학술논문

ESR1 ligand-binding domain mutations in hormone-resistant breast cancer
Document Type
Report
Source
Nature Genetics. December 1, 2013, Vol. 45 Issue 12, p1439, 9 p.
Subject
Identification and classification
Genetic aspects
Estrogen receptors -- Genetic aspects
Gene mutation -- Identification and classification
Drug resistance -- Genetic aspects
Breast cancer -- Genetic aspects
Gene mutations -- Identification and classification
Estrogen -- Receptors
Language
English
ISSN
1061-4036
Abstract
ER is a member of the nuclear receptor family and regulates the transformed phenotype of the majority of breast cancers. Pharmacological inhibitors of estrogen-driven signaling are effective in many of [...]
Seventy percent of breast cancers express estrogen receptor (ER), and most of these are sensitive to ER inhibition. However, many such tumors for unknown reasons become refractory to inhibition of estrogen action in the metastatic setting. We conducted a comprehensive genetic analysis of two independent cohorts of metastatic ER-positive breast tumors and identified mutations in ESR1 affecting the ligand-binding domain (LBD) in 14 of 80 cases. These included highly recurrent mutations encoding p.Tyr537Ser, p.Tyr537Asn and p.Asp538Gly alterations. Molecular dynamics simulations suggest that the structures of the Tyr537Ser and Asp538Gly mutants involve hydrogen bonding of the mutant amino acids with Asp351, thus favoring the agonist conformation of the receptor. Consistent with this model, mutant receptors drive ER-dependent transcription and proliferation in the absence of hormone and reduce the efficacy of ER antagonists. These data implicate LBD-mutant forms of ER in mediating clinical resistance to hormonal therapy and suggest that more potent ER antagonists may be of substantial therapeutic benefit.