Mesothelin Overexpression Promotes Mesothelioma Cell Invasion and MMP-9 Secretion in an Orthotopic Mouse Model and in Epithelioid Pleural Mesothelioma Patients

Published OnlineFirst February 27, 2012; DOI: 10.1158/1078-0432.CCR-11-2614

Clinical Cancer Human Cancer Biology Research

Elliot L. Servais1,2, Christos Colovos1,2, Luis Rodriguez1,2, Adam J. Bograd1,2, Jun-ichi Nitadori1, Camelia Sima3, Valerie W. Rusch1, Michel Sadelain2,4, and Prasad S. Adusumilli1,2

Abstract Purpose: Mesothelin (MSLN) is a tumor-associated antigen, being investigated as a biomarker and therapeutic target in malignant pleural mesothelioma (MPM). The biologic function of MSLN overexpression in MPM is unknown. We hypothesized that MSLN may promote tumor invasion in MPM, a tumor characterized primarily by regional aggressiveness and rare distant metastases. Experimental Design: Human and murine MPM cells with MSLN forced expression and short hairpin RNA knockdown were examined for proliferation, invasion, and matrix metalloproteinase (MMP) secretion. The inﬂuence of MSLN overexpression on MPM cell invasion was assessed in an orthotopic mouse model and in patient samples. Results: MSLN expression promotes MPM cell invasion and MMP secretion in both human and murine MPM cells. In an orthotopic MPM mouse model characterized by our laboratory, MPM cells with MSLN overexpression preferentially localized to the tumor invading edge, colocalized with MMP-9 expression, and promoted decreased survival without an increase in tumor burden progression. In a tissue microarray from epithelioid MPM patients (n ¼ 139, 729 cores), MSLN overexpression correlated with higher MMP-9 expression at individual core level. Among stage III MPM patients (n ¼ 72), high MSLN expression was observed in 26% of T2 tumors and 51% of T3 tumors. Conclusions: Our data provide evidence elucidating a biologic role for MSLN as a factor promoting tumor invasion and MMP-9 expression in MSLN expressing MPM. As regional invasion is the characteristic feature in MSLN expressing solid cancers (MPM, pancreas, and ovarian), our observations add rationale to studies investigating MSLN as a therapeutic target. Clin Cancer Res; 18(9); 1–12. 2012 AACR.

Introduction MSLN is highly expressed in epithelioid MPM, the most Mesothelin (MSLN) is a 40-kDa glycoprotein overex- common MPM subtype constituting 80% of patients. Only pressed in mesothelioma, pancreatic, and ovarian can- 3% of epithelioid MPM patients showed distant metastases cers—malignancies characterized by regionally aggressive in multiple series published by our group (10–12). Despite phenotypes and poor prognosis (1–3). Although MSLN is an absence of distant metastases, a majority of epithelioid being investigated as a tumor biomarker and therapeutic MPM patients are not eligible for surgical resection due to target in malignant pleural mesothelioma (MPM), the bio- advanced T-stage (T3 tumors are unresectable due to local logic role of MSLN remains unexplored (4–9). invasion into the endothoracic fascia, mediastinal fat, chest wall, or pericardium compared with T2 tumors without invasion; refs. 13–15). Matrix metalloproteinases (MMP), a family of endopeptidases capable of degrading extracellular

Authors' Afﬁliations: 1Division of Thoracic Surgery, 2Center for Cell matrix, have been shown to be elevated in MPM and are Engineering, Departments of 3Epidemiology & Biostatistics, and 4Medi- known to increase invasive potential in MPM cells (16). cine, Memorial Sloan-Kettering Cancer Center, New York Furthermore, asbestos exposure, a causative agent in MPM, Note: Supplementary data for this article are available at Clinical Cancer is known to upregulate both MSLN and MMP-9 secretion in Research Online (http://clincancerres.aacrjournals.org/). experimental models of asbestosis (17). E.L. Servais and C. Colovos contributed equally to this work. In this study, we explored the role of MSLN in tumor invasion and its relationship to MMP-9 secretion using Corresponding Author: Prasad S. Adusumilli, Division of Thoracic in vitro Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New human and murine mesothelioma cells both and York, NY, 10065. Phone: 212-639-8093; Fax: 646-422-2340; E-mail: in vivo as well as in clinical specimens from epithelioid MPM [email protected] patients, known to overexpress MSLN. We show for the ﬁrst doi: 10.1158/1078-0432.CCR-11-2614 time that MSLN promotes MMP-9 expression as well as 2012 American Association for Cancer Research. tumor invasion shown by MSLN forced overexpression and

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reinfected 24 hours later. The human MSLN-variant 1 was Translational Relevance isolated from a human ovarian cancer cell line (OVCAR-3). Mesothelin (MSLN) is a cancer-associated antigen Reverse transcriptase PCR (RT-PCR) synthesis of full-length overexpressed in malignant pleural mesothelioma cDNA of human MSLN was done using SuperScript III One- (MPM) and other regionally invasive malignancies. We Step RT-PCR System with Platinum Taq High Fidelity Kit. hypothesized that MSLN expression promotes MPM cell Plasmid DNA was isolated, subcloned into a SFG retroviral invasion. In human and murine MPM cells with MSLN vector, confirmed by sequencing, and used to stably trans- overexpression and knockdown, we show that MSLN duce MSLN. For experiments comparing MSLN-transduced promotes MPM cell invasion. In an orthotopic MPM cells to MSLN-negative cells, transduction control was done mouse model characterized by our laboratory, we show with a GFP-Firefly Luciferase vector. For all experiments, a that MSLN overexpressing MPM cells preferentially stably transduced population of cells was used with con- localize to the tumor invading edge and decrease survival firmation of unchanged MSLN expression by flow cyto- without an increase in tumor burden progression. Both metery and Western blot analysis. in vitro and in vivo and in MPM patient samples, we show an association between MSLN overexpression, tumor Mesothelin knockdown with MSLN-specific shRNA invasion, and matrix metalloproteinases, a family of To obtain a stable cell line with decreased murine MSLN enzymes that facilitate tumor cell invasion and known expression, 3 predesigned siRNA oligonucleotides and com- to be upregulated in MPM. As regional invasion is a plementary murine MSLN shRNA sequences were obtained characteristic feature in MSLN expressing solid cancers (Ambion), ligated into the pSilencer 2.1-U6 hygro plasmid (MPM, pancreas, and ovarian), these findings add sup- (Ambion), and transfected into the AB12 cell line with port for studies investigating MSLN as a therapeutic calcium phosphate. After 2 weeks of selection with 500 target. mg/mL hygromycin (Invitrogen) the AB12 cell line showing greatest murine MSLN silencing by flow cytometry, qPCR analysis, and Western blot was selected for subsequent experiments and is denoted by AB12shRNA. AB12 cells were also transfected with scramble shRNA as a control. confirmed by short hairpin RNA (shRNA) knockdown experiments in mesothelioma cells. To further elucidate Flow cytometry MSLN biology in an appropriate tumor microenvironment, Fluorescence-activated cell sorting (FACS) was carried out we developed and characterized an orthotopic MPM mouse following retroviral transductions using a FACSAria (BD model. With this model, we show that MSLN expressing Biosciences) cytometer to sort for a pool of highly trans- MPM cells are invasive, express MMP-9 on the invasive duced cells. Human MSLN expression was detected using a tumor edge, and decrease overall survival independent of PE-conjugated or APC-conjugated anti-human MSLN rat tumor cell proliferation or metastasis. Furthermore, our IgG2a (R&D systems). Murine MSLN expression was clinical observations from a large cohort of epithelioid detected with an anti-mouse MSLN rat IgG2a primary anti- MPM patients show that MSLN expression correlates with body (MBL). Subsequent flow cytometry for GFP and MSLN MMP-9 expression. The results reported herein provide expression analysis was done on either FACSCaliber or evidence that MSLN also plays an important role in MPM LSRII cytometers (BD Biosciences) and analyzed using biology and suggest the MMP pathway as a mediator of FlowJo (TreeStar) analysis software. invasiveness in MSLN expressing MPM. Cell proliferation assays Materials and Methods MSTO-211H cells with or without MSLN expression were Cell lines and culture plated in 6-well tissue culture plates at a density of 1 105 MSTO-211H (human pleural mesothelioma) and AB12 cells/3 mL/well and were counted on days 1, 2, 4, and 6. At (murine mesothelioma line) were obtained from American each time point, cells were counted in triplicate using trypan Type Culture Collection and CellBank Australia, respective- exclusion after brief trypsinization. Cell number versus time ly. MSTO-211H cells were maintained in RPMI-1640 media was plotted for each cell line and compared at time points and AB12 cells in Dulbecco’s modified Eagle’s medium in a using a Student t test. 5% CO2 humidified incubator at 37 C–all media was supplemented with 10% FBS, 100 units/mL penicillin, and Invasion and migration assays 100 mg/mL streptomycin. BD BioCoat Matrigel Invasion Chamber (BD Bios- ciences) assays were done in 24-well plates using polyeth- Establishment of stably transduced cell lines ylene terephthalate inserts (8-mm pores) without Matrigel GFP-Firefly Luciferase fusion was cloned into a SFG (for migration) and with Matrigel coating (for invasion retroviral vector and transfected into H29 cells with calcium assays). Cells were seeded in the upper well of the chamber phosphate. MSTO-211H was plated in 24-well plates 24 (5 104 to 1 105) in 0.5 mL RPMI-1640 without FBS and hours before transduction. Filtered virus was added to cells 0.75 mL RPMI-1640 with 10% FBS in the bottom chamber. permeablized with 8 mg/mL polybrene (Sigma-Aldrich) and Migration was assessed at 12 hours and invasion at 24 hours

