Research Papers:

Activation of Akt characterizes estrogen receptor positive human breast cancers which respond to anthracyclines

Synnøve Yndestad _, Eilin Austreid, Ida R. Svanberg, Stian Knappskog, Per E. Lønning and Hans P. Eikesdal

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Oncotarget. 2017; 8:41227-41241. https://doi.org/10.18632/oncotarget.17167

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Synnøve Yndestad1,2, Eilin Austreid1, Ida R. Svanberg2, Stian Knappskog1,2, Per E. Lønning1,2 and Hans P. Eikesdal1,2

1Section of Oncology, Department of Clinical Science, University of Bergen, Bergen, Norway

2Department of Oncology, Haukeland University Hospital, Bergen, Norway

Correspondence to:

Hans P. Eikesdal, email: [email protected]

Keywords: Akt, doxorubicin, drug resistance, estrogen receptor, breast cancer

Received: October 17, 2016     Accepted: March 24, 2017     Published: April 17, 2017


Anthracyclines are key components of human breast cancer chemotherapy. Here, we explored the role of Akt signaling in anthracycline resistance.

The antitumor activity of doxorubicin and Akt inhibitor A-443654 alone or combined was examined in estrogen receptor (ER) positive and negative human breast cancer cell lines. Further, we examined mRNA changes induced by anthracyclines in locally advanced breast cancers biopsied before and after treatment in two clinical trials.

Doxorubicin increased Akt phosphorylation in ER positive MCF7 and T47D cell lines, with no effect in ER negative MDA-MB231 breast cancer cells. A-443654 was significantly more cytotoxic in doxorubicin-resistant compared to doxorubicin-naïve MCF7. This difference was not observed in MDA-MB231. Among 24 patients, AKT1 gene expression increased 24 hrs after the initial epirubicin exposure in ER positive tumors responding to therapy (n=6), as compared to ER positive non-responders (n=7) or ER negative tumors (n=11). In contrast, AKT1 mRNA changes after 16 weeks of doxorubicin were unrelated to clinical response and ER status (n=30).

In conclusion, rapid Akt activation was observed in ER positive breast cancers which responded to anthracyclines. Increased cytotoxicity of A-443654 in doxorubicin-resistant MCF7 cells indicates a possible role for Akt inhibitors in ER positive breast cancers where chemoresistance evolves.

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