Abstract

IntroductionResistance to anti-epidermal growth factor receptor (anti-EGFR) therapies is an emerging clinical problem. The efficacy of anti-EGFR therapies can be influenced by the presence of heregulins (HRGs), which can bind erbB3/4 receptors and can activate alternative signalling pathways. In the present study we have examined whether HRG signalling can circumvent EGFR blockade in an EGFR-positive tamoxifen-resistant MCF-7 (Tam-R) breast cancer cell line.MethodsTam-R cells, incubated with the selective EGFR tyrosine kinase inhibitor gefitinib ('Iressa', ZD1839), were exposed to HRGĪ²1 and the effects on erbB receptor dimerization profiles and on activation of associated downstream signalling components were assessed by immunoprecipitation, western blotting and immunocytochemistry. The effects of HRGĪ²1 on gefitinib-treated Tam-R cell growth and invasion were also examined, and HRGĪ²1 expression levels were assessed in breast cancer tissue by immunohistochemistry to address the potential clinical relevance of such a resistance mechanism.ResultsIn Tam-R cells, HRGĪ²1 promoted erbB3/erbB2 and erbB3/EGFR heterodimerization, promoted ERK1/2 and AKT pathway activation and increased cell proliferation and invasion. Gefitinib prevented HRGĪ²1-driven erbB3/EGFR heterodimerization, ERK1/2 activation and Tam-R cell proliferation, but HRGĪ²1-driven erbB3/erbB2 heterodimerization, AKT activation and Tam-R cell invasion were maintained. A combination of gefitinib and the phosphatidylinositol 3-kinase inhibitor LY294002 effectively blocked HRGĪ²1-mediated intracellular signalling activity, growth and invasion in Tam-R cells. Similarly, targeting erbB2 with trastuzumab in combination with gefitinib in Tam-R cells reduced HRGĪ²1-induced erbB2 and ERK1/2 activity; however, HRGĪ²1-driven AKT activity and cell growth were maintained while cell invasion was significantly enhanced with this combination. In clinical tissue all samples demonstrated cytoplasmic tumour epithelial HRGĪ²1 protein staining, with expression correlating with EGFR positivity and activation of both AKT and ERK1/2.ConclusionHRGĪ²1 can overcome the inhibitory effects of gefitinib on cell growth and invasion in Tam-R cells through promotion of erbB3/erbB2 heterodimerization and activation of the phosphatidylinositol 3-kinase/AKT signalling pathway. This may have implications for the effectiveness of anti-EGFR therapies in breast cancer as HRGĪ²1 is enriched in many EGFR-positive breast tumours.

Highlights

  • IntroductionResistance to anti-epidermal growth factor receptor (anti-EGFR) therapies is an emerging clinical problem

  • Resistance to anti-epidermal growth factor receptor therapies is an emerging clinical problem

  • HRGĪ²1 can overcome the inhibitory effects of gefitinib on cell growth and invasion in tamoxifen-resistant MCF-7 (Tam-R) cells through promotion of erbB3/erbB2 heterodimerization and activation of the phosphatidylinositol 3-kinase/AKT signalling pathway

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Summary

Introduction

Resistance to anti-epidermal growth factor receptor (anti-EGFR) therapies is an emerging clinical problem. Receptor dimerization stimulates the intrinsic receptor tyrosine kinase activity and promotes autophosphorylation of tyrosine residues within the cytoplasmic domain of the receptor These phosphotyrosine residues provide docking sites for a variety of adaptor proteins and enzymes involved in the recruitment and activation of downstream intracellular signalling cascades, including the mitogen-activated protein kinase (MAPK) and phosphatidylinositol-3 kinase (PI3K) pathways [2]. These signalling cascades can promote proliferation, angiogenesis and invasion, and can inhibit apoptosis, key mechanisms underlying tumour growth and progression [5]. This oncogenic potential in conjunction with the aberrant expression and/or activation of EGFR, which has been reported in a range of human malignancies including breast cancer, provides a strong rationale for targeting this growth factor receptor [6,7]

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