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JNCI Journal of the National Cancer Institute 2001 93(24):1852-1857; doi:10.1093/jnci/93.24.1852
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Journal of the National Cancer Institute, Vol. 93, No. 24, 1852-1857, December 19, 2001
© 2001 Oxford University Press


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Insulin-Like Growth Factor-I Receptor Signaling and Resistance to Trastuzumab (Herceptin)

Yuhong Lu, Xiaolin Zi, Yunhua Zhao, Desmond Mascarenhas, Michael Pollak

Affiliations of authors: Y. Lu, X. Zi, Y. Zhao, M. Pollak, Department of Oncology, Jewish General Hospital, and McGill University, Montreal, PQ, Canada; D. Mascarenhas, Protigen Incorporated, Mountain View, CA.

Correspondence to: Michael Pollak, M.D., Jewish General Hospital, 3755 Côte Ste-Catherine, Montreal, PQ, Canada H3T 1E2 (e-mail: michael.pollak{at}mcgill.ca).

Background: Trastuzumab (Herceptin), an anti-HER2/neu receptor monoclonal antibody that inhibits growth of ErbB2-overexpressing breast cancer, is used to treat such cancers. Development of resistance to trastuzumab, however, is common. We investigated whether insulin-like growth factor-I (IGF-I), which activates cell survival signals, interferes with the growth-inhibitory action of trastuzumab. Methods: MCF-7/HER2-18 and SKBR3 human breast cancer models were used to assess cell proliferation, colony formation in soft agar, and cell cycle parameters. Throughout, we used trastuzumab at a dose of 10 µg/mL and IGF-I at a dose of 40 ng/mL. All statistical tests were two-sided. Results: Trastuzumab inhibited the growth of MCF-7/HER2-18 cells, which overexpress HER2/neu receptors and express IGF-I receptors (IGF-IRs), only when IGF-IR signaling was minimized. For example, in 1% fetal bovine serum (FBS), trastuzumab reduced cell proliferation by 42% (P = .002); however, in 10% FBS or IGF-I, trastuzumab had no effect on proliferation. In SKBR3 cells, which overexpress HER2/neu receptor but express few IGF-IRs, trastuzumab reduced proliferation by 42% (P = .008) regardless of IGF-I concentration. When SKBR3 cells were genetically altered to overexpress IGF-IRs and cultured with IGF-I, trastuzumab had no effect on proliferation. However, the addition of IGF-binding protein-3, which decreased IGF-IR signaling, restored trastuzumab-induced growth inhibition. Conclusions: In breast cancer cell models that overexpress HER2/neu, an increased level of IGF-IR signaling appears to interfere with the action of trastuzumab. Thus, strategies that target IGF-IR signaling may prevent or delay development of resistance to trastuzumab.



