Autocrine IGF-I/insulin receptor axis compensates for inhibition of AKT in ER-positive breast cancer cells with resistance to estrogen deprivation
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  • 作者:Emily M Fox (1)
    María Gabriela Kuba (2)
    Todd W Miller (3)
    Barry R Davies (4)
    Carlos L Arteaga (1) (5) (6)
  • 关键词:AKT ; ER+ breast cancer ; endocrine resistance ; IGF ; IR ; InsR
  • 刊名:Breast Cancer Research
  • 出版年:2013
  • 出版时间:August 2013
  • 年:2013
  • 卷:15
  • 期:4
  • 全文大小:1,597 KB
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  • 作者单位:Emily M Fox (1)
    María Gabriela Kuba (2)
    Todd W Miller (3)
    Barry R Davies (4)
    Carlos L Arteaga (1) (5) (6)

    1. Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt University, 2220 Pierce Ave, 777 PRB, Nashville, TN, 37232-6307, USA
    2. Department of Pathology, Microbiology & Immunology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, 2220 Pierce Ave, 777 PRB, Nashville, TN, 37232-6307, USA
    3. Department of Pharmacology and Toxicology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, One Medical Center Drive, HB-7936, Lebanon, NH, 03756, USA
    4. Oncology Innovative Medicine, AstraZeneca, Alderley Park, Macclesfield, SK0 4TG, UK
    5. Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University, 2220 Pierce Ave, 777 PRB, Nashville, TN, 37232-6307, USA
    6. Breast Cancer Research Program, Vanderbilt-Ingram Cancer Center, Vanderbilt University, 2220 Pierce Ave, 777 PRB, Nashville, TN, 37232-6307, USA
  • ISSN:1465-5411
文摘
Introduction Estrogen receptor α-positive (ER+) breast cancers adapt to hormone deprivation and acquire resistance to antiestrogen therapies. Upon acquisition of hormone independence, ER+ breast cancer cells increase their dependence on the phosphatidylinositol-3 kinase (PI3K)/AKT pathway. We examined the effects of AKT inhibition and its compensatory upregulation of insulin-like growth factor (IGF)-I/InsR signaling in ER+ breast cancer cells with acquired resistance to estrogen deprivation. Methods Inhibition of AKT using the catalytic inhibitor AZD5363 was examined in four ER+ breast cancer cell lines resistant to long-term estrogen deprivation (LTED) by western blotting and proliferation assays. Feedback upregulation and activation of receptor tyrosine kinases (RTKs) was examined by western blotting, real-time qPCR, ELISAs, membrane localization of AKT PH-GFP by immunofluorescence and phospho-RTK arrays. For studies in vivo, athymic mice with MCF-7 xenografts were treated with AZD5363 and fulvestrant with either the ATP-competitive IGF-IR/InsR inhibitor AZD9362 or the fibroblast growth factor receptor (FGFR) inhibitor AZD4547. Results Treatment with AZD5363 reduced phosphorylation of the AKT/mTOR substrates PRAS40, GSK3α/β and S6K while inducing hyperphosphorylation of AKT at T308 and S473. Inhibition of AKT with AZD5363 suppressed growth of three of four ER+ LTED lines and prevented emergence of hormone-independent MCF-7, ZR75-1 and MDA-361 cells. AZD5363 suppressed growth of MCF-7 xenografts in ovariectomized mice and a patient-derived luminal B xenograft unresponsive to tamoxifen or fulvestrant. Combined treatment with AZD5363 and fulvestrant suppressed MCF-7 xenograft growth better than either drug alone. Inhibition of AKT with AZD5363 resulted in upregulation and activation of RTKs, including IGF-IR and InsR, upregulation of FoxO3a and ERα mRNAs as well as FoxO- and ER-dependent transcription of IGF-I and IGF-II ligands. Inhibition of IGF-IR/InsR or PI3K abrogated AKT PH-GFP membrane localization and T308 P-AKT following treatment with AZD5363. Treatment with IGFBP-3 blocked AZD5363-induced P-IGF-IR/InsR and T308 P-AKT, suggesting that receptor phosphorylation was dependent on increased autocrine ligands. Finally, treatment with the dual IGF-IR/InsR inhibitor AZD9362 enhanced the anti-tumor effect of AZD5363 in MCF-7/LTED cells and MCF-7 xenografts in ovariectomized mice devoid of estrogen supplementation. Conclusions These data suggest combinations of AKT and IGF-IR/InsR inhibitors would be an effective treatment strategy against hormone-independent ER+ breast cancer.

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