We have identified a frequent mutation at nucleotide 908 of ER1 (A908G) in over 30% of women with hyperplasia of the breast, and strikingly in 50% of invasive breast cancers. This mutation resulted in an amino acid substitution of arginine for lysine at residue 303 (K303R ER1), which conferred the ability for enhanced breast tumor cell growth in low levels of estrogen. Upon estrogen withdrawal, mutant-expressing tumors regress, but eventually regrow, suggesting that the mutation also confers resistance to estrogen ablation therapies. When wild type (WT) ER1-overexpressing breast cancer cells were stimulated with growth factors, cells became resistant to the growth-inhibitory effects of the antiestrogen tamoxifen (Tam). In contrast, growth factor stimulation of K303R ER1-expressing cells resulted in Tam acting as a growth agonist. The agonist hypersensitive phenotype of the mutant was associated with decreased protein acetylation, increased receptor coactivator binding, decreased corepressor binding, and increased promoter occupancy of estrogen-regulated genes. The mutation also generated an enhanced phosphorylation substrate for the intracellular signaling kinase pathways AKT, PAK-1, and PKA. Recently, we have discovered that the mutation confers resistance to an aromatase inhibitor as well. Our collective data suggest that the hinge domain where the mutation resides plays a pivotal and potentially interdependent role between other functional domains of the ER1. We therefore hypothesize that the mutation adapts ER1 for enhanced reception of intracellular signal transduction, which confers resistance to hormonal therapies. Our proposed Aims are: (1) To determine the distinct biological consequences of specific ER1 phosphorylation events in the evolution of hormone resistance. We will generate mutations at serines 118 and 305, and tyrosine 537 in ER1. Altered function and localization will be assessed. We will generate aromatase and K303R co-expressing models to be used in anchorage independent assays and xenograft models. We will cross K303R ER1 transgenic mice with dominant active AKT and PKA mice to assess effects of phosphorylation on ER function. (2) To examine the role of the K303R ER1 mutation on the emergence of resistance to estrogen deprivation. We will perform expression microarray analyses, and luciferase reporter assays to determine the effects of phosphorylation. Aromatase co-expressing lines have been developed and will be used in xenograft tumor studies. (3) To determine the impact of phosphorylation and mutation on the luminal breast cancer phenotype and the problem of hormone resistance. We compare the frequency of the K303R ER1 mutant in microarray profiles to determine if the mutant comprises the poor prognosis, luminal B subtype. We will examine the mutation in a retrospective predictive study of patients using sequence analysis and phosphorylation-specific ER antibodies.

Public Health Relevance

We discovered a mutation in the estrogen receptor genes which makes it very sensitive to the low levels of hormone, like the levels found in postmenopausal women. We will test whether the mutation causes a women to not respond to common therapies, such as tamoxifen and an aromatase inhibitor. Our goal is to help women decide which therapy is best for them, and to reduce the risk of relapse and recurrence of breast cancer.

Agency
National Institute of Health (NIH)
Institute
National Cancer Institute (NCI)
Type
Research Project (R01)
Project #
5R01CA072038-13
Application #
7825325
Study Section
Basic Mechanisms of Cancer Therapeutics Study Section (BMCT)
Program Officer
Sathyamoorthy, Neeraja
Project Start
1996-09-01
Project End
2013-04-30
Budget Start
2010-05-01
Budget End
2011-04-30
Support Year
13
Fiscal Year
2010
Total Cost
$300,198
Indirect Cost
Name
Baylor College of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
Rimawi, Mothaffar F; De Angelis, Carmine; Contreras, Alejandro et al. (2018) Low PTEN levels and PIK3CA mutations predict resistance to neoadjuvant lapatinib and trastuzumab without chemotherapy in patients with HER2 over-expressing breast cancer. Breast Cancer Res Treat 167:731-740
Gates, Leah A; Gu, Guowei; Chen, Yue et al. (2018) Proteomic profiling identifies key coactivators utilized by mutant ER? proteins as potential new therapeutic targets. Oncogene 37:4581-4598
Carron, Emily C; Homra, Samuel; Rosenberg, Jillian et al. (2017) Macrophages promote the progression of premalignant mammary lesions to invasive cancer. Oncotarget 8:50731-50746
Gelsomino, Luca; Gu, Guowei; Rechoum, Yassine et al. (2016) ESR1 mutations affect anti-proliferative responses to tamoxifen through enhanced cross-talk with IGF signaling. Breast Cancer Res Treat 157:253-265
Gu, Guowei; Fuqua, Suzanne A W (2016) ESR1 Mutations in Breast Cancer: Proof-of-Concept Challenges Clinical Action. Clin Cancer Res 22:1034-6
Fuqua, Suzanne A W; Rechoum, Yassine; Gu, Guowei (2016) ESR1 Mutations in Cell-Free DNA of Breast Cancer: Predictive ""Tip of the Iceberg"". JAMA Oncol 2:1315-1316
Ciupek, Andrew; Rechoum, Yassine; Gu, Guowei et al. (2015) Androgen receptor promotes tamoxifen agonist activity by activation of EGFR in ER?-positive breast cancer. Breast Cancer Res Treat 154:225-37
Gu, Guowei; Gelsomino, Luca; Covington, Kyle R et al. (2015) Targeting thyroid hormone receptor beta in triple-negative breast cancer. Breast Cancer Res Treat 150:535-45
Rechoum, Yassine; Rovito, Daniela; Iacopetta, Domenico et al. (2014) AR collaborates with ER? in aromatase inhibitor-resistant breast cancer. Breast Cancer Res Treat 147:473-85
Fuqua, Suzanne A W; Gu, Guowei; Rechoum, Yassine (2014) Estrogen receptor (ER) ? mutations in breast cancer: hidden in plain sight. Breast Cancer Res Treat 144:11-9

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