title: Insulin-like growth factor 2 expression modulates Taxol resistance and is a candidate biomarker for reduced disease-free survival in ovarian cancer.
abstract: OBJECTIVE
  This study was undertaken to examine the role of the insulin-like growth factor (IGF) signaling pathway in the response of ovarian cancer cells to Taxol and to evaluate the significance of this pathway in human epithelial ovarian tumors.
  
  
  METHODS
  The effect of Taxol treatment on AKT activation in A2780 ovarian carcinoma cells was evaluated using antibodies specific for phospho-AKT. To study the drug-resistant phenotype, we developed a Taxol-resistant cell line, HEY-T30, derived from HEY ovarian carcinoma cells. IGF2 expression was measured by real-time PCR. A type 1 IGF receptor (IGF1R) inhibitor, NVP-AEW541, and IGF2 small interfering RNA were used to evaluate the effect of IGF pathway inhibition on proliferation and Taxol sensitivity. IGF2 protein expression was evaluated by immunohistochemistry in 115 epithelial ovarian tumors and analyzed in relation to clinical/pathologic factors using the chi(2) or Fisher's exact tests. The influence of IGF2 expression on survival was studied with Cox regression.
  
  
  RESULTS
  Taxol-induced AKT phosphorylation required IGF1R tyrosine kinase activity and was associated with upregulation of IGF2. Resistant cells had higher IGF2 expression compared with sensitive cells, and IGF pathway inhibition restored sensitivity to Taxol. High IGF2 tumor expression correlated with advanced stage (P < 0.001) and tumor grade (P < 0.01) and reduced disease-free survival (P < 0.05).
  
  
  CONCLUSIONS
  IGF2 modulates Taxol resistance, and tumor IGF2 expression is a candidate prognostic biomarker in epithelial ovarian tumors. IGF pathway inhibition sensitizes drug-resistant ovarian carcinoma cells to Taxol. Such novel findings suggest that IGF2 represents a therapeutic target in ovarian cancer, particularly in the setting of Taxol resistance.
authors.affiliation: Department of Obstetrics and Gynecology, Division of Gynecologic Oncology and Pathology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York 10461, USA. gloria.huang@einstein.yu.edu
authors.forename: Gloria S
authors.initials: GS
authors.lastname: Huang
authors.forename: Jurriaan
authors.initials: J
authors.lastname: Brouwer-Visser
authors.forename: Marissa J
authors.initials: MJ
authors.lastname: Ramirez
authors.forename: Christine H
authors.initials: CH
authors.lastname: Kim
authors.forename: Tiffany M
authors.initials: TM
authors.lastname: Hebert
authors.forename: Juan
authors.initials: J
authors.lastname: Lin
authors.forename: Hugo
authors.initials: H
authors.lastname: Arias-Pulido
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Qualls
authors.forename: Eric R
authors.initials: ER
authors.lastname: Prossnitz
authors.forename: Gary L
authors.initials: GL
authors.lastname: Goldberg
authors.forename: Harriet O
authors.initials: HO
authors.lastname: Smith
authors.forename: Susan Band
authors.initials: SB
authors.lastname: Horwitz
mesh_terms: D000972:Antineoplastic Agents, Phytogenic / Q000627:therapeutic use*; D014408:Biomarkers, Tumor / Q000032:analysis; D045744:Cell Line, Tumor; D049109:Cell Proliferation / Q000187:drug effects; D018572:Disease-Free Survival; D019008:Drug Resistance, Neoplasm; D005260:Female; D055785:Gene Knockdown Techniques; D006801:Humans; D007335:Insulin-Like Growth Factor II / Q000032:analysis / Q000378:metabolism*; D010051:Ovarian Neoplasms / Q000188:drug therapy* / Q000378:metabolism; D017239:Paclitaxel / Q000627:therapeutic use*; D010766:Phosphorylation; D011379:Prognosis; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism; D011743:Pyrimidines / Q000494:pharmacology; D011758:Pyrroles / Q000494:pharmacology; D034741:RNA, Small Interfering / Q000494:pharmacology; D017526:Receptor, IGF Type 1 / Q000037:antagonists & inhibitors; D015398:Signal Transduction / Q000187:drug effects
chemical_list: D000972:Antineoplastic Agents, Phytogenic; D014408:Biomarkers, Tumor; C501177:NVP-AEW541; D011743:Pyrimidines; D011758:Pyrroles; D034741:RNA, Small Interfering; D007335:Insulin-Like Growth Factor II; D017526:Receptor, IGF Type 1; D051057:Proto-Oncogene Proteins c-akt; D017239:Paclitaxel
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