1. The androgen receptor is a tumor suppressor in estrogen receptor–positive breast cancer
- Author
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Geraldine Laven-Law, Wilbert Zwart, Tarek M. A. Abdel-Fatah, Theresa E. Hickey, Mun N. Hui, Sarah Alexandrou, Luke A. Selth, Kee Ming Chia, Ian O. Ellis, C. Elizabeth Caldon, Daniel L. Roden, Jessica Finlay-Schultz, Suzan Stelloo, Shalini Jindal, Alexander Swarbrick, Wayne D. Tilley, Stephen N. Birrell, Carol A. Sartorius, Heloisa Helena Milioli, Richard Iggo, Carlo Palmieri, Esmaeil Ebrahimie, Jason S. Carroll, and Elgene Lim
- Subjects
0301 basic medicine ,medicine.drug_class ,Estrogen receptor ,Breast Neoplasms ,General Biochemistry, Genetics and Molecular Biology ,Nuclear Receptor Coactivator 3 ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Downregulation and upregulation ,Cell Line, Tumor ,medicine ,Humans ,Cell Proliferation ,biology ,business.industry ,Proteomics and Chromatin Biology ,Estrogen Receptor alpha ,Cyclin-Dependent Kinase 4 ,Cyclin-Dependent Kinase 6 ,General Medicine ,medicine.disease ,Androgen receptor ,030104 developmental biology ,Receptors, Androgen ,Estrogen ,030220 oncology & carcinogenesis ,Nuclear receptor coactivator 3 ,Androgens ,MCF-7 Cells ,Cancer research ,biology.protein ,Female ,Cyclin-dependent kinase 6 ,business ,Estrogen receptor alpha ,Signal Transduction - Abstract
The role of the androgen receptor (AR) in estrogen receptor (ER)-α-positive breast cancer is controversial, constraining implementation of AR-directed therapies. Using a diverse, clinically relevant panel of cell-line and patient-derived models, we demonstrate that AR activation, not suppression, exerts potent antitumor activity in multiple disease contexts, including resistance to standard-of-care ER and CDK4/6 inhibitors. Notably, AR agonists combined with standard-of-care agents enhanced therapeutic responses. Mechanistically, agonist activation of AR altered the genomic distribution of ER and essential co-activators (p300, SRC-3), resulting in repression of ER-regulated cell cycle genes and upregulation of AR target genes, including known tumor suppressors. A gene signature of AR activity positively predicted disease survival in multiple clinical ER-positive breast cancer cohorts. These findings provide unambiguous evidence that AR has a tumor suppressor role in ER-positive breast cancer and support AR agonism as the optimal AR-directed treatment strategy, revealing a rational therapeutic opportunity. Functional interplay of sex hormones in estrogen receptor–positive breast cancer unveils the therapeutic potential of androgen receptor agonists.
- Published
- 2021
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