Abstract
In most human breast cancers, lowering of TGFβ receptor- or Smad gene expression combined with increased levels of TGFβs in the tumor microenvironment is sufficient to abrogate TGFβs tumor suppressive effects and to induce a mesenchymal, motile and invasive phenotype. In genetic mouse models, TGFβ signaling suppresses de novo mammary cancer formation but promotes metastasis of tumors that have broken through TGFβ tumor suppression. In mouse models of “triple-negative” or basal-like breast cancer, treatment with TGFβ neutralizing antibodies or receptor kinase inhibitors strongly inhibits development of lung- and bone metastases. These TGFβ antagonists do not significantly affect tumor cell proliferation or apoptosis. Rather, they de-repress anti-tumor immunity, inhibit angiogenesis and reverse the mesenchymal, motile, invasive phenotype characteristic of basal-like and HER2-positive breast cancer cells. Patterns of TGFβ target genes upregulation in human breast cancers suggest that TGFβ may drive tumor progression in estrogen-independent cancer, while it mediates a suppressive host cell response in estrogen-dependent luminal cancers. In addition, TGFβ appears to play a key role in maintaining the mammary epithelial (cancer) stem cell pool, in part by inducing a mesenchymal phenotype, while differentiated, estrogen receptor-positive, luminal cells are unresponsive to TGFβ because the TGFBR2 receptor gene is transcriptionally silent. These same cells respond to estrogen by downregulating TGFβ, while antiestrogens act by upregulating TGFβ. This model predicts that inhibiting TGFβ signaling should drive the differentiation of mammary stem cells into ductal cells. Consequently, TGFβ antagonists may convert basal-like or HER2-positive cancers to a more epithelioid, non-proliferating (and, perhaps, non-metastatic) phenotype. Conversely, these agents might antagonize the therapeutic effects of anti-estrogens in estrogen-dependent luminal cancers. These predictions need to be addressed prospectively in clinical trials and should inform the selection of patient populations most likely to benefit from this novel anti-metastatic therapeutic approach.
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Abbreviations
- 4-OH-T:
-
4-Hydroxy-tamoxifen
- ATM:
-
Ataxia teleangiectasia mutated protein
- CIC:
-
Cancer initiating cells
- DC:
-
Dendritic cells
- DMBA:
-
7,12-Dimethylbenz[α]anthracene
- DNTβRII:
-
Dominant negative TGFβ type II receptor
- EMT:
-
Epithelial to mesenchymal transition
- ER:
-
Estrogen receptor
- EST:
-
Expressed sequence tag
- Fc:TβRII:
-
Fc-soluble TGFβ type II receptor fusion protein
- HMEC:
-
Human mammary epithelial cells
- IHC:
-
Immunohistochemistry
- MMTV:
-
Mouse mammary tumor virus
- NK:
-
Natural killer cells
- PBMC:
-
Peripheral blood mononuclear cells
- PR:
-
Progesterone receptor
- PyVmT:
-
Polyoma virus middle T antigen
- TBRS:
-
TGFβ response gene signature
- TGFBR1 :
-
TGFβ type I receptor gene
- TGFBR2 :
-
TGFβ type II receptor gene
- TGFα:
-
Transforming growth factor-α
- TGFβ:
-
Transforming growth factor-β
- TPA:
-
12-Tetradecanoyl-phorbol-13-acetate
- TβR:
-
TGFβ receptor
- WAP:
-
Whey acidic protein
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Acknowledgments
This work was supported by Public Health Service Awards CA-41556, CA-120623 and CA-129125 to MR from the National Cancer Institute, as well as by the Cancer Center Support Grant CA-72720 from the National Cancer Institute.
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Tan, A.R., Alexe, G. & Reiss, M. Transforming growth factor-β signaling: emerging stem cell target in metastatic breast cancer?. Breast Cancer Res Treat 115, 453–495 (2009). https://doi.org/10.1007/s10549-008-0184-1
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DOI: https://doi.org/10.1007/s10549-008-0184-1