Chemotherapy-resistant Triple Negative Breast Research Articles

Abstract P6-03-17: Effect of histone deacetylase inhibitors on patient-derived neoadjuvant chemotherapy resistant triple negative breast cancer xenografts that represent understudied patients

Abstract Triple negative breast cancers (TNBCs) are a clinically and biologically aggressive breast cancer (BC) subtype; TNBC tumors have higher rates of metastasis, relapse and acquired/inherent drug resistance. Incidence and mortality rates of TNBC are stratified based on patient ethnicity - patients with African ancestry have higher mortality rates and diagnoses of invasive cancers compared to patients representing other ethnicities. Louisiana has a high proportion of African-American residents (32.7% in 2018), and New Orleans has among the highest incidences of TNBC in the country. Many of our patients present with TNBC tumors that are partially or completely resistant to neoadjuvant chemotherapies. There are currently no clinically approved targeted therapies for TNBC. Current therapeutic discovery focused TNBC research does not aptly address the knowledge gap regarding ethnic disparity in TNBC incidence/mortality rates and TNBC biology. To date, most TNBC-related research and knowledge has been acquired from Caucasian patients, although patients with African and Hispanic ancestries represent the majority of TNBC cases. Patient-derived xenografts (PDXs) are extensively used in BC research, as they mimic complex microanatomy, oncoarchitecture, and cell-cell/cell-stroma interactions of tumors. Here, we demonstrated the unique composition of PDX tumors is not dramatically affected by serial transplantation in mice, based on molecular phenotypes (examined using qRT-PCR and RNA sequencing) and the oncoarchitecture of the extracellular matrix (based on cryogenic scanning electron microscopy). Using these models in basic research facilitates translation of laboratory findings to the clinical setting, and dramatically enhanced drug discovery research. We have established over twelve TNBC PDX models, 90% of which represent patients of African ancestry, and most of which are resistant to neoadjuvant regimens. We focus on dissecting and evaluating kinase inhibitor/targeted drug response to various individual components (tumor cell biology, stroma, immune, extracellular matrix) of chemotherapy resistant TNBC tumors. Histone deacetylase inhibitors (DACi) are a promising therapeutic agent in TNBC systems; they have been shown to suppress tumorigenesis and metastasis in TNBC through suppression of the mesenchymal phenotype in cell line-based studies. In this study we utilized various TNBC PDX models (TU-BcX-2K1, -2O0, 4IC, -4M4, -4QAN, -4QX) to assess these findings in more translational systems. Interestingly, we showed that DACi effect on tumorigenesis and metastasis varied depending on specific TNBC PDXs utilized. These data implicate specific genes/signaling pathways exist in individual patient tumors that can predict tumor responsiveness to DACi. Preliminary data using the NCI oncology drug set implicated the MEK1/2 pathway contributed to sensitization of TNBC cells. Furthermore, we found a disconnect in gene expressions that were previously shown to be affected by DACi therapy (CDH1, VIM, ZEB1, ZEB2) in various derivations of PDX models (cells, PDX-Os, ex vivo, in vivo). These findings demonstrate that testing various derivations of PDX models is crucial to parsing out specific mechanisms of targeted therapies. Our methods presented here to assess targeted drug response and drug resistance using PDX models can be applied to any area of cancer research and is not limited to breast cancer. Citation Format: Margarite Matossian, Steven Elliott, Maryl Wright, Tiffany Chang, Madlin Alzoubi, Henri Wathieu, Rachel Sabol, Alex Alfortish, Hope Burks, Van Hoang, Deniz Ucar, Gabrielle Windsor, Thomas Yan, Jovanny Zabaleta, Fokhrul Hossain, Bruce Bunnell, Krzysztof Moroz, Arnold Zea, Adam Riker, Steven Jones, Elizabeth Martin, Lucio Miele, Bridgette Collins-Burow, Matthew Burow. Effect of histone deacetylase inhibitors on patient-derived neoadjuvant chemotherapy resistant triple negative breast cancer xenografts that represent understudied patients [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P6-03-17.

