Professional Documents
Culture Documents
Molecular Therapy
…from bench to bedside
University of Milano-Bicocca
MOLECULAR MEDICINE
A multidisciplinary
approach to understand the
functional mechanisms of
cell phisiology and pathology
in different fields
offering a vast potential for
the development of
new therapeutics
University of Milano-Bicocca
MOLECULAR MEDICINE
University of Milano-Bicocca
MOLECULAR MEDICINE
CANCER
University of Milano-Bicocca
MOLECULAR MEDICINE
Burden of Cancer in the World
University of Milano-Bicocca
MOLECULAR MEDICINE
To eliminate the
suffering and death
due to cancer by 2015
…failed!
University of Milano-Bicocca
MOLECULAR MEDICINE
21st Century Personalized Oncology
University of Milano-Bicocca
MOLECULAR MEDICINE
The Processes Involved in Cancer
• Proliferation
• Micro-Invasion
• Immune Evasion
• Cell Recruitment
• Dissemination
• Targeting
• Penetration
• Colonization
• De-Differentiation
University of Milano-Bicocca
MOLECULAR MEDICINE
Transformational Technologies
Exponential Expansion of Knowledge
• Genomics
• Proteomics
• Metabolomics
• Molecular Imaging
• Nanotechnology
• Bioinformatics
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Diagnosis
Profile of the Patient and the Tumor
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Therapeutics
Targeted Intervention
University of Milano-Bicocca
Bcl2
University of Milano-Bicocca
Bcl2 come target molecolare
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Therapeutics
Targeted Intervention
University of Milano-Bicocca
PTEN
University of Milano-Bicocca
Regolazione dell’attività di NFkB
Ubiquitinazione
a carico di 2 Lys Nterm
operato da E3 Ub-ligasi
Degradazione
da parte del proteasoma
Traslocazione al nucleo
Legame sui promotori responsivi
University of Milano-Bicocca
cancer
University of Milano-Bicocca
University of Milano-Bicocca
NFkB pathway come target per la terapia molecolare
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Imaging
Diagnosis and Monitoring in Real-Time
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Therapeutics: TKI
Gleevec and CML, LLA, GIST (block ABL, KIT, PDGFR)
University of Milano-Bicocca
STI571 o imatinib mesilato (Gleevec, Novartis)
• alta affinità anche per chinasi -> abl (bcr-abl) c-Kit e PDGFR
University of Milano-Bicocca
PDGFR in patologia
University of Milano-Bicocca
Azioni del PDGF
University of Milano-Bicocca
C-Kit
University of Milano-Bicocca
University of Milano-Bicocca
c-KIT in patologia
University of Milano-Bicocca
Bcr-Abl
• prodotto di fusione derivante dalla t(9:22) che origina il cosiddetto cromosoma Ph,
la traslocazione puo’ avvenire in due punti diversi dando origine a due proteine di
fusione a differente peso molecolare e coinvolte nella patogenesi di due tipi di
leucemie -> p210 (presente in oltre il 90% delle leucemie mieloide croniche)
e p185 (presente nel 25-30% delle leucemie linfoblastiche acute adulte e nel 2-10%
delle leucemie linfoblastiche acute infantili
• c-abl è l’omologo umano di v-abl del virus della leucemia murina di Abelson
• c-abl codifica per una tirosino-chinasi citoplasmatica che si attiva in seguito a
miristilazione e ancoraggio alla faccia interna della membrana citoplasmatica
• il prodotto di fusione conferisce alla chinasi attivazione costituiva con conseguente
attivazione costitutiva di una serie di pathways da essa regolate -> azione
antiapoptotica e mitogenica
University of Milano-Bicocca
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Therapeutics
Gleevec and Chronic Myelogenous Leukemia
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Imaging
Diagnosis and Monitoring in Real-Time
University of Milano-Bicocca
MOLECULAR MEDICINE
FDG-PET Monitoring
Response to Gleevec in GIST
University of Milano-Bicocca
Epidermal Growth Factor Receptor (EGFR) family
University of Milano-Bicocca
Epidermal Growth Factor Receptor (EGFR) family
University of Milano-Bicocca
University of Milano-Bicocca
ErbBs come target per la terapia molecolare
University of Milano-Bicocca
MOLECULAR MEDICINE
Molecular Imaging
Diagnosis and Monitoring in “Real-Time”
University of Milano-Bicocca
MOLECULAR MEDICINE
Emerging Technology
Nanotechnology
• Target therapies
• Develop biosensors to
monitor therapy within a cell
University of Milano-Bicocca
MOLECULAR MEDICINE
Cancer Bioinformatics
University of Milano-Bicocca
MOLECULAR MEDICINE
REALITY FOR TOMORROW
University of Milano-Bicocca
University of Milano-Bicocca
ESFRI Biological Bio-Medical Sciences Research Infrastructures
BBMRI
Biobanking
ELIXIR
University of Milano-Bicocca
MOLECULAR MEDICINE
RESEARCH ACTIONS
Development Prevention Data- Biological Preclinical
of disease /Treatment mining validation Experimental
model Medicine
Immunological Diseases
Transplantation
…from bench …to bedside
Neurological Disorders
Cardiovascular Diseases
Cancer
University of Milano-Bicocca
MOLECULAR MEDICINE
MEDICINE - BIOTECHNOLOGY
Genomics
B
I
Proteomics
O
Cell biology
I
molecular imaging N
system biology, functional genomic F
O
R
Pre-clinical studies
M
A
T
Novel Therapeutic I
Applications C
S
Links with
Technology platforms European
EC networks
Trained researchers regulations
SME
University of Milano-Bicocca
MOLECULAR MEDICINE
Development of
disease model
Identification Generating Molecular Prevention/
of defective Animal Treatment …from bench to
pathways Therapy of Diseases bedside
Models
Functional Genomics
Comparing animal disease model
versus human disease
Bioinformatic Database
SW Gene
development development expression
database
Bioinformatics
University of Milano-Bicocca
MOLECULAR MEDICINE
Research
6 Coordination activities
Networking
7 RNA profiling
8 Proteomics
9 Database development
Technological
platforms
University of Milano-Bicocca
BBMRI is the pan-European Biobanking and
Biomolecular Resources Research Infrastructure
combines expertise of clinicians, pathologists,
bioinformaticians, and molecular biologists
BBMRI-ERIC Mission
• t o d e v e l o p p e r s o n a l i s e d
500 quality grade biobanks
medicine and disease 60M samples
prevention for the benefit of 480M citizens
European citizens.
