Research Papers:

Estrogen stimulates female cancer progression by inducing myeloid-derived suppressive cells: investigations on pregnant and non-pregnant experimental models

Katsumi Kozasa, Seiji Mabuchi _, Yuri Matsumoto, Hiromasa Kuroda, Eriko Yokoi, Naoko Komura, Mahiru Kawano, Ryoko Takahashi, Tomoyuki Sasano, Kotaro Shimura, Michiko Kodama, Kae Hashimoto, Kenjiro Sawada, Kazunori Nagasaka and Tadashi Kimura

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Oncotarget. 2019; 10:1887-1902. https://doi.org/10.18632/oncotarget.26711

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Katsumi Kozasa1, Seiji Mabuchi1, Yuri Matsumoto1, Hiromasa Kuroda1, Eriko Yokoi1, Naoko Komura1, Mahiru Kawano1, Ryoko Takahashi1, Tomoyuki Sasano1, Kotaro Shimura1, Michiko Kodama1, Kae Hashimoto1, Kenjiro Sawada1, Kazunori Nagasaka2 and Tadashi Kimura1

1Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan

2Department of Obstetrics and Gynecology, Teikyo University School of Medicine, Tokyo, Japan

Correspondence to:

Seiji Mabuchi, email: [email protected]

Keywords: MDSC; estrogen; cervical cancer; brest cancer; pregnancy

Received: January 07, 2019     Accepted: February 09, 2019     Published: March 08, 2019


Objective: To investigate the clinical implications of 17β-estradiol (E2) in estrogen receptor α (ERα)-negative female cancer progression as well as the underlying biological mechanisms.

Methods: Clinical data from 306 locally-advanced cervical cancer (stage IIB-IVA) patients were analyzed in order to investigate the relationships between age, serum E2 levels, and treatment outcomes. Clinical samples, ERα-negative cervical and breast cancer cell lines, and mouse xenograft models of cervical and breast cancers were employed in order to elucidate the mechanisms responsible for the E2- and pregnancy-mediated progression of cervical and breast cancers, with a focus on the role of myeloid-derived suppressor cells (MDSC).

Results: Younger patients with elevated E2 levels showed significantly shorter progression-free survival (P = 0.040) and overall survival (P = 0.039). The exogenous E2 treatment stimulated the mobilization of MDSC from bone marrow and directly augmented their suppressive activities, leading to the progression of ERα-negative cervical and breast cancers. The co-administration of an anti-Gr-1 neutralizing antibody with E2 prevented the E2-mediated induction of MDSC, and attenuated E2-mediated tumor growth in cervical and breast cancer xenografts. Significantly increased MDSC numbers and enhanced tumor growth were observed during pregnancy in mice with cervical or breast cancer. Significantly increased MDSC numbers were also observed during pregnancy in cervical cancer patients.

Conclusions: E2 facilitates the progression of ERα-negative cervical or breast cancer under non-pregnant and pregnant conditions by inducing MDSC. MDSC inhibition therapy may have therapeutic efficacy in premenopausal or pregnant female cancer patients.

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