Innate or acquired chemoresistance to therapeutic agents remains a challenge in the management of cancer and especially metastasis. Multi-drug therapy is often targeted at the heterogeneous residual cancer cells, usually following surgical resection, with the hope of preventing recurrence. In addition to standard-of-care drugs, the choice of particular chemotherapeutics is often guided by histo- and/or expression analysis of various markers -dependent on cancer type [
33]. Expression profiling of tumors before initial chemotherapy is becoming increasingly common and has aided in the development of targeted therapy including Herceptin® and Avastin®.
Histochemical analysis reveals that clinically, loss of BRMS1 is correlated with poor prognosis in a subset of breast carcinomas [
7–
9]. Further, BRMS1 expression is lost in higher grade ovarian [
6] and supraglottic laryngeal carcinomas [
34]. At the molecular level, increased AKT and NF-κB activity have been demonstrated to contribute to chemoresistance [
23–
25]. BRMS1 selectively decreases AKT phosphorylation in response to growth factors [
17] and downregulates NF-κB activity [
21]. Although we show here that BRMS1 does not modulate PTEN expression, PtdIns(4,5)P
2 is decreased by >95% in BRMS1-expressing cells [
20]. Since BRMS1 downregulates a number of mediators of chemoresistance, and since BRMS1 expression appears to be important in determining metastatic fate, these data provided a compelling rationale to test the hypothesis that BRMS1 would increase chemosensitivity of breast cancer cells. To our surprise, BRMS1 expression did not alter chemosensitivity of breast cancer cells in multiple
in vitro assays.
Chemotherapeutic agents in this study were selected based on their known mechanisms of action, and their ability to antagonize or act through some of the same pathways mediated by BRMS1. For example, doxorubicin has been demonstrated to decrease levels of PtdIns(4,5)P
2[
35] while vincristine mediates cell death, in part, by activation of pro-apoptotic genes through NF-κB [
36,
37]. Previous data indicates that BRMS1 expression did not alter
in vitro proliferation or rate of
in vivo tumor growth [
4,
13,
38,
39]. Halogenated pyrimidines including 5-FU are metabolized to derivatives that replace thymidylate in actively dividing cells [
40]. The anthracycline antibiotic doxorubicin (adriamycin) forms a trimer-complex with topoisomerase-II and DNA and also intercalates with DNA in dividing cells preventing DNA replication. The relative lack of effect of 5-FU and doxorubicin on both colony formation and proliferation of BRMS1-expressing cells may therefore be explained by the lack of change in proliferation rate by BRMS1
in vitro, although a comparable dose-dependent decrease in assay end-points is observed. Doxorubicin is also reported to decrease PtdIns(4,5)P
2 levels [
35] (as BRMS1 does), however, no potentiation of growth inhibition was observed when BRMS1-expressing cells were exposed to doxorubicin. The vinca alkaloid vincristine and the diterpenoid paclitaxel both bind β-tubulin and disrupt microtubule polymerization and disassembly respectively. BRMS1 has recently been shown to downregulate β-tubulin 6 (TUBB6) expression by microarray analysis [
41]. In the presence of downregulation of TUBB6, BRMS1-expressing cells show no apparent disruption in cell-cycle progression (data not shown). Inhibition of NF-κB is known to sensitize tumor cells to microtubule disrupting agents such as paclitaxel and vincristine [
42]. Reports also indicate that activation of NF-κB following vincristine exposure is perhaps required for inducing pro-apoptotic genes [
36,
37]. The apparent lack of change in survival of BRMS1-expressing cells may reflect antagonistic signaling through NF-κB. Expression analysis of common mediators of chemoresistance including AKT isoforms and PTEN also did not show consistent changes in BRMS1-expressing cells suggesting that the lack of increased sensitivity to drugs tested may not involve these mediators.
Overall, our data with two different breast cancer cell lines indicates that BRMS1 expression status does not modify the response to commonly used chemotherapeutic agents although the mechanisms of actions of these drugs and BRMS1 intersect at various levels of signaling. Since tumor protein expression analysis increasingly guides therapy decisions, and since loss of BRMS1 is predictive of metastatic outcome [
7], our data may be of translational benefit in directing the course of disease management including profiling for BRMS1 expression before start of therapy.