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Lim B, Seth S, Yam C, Huo L, Fujii T, Lee J, Bassett R, Nasser S, Ravenberg L, White J, Clayborn A, Guerra G, Litton JK, Damodaran S, Layman R, Valero V, Tripathy D, Lewis M, Dobrolecki LE, Lei J, Candelaria R, Arun B, Rauch G, Zhao L, Zhang J, Ding Q, Symmans WF, Chang JT, Thompson AM, Moulder SL, Ueno NT. Phase 2 study of neoadjuvant enzalutamide and paclitaxel for luminal androgen receptor-enriched TNBC: Trial results and insights into "ARness". Cell Rep Med 2024; 5:101595. [PMID: 38838676 PMCID: PMC11228653 DOI: 10.1016/j.xcrm.2024.101595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/29/2023] [Accepted: 05/14/2024] [Indexed: 06/07/2024]
Abstract
Luminal androgen receptor (LAR)-enriched triple-negative breast cancer (TNBC) is a distinct subtype. The efficacy of AR inhibitors and the relevant biomarkers in neoadjuvant therapy (NAT) are yet to be determined. We tested the combination of the AR inhibitor enzalutamide (120 mg daily by mouth) and paclitaxel (80 mg/m2 weekly intravenously) (ZT) for 12 weeks as NAT for LAR-enriched TNBC. Eligibility criteria included a percentage of cells expressing nuclear AR by immunohistochemistry (iAR) of at least 10% and a reduction in sonographic volume of less than 70% after four cycles of doxorubicin and cyclophosphamide. Twenty-four patients were enrolled. Ten achieved a pathologic complete response or residual cancer burden-I. ZT was safe, with no unexpected side effects. An iAR of at least 70% had a positive predictive value of 0.92 and a negative predictive value of 0.97 in predicting LAR-enriched TNBC according to RNA-based assays. Our data support future trials of AR blockade in early-stage LAR-enriched TNBC.
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Affiliation(s)
- Bora Lim
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
| | - Sahil Seth
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Clinton Yam
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lei Huo
- Department of Breast Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Takeo Fujii
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; Cold Spring Harbor Laboratory-Northwell Health Cancer Institute, Riverhead, NY, USA
| | - Jangsoon Lee
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Roland Bassett
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Sara Nasser
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Lisa Ravenberg
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jason White
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Alyson Clayborn
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gil Guerra
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jennifer K Litton
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Senthil Damodaran
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rachel Layman
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vicente Valero
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Debasish Tripathy
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Lewis
- Lester Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA
| | - Lacey E Dobrolecki
- Lester Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA
| | - Jonathan Lei
- Lester Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA
| | - Rosalind Candelaria
- Department of Breast Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Banu Arun
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Gaiane Rauch
- Department of Breast Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Li Zhao
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jianhua Zhang
- Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Qingqing Ding
- Department of Breast Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - W Fraser Symmans
- Department of Breast Pathology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Alastair M Thompson
- Department of Surgical Oncology, Baylor College of Medicine, Houston, TX, USA; Lester Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA
| | - Stacy L Moulder
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naoto T Ueno
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA; University of Hawaii Cancer Center, Honolulu, HI, USA.
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Marhold M, Udovica S, Topakian T, Horak P, Horvat R, Tomasich E, Heller G, Krainer M. MALAT1 Fusions and Basal Cells Contribute to Primary Resistance against Androgen Receptor Inhibition in TRAMP Mice. Cancers (Basel) 2022; 14:cancers14030749. [PMID: 35159020 PMCID: PMC8833778 DOI: 10.3390/cancers14030749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/26/2022] [Accepted: 01/29/2022] [Indexed: 02/06/2023] Open
Abstract
Simple Summary We deeply characterized a frequently used mouse model of prostate cancer and found cellular and molecular regulators of resistance against antihormonal treatment, such as basal cell function and MALAT1 gene fusions. As these mechanisms also occur in human disease, our findings highlight the importance of this model for human cancer and may be helpful for future research focusing on overcoming antihormonal treatment resistance. Abstract Targeting testosterone signaling through androgen deprivation therapy (ADT) or antiandrogen treatment is the standard of care for advanced prostate cancer (PCa). Although the large majority of patients initially respond to ADT and/or androgen receptor (AR) blockade, most patients suffering from advanced PCa will experience disease progression. We sought to investigate drivers of primary resistance against antiandrogen treatment in the TRAMP mouse model, an SV-40 t-antigen driven model exhibiting aggressive variants of prostate cancer, castration resistance, and neuroendocrine differentiation upon antihormonal treatment. We isolated primary tumor cell suspensions from adult male TRAMP mice and subjected them to organoid culture. Basal and non-basal cell populations were characterized by RNA sequencing, Western blotting, and quantitative real-time PCR. Furthermore, effects of androgen withdrawal and enzalutamide treatment were studied. Basal and luminal TRAMP cells exhibited distinct molecular signatures and gave rise to organoids with distinct phenotypes. TRAMP cells exhibited primary resistance against antiandrogen treatment. This was more pronounced in basal cell-derived TRAMP organoids when compared to luminal cell-derived organoids. Furthermore, we found MALAT1 gene fusions to be drivers of antiandrogen resistance in TRAMP mice through regulation of AR. Summarizing, TRAMP tumor cells exhibited primary resistance towards androgen inhibition enhanced through basal cell function and MALAT1 gene fusions.
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Affiliation(s)
- Maximilian Marhold
- Division of Oncology, Department for Medicine I, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (E.T.); (G.H.); (M.K.)
- Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria
- Correspondence:
| | - Simon Udovica
- Clinic of Internal Medicine I and Wilhelminen Cancer Research Institute, Klinik Ottakring, A-1090 Vienna, Austria;
| | - Thais Topakian
- Division of Oncology, Department for Medicine I, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (E.T.); (G.H.); (M.K.)
- Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria
| | - Peter Horak
- National Tumor Center (NCT), DKFZ, 69120 Heidelberg, Germany;
| | - Reinhard Horvat
- Institute for Pathology, Medical University of Vienna, A-1090 Vienna, Austria;
| | - Erwin Tomasich
- Division of Oncology, Department for Medicine I, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (E.T.); (G.H.); (M.K.)
- Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria
| | - Gerwin Heller
- Division of Oncology, Department for Medicine I, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (E.T.); (G.H.); (M.K.)
- Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria
| | - Michael Krainer
- Division of Oncology, Department for Medicine I, Medical University of Vienna, A-1090 Vienna, Austria; (T.T.); (E.T.); (G.H.); (M.K.)
- Comprehensive Cancer Center Vienna, Medical University of Vienna, A-1090 Vienna, Austria
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