Abstract

Aberrant Notch signaling is implicated in several cancers, including breast cancer. However, the mechanistic details of the specific receptors and function of ligand-mediated Notch signaling that promote breast cancer remains elusive. In our studies we show that DLL1, a Notch signaling ligand, is significantly overexpressed in ERα+ luminal breast cancer. Intriguingly, DLL1 overexpression correlates with poor prognosis in ERα+ luminal breast cancer, but not in other subtypes of breast cancer. In addition, this effect is specific to DLL1, as other Notch ligands (DLL3, JAGGED1, and JAGGED2) do not influence the clinical outcome of ERα+ patients. Genetic studies show that DLL1-mediated Notch signaling in breast cancer is important for tumor cell proliferation, angiogenesis, and cancer stem cell function. Consistent with prognostic clinical data, we found the tumor-promoting function of DLL1 is exclusive to ERα+ luminal breast cancer, as loss of DLL1 inhibits both tumor growth and lung metastasis of luminal breast cancer. Importantly, we find that estrogen signaling stabilizes DLL1 protein by preventing its proteasomal and lysososmal degradations. Moreover, estrogen inhibits ubiquitination of DLL1. Together, our results highlight an unexpected and novel subtype-specific function of DLL1 in promoting luminal breast cancer that is regulated by estrogen signaling. Our studies also emphasize the critical role of assessing subtype-specific mechanisms driving tumor growth and metastasis to generate effective subtype-specific therapeutics.

Highlights

  • Breast cancer is the second leading cause of cancer-related death among women worldwide

  • The clinical correlation data using published datasets were further confirmed by western blot analysis of human breast cancer cells that showed that DLL1 expression is higher in three luminal breast cancer cells (MCF7, T47D and ZR-75-1)

  • Using a Dll1 antibody, we show that DLL1 protein is overexpressed in ERα+ luminal breast cancer patient samples when compared to normal tissue or TNBC tumors

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Summary

Introduction

Breast cancer is the second leading cause of cancer-related death among women worldwide. The heterogeneity and diversity of breast cancer challenges both the choice and efficacy of treatment options, thereby enhancing the These authors contributed : Ratnesh Kumar Srivastav, David W. Representative IHC images (a) and calculated H-score (b) show higher DLL1 protein levels in non-TNBC (n = 60) compared to tumoradjacent normal tissue (n = 23) and TNBC (n = 58) patient tumors. C, d Kaplan–Meier (KM) plots show poor distant metastasis-free survival (DMFS) of breast cancer patients by DLL1 expression status (DLL1high or DLL1low) in ER+ (c), ER− (d). E Representative IHC images of non-TNBC patient breast tumors show DLL1high and DLL1low protein expression respectively. H-score was evaluated to stratify patients into DLL1 high and low expressers based on the IHC with DLL1 antibody on the non-TNBC patient breast tumors. 40 μm (a, e) patients and optimal development of targeted therapeutic options

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