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Scheidemann, Erin R.; Demas, Diane M.; Hou, Chunyan; Ma, Junfeng; He, Wei; Sharma, Gaurav; Schultz, Eric; Weilbaecher, Katherine N.; Shajahan‐Haq, Ayesha N.
Molecular carcinogenesis, February 2024, 2024-Feb, 2024-02-00, 20240201, Volume: 63, Issue: 2Journal Article
Cyclin dependent kinase 4 and 6 inhibitors such as abemaciclib are routinely used to treat metastatic estrogen receptor positive (ER+) breast cancer. However, adaptive mechanisms inhibit their effectiveness and allow for disease progression. Using ER+ breast cancer cell models, we show that acquired resistance to abemaciclib is accompanied by increase in metastatic potential. Mass spectrometry‐based proteomics from abemaciclib sensitive and resistant cells showed that lysosomal proteins including CTSD (cathepsin D), cathepsin A and CD68 were significantly increased in resistant cells. Combination of abemaciclib and a lysosomal destabilizer, such as hydroxychloroquine (HCQ) or bafilomycin A1, resensitized resistant cells to abemaciclib. Also, combination of abemaciclib and HCQ decreased migration and invasive potential and increased lysosomal membrane permeability in resistant cells. Prosurvival B cell lymphoma 2 (BCL2) protein levels were elevated in resistant cells, and a triple treatment with abemaciclib, HCQ, and BCL2 inhibitor, venetoclax, significantly inhibited cell growth compared to treatment with abemaciclib and HCQ. Furthermore, resistant cells showed increased levels of Transcription Factor EB (TFEB), a master regulator of lysosomal‐autophagy genes, and siRNA mediated knockdown of TFEB decreased invasion in resistant cells. TFEB was found to be mutated in a subset of invasive human breast cancer samples, and overall survival analysis in ER+, lymph node‐positive breast cancer showed that increased TFEB expression correlated with decreased survival. Collectively, we show that acquired resistance to abemaciclib leads to increased metastatic potential and increased levels of protumorigenic lysosomal proteins. Therefore, the lysosomal pathway could be a therapeutic target in advanced ER+ breast cancer. Cyclin dependent kinase 4 and 6 inhibitors (CDK4/6i) induce lysosomal changes in breast cancer cells. Resistant cells display increased levels of Transcription Factor EB, a master regulator of genes associated with lysosomes, along with proteolytic cathepsins (CTSD) and lysosomal membrane protein CD68 (LAMP4). Prolonged exposure to CDK4/6i also leads to elevated levels of antiapoptotic protein B cell lymphoma 2 (BCL2). Resistant cells leverage these changes to sustain survival and increase metastatic potential but are susceptible to lysosome destabilizers, which restore sensitivity to CDK4/6i and reduce metastatic potential.
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