, lung function has no specific phenotype in this disease; however, some abnormalities could be related to potential risk factors such as tobacco use and exposure to biomass fuel smoke.

Gelatinase activity of matrix metalloproteinases during first-line chemotherapy in lung adenocarcinoma patients: an initial approach.

BACKGROUND: The aim of this study was to determine if gelatinase activity of plasma matrix metalloproteinases (MMPs) can be used as a method to assess chemotherapy response and cancer progression in primary lung adenocarcinoma patients. METHODS: A group of 28 patients was divided according to risk factor as follows: lung cancer associated with wood smoke exposure (LCW), lung cancer in tobacco smokers (LCT), and patients with no association to a known risk factor (LCN). Plasma gelatinase activity was measured by zymography and radiolabeled gelatin degradation. RESULTS: The chemotherapy response was better in the LCW group (25%) compared with the LCT (7.1%) patients (P = 0.039). MMP gelatinase activity was increased in all lung cancer subjects. Patients with progression of the disease had a significant increase in gelatinase activity compared with subjects, with a response to treatment (330.3 ± 44.4 and 64.9 ± 8.5 µg of degraded gelatin/mg of incubated plasma protein, respectively, P = 2.972 × 10(-5)). Zymography assay revealed that the increase in gelatinase activity corresponded mainly to MMP-2. CONCLUSIONS: Patients with progression of lung adenocarcinoma, mainly from the LCT group, had an increase in gelatinase activity compared with subjects that responded to chemotherapy. Therefore, plasma gelatinase activity, particularly MMP-2 enzymatic activity, could be used as a way to assess lung adenocarcinoma progression as well as an indicator for the use of MMP-2 inhibitors.

Brain metastasis development and poor survival associated with carcinoembryonic antigen (CEA) level in advanced non-small cell lung cancer: a prospective analysis.

BACKGROUND: Central nervous system is a common site of metastasis in NSCLC and confers worse prognosis and quality of life. The aim of this prospective study was to evaluate the prognostic significance of clinical-pathological factors (CPF), serum CEA levels, and EGFR and HER2 tissue-expression in brain metastasis (BM) and overall survival (OS) in patients with advanced NSCLC. METHODS: In a prospective manner, we studied 293 patients with NSCLC in IIIB-IV clinical stage. They received standard chemotherapy. CEA was measured prior to treatment; EGFR and HER2 were evaluated by immunohistochemistry. BM development was confirmed by MRI in symptomatic patients. RESULTS: BM developed in 27, and 32% of patients at 1 and 2 years of diagnosis with adenocarcinoma (RR 5.2; 95% CI, 1.002-29; p = 0.05) and CEA > or = 40 ng/mL (RR 11.4; 95% CI, 1.7-74; p < 0.01) as independent associated factors. EGFR and HER2 were not statistically significant. Masculine gender (RR 1.4; 95% CI, 1.002-1.9; p = 0.048), poor performance status (RR 1.8; 95% CI, 1.5-2.3; p = 0.002), advanced clinical stage (RR 1.44; 95% CI, 1.02-2; p = 0.04), CEA > or = 40 ng/mL (RR 1.5; 95% CI, 1.09-2.2; p = 0.014) and EGFR expression (RR 1.6; 95% CI, 1.4-1.9; p = 0.012) were independent associated factors to worse OS. CONCLUSION: High CEA serum level is a risk factor for BM development and is associated with poor prognosis in patients with advanced NSCLC. Surface expression of CEA in tumor cells could be the physiopathological mechanism for invasion to CNS.