title: Vascular endothelial growth factor reduces tamoxifen efficacy and promotes metastatic colonization and desmoplasia in breast tumors.
abstract: Clinical studies have shown that decreased tamoxifen effectiveness correlates with elevated levels of vascular endothelial growth factor (VEGF)-A(165) in biopsy samples of breast cancers. To investigate the mechanisms underlying tamoxifen resistance and metastasis, we engineered the estrogen receptor (ER)-positive MCF-7 human breast cancer cell line to express VEGF to clinically relevant levels in a doxycycline-regulated manner. Induction of VEGF expression in orthotopically implanted xenografts that were initially tamoxifen responsive and noninvasive resulted in tamoxifen-resistant tumor growth and metastasis to the lungs. Lung metastases were also observed in a VEGF-dependent manner following tail vein injection of tumor cells. At both primary and metastatic sites, VEGF-overexpressing tumors exhibited extensive fibroblastic stromal content, a clinical feature called desmoplasia. VEGF-induced metastatic colonies were surrounded by densely packed stromal cells before detectable angiogenesis, suggesting that VEGF is involved in the initiation of desmoplasia. Because expression of VEGF receptors R1 and R2 was undetectable in these tumor cells, the observed VEGF effects on reduction of tamoxifen efficacy and metastatic colonization are most likely mediated by paracrine signaling that enhances tumor/stromal cell interactions and increases the level of desmoplasia. This study reveals new roles for VEGF in breast cancer progression and suggests that combination of antiestrogens and VEGF inhibitors may prolong tamoxifen sensitivity and prevent metastasis in patients with ER-positive tumors.
authors.affiliation: Southern Research Institute, University of Alabama at Birmingham, Birmingham, Alabama 35205, USA. qu@sri.org
authors.forename: Zhican
authors.initials: Z
authors.lastname: Qu
authors.forename: Sabrina
authors.initials: S
authors.lastname: Van Ginkel
authors.forename: Anshu M
authors.initials: AM
authors.lastname: Roy
authors.forename: Louise
authors.initials: L
authors.lastname: Westbrook
authors.forename: Mubina
authors.initials: M
authors.lastname: Nasrin
authors.forename: Yulia
authors.initials: Y
authors.lastname: Maxuitenko
authors.forename: Andra R
authors.initials: AR
authors.lastname: Frost
authors.forename: Delicia
authors.initials: D
authors.lastname: Carey
authors.forename: Wenquan
authors.initials: W
authors.lastname: Wang
authors.forename: Rongbao
authors.initials: R
authors.lastname: Li
authors.forename: William E
authors.initials: WE
authors.lastname: Grizzle
authors.forename: Jaideep V
authors.initials: JV
authors.lastname: Thottassery
authors.forename: Francis G
authors.initials: FG
authors.lastname: Kern
mesh_terms: D018931:Antineoplastic Agents, Hormonal / Q000494:pharmacology*; D001943:Breast Neoplasms / Q000473:pathology*; D006801:Humans; D009362:Neoplasm Metastasis; D015398:Signal Transduction / Q000187:drug effects; D013629:Tamoxifen / Q000494:pharmacology*; D042461:Vascular Endothelial Growth Factor A / Q000502:physiology*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D042461:Vascular Endothelial Growth Factor A; D013629:Tamoxifen