a Department of Medical Oncology , the First Affiliated Hospital of medical school of Xi'an Jiaotong University , Xi'an , China.
b Department of Medical Oncology , the First Affiliated Hospital of Henan University , Kaifeng , China.
Cancer Biol Ther. 2019;20(5):617-632. doi: 10.1080/15384047.2018.1539290. Epub 2018 Nov 21.
Triple-negative breast cancer (TNBC) has a poor prognosis mainly due to insensitivity or resistance to standard anthracycline- and taxane-based chemotherapy, urgently calling for new adjuvants to reverse drug resistance. Dual-target murine double minute 2 (MDM2) and murine double minute X (MDMX) inhibitor has been proved to play a critical part against cancer, particularly focusing on the tremendous potential to enhance the efficacy of doxorubicin (DOX), however little was reported in TNBC. In the present study, we investigated the synergistic antitumor effect of the MDM2/MDMX inhibitor with DOX using three TNBC cell lines, two in situ transplantation tumor models and 214 clinical samples. We observed that the MDM2/MDMX inhibitor combined with DOX could not only inhibit cell vitality and migration and invasion abilities, but also highly inhibit tumor growth in TNBC nude mice. Besides, co-treatment of MDM2/MDMX inhibitor and DOX suppressed epithelial to mesenchymal transition (EMT) through increasing the TAK1-binding protein 1 (TAB1), transforming growth factor β-activated kinase 1 (TAK1) and p38 mitogen-activated protein kinase (MAPK) expression. Small interfering RNA-mediated TAB1 knockdown induced the EMT, desensitized cells to DOX and enhanced the migration and invasion abilities. High MDM2/MDMX expression was positively associated with weak TAB1 expression in 214 TNBC tumor tissues confirmed by immumohistochemical staining and MDM2/MDMX/TAB1 expression was significantly related to TNBC patient survival. These findings indicate that dual-target MDM2/MDMX inhibitor could increase the sensitization of doxorubicin and inhibit migration and invasion abilities in TNBC cells through p38 MAPK pathway activation caused EMT suppression and hence could be useful in TNBC treatments in future.
三阴性乳腺癌(TNBC)的预后较差,主要是由于对标准蒽环类和紫杉烷类化疗药物不敏感或耐药,迫切需要新的辅助药物来逆转耐药性。双重靶向鼠双微体 2(MDM2)和鼠双微体 X(MDMX)抑制剂已被证明在抗癌方面发挥着重要作用,特别是在增强阿霉素(DOX)疗效方面具有巨大潜力,但在 TNBC 中报道较少。在本研究中,我们使用三种 TNBC 细胞系、两个原位移植肿瘤模型和 214 个临床样本研究了 MDM2/MDMX 抑制剂与 DOX 联合使用的协同抗肿瘤作用。我们观察到 MDM2/MDMX 抑制剂与 DOX 联合使用不仅可以抑制细胞活力和迁移侵袭能力,而且可以高度抑制 TNBC 裸鼠肿瘤生长。此外,MDM2/MDMX 抑制剂和 DOX 的联合治疗通过增加 TAK1 结合蛋白 1(TAB1)、转化生长因子β激活激酶 1(TAK1)和 p38 丝裂原活化蛋白激酶(p38 MAPK)的表达,抑制上皮间质转化(EMT)。TAB1 的小干扰 RNA 介导的敲低诱导 EMT,使细胞对 DOX 不敏感,并增强迁移和侵袭能力。免疫组化染色和 MDM2/MDMX/TAB1 表达证实,214 例 TNBC 肿瘤组织中高 MDM2/MDMX 表达与 TAB1 表达较弱呈正相关,且 MDM2/MDMX/TAB1 表达与 TNBC 患者生存显著相关。这些发现表明,双重靶向 MDM2/MDMX 抑制剂可通过抑制 EMT 来增加 DOX 的敏感性,并抑制 TNBC 细胞的迁移和侵袭能力,从而激活 p38 MAPK 通路,因此在未来可能对 TNBC 治疗有用。
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