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Gorringe, K. L.

Publications and source records attributed to Gorringe, K. L..

4 recordsLinked to original sources

Comprehensive drug efficacy data for mucinous ovarian carcinoma using a novel and extensive biobank of patient-derived organoid models

Mucinous Ovarian Carcinoma (MOC) is a rare ovarian cancer histological subtype with distinct pathology, genomics and clinical outcomes compared to other epithelial ovarian cancers. Accordingly, there is little evidence to guide clinical care, particularly in the use of systemic therapies, and the field has lacked informative and diverse pre-clinical models. We developed MOC-specific methods for generating tumour organoids with a success rate of 70% for long-term cultured lines (n=19). Organoid lines were developed from localised, advanced and recurrent tumours, including from biopsy tissue, and represent diverse genomic features not previously captured by existing cell lines. The organoid lines were highly similar to the tumours of origin for genomic and immunohistochemical markers. Screening using a panel of 11 chemotherapy agents highlighted resistance to standard-of-care agents such as carboplatin. Gastrointestinal cancer chemotherapy agents and their combination regimens lacked activity. Paclitaxel was often highly potent at low doses but failed to kill all cells. However, less frequently used drugs such as gemcitabine, topotecan and doxorubicin inhibited many of the lines more effectively than paclitaxel. Available, but non-standard of care, chemotherapy agents should be considered for clinical management of MOC. This is the largest (by [~]10 fold) cohort of fully characterised patient-derived MOC organoid lines described and the first with extensive drug screening data affording an opportunity for drug discovery and screening for personalised treatment.

cancer biology↗

DRP1 inhibition confers cardioprotection against doxorubicin while preserving anticancer efficacy

BackgroundAnthracyclines such as doxorubicin are effective chemotherapeutics but are limited by cardiotoxicity driven in part by mitochondrial dysfunction. Dysregulated mitochondrial dynamics, particularly excessive dynamin-related protein-1 (Drp1)-mediated fission, contribute to doxorubicin-induced cardiac injury and support selective survival of cancer cells. ObjectivesTo determine whether DRP1i2, a novel small molecule Drp1 inhibitor targeting a conserved domain shared between human and mouse, can function as a cardio-oncology therapeutic by reducing doxorubicin-induced cardiotoxicity while maintaining or enhancing anti-cancer efficacy. MethodsCardioprotective effects of DRP1i2 were evaluated in a murine model of chronic doxorubicin cardiotoxicity and in human induced pluripotent stem cell-derived cardiac microtissues exposed to acute doxorubicin injury. Anticancer activity was assessed across multiple cancer cell lines using 2D monolayers and 3D microtissues. ResultsIn vivo, DRP1i2 preserved left ventricular ejection fraction, reduced interstitial fibrosis and cardiomyocyte atrophy, and attenuated doxorubicin-induced myocardial proteomic remodelling. In human cardiac microtissues, DRP1i2 improved viability and restored contractile function despite persistent mitochondrial oxidative stress. DRP1i2 showed modest anticancer activity in MG63 osteosarcoma cells in both 2D and 3D systems and did not diminish doxorubicin efficacy in other cancer models (MDA-MB-231 breast, OVCAR3 ovarian, and A549 lung adenocarcinoma). Combined treatment further enhanced cytotoxicity selectively in MG63 cells. ConclusionsDRP1i2 exerts complementary cardioprotective and anticancer actions through modulation of shared mitochondrial pathways, identifying Drp1 as a druggable target in cardio-oncology. These findings support DRP1i2 as a first-in-class Drp1 inhibitor and highlight mitochondrial dynamics as a promising therapeutic axis to preserve anthracycline efficacy while reducing cardiotoxicity. Clinical PerspectivesExcessive Drp1-mediated mitochondrial fission links anthracycline cardiotoxicity with cancer cell survival. Inhibition with DRP1i2 preserved cardiac structure and function in a chronic doxorubicin cardiotoxicity model without compromising anti-cancer activity, representing mechanism-based cardioprotection, where the heart is protected by directly targeting the molecular processes driving injury. Translation will require pharmacologic profiling and testing in tumour-bearing and comorbid models, followed by early-phase trials to confirm safety and efficacy.

pharmacology and toxicology↗

Predictive biomarkers of breast ductal carcinoma in situ may underestimate the risk of recurrence due to de novo ipsilateral breast carcinoma development

Development of ipsilateral breast carcinoma following diagnosis of breast ductal carcinoma in situ (DCIS) has been assumed to represent recurrence of the primary tumour. However, this may not be the case and it is important to know how often recurrences are new tumours. Ipsilateral primary-recurrence pairs (n=78) were sequenced to test their clonal relatedness. Shared genetic events were identified from whole exome sequencing (n=54 pairs) using haplotype-specific copy number and phylogenetic analysis. The remaining pairs were sequenced by a targeted panel or low-coverage whole genome sequencing. We included 32 non-recurrent DCIS to compare recurrent and non-recurrent disease. We found that 7% of DCIS recurrences were non-clonal by whole exome sequencing, indicative of a new breast carcinoma. Lower resolution methods detected a higher non-clonality rate (29%). Comparing primary DCIS with their recurrences found that evolution of DCIS to invasive disease was associated with increased ploidy and copy number events. TP53 mutations were enriched in DCIS with clonal recurrence compared with non-recurrent DCIS. Our results verify that de novo "recurrent tumours" of independent origin occur in patients who may be at high risk.

cancer biology↗

Utility of stromal lymphocytes in diagnosis and predicting upgrade of B3 breast lesions from core biopsies

For more than two decades attempts have been made to identify a subset of women diagnosed with lesions with uncertain malignant potential (B3 lesions) who could safely be observed rather than being treated with surgical excision and/or chemoprevention. Various histopathological, clinical and imaging parameters for risk recommendation have been evaluated, with little impact on clinical practice. The primary reason for surgery is to rule out an upgrade lesion to either ductal carcinoma in situ (DCIS) or invasive breast cancer (IBC). While on average 30% of these patients are upgraded after diagnostic biopsy, a large number are over treated,making this an important harm of screening. Here we evaluated stromal lymphocytes from B3 biopsies (n=264) as a predictive biomarker for upgrade. A higher number of stromal lymphocytes were observed in upgraded B3 lesions than non-upgraded (p< 0.01, zero inflated binomial model) for both ductal and papillary lesions (n=174). This observation was validated in an independent cohort (p<0.001, p<0.05, zero binomial model, ductal and papillary lesions, respectively) (n=90). Our data suggested that the presence of [&ge;]5% of lymphocytes in the surrounding specialised stroma of B3 lesions are predictive of B3 lesions being upgraded with a specificity of 93% and 87% in our discovery and validation cohorts, respectively. The area under the curve (AUC) for the discovery cohort using lymphocyte count and age as variables was 0.77 and was validated with an AUC of 0.81 in the validation cohort. In conclusion, we can identify a subset of the patients at risk of upgrade with high specificity. Assessing the tumour microenvironment including stromal lymphocytes may contribute to reducing unnecessary surgeries in the clinic.

cancer biology↗