Espinoza, Ingrid

The identification of clinically important molecular mechanisms driving endocrine resistance is a priority in estrogen receptor-positive (ER+) breast cancer. Although both genomic and non-genomic cross-talk between the ER and growth factor receptors such as human epidermal growth factor receptor 2 (HER2) has frequently been associated with both experimental and clinical endocrine therapy resistance, combined targeting of ER and HER2 has failed to improve overall survival in endocrine non-responsive disease. Herein, we questioned the role of fatty acid synthase (FASN), a lipogenic enzyme linked to HER2-driven breast cancer aggressiveness, in the development and maintenance of hormone-independent growth and resistance to anti-estrogens in ER/HER2-positive (ER+/HER2+) breast cancer. The stimulatory effects of estradiol on FASN gene promoter activity and protein expression were blunted by anti-estrogens in endocrine-responsive breast cancer cells. Conversely, an AKT/MAPK-related constitutive hyperactivation of FASN gene promoter activity was unaltered in response to estradiol in non-endocrine responsive ER+/HER2+ breast cancer cells, and could be further enhanced by tamoxifen. Pharmacological blockade with structurally and mechanistically unrelated FASN inhibitors fully impeded the strong stimulatory activity of tamoxifen on the soft-agar colony forming capacity—an in vitro metric of tumorigenicity—of ER+/HER2+ breast cancer cells. In vivo treatment with a FASN inhibitor completely prevented the agonistic tumor-promoting activity of tamoxifen and fully restored its estrogen antagonist properties against ER/HER2-positive xenograft tumors in mice. Functional cancer proteomic data from The Cancer Proteome Atlas (TCPA) revealed that the ER+/HER2+ subtype was the highest FASN protein expressor compared to basal-like, HER2-enriched, and ER+/HER2-negative breast cancer groups. FASN is a biological determinant of HER2-driven endocrine resistance in ER+ breast cancer. Next-generation, clinical-grade FASN inhibitors may be therapeutically relevant to countering resistance to tamoxifen in FASN-overexpressing ER+/HER2+ breast carcinomas.

Sustained HER2/HER3 signaling due to the overproduction of the HER3 ligand heregulin (HRG) is proposed as a key contributor to endocrine resistance in estrogen receptor-positive (ER+) breast cancer. The molecular mechanisms linking HER2 transactivation by HRG-bound HER3 to the acquisition of a hormone-independent phenotype in ER+ breast cancer is, however, largely unknown. Here, we explored the possibility that autocrine HRG signaling drives cytokine-related endocrine resistance in ER+ breast cancer cells. We used human cytokine antibody arrays to semi-quantitatively measure the expression level of 60 cytokines and growth factors in the extracellular milieu of MCF-7 cells engineered to overexpress full-length HRGβ2 (MCF-7/HRG cells). Interleukin-8 (IL-8), a chemokine closely linked to ER inaction, emerged as one the most differentially expressed cytokines. Cytokine profiling using structural deletion mutants lacking both the N-terminus and the cytoplasmic-transmembrane region of HRGβ2—which is not secreted and cannot transactivate HER2—or lacking a nuclear localization signal at the N-terminus—which cannot localize at the nucleus but is actively secreted and transactivates HER2—revealed that the HRG-driven activation of IL-8 expression in ER+ cells required HRG secretion and transactivation of HER2 but not HRG nuclear localization. The functional blockade of IL-8 with a specific antibody inversely regulated ERα-driven transcriptional activation in endocrine-sensitive MCF-7 cells and endocrine-resistant MCF-7/HRG cells. Overall, these findings suggest that IL-8 participates in the HRG-driven endocrine resistance program in ER+/HER2- breast cancer and might illuminate a potential clinical setting for IL8- or CXCR1/2-neutralizing antibodies.

