Penn researchers discover a molecular pathway that leads to recurrence of breast cancer

September 19, 2005

(Philadelphia, PA) - Using a recently developed mouse model of breast cancer, a team from the University of Pennsylvania School of Medicine has shown that Snail, a molecule normally important in embryonic development, can promote breast cancer recurrence. They also found that high Snail expression predicts more rapid tumor recurrence in women who have been treated for breast cancer. These observations suggest that Snail may represent a target for cancer therapy.

Among women, breast cancer is the most common cancer worldwide and is the leading cause of cancer mortality. Of the more than 5 million women currently living with a diagnosis of breast cancer, recurrence represents the most common cause of death from this disease. Remarkably, recurrences can appear up to 20 years following surgery, although most occur within the first two years. "Up to 40 percent of women thought to be cancer free following surgery, radiation, and chemotherapy still have tumor cells in their bodies in a dormant state. As such, approaches to prevent cancer recurrence in these women would be broadly applicable," says senior author Lewis A. Chodosh, MD, PhD, Vice Chair of the Department of Cancer Biology and Director of Cancer Genetics at the Abramson Family Cancer Research Institute at Penn. The researchers published their findings in the September 2005 issue of Cancer Cell.

"To this point there are extraordinarily few targets that have been causally implicated in breast cancer recurrence. Consequently, there are few treatments available to offer women who are at risk for recurrence once they have received standard treatments," says Chodosh.

The Penn team of researchers induced breast cancer in the genetically engineered mice by giving doxycycline to turn on the oncogene HER-2/neu. This oncogene is commonly amplified in human breast cancers and is associated with aggressive disease and poor clinical outcome. The researchers then induced these tumors to regress by turning off the HER2/neu oncogene in fully formed tumors. This mimics important aspects of molecularly targeted therapies and leads to the dramatic regression of tumors to a clinically undetectable state. Nevertheless, residual tumor cells lie in a dormant state and later grow out after a month to a year in the mice.

Using microarrays, Chodosh's team compared recurrent tumors with the original tumors from which they arose. They found that a variety of genes were turned on in recurrent tumors that were not on in the original tumors, including the transcriptional regulatory protein, Snail, which was induced ten-fold. The Penn team also identified changes in the microscopic appearance of the cells in recurrent tumors, which had transformed from a cuboidal, epithelial shape to a spindle, fibroblastic shape - a change associated with more aggressive tumors in humans.

Snail was first identified in fruit flies and later in mice based on its essential role in embryogenesis during a developmental transition in which normal cells undergo a similar change in shape. "Snail controls a complex set of cellular functions that cancer cells appropriate by turning on this master regulatory gene," explains Chodosh.

To prove a cause-and-effect, the researchers added Snail back to the original tumor cells in mice and showed that Snail increased the rate of recurrence.

But could Snail expression play a similar role in women with breast cancer? When the Penn team delved into public databases of breast cancer tissue data, separating cases into those with high levels of Snail and those with low levels of Snail, they found that women whose original breast cancers expressed high levels of Snail were twice as likely to experience a recurrence within five years following surgery compared to women whose cancers expressed low levels of Snail.

The magnitude of risk associated with high Snail expression is comparable to standard prognostic factors such as estrogen-receptor status, HER-2/Neu amplification, tumor size and grade, and lymph node status and - after correcting for the effects of these factors - Snail expression was shown to predict a woman's risk of recurrence independent of these factors.

Currently, Chodosh and colleagues are exploring the precise molecular mechanism by which Snail triggers breast cancer recurrence, as well as ways of targeting Snail's signaling pathways as a possible therapeutic approach to prevent recurrence.
-end-
This research was funded by the National Cancer Institute and the US Army Breast Cancer Research Program. Co-authors are Susan Moody, Denise Perez, Tien-chi Pan, Christopher J. Sterner, and Kathleen L. Notorfrancesco, all from Penn, as well as Robert D. Cardiff from the University of California, Davis. This release and related images can also be found at: www.uphs.upenn.edu/news.

PENN Medicine is a $2.7 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System.

Penn's School of Medicine is ranked #3 in the nation for receipt of NIH research funds; and ranked #4 in the nation in U.S. News & World Report's most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

Penn Health System is comprised of: its flagship hospital, the Hospital of the University of Pennsylvania, consistently rated one of the nation's "Honor Roll" hospitals by U.S. News & World Report; Pennsylvania Hospital, the nation's first hospital; Presbyterian Medical Center; a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home health care and hospice.

The Abramson Cancer Center of the University of Pennsylvania was established in 1973 as a center of excellence in cancer research, patient care, education and outreach. Today, the Abramson Cancer Center ranks as one of the nation's best in cancer care, according to U.S. News & World Report, and is one of the top five in National Cancer Institute (NCI) funding. It is one of only 39 NCI-designated comprehensive cancer centers in the United States. Home to one of the largest clinical and research programs in the world, the Abramson Cancer Center of the University of Pennsylvania has 275 active cancer researchers and 250 Penn physicians involved in cancer prevention, diagnosis and treatment.

University of Pennsylvania School of Medicine

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.