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Increased autophagy blocks HER2-mediated breast tumorigenesis
Contributed by Beth Levine, February 23, 2018 (sent for review October 12, 2017; reviewed by José Baselga and Michael Karin)

Significance
Approximately 20% of breast cancers have amplification of a cancer-causing signaling molecule known as human epidermal growth factor receptor 2 (HER2). Decreased mRNA expression of the autophagy gene, beclin 1/BECN1, increases the risk of HER2-positive breast cancer. However, the role of Beclin 1-dependent autophagy in regulating HER2-mediated tumorigenesis is unknown. Here, we show that a mutation in Becn1 that increases basal autophagy prevents HER2-mediated tumorigenesis in mice and prevents HER2-mediated inhibition of autophagy in cultured cells. Furthermore, treatment with a cell-penetrating, autophagy-inducing peptide derived from Beclin 1 inhibits growth of HER2-positive human breast tumor xenografts in mice as efficiently as a clinically used agent that inhibits HER2 receptor tyrosine kinase activity. These findings demonstrate that genetic and pharmacological activation of autophagy inhibits HER2-mediated breast tumorigenesis.
Abstract
Allelic loss of the autophagy gene, beclin 1/BECN1, increases the risk of patients developing aggressive, including human epidermal growth factor receptor 2 (HER2)-positive, breast cancers; however, it is not known whether autophagy induction may be beneficial in preventing HER2-positive breast tumor growth. We explored the regulation of autophagy in breast cancer cells by HER2 in vitro and the effects of genetic and pharmacological strategies to increase autophagy on HER2-driven breast cancer growth in vivo. Our findings demonstrate that HER2 interacts with Beclin 1 in breast cancer cells and inhibits autophagy. Mice with increased basal autophagy due to a genetically engineered mutation in Becn1 are protected from HER2-driven mammary tumorigenesis, and HER2 fails to inhibit autophagy in primary cells derived from these mice. Moreover, treatment of mice with HER2-positive human breast cancer xenografts with the Tat-Beclin 1 autophagy-inducing peptide inhibits tumor growth as effectively as a clinically used HER2 tyrosine kinase inhibitor (TKI). This inhibition of tumor growth is associated with a robust induction of autophagy, a disruption of HER2/Beclin 1 binding, and a transcriptional signature in the tumors distinct from that observed with HER2 TKI treatment. Taken together, these findings indicate that the HER2-mediated inhibition of Beclin 1 and autophagy likely contributes to HER2-mediated tumorigenesis and that strategies to block HER2/Beclin 1 binding and/or increase autophagy may represent a new therapeutic approach for HER2-positive breast cancers.
Footnotes
↵1Present address: Molecular Genome Analysis Division, German Cancer Research Center, D-69120 Heidelberg, Germany.
- ↵2To whom correspondence should be addressed. Email: beth.levine{at}utsouthwestern.edu.
Author contributions: S.V.-R.-d.-C. and B.L. designed research; S.V.-R.-d.-C., Z.Z., and Á.F.F. performed research; S.V.-R.-d.-C., Z.Z., Á.F.F., B.C., M.K., G.X., Y.X., and B.L. analyzed data; and S.V.-R.-d.-C. and B.L. wrote the paper.
Reviewers: J.B., Memorial Sloan Kettering Cancer Center; and M.K., University of California, San Diego School of Medicine.
The authors declare no conflict of interest.
This article contains supporting information online at www.pnas.org/lookup/suppl/doi:10.1073/pnas.1717800115/-/DCSupplemental.
- Copyright © 2018 the Author(s). Published by PNAS.
This open access article is distributed under Creative Commons Attribution-NonCommercial-NoDerivatives License 4.0 (CC BY-NC-ND).
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