• To facilitate access and
20 countries
interoperability to quality-
defined human health/disease-
relevant biological resources
including associated data in an
efficient and ethically and
legally compliant manner.
University of Milano-Bicocca
EATRIS is the pan-European infrastructure for translational medicine.
9 Members
70 academic institution
EATRIS Mission
• t o t r a n s f o r m l a b o r a t o r y
research outcomes into new
ways to diagnose and treat
patients with the aim of
improving the health of
millions of people worldwide.
• To s u p p o r t t r a n s l a t i o n a l
research projects (pre-clinical
research – proof of principles;
fase I and II clinical trials
University of Milano-Bicocca
ECRIN (European Clinical Research Infrastructures
Network) is the pan-European infrastructure dedicated
to the multinational indipendent clinical research
ECRIN Mission
• to facilitate european clinical
360M citizens
research
7 Members
• To conduct independent trials, 2 Observers
across all disease and topic
areas to assess preventative,
diagnostic and therapeutic
interventions that might not
otherwise be investigated. ItaCRIN is the
• to develop innovative health Italian network of
products. 10 clinical trial
• to Explore new indications for
service providers
authorised health products
Portfolio Ongoing Ended Collaborative
ECRIN trials trials projects
(2016)
21 10 5
University of Milano-Bicocca
ELIXIR: a distributed infrastructure for
Biological data to support research in Life Sciences
ELIXIR Mission
• to support research in the field
of “life sciences” and their 20 countries
translational activities to
medicine, environment,
biotechnological industries and
ELIXIR-IIB
society
The Italian Node of
• t o d e f i n e s t a n d a r d s o f
ELIXIR, has been
interoperability and integration
established as a Joint
of resources.
Research Unit
coordinated by CNR.
University of Milano-Bicocca
EURO-BIOIMAGING is the European Research
Infrastructure for Imaging Technologies in
Biological and Biomedical Sciences
EURO-BIOIMAGING Mission
• to provide access to a broad
29 geographically distributed Nodes
range of state-of-the-art candidates
technologies in biological and 17 countries
biomedical imaging for life
scientists.
• to exchange best practice
• To ensure interoperability of
European and International
imaging infrastructures.
EURO-
BIOIMAGING WGs
• Advanced light
microscopy
• Molecular imaging
• Medical imaging
University of Milano-Bicocca
A coordination effort on mouse disease models to unravel the role of
gene function in human health and disease
University of Milano-Bicocca
ISBE: Research Infrastructure in Systems Biology
ISBE is a distributed ESFRI Infrastructure
University of Milano-Bicocca
MIRRI: Microbial Resource Research Infrastructure
MIRRI is a distributed ESFRI Infrastructure
MIRRI Mission
• to provide facilitated access to high
quality microorganisms, their
derivatives, associated data in a
legal compliant way.
