期刊
MOLECULAR CANCER THERAPEUTICS
卷 18, 期 6, 页码 1115-1126出版社
AMER ASSOC CANCER RESEARCH
DOI: 10.1158/1535-7163.MCT-18-0743
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资金
- NINDS P30 Core Center [NS072030]
- Developmental Research Project Award [9617846, P50CA168504]
- Sand Dollar Fund, a Stand Up To Cancer-American Association for Cancer Research Dream Team Translational Cancer Research Grant [SU2C-AACR-DT0409]
- Breast Cancer Research Foundation [BCRF-16-020]
- Department of Defense Breast Cancer Research Breakthrough Award [W81XWH-16-1-0340]
One of the most recent advances in the treatment of HER2(+) breast cancer is the development of the antibody-drug conjugate, T-DM1. T-DM1 has proven dinical benefits for patients with advanced and/or metastatic breast cancer who have progressed on prior HER2-targeted therapies. However, T-DM1 resistance ultimately occurs and represents a major obstacle in the effective treatment of this disease. Because antiapoptotic BCL-2 family proteins can affect the threshold for induction of apoptosis and thus limit the effectiveness of the chemotherapeutic payload, we examined whether inhibition of BCL-2/X-L would enhance the efficacy of T-DMI in five HER2-expressing patient-derived breast cancerxenograft models. Inhibition of BCL-2/X-L via navitoclax/ABT-263 significantly enhanced the cytotoxicity of T-DM1 in two of three models derived from advanced and treatment-exposed metastatic breast tumors. No additive effects of combined treatment were observed in the third metastatic tumor model, which was highly sensitive to T-DM1, as well as a primary treatment-exposed tumor, which was refractory to T-DM1. A fifth model, derived from a treatment naive primary breast tumor, was sensitive to T-DM1 but markedly benefited from combination treatment. Notably, both PDXs that were highly responsive to the combination therapy expressed low HER2 protein levels and lacked ERBB2 amplification, suggesting that BCL-2/X-L inhibition can enhance sensitivity of tumors with low HER2 expression. Toxicities associated with combined treatments were significantly ameliorated with intermittent ABT-263 dosing. Taken together, these studies provide evidence that T-DM1 cytotoxicity could be significantly enhanced via BCL-2/X-L blockade and support dinical investigation of this combination beyond ERBB2-amplified and/or HER2-overexpressed tumors.
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