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Mol. Cancer Ther., July 1, 2005; 4(7): 1136 - 1136.
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Endocr Relat CancerHome page
H E Jones, J M W Gee, K M Taylor, D Barrow, H D Williams, M Rubini, and R I Nicholson
Development of strategies for the use of anti-growth factor treatments
Endocr. Relat. Cancer, July 1, 2005; 12(Supplement_1): S173 - S182.
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J. Biol. Chem.Home page
D. Lu, H. Zhang, H. Koo, J. Tonra, P. Balderes, M. Prewett, E. Corcoran, V. Mangalampalli, R. Bassi, D. Anselma, et al.
A Fully Human Recombinant IgG-like Bispecific Antibody to Both the Epidermal Growth Factor Receptor and the Insulin-like Growth Factor Receptor for Enhanced Antitumor Activity
J. Biol. Chem., May 20, 2005; 280(20): 19665 - 19672.
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JCOHome page
N. L. Spector, W. Xia, H. Burris III, H. Hurwitz, E. C. Dees, A. Dowlati, B. O'Neil, B. Overmoyer, P. K. Marcom, K. L. Blackwell, et al.
Study of the Biologic Effects of Lapatinib, a Reversible Inhibitor of ErbB1 and ErbB2 Tyrosine Kinases, on Tumor Growth and Survival Pathways in Patients With Advanced Malignancies
J. Clin. Oncol., April 10, 2005; 23(11): 2502 - 2512.
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JCOHome page
J. Baselga and C. L. Arteaga
Critical Update and Emerging Trends in Epidermal Growth Factor Receptor Targeting in Cancer
J. Clin. Oncol., April 10, 2005; 23(11): 2445 - 2459.
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J. Biol. Chem.Home page
T. Criswell, M. Beman, S. Araki, K. Leskov, E. Cataldo, L. D. Mayo, and D. A. Boothman
Delayed Activation of Insulin-like Growth Factor-1 Receptor/Src/MAPK/Egr-1 Signaling Regulates Clusterin Expression, a Pro-survival Factor
J. Biol. Chem., April 8, 2005; 280(14): 14212 - 14221.
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Ann OncolHome page
J. A. Menendez, L. Vellon, R. Colomer, and R. Lupu
Oleic acid, the main monounsaturated fatty acid of olive oil, suppresses Her-2/neu (erbB-2) expression and synergistically enhances the growth inhibitory effects of trastuzumab (HerceptinTM) in breast cancer cells with Her-2/neu oncogene amplification
Ann. Onc., March 1, 2005; 16(3): 359 - 371.
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Clin. Cancer Res.Home page
C. Tuccillo, M. Romano, T. Troiani, E. Martinelli, F. Morgillo, F. De Vita, R. Bianco, G. Fontanini, R. A. Bianco, G. Tortora, et al.
Antitumor Activity of ZD6474, a Vascular Endothelial Growth Factor-2 and Epidermal Growth Factor Receptor Small Molecule Tyrosine Kinase Inhibitor, in Combination with SC-236, a Cyclooxygenase-2 Inhibitor
Clin. Cancer Res., February 1, 2005; 11(3): 1268 - 1276.
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Cancer Res.Home page
P. Nagy, E. Friedlander, M. Tanner, A. I. Kapanen, K. L. Carraway, J. Isola, and T. M. Jovin
Decreased Accessibility and Lack of Activation of ErbB2 in JIMT-1, a Herceptin-Resistant, MUC4-Expressing Breast Cancer Cell Line
Cancer Res., January 15, 2005; 65(2): 473 - 482.
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Clin. Cancer Res.Home page
E. R. Camp, J. Summy, T. W. Bauer, W. Liu, G. E. Gallick, and L. M. Ellis
Molecular Mechanisms of Resistance to Therapies Targeting the Epidermal Growth Factor Receptor
Clin. Cancer Res., January 1, 2005; 11(1): 397 - 405.
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Endocr Relat CancerHome page
H E Jones, L Goddard, J M W Gee, S Hiscox, M Rubini, D Barrow, J M Knowlden, S Williams, A E Wakeling, and R I Nicholson
Insulin-like growth factor-I receptor signalling and acquired resistance to gefitinib (ZD1839; Iressa) in human breast and prostate cancer cells
Endocr. Relat. Cancer, December 1, 2004; 11(4): 793 - 814.
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Mol. Cell. Biol.Home page
J. A. Nagle, Z. Ma, M. A. Byrne, M. F. White, and L. M. Shaw
Involvement of Insulin Receptor Substrate 2 in Mammary Tumor Metastasis
Mol. Cell. Biol., November 15, 2004; 24(22): 9726 - 9735.
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Cancer Res.Home page
S. K. Rabindran, C. M. Discafani, E. C. Rosfjord, M. Baxter, M. B. Floyd, J. Golas, W. A. Hallett, B. D. Johnson, R. Nilakantan, E. Overbeek, et al.
Antitumor Activity of HKI-272, an Orally Active, Irreversible Inhibitor of the HER-2 Tyrosine Kinase
Cancer Res., June 1, 2004; 64(11): 3958 - 3965.
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Clin. Cancer Res.Home page
C. Warburton, W. H. Dragowska, K. Gelmon, S. Chia, H. Yan, D. Masin, T. Denyssevych, A. E. Wallis, and M. B. Bally
Treatment of HER-2/neu Overexpressing Breast Cancer Xenograft Models with Trastuzumab (Herceptin) and Gefitinib (ZD1839): Drug Combination Effects on Tumor Growth, HER-2/neu and Epidermal Growth Factor Receptor Expression, and Viable Hypoxic Cell Fraction
Clin. Cancer Res., April 1, 2004; 10(7): 2512 - 2524.
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Cancer Res.Home page
M. Klinger, H. Farhan, H. Just, H. Drobny, G. Himmler, H. Loibner, G. C. Mudde, M. Freissmuth, and V. Sexl
Antibodies Directed against Lewis-Y Antigen Inhibit Signaling of Lewis-Y Modified ErbB Receptors
Cancer Res., February 1, 2004; 64(3): 1087 - 1093.
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J. Biol. Chem.Home page
D. Lu, H. Zhang, D. Ludwig, A. Persaud, X. Jimenez, D. Burtrum, P. Balderes, M. Liu, P. Bohlen, L. Witte, et al.
Simultaneous Blockade of Both the Epidermal Growth Factor Receptor and the Insulin-like Growth Factor Receptor Signaling Pathways in Cancer Cells with a Fully Human Recombinant Bispecific Antibody
J. Biol. Chem., January 23, 2004; 279(4): 2856 - 2865.
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Clin. Cancer Res.Home page
F. Ciardiello, R. Bianco, R. Caputo, R. Caputo, V. Damiano, T. Troiani, D. Melisi, F. De Vita, S. De Placido, A. R. Bianco, et al.
Antitumor Activity of ZD6474, a Vascular Endothelial Growth Factor Receptor Tyrosine Kinase Inhibitor, in Human Cancer Cells with Acquired Resistance to Antiepidermal Growth Factor Receptor Therapy
Clin. Cancer Res., January 15, 2004; 10(2): 784 - 793.
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Cancer Res.Home page
T. O. Nielsen, H. N. Andrews, M. Cheang, J. E. Kucab, F. D. Hsu, J. Ragaz, C. B. Gilks, N. Makretsov, C. D. Bajdik, C. Brookes, et al.
Expression of the Insulin-Like Growth Factor I Receptor and Urokinase Plasminogen Activator in Breast Cancer Is Associated with Poor Survival: Potential for Intervention with 17-Allylamino Geldanamycin
Cancer Res., January 1, 2004; 64(1): 286 - 291.
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Cancer Res.Home page
D. Burtrum, Z. Zhu, D. Lu, D. M. Anderson, M. Prewett, D. S. Pereira, R. Bassi, R. Abdullah, A. T. Hooper, H. Koo, et al.
A Fully Human Monoclonal Antibody to the Insulin-Like Growth Factor I Receptor Blocks Ligand-Dependent Signaling and Inhibits Human Tumor Growth in Vivo
Cancer Res., December 15, 2003; 63(24): 8912 - 8921.
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Integr Cancer TherHome page
D. B. Boyd
Insulin and Cancer
Integr Cancer Ther, December 1, 2003; 2(4): 315 - 329.
[Abstract] [PDF]


