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Genetic profiles associated with resistance to palbociclib


                                     in combination with fulvestrant in hormone-receptor



                                                       positive breast cancer preclinical model



                                                                                                 Yong Wha Moon,
                                 Hematology and Oncology, Department of Internal Medicine, CHA Bundang Medical Center,  CHA University,

                                                                                                 Seongnam, Korea.






                                      ABSTRACT                                                                                                      RESULTS




   Background: Breast cancer represents the number one global cancer                                  1. Palbociclib-resistant genes by microarray
   burden in women. Although cyclin-dependent kinase 4 and 6 (CDK4/6)

   inhibitors are a highly effective therapy for hormone
   receptor (HR)-positive breast cancer, acquired resistance ultimately                                                                       Drug resistant mouse

   occurs in almost all cases. However, little is known about CDK4/6 inhibitor                                                            RNA
   resistance.                                                                                                                         Microarra

   Methods: Xenografting with HR-positive breast cancer cell line was                                                                       y         Palbociclib resistance
                                                                                                                                                      Control
   performed in nude mice. When the tumor size reached 50-100 mm , drug                                                        v                      Fulvestrant + palbociclib resistance
                                                                                       3
                                                                                                                                                      Fulvestrant resistance
   treatment was initiated. Palbociclib ± fulvestrant resulted in an initial dose-                                             s                                   Palbociclib-resistant genes
   dependent decrease in xenograft tumor size and subsequently acquired                                           v                                             Gene                             Fold

   resistance occurred (>25% regrowth from maximal reduction) after 8-9                                           s                        v
                                                                                                                                           s
   months. Using xenograft tumors, RNA microarray and whole exome                                                                                           SNORA14B                         -3.090357

   sequencing (WES) were performed to find out resistance mechanisms of                                                                                         TPT1                          -2.33181

   fulvestrant/palbociclib.                                                                                           v                 v                   SNORA74A                         -2.325456
                                                                                                                      s
   Results: RNA microarray revealed SNORA14B (-3.09X), TPT1(-2.33X),                                                                    s                     SYNPO2                         2.122405
   SNORA74A(-2.32X) , SYNPO2(2.12X), S100A7A(-2.10X), SNORD10(-                                                                                               S100A7A                        -2.100098

   1.64X), KIR2DL2(-1.61X), PGM5(-1.55X) as palbociclib-resistance genes.                                                                                    SNORD10                         -1.648976

   In addition, WES revealed ACLY, PRB4, and SMPD1 genes as                                                                                                   KIR2DL2                        -1.610371
   palbociclib/fulvestrant combination-resistance genes. We also found                                                                                          PGM5                         -1.554079

   fulvestrant resistance genes such as AGR3, ELOVL2, GFRA1, GREB1,
   IGF1R, IGKV1-17, NRIP1, PPM1K, TM4SF1 by WES. Those resistance                                    2. Mutations from PALOMA-3 found in this study by WES

   genes are under further validation.
                                                                                                                ESR1
                                                                                                             PIK3CA
                                                                                                                TP53                                                   Frame shift variant
                       EXPERIMENTAL SUMMARY                                                                      NF1                                                   Missense variant

                                                                                                              ERBB2                                                    Synonymous variant
                                                                                                               AKT1                                                    Missense + disruptive_inframe variant

                                                                                                                 RB1                                                   Synonymous + missense variant
                                                   Control
                                                                                                               KRAS
                                                                                                           CDKN1B

                         MCF7 Cell line                                                                       FGFR2
                                                  Fulvestrant                                                  CDK4
                                                                                                               CDK6
                                                                                                              FGFR3                                                       Value
                                                                                                               ACLY                                                        Control
                                                 Palbociclib
                                                                                                               PRB4                                                        Fulvestrant

                                                                                                             SMPD1                                                         Combination
                                                                                                                                                                           Palbociclib
                 Nude mouse
                                           Fulvestrant + Palbociclib                                 3. Mutations associated with palbociclib/fulvestrant combination resistance






                                                                                                        Control                                      Fulvestrant


                                                                                                                                                                                        COMB_ ONLY


                                                                                                                       12            2         11                                            ACLY

                                                                                                                                                                                            DDX60L
                                                                                                                                   464
                                                                                                                              4            3                                                 LRCH2

                                                                                                                                                                                             OTOA

                                                                                                                                    8                                                        PRB4

                                                                                                                                                                                             RNF10
                                                                                                                                                                                            SMPD1

                                                                                                                            Combination                                                     ZDHHC8




                                                                                                                                                CONCLUSION

            TEST category                                 Test chip


                                                                                                      We found out Palbociclib and/or fulvestrant -resistance genes in animal model. Our
                 WES                            Agilent SureSelect V6 200X
                                                                                                      Palbociclib/fulvestrant - resistant animal model could be used for drug development to
                                                                                                      overcome CDK4/6 inhibitor resistance.
              Microarray                  Affymetrix Human Gene 2.0 ST Array




                                                                                                                                                 Copyright ©  2022 Yong Wha Moon (ymoon@cha.ac.kr )
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