Abstract 2838: Brief exposure to gefitinib/Iressa during premalignant risk window provides lifelong protection from mammary tumor development in MMTV-erbB-2 transgenic mice
Authors: Ma Zhikun , Jiang Yunbo , Yang Shihe , Kosanke Stanley D. , Feng Xiaoshan , Yang XiaoHe 
Published: June 2012

Abstract
Although chemopreventive agents targeting estrogen/estrogen receptor (ER) pathway have been effective for ER+ breast cancer, hormonal resistance associated with increased receptor tyrosine kinase activities, such as erbB-2 and/or EGFR, remains a significant issue in beast cancer prevention. Previous studies demonstrated that administration of gefitinib, an orally active EGFR tyrosine kinase inhibitor, to MMTV-erbB-2 transgenic mice inhibited mammary tumor development in these mice, suggesting that gefitinib is a promising agent for the prevention of ER-negative breast cancer. However, the prevention was achieved by high dose (100 mg/kg) and prolonged drug exposure (from 12 to 50 weeks). The tolerance to high dose/long-term of drug administration for the prevention regimens raised concerns in clinical application. In this study, we tested the efficacy of brief exposure to gefitinib during the high risk window in the prevention of mammary tumor development in the MMTV-erbB-2 transgenic mice and studied the underlying mechanisms. We found that brief exposure of gefitinib to these mice at a dosage of 100 mg/kg/day from 16 to 23 weeks (total 8 wks) resulted in significant chemopreventive effects. In contrast to no tumor-free animals in the control group by 52 weeks, mice in gefitinib treated group remained 65% tumor-free at the same age, which was comparable to the results from a previous report that mice with lifelong gefitinib were 75% tumor-free by 45 weeks. We further demonstrated that delayed tumor development in the treated mice was preceded with decreased mammary epithelial density. Molecular analysis indicated that gefitinib inhibited phosphorylation and expression of EGFR, erbB-3 and endogenous erbB-2 in premalignant mammary tissues. Phosphorylation of Akt1 and Erk1/2 was also significantly downregulated. Importantly, although tumors developed from this model were ER-, mammary tissues in the premalignant stage were ERα+; and gefitinib treatment drastically inhibited the phosphorylation and expression of ERα and the transcription of ER target genes, including EGF, EGFR, ESR1, Bcl-2, cyclin D1 and c-myc. Moreover, BrdU incorporation analysis demonstrates that cell proliferation in the mammary glands in gefitinib treated mice was significantly inhibited. Taken together, these data demonstrate that brief treatment with EGFR/erbB-2 targeting agents at the appropriate risk window may provide lifelong protection from mammary tumors, and inhibition of ER-erbB-2 crosstalk may play a critical role in this long lasting preventive process. Given the concerns associated with high dose/long-term gefitinib treatment, our findings are of great significance in directing clinical application of EGFR/erbB-2 targeting agents as chemopreventive agents.
Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 2838. doi:10.1158/1538-7445.AM2011-2838