Abstract C016: Oxidative phosphorylation is a metabolic vulnerability in chemotherapy resistant triple negative breast cancer

Abstract There is a pressing need to identify improved therapies for triple negative breast cancers (TNBC) resistant to standard chemotherapy. To identify potential molecular targets, we performed RNA sequencing of pre-treatment biopsies from 43 patients with operable TNBC who received neoadjuvant anthracycline and taxane-based chemotherapy. Ingenuity pathway analysis demonstrated that the top canonical pathway associated with higher likelihood of recurrence was higher expression of oxidative phosphorylation (OXPHOS) signature. We therefore sought to determine the efficacy of IACS-10759, a potent inhibitor of OXPHOS, in 10 TNBC patient-derived xenografts (PDX), 8 generated from chemotherapy-resistant tumors. Partial response was observed in one PDX model and prolonged disease stabilization in 5 of 10 PDXs. PDXs with higher expression of protein coding mitochondrial genes were more sensitive to IACS-10759. AXL overexpression was associated with intrinsic and acquired IACS-10759 resistance. The combination of cabozantinib, a multi-kinase inhibitor targeting AXL, with IACS-10759 significantly improved responses in TNBC PDXs. In contrast, selective AXL inhibitor BGB324 or knockdown of AXL did not enhance IACS-10759 sensitivity. In addition, an in vivo synthetic lethality screen identified CDK4, PARP1 and PARP2 as potential combination targets for IACS-10759. Palbociclib as well as talazoparib enhanced growth inhibitory effect of OXPHOS inhibition in vitro and in vivo. Our data suggests that OXPHOS is a promising target in chemoresistant TNBC. IACS-10759 is currently in Phase 1 testing, including TNBC. Further work is needed to determine the optimal biomarker-driven combination partners. Citation Format: Kurt Evans, Stacy Moulder, Erkan Yuca, Stephen Scott, Natalia Paez Arango, Maryam Shariati, Christopher P Vellano, Turcin Saridogan, Xiaofeng Zheng, Ana Maria Gonzalez-Angulo, Ming Zhao, Xiaoping Su, Coya Tapia, Ken Chen, Argun Akcakanat, Charles M Perou, Bora Lim, Debu Tripathy, Timothy A Yap, Maria E Di Francesco, Giulio Draetta, Philip Jones, Joe Marszalek, Funda Meric-Bernstam. Oxidative phosphorylation is a metabolic vulnerability in chemotherapy resistant triple negative breast cancer [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference on Molecular Targets and Cancer Therapeutics; 2019 Oct 26-30; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2019;18(12 Suppl):Abstract nr C016. doi:10.1158/1535-7163.TARG-19-C016

Abstract 956: Systematic identification of the actionable kinase dependencies of chemotherapy-resistant triple-negative breast cancer

Abstract Triple-negative breast cancer (TNBC) accounts for approximately 15% of all breast cancer cases, with over 35,000 newly diagnosed women per year in the USA. TNBC patients are at high risk of recurrence, and neoadjuvant standard chemotherapy leads to pathologic complete response in only about 30% of patients. No targeted therapy has yet been conclusively established to improve outcome. The management of TNBC will significantly improve once mechanisms responsible for TNBC resistance to chemotherapies are identified. Here, we applied a new functional proteomic strategy to reveal which (dys)regulated phospho-signaling circuits are the effective dependencies of chemotherapy-resistant TNBC cells. The high-throughput kinase activity-mapping (HT-KAM) assay is our new screening technology to assess the catalytic activity of many kinases in parallel. HT-KAM relies on collections of biologic peptide probes that are computationally derived from PhosphoAtlas (Olow and Chen et al., Cancer Research 2016) and are physically used as combinatorial sensors to measure the activity of kinase enzymes in biologic extracts. The HT-KAM system provides access to a vast, untapped resource of meaningful measurements, whether readouts are interpreted irrespective of which enzymes phosphorylate which probes, or analyzed to convert global phospho-signatures into functional profiles of kinase activities. Kinome maps reveal how signaling networks are rewired by drug interventions in the context of different cellular backgrounds or exogenously mutated proteins/pathways, and provide insight into potentially targetable pathways. We previously successfully showed that the HT-KAM platform identifies new, actionable kinases responsible for intrinsic or acquired targeted-therapy resistance in BRAFV600E colorectal cancer cells and melanoma tumors from patients. To study TNBC, we used a 615-peptide sensor library that supports the mapping of >100 kinases and represents >900 functional kinase-substrate interactions relevant to tumor biology, and matches hundreds of druggable components of signaling circuits. We characterized the phospho-catalytic signatures of 10 TNBC cell lines, either untreated or treated with chemotherapeutic drugs (5-FU, carboplatin, doxorubicin) at IC50 concentrations. We also included a panel of 8 luminal BC cells. Based on our advanced preliminary data, we anticipate showing a comprehensive map of the oncogenic kinome of TNBC, and how it rewires its signaling network in response to chemotherapies. The most hyperactive and conserved pathways establish a priority map of strategic kinase hot spots to explore as therapeutic candidates. We find that chemotherapy-induced kinases such as SRC, AKT, CHEK, or regulating NFkB or PARP pathways can be inhibited to improve therapeutic sensitivity in TNBC. Citation Format: Jean-Philippe F. Coppe, Pan Bo, Carolien van der Borden, Nina Koemans, Changjun Wang, Denise Wolf, Christina Yau, Sietske Bakker, Marij Hartog, Miki Mori, Ana Ruiz-Saenz, Zhongzhong Chen, Aleksandra Olow, Pei Rong Evelyn Lee, Laura van 't Veer. Systematic identification of the actionable kinase dependencies of chemotherapy-resistant triple-negative breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 956.

