PMID- 25789974 OWN - NLM STAT- MEDLINE DCOM- 20151130 LR - 20211203 IS - 2041-4889 (Electronic) VI - 6 IP - 3 DP - 2015 Mar 19 TI - Regulation of anti-apoptotic signaling by Kruppel-like factors 4 and 5 mediates lapatinib resistance in breast cancer. PG - e1699 LID - 10.1038/cddis.2015.65 [doi] AB - The Kruppel-like transcription factors (KLFs) 4 and 5 (KLF4/5) are coexpressed in mouse embryonic stem cells, where they function redundantly to maintain pluripotency. In mammary carcinoma, KLF4/5 can each impact the malignant phenotype, but potential linkages to drug resistance remain unclear. In primary human breast cancers, we observed a positive correlation between KLF4/5 transcript abundance, particularly in the human epidermal growth factor receptor 2 (HER2)-enriched subtype. Furthermore, KLF4/5 protein was rapidly upregulated in human breast cancer cells following treatment with the HER2/epidermal growth factor receptor inhibitor, lapatinib. In addition, we observed a positive correlation between these factors in the primary tumors of genetically engineered mouse models (GEMMs). In particular, the levels of both factors were enriched in the basal-like tumors of the C3(1) TAg (SV40 large T antigen transgenic mice under control of the C3(1)/prostatein promoter) GEMM. Using tumor cells derived from this model as well as human breast cancer cells, suppression of KLF4 and/or KLF5 sensitized HER2-overexpressing cells to lapatinib. Indicating cooperativity, greater effects were observed when both genes were depleted. KLF4/5-deficient cells had reduced basal mRNA and protein levels of the anti-apoptotic factors myeloid cell leukemia 1 (MCL1) and B-cell lymphoma-extra large (BCL-XL). Moreover, MCL1 was upregulated by lapatinib in a KLF4/5-dependent manner, and enforced expression of MCL1 in KLF4/5-deficient cells restored drug resistance. In addition, combined suppression of KLF4/5 in cultured tumor cells additively inhibited anchorage-independent growth, resistance to anoikis and tumor formation in immunocompromised mice. Consistent with their cooperative role in drug resistance and other malignant properties, KLF4/5 levels selectively stratified human HER2-enriched breast cancer by distant metastasis-free survival. These results identify KLF4 and KLF5 as cooperating protumorigenic factors and critical participants in resistance to lapatinib, furthering the rationale for combining anti-MCL1/BCL-XL inhibitors with conventional HER2-targeted therapies. FAU - Farrugia, M K AU - Farrugia MK AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] Program in Cancer Cell Biology, West Virginia University, Morgantown, WV 26506, USA. FAU - Sharma, S B AU - Sharma SB AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] Program in Cancer Cell Biology, West Virginia University, Morgantown, WV 26506, USA. FAU - Lin, C-C AU - Lin CC AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA. FAU - McLaughlin, S L AU - McLaughlin SL AD - The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA. FAU - Vanderbilt, D B AU - Vanderbilt DB AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] Program in Cancer Cell Biology, West Virginia University, Morgantown, WV 26506, USA. FAU - Ammer, A G AU - Ammer AG AD - The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA. FAU - Salkeni, M A AU - Salkeni MA AD - 1] The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA [2] Department of Medicine, West Virginia University, Morgantown, WV 26506, USA. FAU - Stoilov, P AU - Stoilov P AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] Program in Cancer Cell Biology, West Virginia University, Morgantown, WV 26506, USA [3] The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA. FAU - Agazie, Y M AU - Agazie YM AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] Program in Cancer Cell Biology, West Virginia University, Morgantown, WV 26506, USA [3] The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA. FAU - Creighton, C J AU - Creighton CJ AD - Department of Medicine and Dan L Duncan Cancer Center, Division of Biostatistics, Baylor College of Medicine, Houston, TX 77030, USA. FAU - Ruppert, J M AU - Ruppert JM AD - 1] Department of Biochemistry, West Virginia University Health Sciences Center, Morgantown, WV 26506, USA [2] Program in Cancer Cell Biology, West Virginia University, Morgantown, WV 26506, USA [3] The Mary Babb Randolph Cancer Center, West Virginia University, Morgantown, WV 26506, USA. LA - eng GR - P20 RR016440/RR/NCRR NIH HHS/United States GR - S10RR026378/RR/NCRR NIH HHS/United States GR - P30 CA125123/CA/NCI NIH HHS/United States GR - P30 RR032138/RR/NCRR NIH HHS/United States GR - P20 RR016477/RR/NCRR NIH HHS/United States GR - P20GM103434/GM/NIGMS NIH HHS/United States GR - P30GM103488/GM/NIGMS NIH HHS/United States GR - S10 RR026378/RR/NCRR NIH HHS/United States GR - S10 RR020866/RR/NCRR NIH HHS/United States GR - P20 GM103434/GM/NIGMS NIH HHS/United States GR - P30 GM103488/GM/NIGMS NIH HHS/United States GR - P30 RR032138/GM103488/GM/NIGMS NIH HHS/United States GR - R01 CA127405/CA/NCI NIH HHS/United States GR - RR020866/RR/NCRR NIH HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PT - Research Support, Non-U.S. Gov't DEP - 20150319 PL - England TA - Cell Death Dis JT - Cell death & disease JID - 101524092 RN - 0 (KLF4 protein, human) RN - 0 (KLF5 protein, human) RN - 0 (Klf4 protein, mouse) RN - 0 (Kruppel-Like Factor 4) RN - 0 (Kruppel-Like Transcription Factors) RN - 0 (MCL1 protein, human) RN - 0 (Myeloid Cell Leukemia Sequence 1 Protein) RN - 0 (Quinazolines) RN - 0VUA21238F (Lapatinib) RN - EC 2.7.10.1 (ERBB2 protein, human) RN - EC 2.7.10.1 (Receptor, ErbB-2) SB - IM MH - Animals MH - Apoptosis/drug effects MH - Breast Neoplasms/*drug therapy/genetics/pathology MH - Drug Resistance, Neoplasm/*genetics MH - Female MH - Gene Expression Regulation, Neoplastic/drug effects MH - Humans MH - Kaplan-Meier Estimate MH - Kruppel-Like Factor 4 MH - Kruppel-Like Transcription Factors/*biosynthesis MH - Lapatinib MH - Mice MH - Myeloid Cell Leukemia Sequence 1 Protein/*biosynthesis/genetics MH - Quinazolines/administration & dosage MH - Receptor, ErbB-2/genetics MH - Signal Transduction/drug effects PMC - PMC4385942 EDAT- 2015/03/20 06:00 MHDA- 2015/12/15 06:00 PMCR- 2015/03/01 CRDT- 2015/03/20 06:00 PHST- 2014/11/12 00:00 [received] PHST- 2015/02/10 00:00 [revised] PHST- 2015/02/12 00:00 [accepted] PHST- 2015/03/20 06:00 [entrez] PHST- 2015/03/20 06:00 [pubmed] PHST- 2015/12/15 06:00 [medline] PHST- 2015/03/01 00:00 [pmc-release] AID - cddis201565 [pii] AID - 10.1038/cddis.2015.65 [doi] PST - epublish SO - Cell Death Dis. 2015 Mar 19;6(3):e1699. doi: 10.1038/cddis.2015.65.