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for MSTO-211H. For AB12 cells, migration was assessed at imaged using the Xenogen IVIS 100 Imaging System (Cal- 6 hours and invasion at 20 hours. Nonmigrating or non- iper Life Sciences). Cell number versus total biolumines- invading cells were removed from the upper membrane cence imaging (BLI) flux (photon/s) was evaluated by surface of the insert using a cotton swab. The insert mem- Pearson’s correlation. brane was fixed and stained using the Diff-Quik staining In vivo BLI in tumor-bearing mice was done using a single system and mounted on glass slides. Stained cells were intraperitoneal dose of 150 mg/kg D-Luciferin. Mice were counted in 10 high-power fields in predetermined areas of imaged with the Xenogen IVIS 100 Imaging System 20 the membrane. minutes following D-Luciferin injection. Images were acquired for 5 to 30 seconds depending on signal strength. Orthotopic pleural mesothelioma animal model BLI data were analyzed using Living Image 2.60 software To develop the orthotopic mouse model of pleural meso- and BLI signal reported as total flux (photons/s). thelioma, female severe combined immunodeficient/beige or BALB/c mice (Taconic) at 6 to 10 weeks of age were used. MRI All procedures were done under approved Institutional MRI was carried out in a Bruker 4.7T USR scanner (Bruker Animal Care and Use Committee protocols. Mice were Biospin Inc.) equipped with a 400 mT/m gradient coil and a anesthetized using inhaled isoflurane and oxygen. Direct 32 mm ID custom build birdcage resonator. Thoracic axial intrapleural injection of 1 105 tumor cells in 200 mL MRI images were acquired using a RARE fast spin-echo serum-free media via a right thoracic incision was admin- sequence [repetition time (TR) ¼ 1.7 seconds, echo time istered to establish orthotopic MPM tumors as previously (TE) ¼ 40 milliseconds, and 12 averages]. The slice thick- described (18–21). For experiments to establish heteroge- ness was 0.7 mm and the in-plane image resolution was 117 neously MSLN expressing tumors, mice were inoculated by 156 mm. Image acquisition was triggered by animal direct pleural injection with a mixture of 1 105 MSTO- respiration and tumor volumes (mm3) were calculated 211H expressing and deficient in MSLN. from tracing tumor boundaries in each slice using Bruker ParaVision Xtip software (Bruker Biospin Inc.). Histology and immunostaining Histopathologic evaluation of tumors was carried out Gene expression analysis following hematoxylin and eosin (H&E) staining of paraf- Gene expression profiles were compared between MSLN fin-embedded, 4% paraformaldehyde fixed tissue samples. expressing and nonexpressing MSTO-211H cells. Cell pel- For angiogenesis, CD34 rat monoclonal antibody (5 mg/mL; lets were collected in triplicate and snap frozen from 3 eBioscience) was incubated for 7 hours, followed by 16 min- separate plates for each cell line. The Genomics Core Lab- utes with (1:200) biotinylated rabbit anti-rat IgG (catalog oratory at MSKCC collected, processed, and hybridized #BA-4000; Vector Labs). Rat IgG2a (5 mg/mL) was used as an RNA samples to Illumina Humanref-6 BeadChips. Using appropriate isotype negative control. For lymphangiogen- Bioconductor package LIMMA, sample probesets were esis, goat polyclonal LYVE-1 antibody (1 mg/mL; R&D normalized to control probesets to minimize inter-bead- Systems) was incubated for 3 hours, followed by 60 minutes chip variability. Individual gene expression was screened with biotinylated rabbit anti-goat IgG (ABC kit from Vector for significance using a false discovery rate threshold of labs). The protocols for immunofluorescence detection less than 0.05 and a fold change threshold of 1.5. Gene set using Tyramide–Alexa Fluor 488 (Invitrogen) or Tyra- enrichment analysis (GSEA; ref. 22) was carried out mide–Alexa Fluor 568 (Invitrogen) for CD34 and LYVE- to determine biologic pathways related to MSLN 1, respectively, were established and done at the MSKCC overexpression. Molecular Cytology Core Facility using a Discovery XT automatic processor (Ventana Medical Systems). Immuno- Matrix metalloproteinase assays histochemistry (IHC) for human MSLN was done with a MMP secretion by tumor cells in vitro was quantified by mouse anti-human MSLN IgG (1:100; Vector Labs) using multiplex bead assays (Millipore) for MMP-1, MMP-2, the Ventana platform. IHC for MMP-9 was done by Premier MMP-7, and MMP-9 on a Luminex 100 xMAP with internal Laboratories using polyclonal rabbit anti-human MMP-9 quality control standards for each analyate. A total of 1 5 (Dako). IHC for MMP-7 was done using a mouse IgG2b anti- 10 cells in 1 mL media were plated in 24-well tissue culture human MMP-7 clone ID2 (Abcam) in a 1:100 dilution. plates and allowed to grow for 24 hours, media was then Placenta with cytoplasmic staining in the villi was used as removed, washed with PBS, and media replaced with 0.5 the MMP-7 positive control. mL RPMI-1640 without FBS. Cell supernatant MMP-9 secretion was quantified by multiplex bead assay for Quantitative bioluminescence imaging MMP-9 (Millipore). Supernatant was collected 12, 24, and In vitro standardization was done using GFP-Firefly Lucif- 36 hours after media exchange and stored at 80C until erase expressing MSTO-211H cells with and without MSLN analyzed. expression. Serially diluted cells were plated in 96-well tissue culture plates (1.6 106 to 2.5 104 cells/100 Epithelioid MPM tissue microarray and IHC mL/well). Twenty minutes after the addition of 100 mL D- Patients diagnosed with epithelioid MPM between 1989 Luciferin (15 mg/mL; Caliper Life Sciences), plates were and 2009 at Memorial Sloan-Kettering Cancer Center were

