Exposure to dim light at night may make breast cancers resistant to tamoxifen

July 25, 2014

PHILADELPHIA -- For rats bearing human breast tumors, exposure to dim light at night made the tumors resistant to the breast cancer drug tamoxifen, according to data published in Cancer Research, a journal of the American Association for Cancer Research. The negative effects of dim light exposure on tamoxifen treatment were overcome by giving rats a melatonin supplement during the night.

"Resistance to tamoxifen is a growing problem among patients with hormone receptor-positive breast cancer," said Steven M. Hill, PhD, professor of structural and cellular biology and the Edmond and Lily Safra chair for breast cancer research at Tulane University School of Medicine in New Orleans. "Our data, although they were generated in rats, have potential implications for the large number of patients with breast cancer who are being treated with tamoxifen, because they suggest that nighttime exposure to light, even dim light, could cause their tumors to become resistant to the drug by suppressing melatonin production.

"Our study does not identify how much light exposure is needed to suppress nighttime melatonin production, and potentially drive tamoxifen resistance in humans, but we think that it could be as a little as the amount of light that comes in the bedroom window from a street light," continued Hill, who is also director of the Tulane Center for Circadian Biology. "We are working toward conducting the studies that will answer this question.

"Although melatonin supplements are readily available over the counter at most drug and health-food stores, our research is not at a point where we can make a general recommendation that breast cancer patients taking tamoxifen should go out and buy melatonin," Hill added. "Melatonin is produced by our bodies at a very specific time of day, exclusively during darkness at night, and taking melatonin supplements at the wrong time of day would potentially disrupt the circadian system, particularly the natural melatonin cycle, which may, in itself, paradoxically impair breast cancer responsiveness to tamoxifen."

For the study, Hill and colleagues analyzed rats living in either normal light/dark conditions, with 12 hours of light followed by 12 hours of complete darkness, or conditions in which there were 12 hours of normal light followed by 12 hours of dim light. Melatonin levels in the blood of rats living in normal light/dark conditions rose during the dark period before decreasing again during the light period. In rats living in the dim night light conditions, melatonin levels remained low throughout the light/dark cycle.

Tumor growth in rats living in the dim night light conditions was 2.6-fold faster compared with tumor growth in rats living in normal light/dark conditions. In addition, tumors in rats living in dim night light conditions were completely resistant to tamoxifen, whereas tumors in rats living in normal light/dark conditions regressed significantly. If rats living in dim night light conditions were given a nighttime melatonin supplement, their tumors regressed.

"These data suggest that, in the not-too distant-future, it may be possible to combine melatonin and tamoxifen," said Hill. "However, before this is done we would need to identify the optimal times of day to give the two because if the timing between the two is off, the advantage of giving them in combination may be lost. This brings up another important point: Our levels of melatonin are not determined by sleep, as many people think. It is actually the darkness that is important. During the night, if you sleep in a brightly lit room, your melatonin levels may be inhibited; however, if you are in the dark but cannot sleep, your melatonin levels will rise normally."
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The co-lead investigator of this study was David E. Blask, MD, PhD, professor in the Department of Structural and Cellular Biology at Tulane University School of Medicine. The study was supported by funds from the National Institutes of Health and the American Association for Laboratory Animal Science. Hill and Blask declare no conflicts of interest.

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About the American Association for Cancer Research

Founded in 1907, the American Association for Cancer Research (AACR) is the world's oldest and largest professional organization dedicated to advancing cancer research and its mission to prevent and cure cancer. AACR membership includes more than 34,000 laboratory, translational, and clinical researchers; population scientists; other health care professionals; and cancer advocates residing in more than 90 countries. The AACR marshals the full spectrum of expertise of the cancer community to accelerate progress in the prevention, biology, diagnosis, and treatment of cancer by annually convening more than 20 conferences and educational workshops, the largest of which is the AACR Annual Meeting with more than 18,000 attendees. In addition, the AACR publishes eight peer-reviewed scientific journals and a magazine for cancer survivors, patients, and their caregivers. The AACR funds meritorious research directly as well as in cooperation with numerous cancer organizations. As the Scientific Partner of Stand Up To Cancer, the AACR provides expert peer review, grants administration, and scientific oversight of team science and individual grants in cancer research that have the potential for near-term patient benefit. The AACR actively communicates with legislators and policymakers about the value of cancer research and related biomedical science in saving lives from cancer. For more information about the AACR, visit http://www.AACR.org.

To interview Steven M. Hill, please contact Arthur Nead at anead@tulane.edu or 504-247-1443. For all other inquiries, please contact Jeremy Moore at jeremy.moore@aacr.org or 215-446-7109.

American Association for Cancer Research

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