title: Sequential versus combined treatment of human breast cancer cells with antiestrogens and the vitamin D analogue EB1089 and evaluation of predictive markers for vitamin D treatment.
abstract: Development of resistance to antihormonal therapy is a major problem in the treatment of breast cancer patients. Metastatic tumors, which progress after a period of response to treatment, often respond to second line endocrine treatment, but eventually develop estrogen independent growth. Vitamin D analogues are promising new drugs, using alternative mechanisms to inhibit growth of breast cancer cells. The sensitivity to antiestrogens and vitamin D analogues has been proposed to be inverse, indicating that the sensitivity to vitamin D analogues might increase after development of antiestrogen resistance and vice versa. In this study, the inverse sensitivity between antiestrogens and the vitamin D analogue EB1089 was examined in antiestrogen and vitamin D resistant breast cancer cell lines. The majority of the investigated antiestrogen resistant cell lines had increased sensitivity to treatment with the vitamin D analogue EB1089. In addition, growth of a vitamin D resistant cell line was more inhibited by the pure antiestrogen ICI 182,780 than the growth of the parental cells, indicating that the compounds may be used sequentially. An association between the expression level of the vitamin D receptor (VDR) and EB1089 sensitivity was observed, suggesting that VDR is a possible predictive marker for response to vitamin D treatment. Valuation of Bcl-2 gene expression may be useful in combination with VDR to predict the outcome of treatment with EB1089. Furthermore, we observed a synergistic growth inhibition and an abrogated development of resistance upon combined treatment with ICI 182,780 and EB1089. Therefore, antiestrogens and vitamin D analogues may also be used as combined treatment for breast cancer patients in the future.
authors.affiliation: Department of Tumor Endocrinology, Institute of Cancer Biology, Danish Cancer Society, Denmark.
authors.forename: G L
authors.initials: GL
authors.lastname: Christensen
authors.forename: J S
authors.initials: JS
authors.lastname: Jepsen
authors.forename: C K
authors.initials: CK
authors.lastname: Fog
authors.forename: I J
authors.initials: IJ
authors.lastname: Christensen
authors.forename: A E
authors.initials: AE
authors.lastname: Lykkesfeldt
mesh_terms: D000970:Antineoplastic Agents / Q000494:pharmacology*; D001943:Breast Neoplasms / Q000188:drug therapy*; D002117:Calcitriol / Q000031:analogs & derivatives* / Q000494:pharmacology*; D045744:Cell Line, Tumor; D019008:Drug Resistance, Neoplasm / Q000187:drug effects; D004359:Drug Therapy, Combination; D004958:Estradiol / Q000031:analogs & derivatives* / Q000494:pharmacology; D020847:Estrogen Receptor Modulators / Q000494:pharmacology*; D047628:Estrogen Receptor alpha; D000077267:Fulvestrant; D019254:Genes, bcl-2 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D011237:Predictive Value of Tests; D018167:Receptors, Calcitriol / Q000187:drug effects; D011960:Receptors, Estrogen / Q000187:drug effects; D013629:Tamoxifen / Q000494:pharmacology; D014807:Vitamin D / Q000031:analogs & derivatives
chemical_list: D000970:Antineoplastic Agents; D020847:Estrogen Receptor Modulators; D047628:Estrogen Receptor alpha; D018167:Receptors, Calcitriol; D011960:Receptors, Estrogen; D013629:Tamoxifen; D014807:Vitamin D; D000077267:Fulvestrant; D004958:Estradiol; D002117:Calcitriol; C078903:seocalcitol