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included. For each of the 139 patients with available speci- for the fact that each of the 139 patients can contribute with mens, all H&E slides (median 9, range 1–43) were reviewed. more than one core to the analysis, leading to a total of 721 Representative blocks were selected to construct a tissue cores. The correlation between increasing MSLN expression microarray (TMA) by taking 9 representative cores (0.6 and T stage was determined using the Fisher exact test. mm) from each patient tumor block and ensuring at least 6 complete tumor cores. Five micrometer–sections were cut from the TMA and stained by speciﬁc antibodies (MSLN: Results Vector, 1:200 dilution; MMP-9:Oncogene Science, 1:200 Mesothelin expression promotes invasion and dilution). Grading of MSLN and MMP-9 intensity was migration in vitro independent of tumor cell carried out on separate occasions by a pathologist who was proliferation blinded to the clinical data as follows: 0 (absent stain), 1 We initially investigated the effect of MSLN overexpres- (weak expression), 2 (moderate expression), and 3 (strong sion on MPM by comparing MSTO-211H cells without expression). The distribution of MSLN-positive tumor cells MSLN expression to those stably transduced to overexpress from all tumor cells found in a single core was graded as MSLN (Fig. 1A) and AB12 cells with natural MSLN expres- 0 (absent), 1 (1%–50%), and 2 (51%–100%). The sum of sion or knockdown (Fig. 1B). We noted no morphologic the MSLN stain intensity and distribution grades was used differences in cultured cells overexpressing MSLN, and cell- to determine a total MSLN score ranging from 0 to 5 at the counting assays showed no effect of MSLN expression on core level. MSLN score for each patient was then determined MSTO-211H proliferation (Fig. 1C). Similarly, we observed using the average of all tumor cores. no differences in morphology or log-phase growth rates We examined the correlation between MMP-9 and MSLN between AB12 cells transfected with control scramble expression using Mantel–Haenszel correlation statistics. shRNA or MSLN-speciﬁc shRNA (data not shown). To The P values were adjusted through bootstrap to account examine whether MSLN expression promoted changes in

Figure 1. MSLN expression promotes invasion and migration in vitro without affecting proliferation. A, flow cytometry histogram showing MSTO-211H mesothelioma cells transduced with human MSLN by use of retroviral vector to stably overexpress MSLN (dark shading) compared with isotype control (light shading). B, flow cytometric analysis of murine MSLN expression in AB12 (dark shading), AB12shRNA (dotted line), and isotype control (light shading). C, cell counting assay shows equivalent cell proliferation in vitro comparing MSTO-211H MSLN-positive and MSLN- negative MPM cells. D, cellular migration and invasion of MSTO-211H was determined by plating equivalent cell number of MSLN-positive or negative MPM cells in standardized transwell Boyden chambers. E, MSLN expression significantly increased both cell migration and invasion in vitro (P < 0.001) in MSTO-211H (left). Migration and invasion of AB12 cells (right) with naturally expressing MSLN (AB12) and MSLN-knockdown (AB12shRNA) shows a correlation between increased MSLN-expression and increased migration and invasion (P < 0.001).

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MSTO-211H proliferation during periods of cellular stress, investigate the biology of MSLN within an appropriate experiments were repeated with serum-starved (2% fetal calf tumor microenvironment. To evaluate local pleural and serum) media; no differences were observed (data not chest wall invasion, an important clinical factor in the shown). Because local invasion is the characteristic clinical progression of MPM, which cannot be fully simulated in feature of mesothelioma, we evaluated in vitro cell migra- subcutaneous or intraperitoneal mouse models, we devel- tion and invasion using a standard Boyden chamber assay. oped an orthotopic mouse model by directly inoculating MSLN overexpression in MSTO-211H significantly MPM cells into the pleural space (18, 20, 23, 24). Resul- increased cell migration (2.56-fold, P < 0.001) and invasion tant tumors mimicked human MPM as shown by (i) gross (1.54-fold, P < 0.001) compared with non-MSLN expressing pleural and mediastinal tumor distribution seen on nec- MPM cells (Fig. 1D and E left panel). To confirm our ropsy and MRI (Fig. 2A); (ii) histology showing tumors observations of MSLN influence on invasion, we next growing along visceral and parietal pleural surfaces, fre- examined the effect of MSLN-knockdown in the AB12 cell quent chest wall and diaphragmatic invasion, and rare line that natively expresses MSLN (Fig. 1B). Decreased lung invasion (Fig. 2B); (iii) frequent metastases to medi- MSLN expression resulted in decreased migration (2.14- astinal lymph nodes confirmed by histology (Fig. 2C) fold, P < 0.001) and invasion (2.35-fold, P < 0.0001; Fig. 1E without distant metastases; (iv) retention of characteristic right panel). These results showed that MSLN overexpres- MPM tumor markers including WT-1, Calretinin, and sion promotes invasion in MPM cells. MSLN even at late stages of disease although TTF-1, a marker of lung adenocarcinoma, remained negative (Fig. Development and characterization of a clinically 2D); and (v) extensive neolymphangiogenesis through- relevant orthotopic mouse model of MPM to out the MPM tumor specimens by CD34 and LYVE-1 investigate mesothelin biology immunofluorescence for angio- and lymphangiogenesis, Having noticed that MSLN overexpression promotes respectively [Fig. 2E; MPM is known to be a well vascu- MPM invasion and migration in vitro, we next sought to larized tumor with high levels of VEGF secretion; refs. 25,

Figure 2. Characterization of a clinically relevant orthotopic mouse model of MPM for investigating MSLN biology. A, MPM tumor in the orthotopic mouse model resembles human disease grossly (top) and by MRI (bottom) as tumor growing along pleural surface and encasing mediastinal structures. In this mouse model: B, histologically, tumor is distributed along visceral pleural surfaces (left, arrowhead), the interlobar fissures (right, arrowhead), and parietal pleural surfaces with frequent chest wall invasion (bottom, arrow). C, MPM metastases to mediastinal lymph nodes (circle) confirmed by H&E (top right) and MSLN immunohistochemical staining (bottom right). D, engrafted tumors maintain characteristic immunohistochemical tumor markers for MPM even in advanced þ þ þ stages (TTF-1 ; WT-1 , Calretinin , Mesothelin ). E, immunofluorescence (LYVE-1 (red)–lymphatics; CD34 (green)–vascular endothelium) shows lymphangiogenesis throughout pleural tumor nodules (arrow shows chest wall, arrowhead tumor nodule) with intratumoral vessels (inset).

