Abstract 1837: Overcoming trastuzumab resistance in HER2-overexpressing breast cancer by utilizing PHB2, a tumor suppressor of multiple resistance pathways

Abstract

Abstract Overexpression of the human epidermal growth factor receptor 2 (HER2) is associated with aggressive tumor behavior and poor prognosis in breast cancer. Although anti-HER2 monoclonal antibody, trastuzumab shows considerable efficacy and extends the overall survival of patients with HER2 overexpressing breast cancer, about half of individuals with HER2-overexpressing breast cancer do not respond to trastuzumab-based therapies due to multiple resistance mechanisms. Therefore, acquired and de novo resistance to trastuzumab remains an important issue in the clinical treatment of HER2-overexpressing breast cancer. Our previous studies demonstrated that Brefeldin A-Inhibited Guanine nucleotide-exchange protein 3 (BIG3), which is exclusively overexpressed in the majority of breast cancers, functions as an A-kinase anchoring protein that binds protein kinase A (PKA) and protein phosphatase 1 (PP1Cα), thereby inactivating prohibitin2 (PHB2) suppressive activity through its dephosphorylation on Ser39. We further developed the stapled dominant-negative peptide (stERAP; stapled ERAP), which is designed to specifically inhibit the BIG3-PHB2 interaction and improve duration of their anti-tumor effects. Here we newly report that stERAP has significant suppressive effects on the HER2 signaling network by activating the tumor suppressive ability of PHB2. Intrinsic PHB2 released from BIG3 by stERAP was rapidly serine- and threonine-phosphorylated via PKCα and/or TTK, which are essential for its tumor suppressive activity, and effectively disrupted the HER2-HER3 interaction associated with acquired resistance to trastuzumab, resulting in significant reduction of proliferation of HER2-overexpressing breast cancer cells (IC50 = 54 nM in SK-BR-3 cells). We also confirm that stERAP inhibited HER2 phosphorylation on Thr488, HER2-HER3 interaction, and NF-κB pathway, which are associated with trastuzumab-resistance, respectively, resulting in significant suppression of growth of trastuzumab-resistant breast cancer cells. More importantly, stERAP treatment led to the enhancement of trastuzumab-sensitivity, resulting in a synergistic growth suppression of HER2-overexpressing and trastuzumab-resistant breast cancer cells, respectively. Our findings strongly suggest that stERAP is a novel promising anti-cancer drug to suppress the growth of trastuzumab-resistant breast cancer in clinical use. Citation Format: Tetsuro Yoshimaru, Yosuke Matsushita, Mitsunori Sasa, Yasuo Miyoshi, Toyomasa Katagiri. Overcoming trastuzumab resistance in HER2-overexpressing breast cancer by utilizing PHB2, a tumor suppressor of multiple resistance pathways [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1837.