Abstract

There is a vital need for improved therapeutic strategies that are effective in both primary and metastatic triple-negative breast cancer (TNBC). Current treatment options for TNBC patients are restricted to chemotherapy; however tyrosine kinases are promising druggable targets due to their high expression in multiple TNBC subtypes. Since coexpression of receptor tyrosine kinases (RTKs) can promote signaling crosstalk and cell survival in the presence of kinase inhibitors, it is likely that multiple RTKs will need to be inhibited to enhance therapeutic benefit and prevent resistance. The MET and EGFR receptors are actionable targets due to their high expression in TNBC; however crosstalk between MET and EGFR has been implicated in therapeutic resistance to single agent use of MET or EGFR inhibitors in several cancer types. Therefore it is likely that dual inhibition of MET and EGFR is required to prevent crosstalk signaling and acquired resistance. In this study, we evaluated the heterogeneity of MET and EGFR expression and activation in primary and metastatic TNBC tumorgrafts and determined the efficacy of MET (MGCD265 or crizotinib) and/or EGFR (erlotinib) inhibition against TNBC progression. Here we demonstrate that combined MET and EGFR inhibition with either MGCD265 and erlotinib treatment or crizotinib and erlotinib treatment were highly effective at abrogating tumor growth and significantly decreased the variability in treatment response compared to monotherapy. These results advance our understanding of the RTK signaling architecture in TNBC and demonstrate that combined MET and EGFR inhibition may be a promising therapeutic strategy for TNBC patients.

Highlights

  • Triple-negative breast cancer (TNBC) accounts for 15–20% of breast cancers and is associated with advanced stage at diagnosis and poorer outcome compared to other breast cancer subtypes [1]

  • We and others have independently demonstrated that MET and EGFR are highly expressed in triple-negative breast cancer (TNBC) and correlate with poor patient prognosis [8,9,10] [17, 31, 32]

  • The results revealed that MET and EGFR are expressed in each of the TNBC subtypes consisting of the basal-like immune-activated (BLIA), basal-like immunosuppressed (BLIS), luminal androgen receptor (LAR), and mesenchymal (MES) (Figure 1G)

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Summary

Introduction

Triple-negative breast cancer (TNBC) accounts for 15–20% of breast cancers and is associated with advanced stage at diagnosis and poorer outcome compared to other breast cancer subtypes [1]. TNBC has significant overlap with the basal-like subtype with approximately 80% of TNBCs being classified as basal-like [1]. Comprehensive gene expression analyses have revealed that TNBC is a highly heterogeneous disease that is composed of 4–6 molecular subtypes [3, 4]. This molecular heterogeneity increases the difficulty of developing targeted therapeutics that will be effective in the majority of TNBC patients

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