HER2 transactivation by the HER3 ligand heregulin (HRG) promotes an endocrine-resistant phenotype in the estrogen receptor-positive (ER+) luminal-B subtype of breast cancer. The underlying biological mechanisms that link them are, however, incompletely understood. Here, we evaluated the putative role of the lipogenic enzyme fatty acid synthase (FASN) as a major cause of HRG-driven endocrine resistance in ER+/HER2-negative breast cancer cells. MCF-7 cells engineered to stably overexpress HRG (MCF-7/HRG), an in vitro model of tamoxifen/fulvestrant-resistant luminal B-like breast cancer, showed a pronounced up-regulation of FASN gene/FASN protein expression. Autocrine HRG up-regulated FASN expression via HER2 transactivation and downstream activation of PI-3K/AKT and MAPK-ERK1/2 signaling pathways. The HRG-driven FASN-overexpressing phenotype was fully prevented in MCF-7 cells expressing a structural deletion mutant of HRG that is sequestered in a cellular compartment and lacks the ability to promote endocrine-resistance in an autocrine manner. Pharmacological inhibition of FASN activity blocked the estradiol-independent and tamoxifen/fulvestrant-refractory ability of MCF-7/HRG cells to anchorage-independently grow in soft-agar. In vivo treatment with a FASN inhibitor restored the anti-tumor activity of tamoxifen and fulvestrant against fast-growing, hormone-resistant MCF-7/HRG xenograft tumors in mice. Overall, these findings implicate FASN as a key enabler for endocrine resistance in HRG+/HER2- breast cancer and highlight the therapeutic potential of FASN inhibitors for the treatment of endocrine therapy-resistant luminal-B breast cancer.

Abstract About 25% of breast carcinomas are characterized by over-expression and/or amplification of the HER2 receptor, one of four members of the HER family of receptor tyrosine kinases. The strong correlation between HER2 levels/activity with more aggressive breast cancer disease, poor prognosis as well as resistance to chemo- and endocrine therapies made it a preferred target for anti-cancer therapy. However, current treatment strategies are only partially effective and the majority of breast cancer patients who initially respond favorably rapidly develop resistance to treatments for still not fully understood reasons. Thus, novel strategies/agents are in need. Structural analyses revealed that sub-domain III in the extracellular domain (ECD) of the HER family members is responsible for dimerization. We hypothesized that disrupting the dimerization loop in the HER2-ECD sub-domain III would ultimately convert HER2 to a non-functional receptor with diminished transforming capacity. To this end, we generated a series of HER2-ECD deletion mutants located in sub-domain III and assessed their oncogenic potential compared to the HER2-wild type (WT) after their expression in MCF10A cells. Importantly, a small deletion (16 amino acids) of the HER2 extracellular domain (named HER2Δ6) abolished its homo- and hetero-dimerization and profoundly affected HER2-catalyzed activation of the HER network. Moreover, this mutant was not able to transform MCF10 cells as it failed to promote anchorage-independent growth and interfered with the activation/Tyr phosphorylation of HER1, HER2 and HER3. Compared to HER2-WT-expressing cells, the HER2α6 mutant proved to be even more effective in inhibiting the oncogenic properties of the receptor than the current drugs of choice such as Trastuzumab and Pertuzumab alone or in combination. In addition, while expression of HER2-WT conferred resistance of MCF10A cells to Paclitaxel, the HER2Δ6 variant failed to do so. To determine the molecular mechanisms underlying this behavior, we assessed the mutant and WT expressing cells lines morphologically and biochemically and demonstrated that the HER2Δ6 is absent from the plasma membrane (PM) in MCF10A cells. Interestingly, we found that the mutant receptor displayed an intracellular trafficking defect and was trapped in the endoplasmic reticulum (ER). Our results reveal that the HER2-ECD bears an essential “activating” region that is indispensable for HER2-mediated oncogenic transformation. Targeting and eliminating this “activating” element in HER2 seems to provide a strong innovative approach for developing a valuable novel anti-HER2 therapeutic drug that would specifically benefit patients with HER2 positive tumors resistant to current therapies. Citation Format: Barbara Schroeder, Ghiara Lugo, Javier Menendez, Ingrid Espinoza, Ruth Lupu. Identification of a key region in the HER2 subdomain III required for transformation capability. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 133. doi:10.1158/1538-7445.AM2015-133