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26)]. These findings not only confirmed that our ortho- Mesothelin expression promotes tumor invasion in topic pleural mesothelioma mouse model resembles vivo and decreases survival without affecting tumor human MPM, but also provided an appropriate in vivo proliferation tumor microenvironment to investigate MPM tumor cell Mice inoculated with equivalent intrapleural MSLN invasion. expressing and nonexpressing MPM cells were compared for in vivo tumor progression. Serial BLI was used to monitor Quantitative bioimaging monitors the effect of tumors in mice and revealed no differences in tumor burden mesothelin on tumor progression in vivo between tumors with or without MSLN expression at any Using our orthotopic MPM mouse model, we first sought point in disease progression (Fig. 4A). Despite equivalent to evaluate whether MSLN imparts a growth advantage in tumor progression rates and tumor burden, mice with vivo. Unlike subcutaneous flank tumors, which are easily MSLN expressing MPM experienced significantly decreased accessible for serial monitoring, evaluating the effect of survival compared with mice with MSLN-negative MSLN expression on pleural tumors required an accurate tumors (29 vs. 37 days, P ¼ 0.001; Fig. 4B). These results noninvasive method to serially evaluate tumor burden and of decreased survival with MSLN expression were repro- progression. To do so, we validated bioluminescencent duced in our syngeneic orthotopic MPM model using BALB/ imaging (BLI) as a quantitative modality to assess tumors c mice with murine AB12 MPM cells. Mice inoculated with in the pleural model. First we carried out an in vitro BLI AB12 wild-type (MSLN expressing) tumors had a median standardization with MSLN expressing and nonexpressing survival of 30 days compared with AB12 shRNA (MSLN MPM cells stably transduced express a GFP-Firefly Luciferase knockdown), which survived the 60-day study period (P < fusion gene (Fig. 3A). Our results showed that BLI signal 0.001). We further evaluated AB12 survival by transducing correlated with number of cells for both MSLN-negative MSLN expressing AB12 cells with mouse MSLN vector to (Pearson r ¼ 0.99, P < 0.0001) and positive (Pearson r ¼ express MSLN at even higher levels (AB12 M). We observed 0.99, P < 0.0001) cell lines (Fig. 3B). We next validated BLI decreased survival of mice inoculated with these high MSLN as an accurate method to monitor tumor progression within expressing AB12 cells compared with AB12 wild-type cells the orthotopic MPM mouse model by serially comparing (24 vs. 30 days, P ¼ 0.005; Supplementary Fig. S1). BLI signal to MRI tumor volume averaging, the gold stan- Systematic histologic evaluation of necropsy specimens dard for tumor volume assessment (27). BLI signal from the showed MSLN expressing tumors to have qualitatively engrafted pleural tumors correlated with MRI tumor vol- increased local tumor invasion of chest wall, diaphragm, ume over a wide range of tumor burdens (r ¼ 0.86, P < and mediastinal structures as compared with tumors with- 0.0001; Fig. 3C and D). Thus, this orthotopic MPM mouse out MSLN. To further investigate the association between model allows for quantifying tumor burden and monitor- MSLN expression and local tumor invasion in vivo,we ing tumor progression in the pleural tumor microenviron- evaluated mice with orthotopic MPM tumors heteroge- ment (21). neously expressing MSLN. Heterogeneously expressing

Figure 3. Validation of BLI in the mouse model to quantitatively monitor MSLN effect on tumor burden and progression. A, ﬂow cytometry dot plots showing human MPM cells (MSTO-211H) stably transduced to express GFP-Fireﬂy Luciferase gene (x-axis) in both MSLN-negative (left plot) and positive (right plot) cells. B, in vitro validation of BLI shows that BLI signal correlates with cell number over a wide range for both MSLN-negative (r ¼ 0.99, P < 0.0001) and MSLN- positive (r ¼ 0.99, P < 0.0001) cells. C, in vivo BLI validation by correlating BLI signal (left column) to tumor volume by MRI volume averaging (right column) in mice with orthotopic MPM tumors. D, BLI signal correlated strongly with tumor volume over a wide range of tumor progression in mice with pleural mesothelioma with and without MSLN expression.

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Figure 4. Mesothelin expression promotes tumor invasion in vivo and decreases survival without affecting tumor proliferation. A, BLI monitors tumor proliferation in mice with orthotopic MPM and reveals no difference in tumor progression between MSLN-positive (n ¼ 12, red line) and negative (n ¼ 12, blue line) tumors. B, Kaplan–Meier survival analysis showed mice with MSLN-positive tumors (n ¼ 12, red line) have decreased survival compared with MSLN- negative (n ¼ 12, blue line) tumors (29 vs. 37 days, P ¼ 0.001). Results confirmed on multiple repeat experiments. C, heterogeneous MSLN expressing MPM tumors in mice show increased MSLN staining at the advancing tumor edge in tumor nodules on both diaphragm (top image asterisk) and chest wall (bottom image arrowhead). D, mice engrafted with tumors of heterogeneous MSLN expression (arrowhead shows area of absent MSLN expression, asterisk shows area of heterogeneous MSLN expression) show consistent MSLN positivity at areas of local tumor invasion (top image arrow). MMP-9 IHC shows increased MMP-9 expression at the leading invasive edge (bottom image arrow) compared with baseline MMP-9 expression in the areas of tumor with low levels of MSLN expression (bottom image asterisk). tumors were established by inoculating mice with a mixture deficient MPM cells (P < 0.01, Fig. 5A). To confirm that of MSLN expressing and MSLN-deficient MSTO-211H cells. MSLN expression has a direct relationship to MMP secre- These tumors uniformly showed clustering of MSLN expres- tion, we examined the effect of MSLN knockdown by shRNA sion at the advancing (invading) edge as determined by using the MSLN expressing murine MPM cell line AB12; MSLN IHC (Fig. 4C and D top panel). decreased MSLN expression was confirmed by flow cytometry (Fig. 1B) and qPCR (relative-fold MSLN expression Mesothelin expression promotes MMP secretion, 0.483 0.29). We found that cell supernatant secretion of which colocalizes at the invading tumor edge MMP-9 was significantly decreased following MSLN knock- Having observed MSLN expression at the invasive edge of down in the AB12 cell line (P < 0.0001, Fig. 5B). MPM tumors, we next investigated whether pathways We then evaluated expression of MMP-9 in MPM tumors known to cause tumor invasion were upregulated in MPM in vivo. We carried out IHC for MMP-9 on heterogeneously cells overexpressing MSLN. GSEA (22) of gene array data MSLN expressing tumors and found increased intensity comparing human MPM cells (MSTO-211H) with or with- of MMP-9 staining at the invasive edge colocalizing with out MSLN expression showed that MSLN expression MSLN staining compared with the baseline level of MMP-9 increased the expression of genes known to regulate MMP staining of non-MSLN expressing cells (Fig. 4D bottom secretion ("SA-MMP-cytokine connection"; hypergeometric panel). These results suggested an association between P < 0.001; Supplementary Table S1). To investigate these MMP-9 and MSLN expression in vivo. findings, we evaluated MMP secretion in cultured human MSTO-211H and murine AB-12 MPM cells. Using multiplex Mesothelin is overexpressed in 90% of epithelioid MPM bead assays for human and murine MMPs, we found that patients MSLN-overexpressing MSTO-211H cells produced signifi- As MSLN IHCs are not routinely done in MPM patients, cantly increased MMP-1, 2, 7, and 9 compared with MSLN- the only MSLN expression data available to date are from

