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Li L, Lin L, Veeraraghavan J, Hu Y, Wang X, Lee S, Tan Y, Schiff R, Wang XS. Therapeutic role of recurrent ESR1-CCDC170 gene fusions in breast cancer endocrine resistance. Breast Cancer Res 2020; 22:84. [PMID: 32771039 PMCID: PMC7414578 DOI: 10.1186/s13058-020-01325-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 07/27/2020] [Indexed: 01/07/2023] Open
Abstract
Background Endocrine therapy is the most common treatment for estrogen receptor (ER)-positive breast cancer, but its effectiveness is limited by high rates of primary and acquired resistance. There are likely many genetic causes, and recent studies suggest the important role of ESR1 mutations and fusions in endocrine resistance. Previously, we reported a recurrent ESR1 fusion called ESR1-CCDC170 in 6–8% of the luminal B breast cancers that has a worse clinical outcome after endocrine therapy. Despite being the most frequent ESR1 fusion, its functional role in endocrine resistance has not been studied in vivo, and the engaged mechanism and therapeutic relevance remain uncharacterized. Methods The endocrine sensitivities of HCC1428 or T47D breast cancer cells following genetic perturbations of ESR1-CCDC170 were assessed using clonogenic assays and/or xenograft mouse models. The underlying mechanisms were investigated by reverse phase protein array, western blotting, immunoprecipitation, and bimolecular fluorescence complementation assays. The sensitivity of ESR1-CCDC170 expressing breast cancer cells to concomitant treatments of tamoxifen and HER/SRC inhibitors was assessed by clonogenic assays. Results Our results suggested that different ESR1-CCDC170 fusions endow different levels of reduced endocrine sensitivity in vivo, resulting in significant survival disadvantages. Further investigation revealed a novel mechanism that ESR1-CCDC170 binds to HER2/HER3/SRC and activates SRC/PI3K/AKT signaling. Silencing of ESR1-CCDC170 in the fusion-positive cell line, HCC1428, downregulates HER2/HER3, represses pSRC/pAKT, and improves endocrine sensitivity. More important, breast cancer cells expressing ectopic or endogenous ESR1-CCDC170 are highly sensitive to treatment regimens combining endocrine agents with the HER2 inhibitor lapatinib and/or the SRC inhibitor dasatinib. Conclusion ESR1-CCDC170 may endow breast cancer cell survival under endocrine therapy via maintaining/activating HER2/HER3/SRC/AKT signaling which implies a potential therapeutic strategy for managing these fusion positive tumors.
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Affiliation(s)
- Li Li
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Pathology, University of Pittsburgh, Pittsburgh, PA, 15261, USA.,Women's Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.,Department of Cell Biology, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, 100191, China
| | - Ling Lin
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Pathology, University of Pittsburgh, Pittsburgh, PA, 15261, USA.,Women's Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA
| | - Jamunarani Veeraraghavan
- Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA.,Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Yiheng Hu
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Pathology, University of Pittsburgh, Pittsburgh, PA, 15261, USA.,Women's Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.,Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Xian Wang
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Pathology, University of Pittsburgh, Pittsburgh, PA, 15261, USA.,Women's Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA.,Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Sanghoon Lee
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA.,Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, 15206, USA
| | - Ying Tan
- Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Rachel Schiff
- Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA.,Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA.,Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX, 77030, USA
| | - Xiao-Song Wang
- Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, 15232, USA. .,Department of Pathology, University of Pittsburgh, Pittsburgh, PA, 15261, USA. .,Women's Cancer Research Center, Magee-Womens Research Institute, Pittsburgh, PA, 15213, USA. .,Lester & Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, 77030, USA. .,Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, TX, 77030, USA. .,Department of Medicine, Baylor College of Medicine, Houston, TX, 77030, USA. .,Molecular & Cellular Biology, Baylor College of Medicine, Houston, TX, 77030, USA. .,Department of Biomedical Informatics, University of Pittsburgh, Pittsburgh, PA, 15206, USA.
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Rimm DL, Han G, Taube JM, Yi ES, Bridge JA, Flieder DB, Homer R, Roden AC, Hirsch FR, Wistuba II, Pusztai L. Reanalysis of the NCCN PD-L1 companion diagnostic assay study for lung cancer in the context of PD-L1 expression findings in triple-negative breast cancer. Breast Cancer Res 2019; 21:72. [PMID: 31196152 PMCID: PMC6567382 DOI: 10.1186/s13058-019-1156-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The companion diagnostic test for checkpoint inhibitor immune therapy is an immunohistochemical test for PD-L1. The test has been shown to be reproducible for expression in tumor cells, but not in immune cells. Immune cells were used in the IMpassion130 trial which showed PD-L1 expression was associated with a better outcome. Two large studies have been done assessing immune cell PD-L1 expression in lung cancer. Here, we reanalyze one of those studies, to show that, even with an easier scoring method, there is still only poor agreement between assays and pathologist for immune cell PD-L1 expression.
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Affiliation(s)
- David L Rimm
- Yale University, School of Medicine, New Haven, CT, USA. .,Department of Pathology, Yale Pathology Tissue Services, Yale University School of Medicine, 310 Cedar St. BML 116, PO Box 208023, New Haven, CT, 06520-8023, USA.
| | - Gang Han
- Texas A&M, College Station, TX, USA
| | - Janis M Taube
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | | | | | - Robert Homer
- Yale University, School of Medicine, New Haven, CT, USA.,VA Connecticut HealthCare System, West Haven, CT, USA
| | | | - Fred R Hirsch
- University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | | | - Lajos Pusztai
- Yale University, School of Medicine, New Haven, CT, USA
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