Metastatic progression with resistance to aromatase inhibitors is driven by the steroid receptor coactivator SRC-1

Cancer Res. 2012 Jan 15;72(2):548-59. doi: 10.1158/0008-5472.CAN-11-2073. Epub 2011 Nov 22.

Abstract

Aromatase inhibitors (AI) are a standard-of-care treatment for postmenopausal, estrogen receptor-positive breast cancers. Although tumor recurrence on AI therapy occurs, the mechanisms underlying acquired resistance to AIs remain unknown. In this study, we examined a cohort of endocrine-treated breast cancer patients and used a cell line model of resistance to the AI letrozole. In patients treated with a first-line AI, hormone receptor switching between primary and resistant tumors was a common feature of disease recurrence. Resistant cells exhibited a switch from steroid-responsive growth to growth factor-responsive and endocrine-independent growth, which was accompanied by the development of a more migratory and disorganized phenotype. Both the resistant cells and tumors from AI-resistant patients showed high expression of the steroid receptor coactivator SRC-1. Direct interactions between SRC-1 and the transcription factor Ets2 regulated Myc and MMP9. SRC-1 was required for the aggressive and motile phenotype of AI-resistant cells. Interestingly, SRC-1 expression in primary and/or recurrent tumors was associated with a reduction in disease-free survival in treated patients. Moreover, there was a significant association between SRC-1 and Ets2 in the recurrent tissue compared with the matched primary tumor. Together, our findings elucidate a mechanism of AI-specific metastatic progression in which interactions between SRC-1 and Ets2 promote dedifferentiation and migration in hormone-dependent breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aromatase Inhibitors / pharmacology*
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / metabolism
  • Cell Line, Tumor
  • Disease Progression
  • Female
  • Humans
  • Neoplasm Metastasis
  • Nuclear Receptor Coactivator 1 / metabolism*
  • Tamoxifen / pharmacology*
  • Transfection

Substances

  • Aromatase Inhibitors
  • Tamoxifen
  • Nuclear Receptor Coactivator 1