Abstract

Alternative survival pathways are commonly seen to be upregulated upon inhibition of receptor tyrosine kinases (RTK), including Her-2. It is established that treatment with Herceptin leads to selective overexpression and activation of epidermal growth factor receptor (EGFR) and Src which further contributes to oncogenesis in Herceptin resistant and triple negative breast cancer (TNBC) patients. Here, we show a co-regulated upregulation in the expression of Annexin A2 (AnxA2), a known substrate of Src and one of the regulators of EGFR receptor endocytosis, in Herceptin resistant and Her-2 negative breast cancer. Immunohistochemical expression analysis revealed a reciprocal regulation between Her-2 and AnxA2 in breast cancer clinical samples as well as in cell lines as confirmed by protein and RNA analysis. The siRNA and Herceptin mediated downregulation/inhibition of Her-2 in Her-2 amplified cells induced AnxA2 expression and membrane translocation. In this study we report a possible involvement of AnxA2 in maintaining constitutively activated EGFR downstream signaling intermediates and hence in cell proliferation, migration and viability. This effect was consistent in Herceptin resistant JIMT-1 cells as well as in Her-2 negative breast cancer. The siRNA mediated AnxA2 downregulation leads to increased apoptosis, decreased cell viability and migration. Our studies further indicate the role of AnxA2 in EGFR-Src membrane bound signaling complex and ligand induced activation of downstream signaling pathways. Targeting this AnxA2 dependent positive regulation of EGFR signaling cascade may be of therapeutic value in Her-2 negative breast cancer.

Highlights

  • Her-2 (ErbB-2), Estrogen Receptor (ER) and Progesterone Receptor (PR) are the most commonly used biomarkers and therapeutic targets in breast cancer patients

  • This study reports a significant finding about the potential of Annexin A2 (AnxA2) as a diagnostic and/or prognostic marker as well as a therapeutic target in Her-2 negative, Herceptin-resistant and triple negative breast cancer (TNBC) subset of breast cancer

  • The expression of AnxA2 in Her-2 negative and Herceptin-resistant subsets, as well as other molecular markers such as epidermal growth factor receptor (EGFR), could be used to define whether Herceptin can be used as a first line therapy for these patients

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Summary

Introduction

Her-2 (ErbB-2), Estrogen Receptor (ER) and Progesterone Receptor (PR) are the most commonly used biomarkers and therapeutic targets in breast cancer patients. These biomarkers are not expressed in 17–30% of women with breast cancer which limits the use of existing therapies [1]. Recent reports suggest that cells acquire resistance to the targeted therapies against receptor tyrosine kinases (RTKs) by several mechanisms [9,10]. We found that Annexin A2 (AnxA2), a calcium dependent phospholipid binding protein, is inversely correlated with Her-2 expression This observation holds true in case of Herceptin resistance, both in experimental and clinical situations

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