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Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial

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Bibliographische Detailangaben
Zeitschriftentitel: Clinical Cancer Research
Personen und Körperschaften: Sudhan, Dhivya R., Schwarz, Luis J., Guerrero-Zotano, Angel, Formisano, Luigi, Nixon, Mellissa J., Croessmann, Sarah, González Ericsson, Paula I., Sanders, Melinda, Balko, Justin M., Avogadri-Connors, Francesca, Cutler, Richard E., Lalani, Alshad S., Bryce, Richard, Auerbach, Alan, Arteaga, Carlos L.
In: Clinical Cancer Research, 25, 2019, 2, S. 771-783
Format: E-Article
Sprache: Englisch
veröffentlicht:
American Association for Cancer Research (AACR)
Schlagwörter:
author_facet Sudhan, Dhivya R.
Schwarz, Luis J.
Guerrero-Zotano, Angel
Formisano, Luigi
Nixon, Mellissa J.
Croessmann, Sarah
González Ericsson, Paula I.
Sanders, Melinda
Balko, Justin M.
Avogadri-Connors, Francesca
Cutler, Richard E.
Lalani, Alshad S.
Bryce, Richard
Auerbach, Alan
Arteaga, Carlos L.
Sudhan, Dhivya R.
Schwarz, Luis J.
Guerrero-Zotano, Angel
Formisano, Luigi
Nixon, Mellissa J.
Croessmann, Sarah
González Ericsson, Paula I.
Sanders, Melinda
Balko, Justin M.
Avogadri-Connors, Francesca
Cutler, Richard E.
Lalani, Alshad S.
Bryce, Richard
Auerbach, Alan
Arteaga, Carlos L.
author Sudhan, Dhivya R.
Schwarz, Luis J.
Guerrero-Zotano, Angel
Formisano, Luigi
Nixon, Mellissa J.
Croessmann, Sarah
González Ericsson, Paula I.
Sanders, Melinda
Balko, Justin M.
Avogadri-Connors, Francesca
Cutler, Richard E.
Lalani, Alshad S.
Bryce, Richard
Auerbach, Alan
Arteaga, Carlos L.
spellingShingle Sudhan, Dhivya R.
Schwarz, Luis J.
Guerrero-Zotano, Angel
Formisano, Luigi
Nixon, Mellissa J.
Croessmann, Sarah
González Ericsson, Paula I.
Sanders, Melinda
Balko, Justin M.
Avogadri-Connors, Francesca
Cutler, Richard E.
Lalani, Alshad S.
Bryce, Richard
Auerbach, Alan
Arteaga, Carlos L.
Clinical Cancer Research
Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
Cancer Research
Oncology
author_sort sudhan, dhivya r.
spelling Sudhan, Dhivya R. Schwarz, Luis J. Guerrero-Zotano, Angel Formisano, Luigi Nixon, Mellissa J. Croessmann, Sarah González Ericsson, Paula I. Sanders, Melinda Balko, Justin M. Avogadri-Connors, Francesca Cutler, Richard E. Lalani, Alshad S. Bryce, Richard Auerbach, Alan Arteaga, Carlos L. 1078-0432 1557-3265 American Association for Cancer Research (AACR) Cancer Research Oncology http://dx.doi.org/10.1158/1078-0432.ccr-18-1131 <jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose:</jats:title><jats:p>The phase III ExteNET trial showed improved invasive disease-free survival in patients with HER2+ breast cancer treated with neratinib versus placebo after trastuzumab-based adjuvant therapy. The benefit from neratinib appeared to be greater in patients with ER+/HER2+ tumors. We thus sought to discover mechanisms that may explain the benefit from extended adjuvant therapy with neratinib.</jats:p><jats:p>Experimental Design: Mice with established ER+/HER2+ MDA-MB-361 tumors were treated with paclitaxel plus trastuzumab ± pertuzumab for 4 weeks, and then randomized to fulvestrant ± neratinib treatment. The benefit from neratinib was evaluated by performing gene expression analysis for 196 ER targets, ER transcriptional reporter assays, and cell-cycle analyses.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Mice receiving “extended adjuvant” therapy with fulvestrant/neratinib maintained a complete response, whereas those treated with fulvestrant relapsed rapidly. In three ER+/HER2+ cell lines (MDA-MB-361, BT-474, UACC-893) but not in ER+/HER2− MCF7 cells, treatment with neratinib induced ER reporter transcriptional activity, whereas treatment with fulvestrant resulted in increased HER2 and EGFR phosphorylation, suggesting compensatory reciprocal crosstalk between the ER and ERBB RTK pathways. ER transcriptional reporter assays, gene expression, and immunoblot analyses showed that treatment with neratinib/fulvestrant, but not fulvestrant, potently inhibited growth and downregulated ER reporter activity, P-AKT, P-ERK, and cyclin D1 levels. Finally, similar to neratinib, genetic and pharmacologic inactivation of cyclin D1 enhanced fulvestrant action against ER+/HER2+ breast cancer cells.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>These data suggest that ER blockade leads to reactivation of ERBB RTKs and thus extended ERBB blockade is necessary to achieve durable clinical outcomes in patients with ER+/HER2+ breast cancer.</jats:p></jats:sec> Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial Clinical Cancer Research
