Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, Texas.
Department of Molecular and Cellular Biology, Baylor College of Medicine, Houston, Texas.
Cancer Prev Res (Phila). 2023 Feb 6;16(2):65-73. doi: 10.1158/1940-6207.CAPR-22-0275.
Antiestrogen medication is the only chemoprevention currently available for women at a high risk of developing breast cancer; however, antiestrogen therapy requires years to achieve efficacy and has adverse side effects. Therefore, it is important to develop an efficacious chemoprevention strategy that requires only a short course of treatment. PIK3CA is commonly activated in breast atypical hyperplasia, the known precancerous precursor of breast cancer. Targeting PI3K signaling in these precancerous lesions may offer a new strategy for chemoprevention. Here, we first established a mouse model that mimics the progression from precancerous lesions to breast cancer. Next, we demonstrated that a short-course prophylactic treatment with the clinically approved PI3K inhibitor alpelisib slowed early lesion expansion and prevented cancer formation in this model. Furthermore, we showed that alpelisib suppressed ex vivo expansion of patient-derived atypical hyperplasia. Together, these data indicate that the progression of precancerous breast lesions heavily depends on the PI3K signaling, and that prophylactic targeting of PI3K activity can prevent breast cancer.
PI3K protein is abnormally high in breast precancerous lesions. This preclinical study demonstrates that the FDA-approved anti-PI3K inhibitor alpelisib can prevent breast cancer and thus warrant future clinical trials in high-risk women.
抗雌激素药物是目前唯一可用于高乳腺癌风险女性的化学预防药物;然而,抗雌激素治疗需要数年才能产生疗效,并具有不良反应。因此,开发一种有效的化学预防策略非常重要,这种策略只需要短期的治疗。PIK3CA 在乳腺非典型性增生中普遍被激活,乳腺非典型性增生是乳腺癌已知的癌前前兆。针对这些癌前病变中的 PI3K 信号可能提供一种新的化学预防策略。在这里,我们首先建立了一个模拟癌前病变向乳腺癌进展的小鼠模型。接下来,我们证明了用临床批准的 PI3K 抑制剂 alpelisib 进行短期预防性治疗可减缓早期病变的扩张,并防止该模型中的癌症形成。此外,我们还表明 alpelisib 抑制了患者来源的非典型性增生的体外扩张。这些数据表明,癌前乳腺病变的进展严重依赖于 PI3K 信号,预防性靶向 PI3K 活性可以预防乳腺癌。
PI3K 蛋白在乳腺癌前病变中异常升高。这项临床前研究表明,FDA 批准的抗 PI3K 抑制剂 alpelisib 可以预防乳腺癌,因此值得在高风险女性中进行未来的临床试验。