• To provide access to state-of-the-
art technologies and innovative
services with the aim to connect
public resource centres with
researchers and policy makers
University of Milano-Bicocca
Biobanks
Translational research
Clinical research
Biological information
Systems biology
Marine BRC
Openscreen platforms
Biomedical imaging
Highly pathogenic agents ERINHA
Model mamm. genomes
Structural biology
University of Milano-Bicocca
University of Milano-Bicocca
Biomarcatori theranostici - Chemioresistenza
University of Milano-Bicocca
Nuovi geni coinvolti nella farmaco-resistenza
TARGET IDENTIFICATION
TARGET VALIDATION
in vitro
(phenotype screen)
BIOBANKS in vivo
ex vivo
patient tissue analysis
Teranostic marker
University of Milano-Bicocca
IDENTIFICAZIONE DEI GENI COINVOLTI NELLA FARMACO-RESISTENZA
TRAMITE SCREENING FENOTIPICO CON RNAi LIBRARY
Infezione di 20x106 HCT116p53KO con l'intera libreria o il pool kinasico della libreria di shRNA
Selezione con puromicina à selezionati i soli geni il cui silenziamento è compatibile con la sopravvivenza
200 µM 5FU per 72 hs à cellule morte, flottanti raccolte dalla piastra (~20-30%)
Estrazione del DNA & PCR di frammenti di 643bp contenenti promotore H1 e hairpin region
digestione EcoRI-XhoI e clonaggio in pRS (p Retro Super)
Re-infezione del pool arricchito dei pRS-shRNA in HCT116p53KO à selezione à trattamento con 5FU
cellule morte, flottanti raccolte dalla piastra (~60-70%)
Estrazione del DNA & PCR di frammenti di 643bp contenenti promotore H1 e hairpin region
digestione EcoRI-XhoI e clonaggio in pRS à trasformazione di DH5α transformation à
Sequenziamento dei prodotti di Colony-PCR
University of Milano-Bicocca
RISULTATI DELLO SCREEN
University of Milano-Bicocca
GSK-3
GSK3A
GSK3B
University of Milano-Bicocca
University of Milano-Bicocca
BTK
University of Milano-Bicocca
University of Milano-Bicocca Grassilli et al, Oncogene, in press
University of Milano-Bicocca
TEST DIAGNOSTICO FUNZIONALE
CELLULE DEL TUMORE DEL PAZIENTE
Test su biopsia postchirurgica, caratteristiche:
• semplice da eseguire
• a costi contenuti
University of Milano-Bicocca
CA Colon
OD NT – OD trattamento
Distribuzione dei valori ottenuti come differenza tra la media del triplicato dei campioni non trattati con farmaco e
la media del triplicato dei campioni trattati nei 135 campioni di ca colon.
A sinistra i delta dei campioni risultati resistenti con il test t di Student, a destra i delta dei campioni risultati
sensibili con lo stesso test.
University of Milano-Bicocca
CA OVAIO
RES Student’s t test
SENS Student’s t test
DIFFERENZA NT-TRATTATO
SENS
RES
PTX CARBO BEVA PTX + PTX + BEVA + PTX + IBR. IBR + IBR + IBR + IBR + IBR + PTX +
CARBO BEVA CARBO CARBO + PTX CARBO BEVA PTX + CARBO +
BEVA CARBO BEVA
University of Milano-Bicocca
• 12 brevetti (6 granted)
1. Lavitrano et al. “Gene Transfer Composition and Method" Europe Patent No. 02766976.1 (concesso) ceduto alla
Revivicor Inc Blacksburg, VA USA nel 2004.
2. Lavitrano M, Grassilli E, Helin K (2007). Composti modulatori della resistenza farmacologica in cellule epiteliali
tumorali. Brevetto italiano 0001378871 (concesso)
3. Lavitrano M, Grassilli E, Helin K. siRNA-mediated silencing of genes for treating chemotherapeutic drug-resistant
epithelial tumors. Patent application WO/2008/110,624
4. Lavitrano M, Grassilli E, Helin K (2012). NEW ISOFORM OF BRUTON’S TYROSINE KINASE (BTK) PROTEIN. Patent
application US 13/532,669
5. Lavitrano M, Grassilli E, Helin K (2012). MODULATOR COMPOUNDS OF THE DRUG RESISTANCE IN EPITHELIAL
TUMOUR CELLS. Patent application EP 12179806.0
6. Lavitrano M, Grassilli E, Helin K (2012). MODULATOR COMPOUNDS OF THE DRUG RESISTANCE IN EPITHELIAL
TUMOUR CELLS. Patent application EP 12179801.1
7. Lavitrano M, Grassilli E, Helin K (2012). ISOFORM OF BRUTON'S TYROSINE KINASE (BTK) PROTEIN. US Patent no
8,232,085 (concesso)
8. Lavitrano M, Grassilli E, Helin K (2014). Isoform of Bruton's tyrosine kinase (BTK) protein. US Patent no 8,889,643
(concesso)
9. Lavitrano M, Cerrito MG, Giovannoni R, Grassilli E, Masiero L, Pisano F, Romano G (2013). Pharmaceutical kit for
use in the treatment of colon and colorectal cancer. Patent application EP 2013179049.5
10. Lavitrano M, Cerrito MG, Giovannoni R, Grassilli E, Masiero L, Pisano F, Romano G (2014). Methods of treating
cancers. Patent application PCT/EP2014/066724
11. Lavitrano M, Grassilli E, Helin K. (2013). BTK INHIBITORS FOR USE IN TREATING CHEMOTHERAPEUTIC DRUG-
RESISTANT EPITHELIAL TUMOURS. Patent no EP 2 134 374 B1 (concesso).
12. Conconi D, Dalprà' L, Grassilli E, Lavitrano M (2014). Methods for determining the sensitivity or resistance of
cancer cells to at least one anticancer drug and/or therapeutically active molecule. Patent application PCT/
IB2014/062303
University of Milano-Bicocca