Abstract

Biphasic malignant pleural mesothelioma (MPM) is the second most common histotype of MPM. It is histologically characterized by the concomitant presence of epithelioid and sarcomatoid features, the latter associated with worse prognosis. In this report we describe that silencing of AKT1 in spindle-shaped biphasic MPM cells promotes the shift toward an epithelioid phenotype. Furthermore, AKT1 silencing resulted in decreased expression of the lactate/H+ symporter MCT4 and its chaperone CD147/Basigin, and in the induction of estrogen receptor β (ERβ) expression. We provide evidence that ERβ expression is induced by increased intracellular lactate concentration. Spheroid culturing and tumor growth of ERβ negative biphasic MPM in nude mice resulted in the induction of ERβ expression and response to the selective agonist KB9520. In both models, the treatment with the ERβ agonist results in reduced cell proliferation, decreased expression of MCT4 and CD147/Basigin and increased acetylation and inactivation of AKT1. Collectively, in response to metabolic changes, ERβ expression is induced and exerts an anti-tumor effect through selective agonist activation. The possibility to reverse the more aggressive biphasic mesothelioma histotype by targeting ERβ with a selective agonist could represent a new effective treatment strategy.

Highlights

  • Malignant pleural mesothelioma (MPM) is a highly aggressive cancer associated with asbestos exposure [1,2,3]

  • We recently described that activation of estrogen receptor β (ERβ) with the selective agonist KB9520 increased the sensitivity of malignant pleural mesothelioma (MPM) tumors to the cisplatin/pemetrexed combination, providing evidence that drugs that selectively activate ERβ might prove promising in the development of novel, targeted therapies for the clinical management of human MPM [32]

  • We recently published that MPM derived cell lines express AKT1 and AKT3 but not AKT2 [17]

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Summary

Introduction

Malignant pleural mesothelioma (MPM) is a highly aggressive cancer associated with asbestos exposure [1,2,3]. MPM is divided into three histological categories including epithelioid, biphasic and sarcomatoid. Biphasic tumors are a mix of cube-like epithelial cells and spindle-shaped sarcomatoid cells [7]. These two cell types typically reside in separate areas of the tumor, but they can develop close together. How well a biphasic tumor responds to treatment depends on the ratio of epithelial to sarcomatoid cells. A tumor composed mostly of epithelioid cells grows more slowly and responds better to treatment [8, 9]

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