Abstract

Gene regulation of many key cell-cycle players in S-, G(2) phase, and mitosis results from transcriptional repression in their respective promoter regions during the G(0) and G(1) phases of cell cycle. Within these promoter regions are phylogenetically conserved sequences known as the cell-cycle-dependent element (CDE) and cell-cycle genes homology regions (CHR) sites. Thus, we hypothesize that transcriptional regulation of cell-cycle regulation via the CDE/CHR region together with liver-specific apolipoprotein E (apoE)-hAAT promoter could bring about a selective transgene expression in proliferating human hepatocellular carcinoma. We show that the newly generated vector AH-6CC-L2C could mediate hepatocyte-targeted luciferase gene expression in tumor cells and freshly isolated short-term hepatocellular carcinoma cultures from patient biopsy. In contrast, normal murine and human hepatocytes infected with AH-6CC-L2C expressed minimal or low luciferase activities. In the presence of prodrug 5-fluorocytosine (5-FC), AH-6CC-L2C effectively suppressed the growth of orthotopic hepatocellular carcinoma patient-derived xenograft mouse model via the expression of yeast cytosine deaminase (yCD) that converts 5-FC to anticancer metabolite 5-fluoruracil. More importantly, we show that combination treatment of AH-6CC-L2C with an EZH2 inhibitor, DZNep, that targets EpCAM-positive hepatocellular carcinoma, can bring about a greater therapeutic efficacy compared with a single treatment of virus or inhibitor. Our study showed that targeting proliferating human hepatocellular carcinoma cells through the transcriptional control of therapeutic gene could represent a feasible approach against hepatocellular carcinoma.

Highlights

  • Hepatocellular carcinoma (HCC) is the third leading cause of death from cancer in the world [1]

  • Additional modifications were made to this vector which included the use of (i) multimerized cycle–dependent element (CDE)/cellcycle genes homology regions (CHR) regulatory motifs within the minimal cyclin A2 promoter to improve the kinetics of cell-cycle regulation and (ii) a bicistronic 2A-mediated therapeutic and reporter gene expression cassette for assessing the preclinical therapeutic efficacy while providing real-time monitoring of the vector activities

  • Comparison of differentially regulated genes in hepatocellular carcinoma compared with normal liver using microarray analysis has enabled the identification of several hepatocellular carcinoma-specific promoters which may be a valuable tool for the generation of hepatocellular carcinoma-specific viral vectors [24]

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Summary

Introduction

Hepatocellular carcinoma (HCC) is the third leading cause of death from cancer in the world [1]. Curative treatments are available for patients with hepatocellular carcinoma such as liver transplantation, surgical resection, and radiofrequency ablation [2], these treatment regimens are not always possible due to the size and location of the tumors. The most effective medical treatment for advanced hepatocellular carcinoma is with the antiangiogenic drug sorafenib. Despite the success of sorafenib to serve as the only approved medical drug for treating advanced hepatocellular carcinoma, only 2.3 months improvement in median overall survival was observed in Asian hepatocellular carcinoma patients [4]. Treatment options for hepatocellular carcinoma remained universally dismal and require a concerted effort from research and innovative medical interventions

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