Trastuzumab therapy for tamoxifen-stimulated endometrial cancer

Clodia Osipo1, Kathleen Meeke, Hong Liu

  • 1Robert H. Lurie Comprehensive Cancer Center, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Cancer Research
|September 17, 2005
PubMed

Insights

Trastuzumab effectively inhibits both estrogen (E2) and tamoxifen-stimulated endometrial cancer growth by targeting HER-2/neu. This novel therapy shows greater efficacy in tamoxifen-stimulated tumors due to diminished insulin-like growth factor (IGF-I) signaling.

Area of Science:

  • Oncology
  • Molecular Biology
  • Pharmacology

Background:

  • Endometrial cancer (EC) growth can be stimulated by 17beta-estradiol (E2) and tamoxifen, a selective estrogen receptor modulator.
  • The role of HER-2/neu in tamoxifen-stimulated EC and its therapeutic targeting remain areas of active investigation.

Purpose of the Study:

  • To develop a novel in vivo model of tamoxifen-stimulated endometrial cancer.
  • To investigate the role of HER-2/neu in E2- and tamoxifen-stimulated EC using trastuzumab.
  • To elucidate the downstream signaling pathways affected by trastuzumab in EC models.

Main Methods:

  • Development of tamoxifen-stimulated endometrial cancer xenografts (ECC-1TAM) in vivo.
  • Treatment of tumors with 17beta-estradiol (E2), tamoxifen, or raloxifene, and assessment of growth inhibition by trastuzumab.
  • Analysis of estrogen receptor alpha (ER alpha) target gene expression (pS2, c-myc) via mRNA.
  • Assessment of HER-2/neu, phospho-ERK-1/2, and phospho-Akt protein levels.
  • Evaluation of insulin-like growth factor (IGF-I) signaling pathway components (IGF-I, IGF-IR mRNAs, phospho-IRS-1).

Main Results:

  • Trastuzumab inhibited E2-stimulated ECC-1E2 tumors by 50% and tamoxifen-stimulated ECC-1TAM tumors by 100%.
  • Trastuzumab significantly blocked E2-induced pS2 mRNA and tamoxifen-induced c-myc mRNA expression.
  • Trastuzumab decreased phosphorylated and total HER-2/neu protein, and specifically phospho-ERK-1/2 in tamoxifen-treated tumors.
  • Diminished IGF-I signaling was observed in ECC-1TAM compared to ECC-1E2 tumors, correlating with enhanced trastuzumab efficacy.

Conclusions:

  • Trastuzumab is a potent therapeutic agent for both E2- and tamoxifen-stimulated endometrial cancer.
  • Estrogenic activities of E2 and tamoxifen are partly mediated by HER-2/neu.
  • Reduced IGF-I signaling enhances trastuzumab's efficacy by enabling complete blockade of downstream phospho-ERK-1/2 signaling in tamoxifen-stimulated EC.