Abstract The HER2 receptor is over-expressed in about 25% of breast carcinomas and correlates with more aggressive breast cancer disease, poor prognosis as well as resistance to chemo- and endocrine therapies. The strong correlation between HER2 levels/activity and the malignancy of the disease made it a preferred target for anti-cancer therapy. For example, Trastuzumab, which targets HER2 homo-dimerization and Pertuzumab, which interferes with HER2 hetero-dimerization, are in clinical use. Unfortunately, Trastuzumab monotherapy is only partially effective and the majority of breast cancer patients who initially respond to Trastuzumab rapidly develop resistance to the drug. Thus, novel strategies/agents are in need, especially drugs that prevent hetero-dimerization with other HER family members. Structural analyses revealed that sub-domain III in the extracellular domain (ECD) of the HER family members is responsible for dimerization. Therefore, we hypothesized that disabling the dimerization loop in the HER2-ECD sub-domain III would ultimately convert HER2 to a non-functional receptor. Therefore, we introduced a series of deletions in the HER2-ECD sub-domain III and determined their oncogenic properties compared to HER2wt expressing cells. Importantly, a small deletion (16 amino acids) of the HER2 extracellular domain (named HER2Δ6) abolished its homo- and hetero-dimerization and profoundly affected HER2-catalyzed activation of the HER network, both in the context of HER2 over-expression and ligand-induced trans-activation of HER2. Expression of the HER2Δ6 variant failed to promote anchorage-independent growth and interfered with the activation/Tyr phosphorylation of HER1, HER2 and HER3. Moreover, this mutant failed to promote resistance to Paclitaxel treatment in HER2-overexpressing breast cancer cells. To determine the molecular mechanisms underlying this behavior, we assessed the mutant and wt expressing cells lines morphologically and biochemically and demonstrated that the HER2Δ6 is absent from the plasma membrane (PM), most likely due to a intracellular trafficking defect that mistargets the receptor to or traps it in an endomembrane compartment. Compared to HER2wt-expressing cells, the HER2Δ6 mutant proves to be even more effective in inhibiting the oncogenic properties of the receptor than the current drugs of choice such as Trastuzumab, Pertuzumab and Cetuximab alone or in combination as measured by anchorage-independent growth. These findings reveal that the HER2-ECD bears an essential "activating" region that is indispensable for HER2 homo-and heterodimerization. Elimination of this "activating" element in HER2 seems to recapitulate and greatly improve the combined actions of Trastuzumab and Pertuzumab. These findings offer a strong rationale for developing this peptide sequence into a valuable anti-HER2 therapeutic drug. Citation Format: Barbara Schroeder, Menendez Javier, Espinoza Ingrid, Lupu Ruth. Blocking a key region in the HER2 subdomain III inhibits the HER2-network in patients with resistance to HER2-targeted therapy [abstract]. In: Proceedings of the Thirty-Seventh Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2014 Dec 9-13; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2015;75(9 Suppl):Abstract nr P6-07-08.

Abstract Fatty acid synthase (FASN), the key enzyme in de novo lipogenesis, is significantly upregulated and activated in many carcinomas, including breast cancer. Pharmacological inhibition of FASN induces apoptosis of FASN expressing cancer cells. However, the mechanism is still unclear. Inhibition of FASN in breast cancer cells induces a dose dependent increase in apoptotic cell death with a concomitant upregulation of the pro-apoptotic BH3-only proteins Noxa, Bim and Puma (mRNA and protein). Blockage of the BH3-only protein expression using specific small interfering ribonucleic acid (siRNA), significantly diminishes the apoptotic effect induced by the inhibition of FASN. Moreover, addition of palmitate, the end product of FASN, protects the cells from the proapoptotic effects of FASN inhibition by suppressing expression of Noxa, Bim and Puma. These data indicate that Noxa, Bim and Puma are essential for the apoptotic effect induced by the inhibition of FASN. Combination therapeutic regimens have received growing attention for the possibility of higher efficacy with reduced toxicity. Thus, we investigated the combinatorial effect of pharmacological inhibition of FASN and Bcl-2/Bcl-xL. While a small molecule Bcl-2/Bcl-xL inhibitor alone did not induce apoptosis, co-treatment of the small molecule Bcl-2/Bcl-xL inhibitor with a synthetic FASN inhibitor significantly surpassed the apoptotic effect of the synthetic FASN inhibitor alone. Accordingly, combined treatment of a FASN inhibitors and Bcl-2/Bcl-xL antagonists represents a new rational combination that merits further consideration in FASN overexpressing tumors. Citation Format: Chandra Mohan Kurapaty Venkatapoorna, Ingrid Espinoza, Scott H Kaufmann, Ruth Lupu. Pharmacological inhibition of fatty acid synthase regulates BH3-only proteins and sensitizes breast cancer cells to a small molecule Bcl-2/Bcl-xL inhibitor to induce apoptosis. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 1737. doi:10.1158/1538-7445.AM2013-1737 Note: This abstract was not presented at the AACR Annual Meeting 2013 because the presenter was unable to attend.