doi_str_mv 10.1158/1078-0432.ccr-18-1131
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title Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_unstemmed Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_full Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_fullStr Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_full_unstemmed Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_short Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_sort extended adjuvant therapy with neratinib plus fulvestrant blocks er/her2 crosstalk and maintains complete responses of er+/her2+ breast cancers: implications to the extenet trial
topic Cancer Research
Oncology
url http://dx.doi.org/10.1158/1078-0432.ccr-18-1131
publishDate 2019
physical 771-783
description <jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose:</jats:title><jats:p>The phase III ExteNET trial showed improved invasive disease-free survival in patients with HER2+ breast cancer treated with neratinib versus placebo after trastuzumab-based adjuvant therapy. The benefit from neratinib appeared to be greater in patients with ER+/HER2+ tumors. We thus sought to discover mechanisms that may explain the benefit from extended adjuvant therapy with neratinib.</jats:p><jats:p>Experimental Design: Mice with established ER+/HER2+ MDA-MB-361 tumors were treated with paclitaxel plus trastuzumab ± pertuzumab for 4 weeks, and then randomized to fulvestrant ± neratinib treatment. The benefit from neratinib was evaluated by performing gene expression analysis for 196 ER targets, ER transcriptional reporter assays, and cell-cycle analyses.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Mice receiving “extended adjuvant” therapy with fulvestrant/neratinib maintained a complete response, whereas those treated with fulvestrant relapsed rapidly. In three ER+/HER2+ cell lines (MDA-MB-361, BT-474, UACC-893) but not in ER+/HER2− MCF7 cells, treatment with neratinib induced ER reporter transcriptional activity, whereas treatment with fulvestrant resulted in increased HER2 and EGFR phosphorylation, suggesting compensatory reciprocal crosstalk between the ER and ERBB RTK pathways. ER transcriptional reporter assays, gene expression, and immunoblot analyses showed that treatment with neratinib/fulvestrant, but not fulvestrant, potently inhibited growth and downregulated ER reporter activity, P-AKT, P-ERK, and cyclin D1 levels. Finally, similar to neratinib, genetic and pharmacologic inactivation of cyclin D1 enhanced fulvestrant action against ER+/HER2+ breast cancer cells.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>These data suggest that ER blockade leads to reactivation of ERBB RTKs and thus extended ERBB blockade is necessary to achieve durable clinical outcomes in patients with ER+/HER2+ breast cancer.</jats:p></jats:sec>
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author Sudhan, Dhivya R., Schwarz, Luis J., Guerrero-Zotano, Angel, Formisano, Luigi, Nixon, Mellissa J., Croessmann, Sarah, González Ericsson, Paula I., Sanders, Melinda, Balko, Justin M., Avogadri-Connors, Francesca, Cutler, Richard E., Lalani, Alshad S., Bryce, Richard, Auerbach, Alan, Arteaga, Carlos L.
author_facet Sudhan, Dhivya R., Schwarz, Luis J., Guerrero-Zotano, Angel, Formisano, Luigi, Nixon, Mellissa J., Croessmann, Sarah, González Ericsson, Paula I., Sanders, Melinda, Balko, Justin M., Avogadri-Connors, Francesca, Cutler, Richard E., Lalani, Alshad S., Bryce, Richard, Auerbach, Alan, Arteaga, Carlos L., Sudhan, Dhivya R., Schwarz, Luis J., Guerrero-Zotano, Angel, Formisano, Luigi, Nixon, Mellissa J., Croessmann, Sarah, González Ericsson, Paula I., Sanders, Melinda, Balko, Justin M., Avogadri-Connors, Francesca, Cutler, Richard E., Lalani, Alshad S., Bryce, Richard, Auerbach, Alan, Arteaga, Carlos L.
author_sort sudhan, dhivya r.