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Molecular Cancer TherapeuticsHome page
L. Fuino, P. Bali, S. Wittmann, S. Donapaty, F. Guo, H. Yamaguchi, H.-G. Wang, P. Atadja, and K. Bhalla
Histone deacetylase inhibitor LAQ824 down-regulates Her-2 and sensitizes human breast cancer cells to trastuzumab, taxotere, gemcitabine, and epothilone B
Mol. Cancer Ther., October 1, 2003; 2(10): 971 - 984.
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Cancer Res.Home page
H. Lapillonne, M. Konopleva, T. Tsao, D. Gold, T. McQueen, R. L. Sutherland, T. Madden, and M. Andreeff
Activation of Peroxisome Proliferator-activated Receptor {gamma} by a Novel Synthetic Triterpenoid 2-Cyano-3,12-dioxooleana-1,9-dien-28-oic Acid Induces Growth Arrest and Apoptosis in Breast Cancer Cells
Cancer Res., September 15, 2003; 63(18): 5926 - 5939.
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Ann OncolHome page
G. Atalay, F. Cardoso, A. Awada, and M. J. Piccart
Novel therapeutic strategies targeting the epidermal growth factor receptor (EGFR) family and its downstream effectors in breast cancer
Ann. Onc., September 1, 2003; 14(9): 1346 - 1363.
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Cancer Res.Home page
E. K. Maloney, J. L. McLaughlin, N. E. Dagdigian, L. M. Garrett, K. M. Connors, X.-M. Zhou, W. A. Blattler, T. Chittenden, and R. Singh
An Anti-Insulin-like Growth Factor I Receptor Antibody That Is a Potent Inhibitor of Cancer Cell Proliferation
Cancer Res., August 15, 2003; 63(16): 5073 - 5083.
[Abstract] [Full Text] [PDF]


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Ann OncolHome page
M. P. Goetz, D. O. Toft, M. M. Ames, and C. Erlichman
The Hsp90 chaperone complex as a novel target for cancer therapy
Ann. Onc., August 1, 2003; 14(8): 1169 - 1176.
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JCOHome page
D. H. Johnson and C. L. Arteaga
Gefitinib in Recurrent Non-Small-Cell Lung Cancer: An IDEAL Trial?
J. Clin. Oncol., June 15, 2003; 21(12): 2227 - 2229.
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C. L. Arteaga and J. Baselga
Clinical Trial Design and End Points for Epidermal Growth Factor Receptor-targeted Therapies: Implications for Drug Development and Practice
Clin. Cancer Res., May 1, 2003; 9(5): 1579 - 1589.
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Cancer Res.Home page
D. Sachdev, S.-L. Li, J. S. Hartell, Y. Fujita-Yamaguchi, J. S. Miller, and D. Yee
A Chimeric Humanized Single-Chain Antibody against the Type I Insulin-like Growth Factor (IGF) Receptor Renders Breast Cancer Cells Refractory to the Mitogenic Effects of IGF-I
Cancer Res., February 1, 2003; 63(3): 627 - 635.
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The OncologistHome page
R. Nahta, G. N. Hortobagyi, and F. J. Esteva
Growth Factor Receptors in Breast Cancer: Potential for Therapeutic Intervention
Oncologist, February 1, 2003; 8(1): 5 - 17.
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J. Biol. Chem.Home page
A. Hurbin, L. Dubrez, J.-L. Coll, and M.-C. Favrot
Inhibition of Apoptosis by Amphiregulin via an Insulin-like Growth Factor-1 Receptor-dependent Pathway in Non-small Cell Lung Cancer Cell Lines
J. Biol. Chem., December 13, 2002; 277(51): 49127 - 49133.
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JNCI J Natl Cancer InstHome page
J. Albanell and J. Baselga
Unraveling Resistance to Trastuzumab (Herceptin): Insulin-Like Growth Factor-I Receptor, a New Suspect
J Natl Cancer Inst, December 19, 2001; 93(24): 1830 - 1832.
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