Abstract 178: PIM1, a novel target in chemotherapy-resistant triple-negative breast cancer

Abstract Triple-Negative Breast Cancers (TNBCs) are aggressive, associated with poor prognosis and lack targeted therapies, mainly due to the absence of suitable molecular targets. The genomic region 6p21-p25 is recurrently amplified in TNBCs and encompasses the PIM1 oncogene. This study interrogated genomic breast cancer datasets and identified gene copy number-driven increase of PIM1 expression in TNBC. To understand the role of PIM1 in malignant phenotypes of TNBCs, functional studies were carried out in breast cancer and non-malignant mammary epithelial cell line models. RNA interference and rescue-of-function experiments revealed addiction to PIM1 kinase for cell population growth and apoptosis protection in TNBC cells, absent in non-malignant cells. In cells sensitive to PIM1 knockdown, we observed a subsequent reduction of the expression of the anti-apoptotic proteins BCL2 and MCL1. Moreover, exogenous expression of BCL2 prevented apoptosis caused by PIM1 knockdown. BH3-profiling analysis further confirmed that PIM1 blocks apoptosis elicited through the mitochondrial pathway in TNBC cell lines. The activity of PIM1 in other cancers has been closely linked to the regulation of c-MYC, an “un-targetable” oncogene that drives malignancy and that is frequently amplified and highly expressed in primary TNBCs and post-chemotherapy residual disease. Importantly, we found that PIM1 expression associates with several MYC-transcriptional signatures in TNBCs and mediates phosphorylation of c-MYC Ser62 and Histone-H3 Ser10, key targets for MYC-driven transcription. Exogenous expression of MYC rescued the phenotypes caused by PIM1 knockdown, providing mechanistic insights for the observed addiction. Finally, the therapeutic potential of targeting PIM1 was assessed using AZD1208, a small molecule inhibitor of the PIM kinase family. AZD1208 inhibited growth and sensitized TNBC derived cell lines, cell line xenografts and PDXs to chemotherapy by increasing apoptosis. We therefore identify PIM1 as a driver of malignancy in TNBC, illustrating relationships with MYC-activation and regulation of anti-apoptotic BCL2 and MCL1 proteins. PIM1 inhibitors could provide a potential therapeutic to abrogate chemotherapy resistance in TNBCs. Citation Format: Fara Braso-Maristany, Simone Filosto, Steven Catchpole, Rebecca Marlow, Jelmar Quist, Erika Francesch Domenech, Gianmaria Liccardi, Leila Zakka, Violeta Serra, Albert Gris, Maggie Cheang, Nirmesh Patel, Anna Perdrix Rosell, Patrycja Gazinska, Elodie Noel, Jonathan Watkins, Pierfrancesco Marra, Anita Grigoriadis, Andrew Tutt. PIM1, a novel target in chemotherapy-resistant triple-negative breast cancer. [abstract]. In: Proceedings of the 107th Annual Meeting of the American Association for Cancer Research; 2016 Apr 16-20; New Orleans, LA. Philadelphia (PA): AACR; Cancer Res 2016;76(14 Suppl):Abstract nr 178.