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Figure 5. MSLN expression upregulates tumor cell MMP secretion. A, human MPM cells (MSTO-211H) with and without MSLN expression were compared in vitro for MMP secretion by multiplex bead array assay of cell culture supernatant. MMP-1, 2, 7, and 9 were all signiﬁcantly increased with MSLN expression. B, MSLN knockdown correlated with decreased tumor cell secretion of MMP-9 as determined by multiplex bead assay (, P < 0.01) in AB12 MPM cells.

small case series (33–49 patients) comprising varying his- Mesothelin intensity and distribution in epithelioid tologic subtypes (28, 29). Therefore, we ﬁrst evaluated MPM patients MSLN expression in a large uniform cohort of epithelioid We examined MSLN expression score (sum of intensity MPM patients (n ¼ 139). MSLN is overexpressed in 90% of and distribution) in stage III epithelioid MPM patients. To epithelioid MPM patients (score 1–5), with strong expres- avoid confounding effects due to heterogeneous clinical sion present in 29% of epithelioid MPM patients (score 4– stages and neoadjuvant therapy, we selected a uniform 5; Fig. 6A). cohort of 72 stage III patients with no prior therapy [T1 ¼ 1 (excluded), T2 ¼ 17 and T3 ¼ 54 patients]. In this Mesothelin overexpression is associated with high cohort, a high MSLN score (4–5) is observed in 26% versus MMP-9 expression in human epithelioid MPM 51% for T2 and T3 patients, respectively (Fig. 6C, P ¼ 0.05). specimens These data were notable because increasing T-stage repre- To determine the relationship between MSLN and MMP- sents an important clinical distinction of tumor invasion. 9 expression in human tumor samples, a TMA (6 tumor cores per patient) derived from 139 surgically resected epithelioid MPM tumors (Supplementary Table S2) was Discussion examined by IHC (Fig. 6A). We detected a strong correlation Tumors that are known to express MSLN including MPM, between MMP-9 expression and MSLN intensity at individ- pancreatic, and serous ovarian cancers are characterized by ual core level—observing increased levels of MMP-9 expres- locoregional aggressiveness (12). Local tumor invasion is sion with increasing MSLN expression (Fig. 6B, P < 0.001). the primary cause of morbidity in patients with MPM and These clinical ﬁndings supported our preclinical observa- the factor most often preventing tumor resectability tions associating MSLN expression with increased MMP (11, 14). The majority of studies in MPM and other region- levels. ally aggressive malignancies have focused on MSLN as a

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Figure 6. TMA constructed from 139 epithelioid MPM tumors reveals an association between MSLN expression and MMP-9 overexpression. A, representative TMA cores depicting strong or low MSLN and MMP-9 expression (bar ¼ 50 mm). B, MMP-9 expression increases as the proportion of tumor cores showing strong (black) and moderate (gray) expression of MSLN increases as compared with weak (hatched) or absent (white) MSLN expression (P < 0.001). C, in patients with invasion into the endothoracic fascia, mediastinal fat, chest wall, or pericardium (T3-tumors), there is a trend toward increased strong MSLN expression (black; score 4–5) compared with absent-moderate expression (gray; score 0–3) when compared with T-2 tumors (P ¼ 0.05). tumor biomarker (8, 9) and therapeutic target, although shown an association between MSLN and MMP-9 expres- none have evaluated the influence of MSLN on tumor sion. It is notable that, in contrast to data reported for biology. Our study provides evidence showing for the first ovarian cancer (39), we found no correlation in human time a correlation between MSLN and MMP expression as MPM tumor specimens between MMP-7 and either MSLN well as regional tumor aggressiveness and invasion in MPM expression or tumor stage (data not shown). Our data cells, in an orthotopic MPM model, and in epithelioid MPM suggest that although secretion of multiple MMPs is patients increased in association with MSLN in vitro, MMP-9 plays It is well documented that MMP-mediated degradation of a predominant role in the in vivo human MPM tumor. The extracellular matrix proteins facilitates cancer cell migration results reported herein highlight MMP-9 as a potential and invasion (30, 31). MMPs have been implicated in the pathway for MSLN-mediated MPM invasiveness. tumor progression of several cancers including breast (32, MSLN is a glycophosphoinositol (GPI)-anchored cell- 33), pancreatic (34), lung (35), ovarian (36), and meso- surface protein, for which signal transduction depends thelioma (37, 38). In a recent publication, Chang and upon associating with accessory proteins. GPI-anchored colleagues showed an associated between MMP-7 and proteins such as T-cadherin can transduce signals that MSLN expression in ovarian cancer using murine cell lines modulate cell migration and invasion by mechanisms and human tumor specimens (39). In this study, we have mediated through direct interactions with integrin-linked shown that MSLN overexpression increases tumor cell MMP kinase (44) and integrin b3 (45). Data from our gene array secretion, whereas shRNA knockdown of MSLN decreases studies show an association between integrin b4 and MSLN MMP secretion in mesothelioma (Fig. 2A and B and Fig. 3). overexpression in MPM (Supplementary Table S1). We have These data provide evidence that MSLN promotes MMP confirmed the expression of integrin b4 in MSLN over- secretion contributing to tumor aggressiveness. A recent expressing MPM cells by flow cytometry (Supplementary report further highlights the role of MMP-9–mediated inva- Fig. S2). Integrin b4 is expressed by epithelioid MPM (46), sion in MPM and the beneficial therapeutic efficacy of and published literature implicates integrin b4 expression suppressing MMP-9 expression (40). In addition to with tumor cell migration, invasion, and MMP expression MMP-9, we have observed increased in vitro secretion of (47). Further studies to better define the association MMP 1, 2, and 7 with MSLN overexpression—consistent between MSLN and integrin b4 may ultimately help eluci- with published observations that in promoting cancer cell date the relationship of this pathway to MPM tumor cell invasion, MMPs can influence each other directly (39, 41). migration, invasion, and MMP expression. In an orthotopic MPM mouse model, we showed that MSLN Review of the literature reveals other putative mechan- and MMP-9 colocalize along the invasive edge of pleural isms for influence of MSLN on tumor phenotype besides the tumor nodules. Although we report for the first time that association with MMP expression that we have shown. MSLN is expressed along the invading tumor edge in MPM, Functionally, investigators have shown high-affinity bind- other investigators have reported similar observations in ing between MSLN and CA-125 present on mesothelial cells rats following exposure to multiwall carbon nanotubes, (48)—an interaction thought to contribute to peritoneal which are hypothesized to cause MPM, strengthening our migration of ovarian cancer. Uehara and colleagues (49) observation (42). Furthermore, in colorectal cancer, more have found MSLN overexpression to promote anchorage- than 50% of patient specimens showed MSLN expression independent growth and resistance to anoikis in association along the invading edge of tumors (43). These data correlate with suppression of proapoptotic Bim. Chang and collea- with clinical MPM tumor specimens in which we have gues (50) have implicated the phosphoinositide 3-kinase

