Abstract

Abstract Invasive lobular cancer (ILC) is the second most common subtype of breast cancers after invasive carcinoma of no special type (NST) but associated with worse outcomes. Despite the known molecular differences between ILC and NST, ILC treatment is the same as stage matched NST making the development of ILC targeted therapies an urgent need. Therefore, this study was conducted to identify novel molecular alterations in ILC that could be exploited for therapeutic purposes. Differential gene expression and Geneset Enrichment and Variation analyses were performed on RNA-seq data from three large public breast cancer databases – the Sweden Cancerome Analysis Network-Breast (SCAN-B), The Cancer Genome Atlas (TCGA) and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). Pathways enriched in overlapping differentially expressed genes from these datasets were clustered using Jaccard index to identify novel pathways related to ILC. The cAMP/PKA/CREB signaling was studied in ILC, ILC-like and NST cell lines and patient-derived organoids (POD) using Forskolin, an activator of the pathway. Clinicopathological features of patients with ILC and NST in SCAN-B were similar to prior population-based studies. There was a consistent pattern of up-regulation of cAMP/PKA/CREB related signaling in ILC compared to NST tumors in SCAN-B, TCGA and METABRIC. Treatment with forskolin resulted in a greater increase in phospho-CREB in ILC cell lines and organoids compared to NST. CRISPR deletion of CDH1 in NST cell lines did not alter response of cells to forskolin as measured by phospho-CREB. Co-immunofluorescence supported the enhanced nuclear localization and subsequent phosphorylation of CREB at Serine 133 in ILC cell lines. Forskolin treatment caused growth inhibition in ILC and NST cells, with ILC cell lines being more sensitive to forskolin-mediated growth inhibition. Collectively the data indicate that the cAMP/PKA/CREB signaling is higher in ILC than NST tumors. This was consistent across three separate cancer datasets and was validated in cell lines and organoids. Loss of CDH1 is not sufficient to mediate this phenotype in lobular tumors. Future studies should investigate the mechanisms for differential cAMP/PKA/CREB signaling in ILC and NST and investigate the potential for therapeutic targeting especially in patients with ILC. Citation Format: Abdalla Wedn, Susrutha Puthanmadhom-Narayanan, Adrian Lee, Steffi Oesterreich. Bioinformatic and in-vitro analyses identify cAMP/PKA/CREB signaling as a major molecular alteration in invasive lobular breast cancer [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr B014.

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