Sikora, Matthew J.

Invasive lobular breast carcinoma (ILC), the most common special histological subtype of breast cancer, is characterized by nearly universal expression of estrogen receptor alpha (ER) and unique sites of metastases, neither of which is fully recapitulated by genetically engineered mouse models. Using reporter-labeled ILC mouse xenografts, herein we used mammary fat pad, tail vein and intracardiac orthotopic growth to analyze spontaneous and experimental metastasis and gene expression. We observed ER-positive primary tumors with single-file histology and collagen deposition, and spontaneous metastasis from the mammary fat pad to bones, ovaries, and brain including the leptomeninges, thereby closely mirroring the growth and metastatic spread of human ILC. Brain metastases showed strong ER staining, confirmed by sequencing analyses which identified estrogen signaling as top activated pathway, and the lesions exhibited robust response to endocrine therapy. In summary, we report endocrine responsive mammary fat pad, tail vein and intracardiac xenografts that faithfully demonstrate unique ILC features and can serve as invaluable pre-clinical translational platforms for validating candidate ILC genetic drivers and testing novel therapeutics.

Abstract Ovarian cancer is the most common and most lethal gynecologic malignancy. Despite clear histologic and molecular differences between disease subtypes, all patients receive cytotoxic chemotherapy and survival has not improved significantly for several decades. Identifying avenues for targeted therapy is critical to improving clinical outcomes. Given the vast heterogeneity of ovarian cancer, therapeutic strategies will vary based on subtype and specific biomarkers. Estrogen receptor-alpha (ER) is expressed in ∼70% of serous ovarian tumors and epidemiologic evidence indicates estrogen contributes to the disease etiology. Further, clinical data suggest that a subset of patients with serous carcinoma benefit from endocrine therapy. However, the full potential of endocrine therapy in ovarian cancer has been understudied. We hypothesize that a subset of serous ovarian tumors are dependent upon estrogen and that expression of ER target genes will identify patients who can be successfully treated with endocrine therapy. We characterized response to estradiol (E2) in four ER+ serous ovarian cancer cell lines, focusing on cell proliferation, survival, and gene expression. Proliferation was evaluated in 2-D and in a 3-D matrigel system. Survival was assayed in low-attachment conditions. We also evaluated response to anti-estrogens 4-hydroxytamoxifen (4OHT) and fulvestrant (ICI). Expression of canonical ER targets (e.g. GREB1, IGFBP3) was measured by qPCR. Gene expression microarrays after E2 treatment were used to identify genome-wide effects of ER. Studies of endocrine response in vivo are ongoing in patient-derived xenograft models. E2 promotes growth of PEO1 and PEO4 cells in 2-D and 3-D culture, with PEO4 cells exhibiting greater E2 dependence. Preliminary results indicate that E2 also promotes survival in low-attachment conditions. Growth and survival are both decreased by treatment with fulvestrant or 4-hydroxytamoxifen. Conversely, OVCA432 and OVSAHO cells do not respond to treatment with ER ligands. Microarrays identified E2-regulated genes in PEO1 and PEO4 cells that may be utilized as biomarkers of ER activity. Several of these ER targets are differentially expressed between E2-responsive and E2-independent cell lines including DEPTOR, GREB1, GFRA2, and EPHB3. We are currently overlapping our array results with publicly available datasets to develop a gene signature of E2 response, which we will use to profile ER signaling in clinical specimens and patient derived xenografts. Our results suggest that a subset of serous ovarian cancers are endocrine responsive. These studies will determine if expression of specific ER targets correlates with endocrine response and thus if they can be harnessed to predict clinical response to endocrine therapy. Citation Format: Courtney L. Andersen, Matthew J. Sikora, Soumya Luthra, Uma Chandran, Paul Haluska, Steffi Oesterreich. Utilizing ER target genes as biomarkers of endocrine response in serous ovarian carcinoma. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 2103. doi:10.1158/1538-7445.AM2014-2103

Abstract Ovarian cancer is the fifth leading cause of cancer death among women in the United States. Despite advances in treatment for other cancers, ovarian cancer patient prognosis has not improved significantly since the advent of platinum-based chemotherapy. It is a highly heterogeneous disease with at least four distinct histological subtypes: serous, mucinous, endometrioid, and clear cell. However, no subtype- or biomarker-specific therapies are approved for ovarian cancer. Identifying targeted therapies is crucial to improving clinical outcomes. Specific therapies will likely vary based on tumor histology and biomarkers. Expression of estrogen receptor alpha (ER) is a well established biomarker of response to endocrine therapies in breast cancer. Despite the success of anti-estrogen therapies in treating breast cancer, little attention has been given to their potential in ovarian cancer. However, epidemiologic studies show that approximately 70% of epithelial ovarian tumors express ER, particularly serous and endometrioid subtypes, and that estrogen plays a role in ovarian cancer etiology. Further, clinical data suggest that a subset of ovarian cancer patients can be successfully treated with endocrine therapy. We hypothesize that some ovarian tumors require estrogen for growth and that predictive biomarkers will identify patients who will benefit from endocrine therapy. Using cell line models, we examined the response of ovarian cancer cells to estrogen (E2) and anti-estrogens with regard to gene expression and cell proliferation. E2 induces expression of canonical ER target genes (e.g. GREB1) in these cells, suggesting that they are estrogen-responsive. We observe that 4-hydroxytamoxifen and fulvestrant inhibit growth of ovarian cancer cells including the chemo-resistant line PEO4. Gene expression microarray studies identified additional E2-regulated genes in ovarian cancer cells that may be utilized as biomarkers of ER activity. We are expanding our studies to in vivo models (human primary tumor xenografts) to evaluate the role of E2 in driving tumor progression and determine the efficacy of anti-estrogens in treating serous ovarian cancer. There is a critical need for targeted therapies in ovarian cancer. Our studies will determine if endocrine responsiveness correlates with gene expression of specific biomarkers, which may lead to the identification of predictive clinical markers of response to endocrine therapy. Citation Format: Courtney L. Andersen, Matthew J. Sikora, Paul Haluska, Steffi Oesterreich. Identifying biomarkers of estrogen response in models of serous ovarian cancer. [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 94. doi:10.1158/1538-7445.AM2013-94