Monter Cancer Center, Don Monti Division of Oncology, Division of Hematology, Hofstra North Shore Long Island Jewish School of Medicine, United States.
Crit Rev Oncol Hematol. 2013 Nov;88(2):284-92. doi: 10.1016/j.critrevonc.2013.05.003. Epub 2013 Jun 5.
There is no available targeted therapy for triple-negative or its more aggressive subtype, basal-like breast cancer. Multiple therapeutic strategies based on translational knowledge have not improved the treatment options for triple negative patients. As understanding of molecular pathways that drive tumor development is rapidly increasing, it is imperative to adapt our treatment strategies to perturbations in molecular pathways driving the malignant process. Basal-like breast cancers over-express EGFR (without mutations or EGFR gene amplifications) and have p53 mutations. While EGFR drives the malignant behavior in triple negative breast cancer (TNBC), anti-EGFR therapies have fallen short of the expected results in clinical trials. Here we bring evidence that the less than optimal results of the anti-EGFR therapies may be explained in part by the increased potency of the EGFR signaling due to increased endosomal recycling. The functional connection between EGFR and endosomal trafficking in TNBC is mutant p53 found in the most aggressive forms of TNBC. Mutant p53 acquires oncogenic functions and binds p63 protein, a member of p53 family with tumor suppressor activities. In the absence of functional p63 there is an upregulation of endosomal recycling EGFR and integrin to the membrane with increased proinvasive abilities of cancer cells. Blocking endosomal trafficking combined with anti-EGFR treatments may result in better clinical outcomes in TNBC.
目前针对三阴性或更具侵袭性的基底样乳腺癌,尚无有效的靶向治疗方法。基于转化知识的多种治疗策略并未改善三阴性患者的治疗选择。随着对驱动肿瘤发展的分子途径的理解迅速增加,我们必须调整我们的治疗策略以适应驱动恶性过程的分子途径的变化。基底样乳腺癌过度表达 EGFR(没有突变或 EGFR 基因扩增),并且有 p53 突变。虽然 EGFR 驱动三阴性乳腺癌(TNBC)的恶性行为,但抗 EGFR 治疗在临床试验中的结果并未达到预期。在这里,我们提供的证据表明,抗 EGFR 治疗效果不理想的部分原因可能是由于内体循环增加导致 EGFR 信号的增强。在 TNBC 中,EGFR 与内体运输之间的功能联系是在最具侵袭性的 TNBC 中发现的突变型 p53。突变型 p53获得致癌功能并与 p63 蛋白结合,p63 蛋白是具有肿瘤抑制活性的 p53 家族的成员。在缺乏功能性 p63 的情况下,内体循环中 EGFR 和整合素的上调会增加癌细胞的侵袭能力。阻断内体运输并结合抗 EGFR 治疗可能会改善 TNBC 的临床结局。