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pathway in MSLN-associated antiapoptosis. Perturbations highlighted by the use of a clinically relevant orthotopic in Wnt1/b-catenin or Ras pathways lead to the expression of mouse model that accurately recapitulates human disease MSLN in mammary (51) and pancreatic adenocarcinomas and provides an appropriate pleural tumor microenviron- (52). Overexpression of Wnt1 in colorectal cancer cells, ment to investigate tumor cell invasion and MSLN biology. which is also often constitutively activated in mesothelio- Our observations are reproduced with both human and ma, ovarian, and pancreatic cancers, was associated with murine MSLN cells and have been verified in samples from MSLN expression (43). However, these mechanisms neither 139 human epithelioid MPM tumors. This study provides a explain nor provide a pathway for the specific observation better understanding of the locoregional aggressiveness of of MSLN-associated local tumor invasion, a clinically MSLN expressing tumors, shows impact of MSLN on tumor important characteristic of MSLN expressing cancers. MMP, and provides rationale for further clinical study of Tumor invasion has typically been studied using the MSLN as a potential therapeutic target. Boyden chamber and scratch assays in vitro. We have established a novel orthotopic MPM mouse model wherein Disclosure of Potential Conflicts of Interest tumor invasion into diaphragm, mediastinal fat, and peri- No potential conflicts of interest were disclosed. cardium mimic human MPM and have shown that MSLN overexpressing cells localized to the invading edge. Further- Authors' Contributions more, to show that MSLN is indeed associated with inva- Conception and design: E.L. Servais, C. Colovos, P.S. Adusumilli Development of methodology: E.L. Servais, C. Colovos, A.J. Bograd, sion, we have used a uniform cohort of stage III epithelioid M. Sadelain, P.S. Adusumilli MPM patients differing by T-stage and confirmed our pre- Acquisition of data (provided animals, acquired and managed patients, clinical observations of MSLN and MMP-9 expression at provided facilities, etc.): E.L. Servais, C. Colovos, L.A. Rodriguez, A.J. Bograd, J. Nitadori, P.S. Adusumilli tumor core level. In the experience of our group and others, Analysis and interpretation of data (e.g., statistical analysis, biosta- MPM local invasion and regional aggressiveness is a major tistics, and computational analysis): E.L. Servais, C. Colovos, L.A. Rodri- guez, A.J. Bograd, J. Nitadori, C.S. Sima, M. Sadelain, P.S. Adusumilli factor preventing surgical resection with curative intent Writing, review, and/or revision of the manuscript: E.L. Servais, C. (14, 53); 40% of patients are deemed unresectable on the Colovos, A.J. Bograd, J. Nitadori, V.W. Rusch, M. Sadelain, P.S. Adusumilli operating table in spite of extensive preoperative imaging Administrative, technical, or material support (i.e., reporting or orga- nizing data, constructing databases): E.L. Servais, V.W. Rusch, C. Colo- studies. On the basis of our observations, we are currently vos, L.A. Rodriguez, J. Nitadori, M. Sadelain, P.S. Adusumilli investigating the role of MSLN level in both tumor tissue Study supervision: M. Sadelain, P.S. Adusumilli and patient serum to predict resectability for patients with a low clinical "T" stage based. In addition, recent cancer Acknowledgments vaccine clinical trials in patients with pancreatic cancer have The authors thank Drs. William Travis and Kyuichi Kadota for pathologic review and interpretation of human specimens and Irina Linkov for shown the beneficial effects of MSLN-specific immune immunohistochemistry. responses in prolonging survival (54, 55)—a feature currently being explored for the development of MSLN-tar- Grant Support geted immunotherapies by our group and others (56–58). This work was supported in part by PR101053 Department of Defense This study provides further rationale for investigating Research Grant; Mesothelioma Applied Research Foundation (MARF) Grant MSLN-targeted therapies in MPM, as MSLN provides a in memory of Lance S. Ruble; William H. Goodwin and Alice Goodwin, the Commonwealth Foundation for Cancer Research, the Experimental Thera- molecular target that is commonly expressed in human peutics Center of Memorial Sloan-Kettering Cancer Center; American epithelioid MPM and promotes tumor invasion. Association for Thoracic Surgery (AATS)-Third Edward D. Churchill Research In summary, this study is the first to show an association Scholarship; IASLC–International Association for the Study of Lung Cancer Young Investigator Award; National Lung Cancer Partnership/LUN- between MSLN expression and tumor MMP-9 secretion in Gevity Foundation Research Grant; Stony Wold-Herbert Fund, New York MPM. We also illustrate the association between MSLN State Empire Clinical Research Investigator Program (ECRIP); and U54CA137788/U54CA132378 from the National Cancer Institute. expression and local tumor invasion in MPM. These results The costs of publication of this article were defrayed in part by the are consistent with the fact that MSLN expressing solid payment of page charges. This article must therefore be hereby marked tumors such as MPM, pancreatic cancer, and serous ovarian advertisement in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. carcinoma uniformly display regionally aggressive features and dismal outcomes. We have shown our findings not only Received October 10, 2011; revised February 4, 2012; accepted February in vitro, but also in vivo. The strength of these observations is 14, 2012; published OnlineFirst February 27, 2012.

References 1. Hassan R, Bera T, Pastan I. Mesothelin: a new target for immunother- with mesothelioma and lung cancer. Clin Cancer Res 2007;13: apy. Clin Cancer Res 2004;10:3937–42. 5076–81. 2. Ho M, Bera TK, Willingham MC, Onda M, Hassan R, FitzGerald D, et al. 5. Grigoriu BD, Scherpereel A, Devos P, Chahine B, Letourneux M, Mesothelin expression in human lung cancer. Clin Cancer Res Lebailly P, et al. Utility of osteopontin and serum mesothelin in 2007;13:1571–5. malignant pleural mesothelioma diagnosis and prognosis assess- 3. Hassan R, Ho M. Mesothelin targeted cancer immunotherapy. Eur ment. Clin Cancer Res 2007;13:2928–35. J Cancer 2008;44:46–53. 6. Pass HI, Wali A, Tang N, Ivanova A, Ivanov S, Harbut M, et al. Soluble 4. Cristaudo A, Foddis R, Vivaldi A, Guglielmi G, Dipalma N, Filiberti mesothelin-related peptide level elevation in mesothelioma serum and R, et al. Clinical signiﬁcance of serum mesothelin in patients pleural effusions. Ann Thorac Surg 2008;85:265–72; discussion 72.

