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联合抑制 CDK4/6 和 AKT 对三阴性乳腺癌的腔面雄激素受体(LAR)亚型非常有效。

Combined inhibition of CDK4/6 and AKT is highly effective against the luminal androgen receptor (LAR) subtype of triple negative breast cancer.

机构信息

UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX, 75390, USA.

UT Southwestern Simmons Comprehensive Cancer Center, Dallas, TX, 75390, USA; Yonsei University College of Medicine, Seoul, South Korea.

出版信息

Cancer Lett. 2024 Nov 1;604:217219. doi: 10.1016/j.canlet.2024.217219. Epub 2024 Sep 6.


DOI:10.1016/j.canlet.2024.217219
PMID:39244005
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11837982/
Abstract

Luminal Androgen Receptor (LAR) triple-negative breast cancers (TNBC) express androgen receptors (AR), exhibit high frequency of PIK3CA mutations and intact RB. Herein, we investigated combined blockade of the CDK4/6 and PI3K signaling with palbociclib, alpelisib, and capivasertib, which inhibit CDK4/6, PI3Kα, and AKT1-3, respectively. The combination of palbociclib/capivasertib, but not palbociclib/alpelisib, synergistically inhibited proliferation of MDA-MB-453 and MFM-223 LAR cells [synergy score 7.34 (p = 5.81x10) and 4.78 (p = 0.012), respectively]. The AR antagonist enzalutamide was inactive against MDA-MB-453, MFM-223, and CAL148 cells and did not enhance the efficacy of either combination. Palbociclib/capivasertib inhibited growth of LAR patient-derived xenografts more potently than palbociclib/alpelisib. Treatment of LAR cells with palbociclib suppressed phosphorylated-RB and resulted in adaptive phosphorylation/activation of S473 pAKT and AKT substrates GSK3β, PRAS40, and FoxO3a. Capivasertib blocked palbociclib-induced phosphorylation of AKT substrates more potently than alpelisib. Treatment with PI3Kβ inhibitors did not block phosphorylation of AKT substrates, suggesting that PI3Kβ did not mediate the adaptive response to CDK4/6 inhibition. Phosphokinase arrays of MDA-MB-453 cells treated with palbociclib showed time-dependent upregulation of PDGFRβ, GSK3β, STAT3, and STAT6. RNA silencing of PDGFRβ in palbociclib-treated MDA-MB-453 and MFM-223 cells blocked the upregulation of S473 pAKT, suggesting that the adaptive response to CDK4/6 blockade involves PDGFRβ signaling. Finally, treatment with palbociclib and the PDGFR inhibitor CP637451 arrested growth of MDA-MB-453 and MFM-223 cells to the same degree as palbociclib/capivasertib. These findings support testing the combination of CDK4/6 and AKT inhibitors in patients with LAR TNBC, and further investigation of PDGFR antagonists in this breast cancer subtype.

摘要

腔面雄激素受体 (LAR) 三阴性乳腺癌 (TNBC) 表达雄激素受体 (AR),表现出高频 PIK3CA 突变和完整的 RB。在此,我们研究了用 palbociclib、alpelisib 和 capivasertib 联合阻断 CDK4/6 和 PI3K 信号通路,分别抑制 CDK4/6、PI3Kα 和 AKT1-3。palbociclib/capivasertib 的组合,但不是 palbociclib/alpelisib,协同抑制 MDA-MB-453 和 MFM-223 LAR 细胞的增殖[协同评分分别为 7.34(p=5.81x10)和 4.78(p=0.012)]。AR 拮抗剂恩杂鲁胺对 MDA-MB-453、MFM-223 和 CAL148 细胞无效,也不能增强任何一种组合的疗效。palbociclib/capivasertib 抑制 LAR 患者来源异种移植物的生长比 palbociclib/alpelisib 更有效。用 palbociclib 处理 LAR 细胞可抑制磷酸化-RB,并导致 AKT 底物 GSK3β、PRAS40 和 FoxO3a 的适应性磷酸化/激活。Capivasertib 比 alpelisib 更有效地阻断 palbociclib 诱导的 AKT 底物磷酸化。用 PI3Kβ 抑制剂处理不能阻断 AKT 底物的磷酸化,这表明 PI3Kβ 没有介导对 CDK4/6 抑制的适应性反应。用 palbociclib 处理的 MDA-MB-453 细胞的磷酸激酶阵列显示出 PDGFRβ、GSK3β、STAT3 和 STAT6 的时间依赖性上调。在 palbociclib 处理的 MDA-MB-453 和 MFM-223 细胞中沉默 PDGFRβ,阻断 S473 pAKT 的上调,表明对 CDK4/6 阻断的适应性反应涉及 PDGFRβ 信号。最后,用 palbociclib 和 PDGFR 抑制剂 CP637451 处理,使 MDA-MB-453 和 MFM-223 细胞的生长与 palbociclib/capivasertib 一样受到抑制。这些发现支持在 LAR TNBC 患者中测试 CDK4/6 和 AKT 抑制剂的联合用药,并进一步研究该乳腺癌亚型中的 PDGFR 拮抗剂。

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引用本文的文献

[1]
Advances of androgen receptor in triple-negative breast cancer: from molecular mechanisms to clinical applications.

Discov Oncol. 2025-9-3

[2]
A bedside-to-bench translational analysis of NF1 alterations and CDK4/6 inhibitor resistance in hormone receptor-positive metastatic breast cancer.

EBioMedicine. 2025-6-26

本文引用的文献

[1]
Comprehensive Analysis Identifies Variability in PI3K Pathway Alterations in Triple-Negative Breast Cancer Subtypes.

JCO Precis Oncol. 2024-3

[2]
Final Results From the Randomized Phase III ASCENT Clinical Trial in Metastatic Triple-Negative Breast Cancer and Association of Outcomes by Human Epidermal Growth Factor Receptor 2 and Trophoblast Cell Surface Antigen 2 Expression.

J Clin Oncol. 2024-5-20

[3]
A human breast cancer-derived xenograft and organoid platform for drug discovery and precision oncology.

Nat Cancer. 2022-2

[4]
Treatment landscape of triple-negative breast cancer - expanded options, evolving needs.

Nat Rev Clin Oncol. 2022-2

[5]
Activity of Combined Androgen Receptor Antagonism and Cell Cycle Inhibition in Androgen Receptor Positive Triple Negative Breast Cancer.

Mol Cancer Ther. 2021-6

[6]
Prognostic and predictive impact of stroma cells defined by PDGFRb expression in early breast cancer: results from the randomized SweBCG91RT trial.

Breast Cancer Res Treat. 2021-5

[7]
PDGFRβ is an essential therapeutic target for BRCA1-deficient mammary tumors.

Breast Cancer Res. 2021-1-21

[8]
Resistance to Neoadjuvant Treatment in Breast Cancer: Clinicopathological and Molecular Predictors.

Cancers (Basel). 2020-7-22

[9]
Response to mTOR and PI3K inhibitors in enzalutamide-resistant luminal androgen receptor triple-negative breast cancer patient-derived xenografts.

Theranostics. 2020

[10]
TBCRC 032 IB/II Multicenter Study: Molecular Insights to AR Antagonist and PI3K Inhibitor Efficacy in Patients with AR Metastatic Triple-Negative Breast Cancer.

Clin Cancer Res. 2020-5-1

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