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Anti-estrogen resistance in human breast tumors is driven by JAG1-NOTCH4-dependent cancer stem cell activity

Simões, Bruno M., O'Brien, Ciara S., Eyre, Rachel, Silva, Andreia, Yu, Ling, Sarmiento-Castro, Aida, Alférez, Denis G., Spence, Kath, Santiago-Gómez, Angélica, Chemi, Francesca, Acar, Ahmet, Gandhi, Ashu, Howell, Anthony, Brennan, Keith, Rydén, Lisa, Catalano, Stefania, Andó, Sebastiano, Gee, Julia Margaret Wendy, Ucar, Ahmet, Sims, Andrew H., Marangoni, Elisabetta, Farnie, Gillian, Landberg, Göran, Howell, Sacha J. and Clarke, Robert B. 2015. Anti-estrogen resistance in human breast tumors is driven by JAG1-NOTCH4-dependent cancer stem cell activity. Cell Reports 12 (12) , pp. 1968-1977. 10.1016/j.celrep.2015.08.050

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Breast cancers (BCs) typically express estrogen receptors (ERs) but frequently exhibit de novo or acquired resistance to hormonal therapies. Here, we show that short-term treatment with the anti-estrogens tamoxifen or fulvestrant decrease cell proliferation but increase BC stem cell (BCSC) activity through JAG1-NOTCH4 receptor activation both in patient-derived samples and xenograft (PDX) tumors. In support of this mechanism, we demonstrate that high ALDH1 predicts resistance in women treated with tamoxifen and that a NOTCH4/HES/HEY gene signature predicts for a poor response/prognosis in 2 ER+ patient cohorts. Targeting of NOTCH4 reverses the increase in Notch and BCSC activity induced by anti-estrogens. Importantly, in PDX tumors with acquired tamoxifen resistance, NOTCH4 inhibition reduced BCSC activity. Thus, we establish that BCSC and NOTCH4 activities predict both de novo and acquired tamoxifen resistance and that combining endocrine therapy with targeting JAG1-NOTCH4 overcomes resistance in human breast cancers.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Pharmacy
Subjects: R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
R Medicine > RM Therapeutics. Pharmacology
Publisher: Cell Press
ISSN: 2211-1247
Date of First Compliant Deposit: 30 March 2016
Date of Acceptance: 17 August 2015
Last Modified: 04 Jun 2017 08:23

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