OF10 Clin Cancer Res; 18(9) May 1, 2012 Clinical Cancer Research

Mesothelin Promotes Invasion in Mesothelioma

7. Rai AJ, Flores RM, Mathew A, Gonzalez-Espinoza R, Bott M, Ladanyi 25. Masood R, Kundra A, Zhu S, Xia G, Scalia P, Smith DL, et al. Malignant M, et al. Soluble mesothelin related peptides (SMRP) and osteopontin mesothelioma growth inhibition by agents that target the VEGF and as protein biomarkers for malignant mesothelioma: analytical valida- VEGF-C autocrine loops. Int J Cancer 2003;104:603–10. tion of ELISA based assays and characterization at mRNA and protein 26. Kumar-Singh S, Weyler J, Martin MJ, Vermeulen PB, Van Marck E. levels. Clin Chem Lab Med 2010;48:271–8. Angiogenic cytokines in mesothelioma: a study of VEGF, FGF-1 and 8. Wheatley-Price P, Yang B, Patsios D, Patel D, Ma C, Xu W, et al. -2, and TGF beta expression. J Pathol 1999;189:72–8. Soluble mesothelin-related Peptide and osteopontin as markers of 27. Garbow JR, Wang M, Wang Y, Lubet RA, You M. Quantitative mon- response in malignant mesothelioma. J Clin Oncol 2010;28:3316–22. itoring of adenocarcinoma development in rodents by magnetic res- 9. Creaney J, Francis RJ, Dick IM, Musk AW, Robinson BW, Byrne MJ, onance imaging. Clin Cancer Res 2008;14:1363–7. et al. Serum soluble mesothelin concentrations in malignant pleural 28. Roe OD, Creaney J, Lundgren S, Larsson E, Sandeck H, Boffetta P, mesothelioma: relationship to tumor volume, clinical stage and et al. Mesothelin-related predictive and prognostic factors in malignant changes in tumor burden. Clin Cancer Res 2011;17:1181–9. mesothelioma: a nested case-control study. Lung Cancer 2008;61 10. Flores RM, Akhurst T, Gonen M, Zakowski M, Dycoco J, Larson SM, :235–43. et al. Positron emission tomography predicts survival in malignant 29. Sandeck HP, Roe OD, Kjaerheim K, Willen H, Larsson E. Re-evaluation pleural mesothelioma. J Thorac Cardiovasc Surg 2006;132:763–8. of histological diagnoses of malignant mesothelioma by immunohis- 11. Flores RM, Riedel E, Donington JS, Alago W, Ihekweazu U, Krug L, tochemistry. Diagn Pathol 2010;5:47. et al. Frequency of use and predictors of cancer-directed surgery in the 30. Roy DK, O'Neill TW, Finn JD, Lunt M, Silman AJ, Felsenberg D, et al. management of malignant pleural mesothelioma in a community- Determinants of incident vertebral fracture in men and women: results based (Surveillance, Epidemiology, and End Results [SEER]) popula- from the European Prospective Osteoporosis Study (EPOS). Osteo- tion. J Thorac Oncol 2010;5:1649–54. poros Int 2003;14:19–26. 12. Kadota K, Suzuki K, Sima CS, Rusch VW, Adusumilli PS, Travis WD. 31. Liotta LA, Kohn EC. The microenvironment of the tumour-host inter- Pleomorphic epithelioid diffuse malignant pleural mesothelioma. A face. Nature 2001;411:375–9. clinicopathological review and conceptual proposal to reclassify as 32. La Rocca G, Pucci-Minafra I, Marrazzo A, Taormina P, Minafra S. biphasic or sarcomatoid mesothelioma. J Thorac Oncol 2011;6:896– Zymographic detection and clinical correlations of MMP-2 and MMP-9 904. in breast cancer sera. Br J Cancer 2004;90:1414–21. 13. Rusch VW, Venkatraman E. The importance of surgical staging in the 33. Wu ZS, Wu Q, Yang JH, Wang HQ, Ding XD, Yang F, et al. Prognostic treatment of malignant pleural mesothelioma. J Thorac Cardiovasc significance of MMP-9 and TIMP-1 serum and tissue expression in Surg 1996;111:815–25; discussion 25–6. breast cancer. Int J Cancer 2008;122:2050–6. 14. Flores RM, Zakowski M, Venkatraman E, Krug L, Rosenzweig K, 34. Jones LE, Humphreys MJ, Campbell F, Neoptolemos JP, Boyd MT. Dycoco J, et al. Prognostic factors in the treatment of malignant pleural Comprehensive analysis of matrix metalloproteinase and tissue inhib- mesothelioma at a large tertiary referral center. J Thorac Oncol itor expression in pancreatic cancer: increased expression of matrix 2007;2:957–65. metalloproteinase-7 predicts poor survival. Clin Cancer Res 2004;10: 15. Richards WG, Godleski JJ, Yeap BY, Corson JM, Chirieac LR, Zellos L, 2832–45. et al. Proposed adjustments to pathologic staging of epithelial malig- 35. Schutz A, Schneidenbach D, Aust G, Tannapfel A, Steinert M, Witte- nant pleural mesothelioma based on analysis of 354 cases. Cancer kind C. Differential expression and activity status of MMP-1, MMP-2 2010;116:1510–7. and MMP-9 in tumor and stromal cells of squamous cell carcinomas of 16. Doi T, Maniwa Y, Tanaka Y, Tane S, Hashimoto S, Ohno Y, et al. MT1- the lung. Tumour Biol 2002;23:179–84. MMP plays an important role in an invasive activity of malignant pleural 36. Perigny M, Bairati I, Harvey I, Beauchemin M, Harel F, Plante M, et al. mesothelioma cell. Exp Mol Pathol 2011;90:91–6. Role of immunohistochemical overexpression of matrix metallopro- 17. Tan RJ, Fattman CL, Niehouse LM, Tobolewski JM, Hanford LE, Li Q, teinases MMP-2 and MMP-11 in the prognosis of death by ovarian et al. Matrix metalloproteinases promote inflammation and fibrosis in cancer. Am J Clin Pathol 2008;129:226–31. asbestos-induced lung injury in mice. Am J Respir Cell Mol Biol 37. Edwards JG, McLaren J, Jones JL, Waller DA, O'Byrne KJ. Matrix 2006;35:289–97. metalloproteinases 2 and 9 (gelatinases A and B) expression in malig- 18. Adusumilli PS, Eisenberg DP, Stiles BM, Chung S, Chan MK, Rusch nant mesothelioma and benign pleura. Br J Cancer 2003;88:1553–9. VW, et al. Intraoperative localization of lymph node metastases with a 38. Roomi MW, Monterrey JC, Kalinovsky T, Niedzwiecki A, Rath M. replication-competent herpes simplex virus. J Thorac Cardiovasc Surg Modulation of MMP-2 and MMP-9 by cytokines, mitogens and inhi- 2006;132:1179–88. bitors in lung cancer and malignant mesothelioma cell lines. Oncol Rep 19. Servais EL, Colovos C, Kachala SS, Adusumilli PS. Pre-clinical mouse 2009;22:1283–91. models of primary and metastatic pleural cancers of the lung and 39. Chang MC, Chen CA, Chen PJ, Chiang YC, Chen YL, Mao TL, et al. breast and the use of bioluminescent imaging to monitor pleural tumor Mesothelin enhances invasion of ovarian cancer by inducing MMP-7 burden. Curr Protoc Pharmacol 2011;Chapter 14:Unit14 21. through MAPK/ERK and JNK pathways. Biochem J 2012;442:293–302. 20. Stiles BM, Adusumilli PS, Bhargava A, Stanziale SF, Kim TH, Chan MK, 40. Nasu M, Carbone M, Gaudino G, Ly BH, Bertino P, Shimizu D, et al. et al. Minimally invasive localization of oncolytic herpes simplex viral Ranpirnase interferes with NF-kappaB pathway and MMP9 activity, therapy of metastatic pleural cancer. Cancer Gene Ther 2006;13: inhibiting malignant mesothelioma cell invasiveness and xenograft 53–64. growth. Genes Cancer 2011;2:576–84. 21. Servais EL, Suzuki K, Colovos C, Rodriguez L, Sima C, Fleisher M, et al. 41. Kan JS, Delassus GS, D'Souza KG, Hoang S, Aurora R, Eliceiri GL. An in vivo platform for tumor biomarker assessment. PloS One 2011;6: Modulators of cancer cell invasiveness. J Cell Biochem 2010;111: e26722. 791–6. 22. Subramanian A, Tamayo P, Mootha VK, Mukherjee S, Ebert BL, Gillette 42. Sakamoto Y, Dai N, Hagiwara Y, Satoh K, Ohashi N, Fukamachi K, et al. MA, et al. Gene set enrichment analysis: a knowledge-based approach Serum level of expressed in renal carcinoma (ERC)/mesothelin in rats for interpreting genome-wide expression profiles. Proc Natl Acad Sci U with mesothelial proliferative lesions induced by multi-wall carbon S A 2005;102:15545–50. nanotube (MWCNT). J Toxicol Sci 2010;35:265–70. 23. Adusumilli PS, Stiles BM, Chan MK, Mullerad M, Eisenberg DP, Ben- 43. Liebig B, Brabletz T, Staege MS, Wulfanger J, Riemann D, Burdach S, Porat L, et al. Imaging and therapy of malignant pleural mesothelioma et al. Forced expression of deltaN-TCF-1B in colon cancer derived cell using replication-competent herpes simplex viruses. J Gene Med lines is accompanied by the induction of CEACAM5/6 and mesothelin. 2006;8:603–15. Cancer Lett 2005;223:159–67. 24. Servais EL, Colovos C, Bograd AJ, White J, Sadelain M, Adusumilli PS. 44. Joshi MB, Ivanov D, Philippova M, Erne P, Resink TJ. Integrin-linked Animal models and molecular imaging tools to investigate lymph node kinase is an essential mediator for T-cadherin-dependent signaling via metastases. J Mol Med (Berl) 2011;89:753–69. Akt and GSK3beta in endothelial cells. FASEB J 2007;21:3083–95.

