一种针对 HER2 的重组人蛋白克服了 HER2 阳性乳腺癌的耐药性。

A recombinant human protein targeting HER2 overcomes drug resistance in HER2-positive breast cancer.

机构信息

Department of Pharmacology and Therapeutics, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.

Department of Urology, Roswell Park Comprehensive Cancer Center, Buffalo, NY 14263, USA.

出版信息

Sci Transl Med. 2019 Jan 23;11(476). doi: 10.1126/scitranslmed.aav1620.

Abstract

Resistance to current human epidermal growth factor receptor 2 (HER2) inhibitors, such as trastuzumab (Ttzm), is a major unresolved clinical problem in HER2-positive breast cancer (HER2-BC). Because HER2 remains overexpressed in drug-resistant HER2-BC cells, we investigated whether PEPD can overcome the resistance. PEPD is a recombinant enzymatically inactive mutant of human peptidase D, which strongly inhibits HER2 in cancer cells by binding to its extracellular domain. Here, we show that PEPD is highly active in preclinical models of HER2-BC resistant to Ttzm and other HER2 inhibitors and also enhances the therapeutic efficacy of paclitaxel. The therapeutic activity is underscored by its ability to bind to HER2 and free it from protection by mucin 4, disrupt its interplay with other receptor tyrosine kinases, and subsequently direct HER2 for degradation. PEPD also down-regulates epidermal growth factor receptor, which contributes to drug resistance in HER2-BC. In contrast, Ttzm, whose therapeutic activity also depends on its binding to the extracellular domain of HER2, cannot perform any of these functions of PEPD PEPD inhibits HER2-BC cells and tumors that carry clinically relevant molecular changes that confer resistance to Ttzm. Our results show that HER2 remains a critical target in drug-resistant HER2-BC and that PEPD is a promising agent for overcoming drug resistance in this disease.

摘要

针对当前人类表皮生长因子受体 2(HER2)抑制剂(如曲妥珠单抗[Ttzm])的耐药性是 HER2 阳性乳腺癌(HER2-BC)中一个未解决的主要临床问题。由于耐药性的 HER2-BC 细胞中 HER2 仍然过表达,我们研究了 PEPD 是否可以克服这种耐药性。PEPD 是一种重组的、酶失活的人肽酶 D 突变体,通过与细胞外结构域结合,在癌细胞中强烈抑制 HER2。在这里,我们表明,PEPD 在对 Ttzm 和其他 HER2 抑制剂耐药的 HER2-BC 的临床前模型中具有高度活性,并且还增强了紫杉醇的治疗效果。其结合 HER2 并将其从粘蛋白 4 的保护中释放出来、破坏其与其他受体酪氨酸激酶的相互作用、随后将 HER2 定向降解的能力突出了其治疗活性。PEPD 还下调表皮生长因子受体,这有助于 HER2-BC 的耐药性。相比之下,Ttzm 的治疗活性也依赖于其与 HER2 细胞外结构域的结合,无法执行 PEPD 的任何这些功能。PEPD 抑制携带赋予 Ttzm 耐药性的临床相关分子变化的 HER2-BC 细胞和肿瘤。我们的结果表明,HER2 仍然是耐药性 HER2-BC 的关键靶标,PEPD 是克服这种疾病耐药性的有前途的药物。

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