In ovarian carcinomas, recurrence and acquired chemoresistance are the first leading causes of therapeutic failure and are responsible for the poor overall survival rate. Cisplatin exposure of sensitive cells has been previously associated with a down-regulation of Bcl-x L expression and apoptosis, whereas recurrence was systematically observed when Bcl-x L expression was maintained. Bcl-x L down-regulation could thus constitute an interesting chemosensitizing strategy. We showed that a Bclx L targeted RNA interference strategy efficiently sensitized chemoresistant ovarian carcinoma cells to cisplatin, but some of them were still able to re-proliferate. Considering the possible cooperation between Bcl-x L and MCL-1, we investigated the possibility to avoid recurrence in vitro using a multi-targeted RNAi strategy directed against these two anti-apoptotic proteins. We showed that their concomitant inhibition lead to massive apoptosis in absence of cisplatin, this multi-targeted RNAi approach being much more efficient than conventional chemotherapy. We thus demonstrated that Bcl-x L and MCL-1 cooperate to constitute together a strong molecular ''bolt'', which elimination could be sufficient to allow chemoresistant ovarian carcinoma cells apoptosis. Moreover, we demonstrated that in presence of a low concentration of cisplatin, the concomitant down-regulation of Bcl-x L and MCL-1 allowed a complete annihilation of tumour cells population thus avoiding subsequent recurrence in vitro in cell lines highly refractory to any type of conventional chemotherapy. Therefore, Bcl-x L and MCL-1 targeted strategies could constitute an efficient therapeutic tool for the treatment of chemoresistant ovarian carcinoma, in association with conventional chemotherapy.Ovarian cancer is the leading cause of death from gynecological malignancies worldwide and the fifth most common cause of cancer death in women. 1 Early diagnosis is difficult owing to the asymptomatic character of this disease in early stages, and more than 70% of these cancers are diagnosed in an advanced stage (FIGO stages III or IV). Patients with advanced ovarian cancer are treated initially with optimal debulking surgery and standard chemotherapy (platinumdrugs usually associated to taxanes). 2 Despite an initial 70-80% response rate, most patients will relapse within 1-2 years and develop resistance to chemotherapy 3 and the overall 5-year survival is less than 30%. The identification of new drugs or novel therapeutic strategies able to (re)sensitize ovarian carcinoma cells to existing chemotherapy thus appear as a major challenge.Cisplatin, a DNA-damaging agent that forms DNA adducts, is commonly used for the treatment of advanced ovarian cancers. It is widely accepted that these adducts lead to a cell cycle arrest followed by the induction of apoptotic cell death. 4 However, it should be considered that in resistant cells, a strong protection against apoptosis exist when the DNA damages reach their maximum level, to allow the reparation of these injuries and the r...
At least one-third of patients with epithelial ovarian cancer (OC) present ascites at diagnosis and almost all have ascites at recurrence. The presence of ascites, which acts as a dynamic reservoir of active molecules and cellular components, correlates with the OC peritoneal metastasis and is associated with poor prognosis. Since epithelial-mesenchymal transition (EMT) is involved in different phases of OC progression, we have investigated the effect of the unique ascitic tumor microenvironment on the EMT status and the behavior of OC cells. The exposure of three OC cell lines to ascites leads to changes in cellular morphologies. Within ascites, OC cells harboring an initial intermediate epithelial phenotype are characterized by marked dislocation of epithelial markers (E-cadherin, ZO-1 staining) while OC cells initially harboring an intermediate mesenchymal phenotype strengthen their mesenchymal markers (N-cadherin, vimentin). Ascites differentially triggers a dissemination phenotype related to the initial cell features by either allowing the proliferation and the formation of spheroids and the extension of colonies for cells that present an initial epithelial intermediate phenotype, or favoring the migration of cells with a mesenchymal intermediate phenotype. In an ascitic microenvironment, a redeployment of αv integrins into cells was observed and the ascites-induced accentuation of the two different invasive phenotypes (i.e. spheroids formation or migration) was shown to involve αv integrins. Thus, ascites induces a shift toward an unstable intermediate state of the epithelial-mesenchymal spectrum and confers a more aggressive cell behavior that takes on a different pathway based on the initial epithelial-mesenchymal cell features.
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