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在PTEN缺陷型雌激素受体阳性乳腺癌中,持续的治疗效果需要同时抑制磷脂酰肌醇3激酶的p110α和p110β亚型。

Combined Inhibition of Both p110α and p110β Isoforms of Phosphatidylinositol 3-Kinase Is Required for Sustained Therapeutic Effect in PTEN-Deficient, ER Breast Cancer.

作者信息

Hosford Sarah R, Dillon Lloye M, Bouley Stephanie J, Rosati Rachele, Yang Wei, Chen Vivian S, Demidenko Eugene, Morra Rocco P, Miller Todd W

机构信息

Depts. of Molecular & Systems Biology, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH.

Depts. of Community & Family Medicine, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH.

出版信息

Clin Cancer Res. 2017 Jun 1;23(11):2795-2805. doi: 10.1158/1078-0432.CCR-15-2764. Epub 2016 Nov 30.

Abstract

Determine the roles of the PI3K isoforms p110α and p110β in PTEN-deficient, estrogen receptor α (ER)-positive breast cancer, and the therapeutic potential of isoform-selective inhibitors. Anti-estrogen-sensitive and -resistant PTEN-deficient, ER human breast cancer cell lines, and mice bearing anti-estrogen-resistant xenografts were treated with the anti-estrogen fulvestrant, the p110α inhibitor BYL719, the p110β inhibitor GSK2636771, or combinations. Temporal response to growth factor receptor-initiated signaling, growth, apoptosis, predictive biomarkers, and tumor volumes were measured. p110β primed cells for response to growth factor stimulation. Although p110β inhibition suppressed cell and tumor growth, dual targeting of p110α/β enhanced apoptosis and provided sustained tumor response. The growth of anti-estrogen-sensitive cells was inhibited by fulvestrant, but fulvestrant inconsistently provided additional therapeutic effects beyond PI3K inhibition alone. Treatment-induced decreases in phosphorylation of AKT and Rb were predictive of therapeutic response. Short-term drug treatment induced tumor cell apoptosis and proliferative arrest to induce tumor regression, whereas long-term treatment only suppressed proliferation to provide durable regression. p110β is the dominant PI3K isoform in PTEN-deficient, ER breast cancer cells. Upon p110β inhibition, p110α did not induce significant reactivation of AKT, but combined targeting of p110α/β most effectively induced apoptosis and and provided durable tumor regression. Because apoptosis and tumor regression occurred early but not late in the treatment course, and proliferative arrest was maintained throughout treatment, p110α/β inhibitors may be considered short-term cytotoxic agents and long-term cytostatic agents. .

摘要

确定PI3K亚型p110α和p110β在PTEN缺陷型、雌激素受体α(ER)阳性乳腺癌中的作用,以及亚型选择性抑制剂的治疗潜力。用抗雌激素氟维司群、p110α抑制剂BYL719、p110β抑制剂GSK2636771或联合用药处理抗雌激素敏感和耐药的PTEN缺陷型ER人乳腺癌细胞系,以及携带抗雌激素耐药异种移植物的小鼠。检测对生长因子受体启动信号的时间反应、生长、凋亡、预测性生物标志物和肿瘤体积。p110β使细胞对生长因子刺激产生反应。虽然抑制p110β可抑制细胞和肿瘤生长,但双重靶向p110α/β可增强凋亡并提供持续的肿瘤反应。氟维司群可抑制抗雌激素敏感细胞的生长,但氟维司群单独提供的额外治疗效果并不一致,超出PI3K抑制作用。治疗诱导的AKT和Rb磷酸化降低可预测治疗反应。短期药物治疗诱导肿瘤细胞凋亡和增殖停滞以诱导肿瘤消退,而长期治疗仅抑制增殖以提供持久消退。p110β是PTEN缺陷型ER乳腺癌细胞中的主要PI3K亚型。抑制p110β后,p110α不会显著诱导AKT重新激活,但联合靶向p110α/β最有效地诱导凋亡并提供持久的肿瘤消退。由于凋亡和肿瘤消退在治疗过程早期而非晚期发生,且增殖停滞在整个治疗过程中维持,p110α/β抑制剂可被视为短期细胞毒性药物和长期细胞生长抑制剂。

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