August 24, 2017

Cleveland Clinic Researchers Discover Cancer Stem Cell Pathway in Endometrial Cancer

Study in Journal of Experimental Medicine opens new line of research for treatment-resistant tumors

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A team of Cleveland Clinic researchers have discovered a key pathway that leads to recurrence and treatment resistance in endometrial cancer, providing the potential for much needed new therapies for women with limited options.

Cleveland Clinic Lerner Research Institute

For the past 25 years, standard therapy for endometrial and ovarian cancers has included surgery and the chemotherapy drug cisplatin. While these treatments typically are initially successful, the cancer often recurs and becomes resistant to cisplatin, leaving patients with limited treatment options.

The Cleveland Clinic team studied the unique role of an immune regulatory protein, called CD55, which is abundant on the surface of endometrioid ovarian cancer and uterine cancer cells. Using human cells and patient-derived tissue models, they found CD55 to be the most prevalent on cancer stem cells, a subgroup of aggressive cancer cells that are thought to be responsible for recurrence and spread of many types of cancer.

The researchers discovered that high levels of CD55 caused cancer stem cells to be more aggressive and resistant to cisplatin than non-stem cell cancer cells. The CD55 pathway is unique in that it controls both stem cell self-regulation/growth and therapeutic resistance, while other mechanisms control just one or the other.

In addition, when CD55 was removed from cells, they became sensitive to cisplatin in cell culture models and in pre-clinical mouse models. The researchers hope that blocking the protein will enhance cisplatin treatments and that high expression of CD55 could be used as a biological marker of aggressive gynecologic cancers. The team plans to complete further preclinical testing followed by a clinical trial in patients with CD55-expressing endometrial cancers.

The study was co-led by Justin Lathia, Ph.D., and Ofer Reizes, Ph.D., both of the Department of Cellular & Molecular Medicine in Cleveland Clinic Lerner Research Institute. Dr. Reizes holds the Laura J. Fogarty Endowed Chair for Uterine Cancer Research at Cleveland Clinic.

“We have discovered a unique role for the CD55 complement signaling pathway in cancer as a target which offers an opportunity to prevent recurrence and associated mortality in endometrial cancer patients. Fortunately, there is already an FDA investigational drug that can inhibit the CD55 signaling pathway,” Dr. Lathia said. “We hypothesize that using this drug in combination with cisplatin will improve treatment outcomes.”

“Endometrial cancer is the most common gynecologic malignancy in the United States, yet research in this area is understudied and underfunded,” Dr. Reizes added. “We hope that our study will lead to much needed new therapy options for women with treatment resistant, relapsed disease.”

Research fellow Caner Saygin, M.D., was first author on this study, which was published in the Journal of Experimental Medicine.

This work is funded by National Institutes of Health (NIH) grant CA191263. The work in the Reizes laboratory is also supported by Cleveland Clinic Foundation, Clinical and Translational Science Collaborative of Cleveland (UL1TR000439), Case Comprehensive Cancer Center (P30 CA043703), Cleveland Clinic VeloSano Bike Race, and the Laura J. Fogarty Endowed Chair for Uterine Cancer Research (O.R.). The Lathia laboratory also receives funding from the NIH grants NS089641, NS083629, and CA157948; a Distinguished Scientist Award from the Sontag Foundation, a Research Scholar Award from American Cancer Society, Blast GBM, Cleveland Clinic VeloSano Bike Race, and Case Comprehensive Cancer Center. This work utilized the Leica SP8 confocal microscope that was purchased from NIH SIG grant 1S10OD019972-01.

About Cleveland Clinic

Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. Cleveland Clinic is consistently recognized in the U.S. and throughout the world for its expertise and care. Among Cleveland Clinic’s 81,000 employees worldwide are more than 5,743 salaried physicians and researchers, and 20,160 registered nurses and advanced practice providers, representing 140 medical specialties and subspecialties. Cleveland Clinic is a 6,690-bed health system that includes a 173-acre main campus near downtown Cleveland, 23 hospitals, 276 outpatient facilities, including locations in northeast Ohio; Florida; Las Vegas, Nevada; Toronto, Canada; Abu Dhabi, UAE; and London, England. In 2023, there were 13.7 million outpatient encounters, 323,000 hospital admissions and observations, and 301,000 surgeries and procedures throughout Cleveland Clinic’s health system. Patients came for treatment from every state and 132 countries. Visit us at clevelandclinic.org. Follow us at twitter.com/CleClinicNews. News and resources available at newsroom.clevelandclinic.org.

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