Dynamic changes in gene expression in vivo predict prognosis of tamoxifen-treated patients with breast cancer
BREAST CANCER RESEARCH
Authors: Taylor, Karen J.; Sims, Andrew H.; Liang, Liang; Faratian, Dana; Muir, Morwenna; Walker, Graeme; Kuske, Barbara; Dixon, J. Michael; Cameron, David A.; Harrison, David J.; Langdon, Simon P.
Abstract
Introduction: Tamoxifen is the most widely prescribed anti-estrogen treatment for patients with estrogen receptor (ER)-positive breast cancer. However, there is still a need for biomarkers that reliably predict endocrine sensitivity in breast cancers and these may well be expressed in a dynamic manner. Methods: In this study we assessed gene expression changes at multiple time points (days 1, 2, 4, 7, 14) after tamoxifen treatment in the ER-positive ZR-75-1 xenograft model that displays significant changes in apoptosis, proliferation and angiogenesis within 2 days of therapy. Results: Hierarchical clustering identified six time-related gene expression patterns, which separated into three groups: two with early/transient responses, two with continuous/late responses and two with variable response patterns. The early/transient response represented reductions in many genes that are involved in cell cycle and proliferation (e.g. BUB1B, CCNA2, CDKN3, MKI67, UBE2C), whereas the continuous/late changed genes represented the more classical estrogen response genes (e.g. TFF1, TFF3, IGFBP5). Genes and the proteins they encode were confirmed to have similar temporal patterns of expression in vitro and in vivo and correlated with reduction in tumour volume in primary breast cancer. The profiles of genes that were most differentially expressed on days 2, 4 and 7 following treatment were able to predict prognosis, whereas those most changed on days 1 and 14 were not, in four tamoxifen treated datasets representing a total of 404 patients. Conclusions: Both early/transient/proliferation response genes and continuous/late/estrogen-response genes are able to predict prognosis of primary breast tumours in a dynamic manner. Temporal expression of therapy-response genes is clearly an important factor in characterising the response to endocrine therapy in breast tumours which has significant implications for the timing of biopsies in neoadjuvant biomarker studies.
Dual Src Kinase/Pretubulin Inhibitor KX-01, Sensitizes ER alpha-negative Breast Cancers to Tamoxifen through ER alpha Reexpression
MOLECULAR CANCER RESEARCH
Authors: Anbalagan, Muralidharan; Sheng, Mei; Fleischer, Brian; Zhang, Yifang; Gao, Yuanjun; Van Hoang; Matossian, Margarite; Burks, Hope E.; Burow, Matthew E.; Collins-Burow, Bridgette M.; Hangauer, David; Rowan, Brian G.
Abstract
Unlike breast cancer that is positive for estrogen receptor-a (ER alpha), there are no targeted therapies for triple-negative breast cancer (TNBC). ER alpha is silenced in TNBC through epigenetic changes including DNA methylation and histone acetylation. Restoring ER alpha expression in TNBC may sensitize patients to endocrine therapy. Expression of c-Src and ER alpha are inversely correlated in breast cancer suggesting that c-Src inhibition may lead to reexpression of ERain TNBC. KX-01 is a peptide substrate-targeted Src/pretubulin inhibitor in clinical trials for solid tumors. KX-01 (1 mg/kg body weight-twice daily) inhibited growth of tamoxifen-resistant MDA-MB-231 and MDA-MB-157 TNBC xenografts in nude mice that was correlated with Src kinase inhibition. KX-01 also increased ERa mRNA and protein, as well as increased the ER alpha targets progesterone receptor (PR), pS2 (TFF1), cyclin D1 (CCND1), and c-myc (MYC) in MDA-MB-231 and MDA-MB-468, but not MDA-MB-157 xenografts. MDA-MB-231 and MDA-MB-468 tumors exhibited reduction in mesenchymal markers (vimentin, beta-catenin) and increase in epithelial marker (E-cadherin) suggesting mesenchymal-to-epithelial transition (MET). KX-01 sensitized MDA-MB-231 and MDA-MB-468 tumors to tamoxifen growth inhibition and tamoxifen repression of the ER alpha targets pS2, cyclin D1, and c-myc. Chromatin immunoprecipitation (ChIP) of the ERa promoter in KX-01-treated tumors demonstrated enrichment of active transcription marks (acetyl-H3, acetyl-H3Lys9), dissociation of HDAC1, and recruitment of RNA polymerase II. Methylation-specific PCR and bisulfite sequencing demonstrated no alteration in ERa promoter methylation by KX-01. These data demonstrate that in addition to Src kinase inhibition, peptidomimetic KX-01 restores ERa expression in TNBC through changes in histone acetylation that sensitize tumors to tamoxifen.