Breast cancer is the most common cancer and the second leading cause of cancer death in women. A better understanding of breast cancer etiology would help us to better prevent and treat this disease. The LBK1-AMPK pathway is a central regulator of energy metabolism, and misregulation of this pathway has been implicated in cancers, including breast cancer. Indirect AMPK activators such as metformin have shown beneficial effect in breast cancer prevention and treatment. However, other than LKB1 mutations, how this pathway might be misregulated in breast cancer remains unclear. In this application, based on our extensive Preliminary Data, we propose to characterize several factors based on their newly identified roles in AMPK regulation and in turn, on breast cancer and treatment response. The first factor is called tumor suppressor protein 52 (TPD52) which we found to negatively regulate AMPK. TPD52 is known to overexpress in HER2+ breast cancer and, together with HER2, to promote tumor growth. The AMPK pathway is also known to be involved in anti-HER2 response. Furthermore, we found that AMPK regulates USP10. USP10 can enhance the stability of two important tumor suppressors, p53 and SIRT6, so our finding has established a new downstream pathway to AMPK. It is reported that SIRT6 can also activate AMPK. Therefore, we have identified a new axis of AMPK regulation with TPD52 negatively regulating AMPK with the AMPK downstream factors, UPS10/SIRT6 forming a positive feedback loop, further activating AMPK, all of which would be important in energy metabolism and response to metabolic stress induced by metformin. Metformin response is heterogeneous; therefore our findings could shed light on the underlying mechanisms. Our preliminary data indicated that cells with TPD52 overexpression were more sensitive to metformin as well as combined metformin+HER2 inhibitors. This is consistent with previous studies indicating that metformin can inhibit cell proliferation and increase patient survival in HER2+ breast cancer. Based on these preliminary findings, we hypothesize that the AMPK-USP10 axis contributes to the metabolic function of AMPK; TPD52, by negatively regulating AMPK, can promote misregulation of energy metabolism and contribute to breast cancer development. Drugs like metformin would be more effective in patients with TPD52 overexpression and might be used in combination with HER2 inhibitors in HER2+ cancers. Therefore, in this application, we propose to determine how TPD52 regulates the AMPK pathway and how AMPK might regulate SIRT6 and p53 through the regulation of USP10 as well as the impact of this regulation on response to biguanides and anti-HER2 therapy using cell lines, breast tumor samples, and breast cancer patient derived xenografts. In summary, these studies would help us to understand how this new axis TPD52-AMPK-USP10-SIRT6/p53 contributes to tumorigenesis and treatment response.

Public Health Relevance

AMPK activators such as metformin, a drug used to treat type II diabetes, have shown beneficial effect in breast cancer prevention and treatment. However, other than LKB1 mutation, how this pathway is misregulated in breast cancer remains unclear. In this application, based on our extensive Preliminary Data, we propose to characterize the effect of our two new factors that we have identified, TPD52 and SIRT6, on AMPK regulation and on breast cancer treatment, information that could ultimately help us to better individualize breast cancer therapy.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project (R01)
Project #
Application #
Study Section
Basic Mechanisms of Cancer Therapeutics Study Section (BMCT)
Program Officer
Kondapaka, Sudhir B
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Mayo Clinic, Rochester
United States
Zip Code
Kurmi, Kiran; Hitosugi, Sadae; Yu, Jia et al. (2018) Tyrosine Phosphorylation of Mitochondrial Creatine Kinase 1 Enhances a Druggable Tumor Energy Shuttle Pathway. Cell Metab 28:833-847.e8
Wang, Liewei; Ingle, James; Weinshilboum, Richard (2018) Pharmacogenomic Discovery to Function and Mechanism: Breast Cancer as a Case Study. Clin Pharmacol Ther 103:243-252
Athreya, Arjun P; Gaglio, Alan J; Cairns, Junmei et al. (2018) Machine Learning Helps Identify New Drug Mechanisms in Triple-Negative Breast Cancer. IEEE Trans Nanobioscience 17:251-259
Ho, Ming-Fen; Lummertz da Rocha, Edroaldo; Zhang, Cheng et al. (2018) TCL1A, a Novel Transcription Factor and a Coregulator of Nuclear Factor ?B p65: Single Nucleotide Polymorphism and Estrogen Dependence. J Pharmacol Exp Ther 365:700-710
Yu, Jia; Qin, Bo; Moyer, Ann M et al. (2018) DNA methyltransferase expression in triple-negative breast cancer predicts sensitivity to decitabine. J Clin Invest 128:2376-2388
Ho, Ming-Fen; Correia, Cristina; Ingle, James N et al. (2018) Ketamine and ketamine metabolites as novel estrogen receptor ligands: Induction of cytochrome P450 and AMPA glutamate receptor gene expression. Biochem Pharmacol 152:279-292
Qin, Sisi; Liu, Duan; Kohli, Manish et al. (2018) TSPYL Family Regulates CYP17A1 and CYP3A4 Expression: Potential Mechanism Contributing to Abiraterone Response in Metastatic Castration-Resistant Prostate Cancer. Clin Pharmacol Ther 104:201-210
Cairns, Junmei; Fridley, Brooke L; Jenkins, Gregory D et al. (2018) Differential roles of ERRFI1 in EGFR and AKT pathway regulation affect cancer proliferation. EMBO Rep 19:
Qin, Sisi; Ingle, James N; Liu, Mohan et al. (2017) Calmodulin-like protein 3 is an estrogen receptor alpha coregulator for gene expression and drug response in a SNP, estrogen, and SERM-dependent fashion. Breast Cancer Res 19:95
Athreya, Arjun P; Kalari, Krishna R; Cairns, Junmei et al. (2017) Model-based unsupervised learning informs metformin-induced cell-migration inhibition through an AMPK-independent mechanism in breast cancer. Oncotarget 8:27199-27215

Showing the most recent 10 out of 23 publications