Language

English

Publication Date

5-1-2024

Journal

Clinical Cancer Research

DOI

10.1158/1078-0432.CCR-23-2975

PMID

38381406

PMCID

PMC11061603

PubMedCentral® Posted Date

2-21-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Purpose: Resistance to endocrine therapy (ET) and CDK4/6 inhibitors (CDK4/6i) is a clinical challenge in estrogen receptor (ER)-positive (ER+) breast cancer. Cyclin-dependent kinase 7 (CDK7) is a candidate target in endocrine-resistant ER+ breast cancer models and selective CDK7 inhibitors (CDK7i) are in clinical development for the treatment of ER+ breast cancer. Nonetheless, the precise mechanisms responsible for the activity of CDK7i in ER+ breast cancer remain elusive. Herein, we sought to unravel these mechanisms.

Experimental design: We conducted multi-omic analyses in ER+ breast cancer models in vitro and in vivo, including models with different genetic backgrounds. We also performed genome-wide CRISPR/Cas9 knockout screens to identify potential therapeutic vulnerabilities in CDK4/6i-resistant models.

Results: We found that the on-target antitumor effects of CDK7 inhibition in ER+ breast cancer are in part p53 dependent, and involve cell cycle inhibition and suppression of c-Myc. Moreover, CDK7 inhibition exhibited cytotoxic effects, distinctive from the cytostatic nature of ET and CDK4/6i. CDK7 inhibition resulted in suppression of ER phosphorylation at S118; however, long-term CDK7 inhibition resulted in increased ER signaling, supporting the combination of ET with a CDK7i. Finally, genome-wide CRISPR/Cas9 knockout screens identified CDK7 and MYC signaling as putative vulnerabilities in CDK4/6i resistance, and CDK7 inhibition effectively inhibited CDK4/6i-resistant models.

Conclusions: Taken together, these findings support the clinical investigation of selective CDK7 inhibition combined with ET to overcome treatment resistance in ER+ breast cancer. In addition, our study highlights the potential of increased c-Myc activity and intact p53 as predictors of sensitivity to CDK7i-based treatments.

Keywords

Humans, Breast Neoplasms, Female, Drug Resistance, Neoplasm, Apoptosis, Animals, Mice, Receptors, Estrogen, Cyclin-Dependent Kinase-Activating Kinase, Cyclin-Dependent Kinases, Proto-Oncogene Proteins c-myc, Protein Kinase Inhibitors, Signal Transduction, Cell Cycle, Xenograft Model Antitumor Assays, Cell Line, Tumor, Cell Proliferation, Gene Expression Regulation, Neoplastic, Cyclin-Dependent Kinase 4, CRISPR-Cas Systems

Published Open-Access

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