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Decitabine Response in Breast Cancer Requires Efficient Drug Processing and Is Not Limited by Multidrug Resistance
Margaret L Dahn1, Brianne M Cruickshank1, Ainsleigh J Jackson2
1Department of Pathology, Dalhousie University, Halifax, Nova Scotia, Canada.
Abstract:
Dysregulation of DNA methylation is an established feature of breast cancers. DNA demethylating therapies like decitabine are proposed for the treatment of triple-negative breast cancers (TNBC) and indicators of response need to be identified. For this purpose, we characterized the effects of decitabine in a panel of 10 breast cancer cell lines and observed a range of sensitivity to decitabine that was not subtype specific. Knockdown of potential key effectors demonstrated the requirement of deoxycytidine kinase (DCK) for decitabine response in breast cancer cells. In treatment-naïve breast tumors, DCK was higher in TNBCs, and DCK levels were sustained or increased post chemotherapy treatment. This suggests that limited DCK levels will not be a barrier to response in patients with TNBC treated with decitabine as a second-line treatment or in a clinical trial. Methylome analysis revealed that genome-wide, region-specific, tumor suppressor gene-specific methylation, and decitabine-induced demethylation did not predict response to decitabine. Gene set enrichment analysis of transcriptome data demonstrated that decitabine induced genes within apoptosis, cell cycle, stress, and immune pathways. Induced genes included those characterized by the viral mimicry response; however, knockdown of key effectors of the pathway did not affect decitabine sensitivity suggesting that breast cancer growth suppression by decitabine is independent of viral mimicry. Finally, taxol-resistant breast cancer cells expressing high levels of multidrug resistance transporter ABCB1 remained sensitive to decitabine, suggesting that the drug could be used as second-line treatment for chemoresistant patients.
Insights
Decitabine shows promise for treating triple-negative breast cancer (TNBC), with deoxycytidine kinase (DCK) levels indicating potential response. This DNA demethylating therapy may benefit chemoresistant patients.
Area of Science:
- Oncology
- Cancer Therapeutics
- Epigenetics
Background:
- DNA methylation dysregulation is common in breast cancers.
- Decitabine, a DNA demethylating agent, is a potential treatment for triple-negative breast cancers (TNBC).
- Identifying response indicators for decitabine therapy in TNBC is crucial.
Purpose of the Study:
- To investigate decitabine's effects on breast cancer cell lines.
- To identify key factors influencing decitabine response.
- To evaluate decitabine's potential as a second-line treatment for chemoresistant breast cancer.
Main Methods:
- Screening decitabine sensitivity across 10 breast cancer cell lines.
- Investigating the role of deoxycytidine kinase (DCK) via knockdown experiments.
- Analyzing methylome and transcriptome data to understand decitabine's molecular mechanisms.
- Assessing decitabine response in taxol-resistant cell lines with high ABCB1 expression.
Main Results:
- Decitabine sensitivity varied across cell lines, not correlating with specific subtypes.
- Deoxycytidine kinase (DCK) is essential for decitabine response in breast cancer cells.
- Higher DCK levels were observed in TNBCs and were maintained post-chemotherapy.
- Methylome changes and viral mimicry pathways did not predict decitabine response.
- Decitabine induced apoptosis, cell cycle, stress, and immune-related gene expression.
- Taxol-resistant cells remained sensitive to decitabine.
Conclusions:
- Deoxycytidine kinase (DCK) is a key determinant of decitabine response in breast cancer.
- Sufficient DCK levels are likely present in TNBC patients for decitabine treatment.
- Decitabine's efficacy is independent of viral mimicry response.
- Decitabine shows potential as a second-line therapy for chemoresistant breast cancer, including TNBC.
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