Lin You-Zhe, Lee Chuan-Chun, Cho Der-Yang, Wang Yuan-Liang, Chen Chia-Yun, Weng Ching-Yu, Chiu Shao-Chih, Hung Mien-Chie, Wang Shao-Chun
Graduate Institute of Biomedical Sciences, College of Medicine, China Medical University Taichung 40402, Taiwan.
Center for Molecular Medicine, China Medical University Hospital Taichung 404332, Taiwan.
Am J Cancer Res. 2021 Sep 15;11(9):4455-4469. eCollection 2021.
Anti-estrogens as hormone therapy are the mainstay treatment for estrogen receptor (ER)-positive breast cancer. ER inhibitors through modulating the transcriptional function of ER have been the frontline anti-estrogens to which refractory phenotype often developed in advanced cancer. The anti-estrogen fulvestrant is currently the only clinically approved pure anti-estrogen which causes ER degradation. However, resistance to fulvestrant still occurs and unfortunately it leaves few choices other than chemotherapy as the later-line treatments to fulvestrant-resistant tumors. Here we show that fulvestrant resistance was accompanied by increased expression of a number of innate immune response genes including the natural killer (NK) cell ligand B7-H6 on the cell surface. In an attempt to overcome the drug resistance phenotype, a NK-based molecular approach taking advantage of a chimeric antigen receptor (CAR) system targeting B7-H6 was established and tested in cells with acquired resistance to fulvestrant. The results demonstrate that the cell therapy approach as a single agent can effectively induce cell death of the resistant cancer cells which is enhanced by the increased expression of cell surface B7-H6. This approach departs from the traditional strategies of conquering anti-estrogen resistant breast cancer and offers a new avenue to eradicate hormone-refractory malignant solid tumors.
抗雌激素作为激素疗法是雌激素受体(ER)阳性乳腺癌的主要治疗方法。通过调节ER转录功能的ER抑制剂一直是一线抗雌激素药物,但晚期癌症往往会出现对其难治的表型。抗雌激素药物氟维司群是目前唯一临床上批准的可导致ER降解的纯抗雌激素药物。然而,对氟维司群的耐药性仍然会出现,不幸的是,除了化疗作为氟维司群耐药肿瘤的后续治疗方法外,几乎没有其他选择。在这里,我们表明氟维司群耐药伴随着许多先天免疫反应基因表达的增加,包括细胞表面的自然杀伤(NK)细胞配体B7-H6。为了克服耐药表型,我们建立了一种基于NK的分子方法,利用靶向B7-H6的嵌合抗原受体(CAR)系统,并在对氟维司群获得性耐药的细胞中进行了测试。结果表明,这种细胞治疗方法作为单一药物可以有效诱导耐药癌细胞的死亡,细胞表面B7-H6表达的增加会增强这种效果。这种方法不同于攻克抗雌激素耐药乳腺癌的传统策略,为根除激素难治性恶性实体瘤提供了一条新途径。
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