www.aacrjournals.org Clin Cancer Res; 18(9) May 1, 2012 OF11

Servais et al.

45. Philippova M, Ivanov D, Joshi MB, Kyriakakis E, Rupp K, Afonyushkin adenocarcinomas. Biochem Biophys Res Commun 2009;390: T, et al. Identification of proteins associating with glycosylphospha- 636–41. tidylinositol- anchored T-cadherin on the surface of vascular endo- 53. Rice DC, Erasmus JJ, Stevens CW, Vaporciyan AA, Wu JS, Tsao AS, thelial cells: role for Grp78/BiP in T-cadherin-dependent cell survival. et al. Extended surgical staging for potentially resectable malignant Mol Cell Biol 2008;28:4004–17. pleural mesothelioma. Ann Thorac Surg 2005;80:1988–92; discussion 46. Barth TF, Bruderlein S, Rinaldi N, Mechtersheimer G, Moller P. Pleural 92–3. mesothelioma mimics the integrin profile of activated, sessile rather 54. Johnston FM, Tan MC, Tan BR Jr, Porembka MR, Brunt EM, Linehan than detached mesothelial cells. Int J Cancer 1997;72:77–86. DC, et al. Circulating mesothelin protein and cellular antimesothelin 47. Daemi N, Thomasset N, Lissitzky JC, Dumortier J, Jacquier MF, immunity in patients with pancreatic cancer. Clin Cancer Res 2009;15: Pourreyron C, et al. Anti-beta4 integrin antibodies enhance migratory 6511–8. and invasive abilities of human colon adenocarcinoma cells and their 55. Lutz E, Yeo CJ, Lillemoe KD, Biedrzycki B, Kobrin B, Herman J, et al. A MMP-2 expression. Int J Cancer 2000;85:850–6. lethally irradiated allogeneic granulocyte-macrophage colony stimu- 48. Gubbels JA, Belisle J, Onda M, Rancourt C, Migneault M, Ho M, et al. lating factor-secreting tumor vaccine for pancreatic adenocarcinoma. Mesothelin-MUC16 binding is a high affinity, N-glycan dependent A phase II trial of safety, efficacy, and immune activation. Ann Surg interaction that facilitates peritoneal metastasis of ovarian tumors. 2011;253:328–35. Mol Cancer 2006;5:50. 56. Carpenito C, Milone MC, Hassan R, Simonet JC, Lakhal M, Suhoski 49. Uehara N, Matsuoka Y, Tsubura A. Mesothelin promotes anchorage- MM, et al. Control of large, established tumor xenografts with genet- independent growth and prevents anoikis via extracellular signal- ically retargeted human T cells containing CD28 and CD137 domains. regulated kinase signaling pathway in human breast cancer cells. Mol Proc Natl Acad Sci U S A 2009;106:3360–5. Cancer Res 2008;6:186–93. 57. HassanR,EbelW,RouthierEL,PatelR,KlineJB,ZhangJ,etal. 50. Chang MC, Chen CA, Hsieh CY, Lee CN, Su YN, Hu YH, et al. Preclinical evaluation of MORAb-009, a chimeric antibody Mesothelin inhibits paclitaxel-induced apoptosis through the PI3K targeting tumor-associated mesothelin. Cancer Immun 2007; pathway. Biochem J 2009;424:449–58. 7:20. 51. Prieve MG, Moon RT. Stromelysin-1 and mesothelin are differentially 58. Hassan R, Lerner MR, Benbrook D, Lightfoot SA, Brackett DJ, Wang regulated by Wnt-5a and Wnt-1 in C57mg mouse mammary epithelial QC, et al. Antitumor activity of SS(dsFv)PE38 and SS1(dsFv)PE38, cells. BMC Dev Biol 2003;3:2. recombinant antimesothelin immunotoxins against human gyneco- 52. Fukamachi K, Tanaka H, Hagiwara Y, Ohara H, Joh T, Iigo M, et al. logic cancers grown in organotypic culture in vitro. Clin Cancer Res An animal model of preclinical diagnosis of pancreatic ductal 2002;8:3520–6.

OF12 Clin Cancer Res; 18(9) May 1, 2012 Clinical Cancer Research

Mesothelin Overexpression Promotes Mesothelioma Cell Invasion and MMP-9 Secretion in an Orthotopic Mouse Model and in Epithelioid Pleural Mesothelioma Patients

Elliot L. Servais, Christos Colovos, Luis Rodriguez, et al.

Clin Cancer Res Published OnlineFirst February 27, 2012.

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