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description <jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose:</jats:title><jats:p>The phase III ExteNET trial showed improved invasive disease-free survival in patients with HER2+ breast cancer treated with neratinib versus placebo after trastuzumab-based adjuvant therapy. The benefit from neratinib appeared to be greater in patients with ER+/HER2+ tumors. We thus sought to discover mechanisms that may explain the benefit from extended adjuvant therapy with neratinib.</jats:p><jats:p>Experimental Design: Mice with established ER+/HER2+ MDA-MB-361 tumors were treated with paclitaxel plus trastuzumab ± pertuzumab for 4 weeks, and then randomized to fulvestrant ± neratinib treatment. The benefit from neratinib was evaluated by performing gene expression analysis for 196 ER targets, ER transcriptional reporter assays, and cell-cycle analyses.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Mice receiving “extended adjuvant” therapy with fulvestrant/neratinib maintained a complete response, whereas those treated with fulvestrant relapsed rapidly. In three ER+/HER2+ cell lines (MDA-MB-361, BT-474, UACC-893) but not in ER+/HER2− MCF7 cells, treatment with neratinib induced ER reporter transcriptional activity, whereas treatment with fulvestrant resulted in increased HER2 and EGFR phosphorylation, suggesting compensatory reciprocal crosstalk between the ER and ERBB RTK pathways. ER transcriptional reporter assays, gene expression, and immunoblot analyses showed that treatment with neratinib/fulvestrant, but not fulvestrant, potently inhibited growth and downregulated ER reporter activity, P-AKT, P-ERK, and cyclin D1 levels. Finally, similar to neratinib, genetic and pharmacologic inactivation of cyclin D1 enhanced fulvestrant action against ER+/HER2+ breast cancer cells.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>These data suggest that ER blockade leads to reactivation of ERBB RTKs and thus extended ERBB blockade is necessary to achieve durable clinical outcomes in patients with ER+/HER2+ breast cancer.</jats:p></jats:sec>
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spelling Sudhan, Dhivya R. Schwarz, Luis J. Guerrero-Zotano, Angel Formisano, Luigi Nixon, Mellissa J. Croessmann, Sarah González Ericsson, Paula I. Sanders, Melinda Balko, Justin M. Avogadri-Connors, Francesca Cutler, Richard E. Lalani, Alshad S. Bryce, Richard Auerbach, Alan Arteaga, Carlos L. 1078-0432 1557-3265 American Association for Cancer Research (AACR) Cancer Research Oncology http://dx.doi.org/10.1158/1078-0432.ccr-18-1131 <jats:title>Abstract</jats:title><jats:sec><jats:title>Purpose:</jats:title><jats:p>The phase III ExteNET trial showed improved invasive disease-free survival in patients with HER2+ breast cancer treated with neratinib versus placebo after trastuzumab-based adjuvant therapy. The benefit from neratinib appeared to be greater in patients with ER+/HER2+ tumors. We thus sought to discover mechanisms that may explain the benefit from extended adjuvant therapy with neratinib.</jats:p><jats:p>Experimental Design: Mice with established ER+/HER2+ MDA-MB-361 tumors were treated with paclitaxel plus trastuzumab ± pertuzumab for 4 weeks, and then randomized to fulvestrant ± neratinib treatment. The benefit from neratinib was evaluated by performing gene expression analysis for 196 ER targets, ER transcriptional reporter assays, and cell-cycle analyses.</jats:p></jats:sec><jats:sec><jats:title>Results:</jats:title><jats:p>Mice receiving “extended adjuvant” therapy with fulvestrant/neratinib maintained a complete response, whereas those treated with fulvestrant relapsed rapidly. In three ER+/HER2+ cell lines (MDA-MB-361, BT-474, UACC-893) but not in ER+/HER2− MCF7 cells, treatment with neratinib induced ER reporter transcriptional activity, whereas treatment with fulvestrant resulted in increased HER2 and EGFR phosphorylation, suggesting compensatory reciprocal crosstalk between the ER and ERBB RTK pathways. ER transcriptional reporter assays, gene expression, and immunoblot analyses showed that treatment with neratinib/fulvestrant, but not fulvestrant, potently inhibited growth and downregulated ER reporter activity, P-AKT, P-ERK, and cyclin D1 levels. Finally, similar to neratinib, genetic and pharmacologic inactivation of cyclin D1 enhanced fulvestrant action against ER+/HER2+ breast cancer cells.</jats:p></jats:sec><jats:sec><jats:title>Conclusions:</jats:title><jats:p>These data suggest that ER blockade leads to reactivation of ERBB RTKs and thus extended ERBB blockade is necessary to achieve durable clinical outcomes in patients with ER+/HER2+ breast cancer.</jats:p></jats:sec> Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial Clinical Cancer Research
spellingShingle Sudhan, Dhivya R., Schwarz, Luis J., Guerrero-Zotano, Angel, Formisano, Luigi, Nixon, Mellissa J., Croessmann, Sarah, González Ericsson, Paula I., Sanders, Melinda, Balko, Justin M., Avogadri-Connors, Francesca, Cutler, Richard E., Lalani, Alshad S., Bryce, Richard, Auerbach, Alan, Arteaga, Carlos L., Clinical Cancer Research, Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial, Cancer Research, Oncology
title Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_full Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_fullStr Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_full_unstemmed Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_short Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
title_sort extended adjuvant therapy with neratinib plus fulvestrant blocks er/her2 crosstalk and maintains complete responses of er+/her2+ breast cancers: implications to the extenet trial
title_unstemmed Extended Adjuvant Therapy with Neratinib Plus Fulvestrant Blocks ER/HER2 Crosstalk and Maintains Complete Responses of ER+/HER2+ Breast Cancers: Implications to the ExteNET Trial
topic Cancer Research, Oncology
url http://dx.doi.org/10.1158/1078-0432.ccr-18-1131