Selective ETAR antagonist atrasentan inhibits hypoxia-induced breast cancer cell invasion

Breast Cancer Res Treat. 2008 Mar;108(2):175-82. doi: 10.1007/s10549-007-9589-5. Epub 2007 Apr 28.


Tumour hypoxia, being widespread in solid tumours, is related to an increased risk of invasion and metastasis as well as to resistance to chemotherapy and radiotherapy. Hypoxia-inducible factor-1alpha (HIF-1alpha) has emerged as the key regulator of the cellular response to hypoxia. In primary breast cancers, HIF-1alpha is overexpressed, and high levels of HIF-1alpha predict for early relapse and increased metastasis. The endothelin (ET) axis, comprising the peptides ET-1, -2, -3 and their receptors A (ETAR) and B (ETBR), is another regulatory system of major relevance in human breast cancer. However, little is known about the interaction of HIF-1alpha and the ET axis in breast carcinomas. Therefore, we analysed expression of HIF-1alpha and the ET axis in 600 breast cancer tissue samples by immunohistochemistry, observing a significant correlation between expression of HIF-1alpha and ET-1 (P<0.001). In vitro, hypoxia was found to double ET-1 secretion of MCF-7 breast cancer cells (203.5% of controls; P<0.001), thereby promoting an invasive phenotype. Of note, real-time PCR analysis revealed that the increase of ET-1 was not due to enhanced transcription of the ET-1 gene. In invasion assays, breast cancer cell invasiveness was strongly increased by hypoxia (150.0% of controls; P=0.007). Most important, this increase was completely inhibited by the selective ETAR antagonist atrasentan. In conclusion, we provide evidence for a relevant interaction between hypoxia and the ET axis in breast cancer cells. Our data suggest that tumour hypoxia induces breast carcinoma invasiveness by releasing intracellularly stored ET-1. However, induction of invasiveness may be inhibited by selective ETAR antagonism, thus emphasising the promising status of the ET axis as a therapeutic target in breast cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antineoplastic Agents / pharmacology*
  • Antineoplastic Agents / therapeutic use
  • Aspartic Acid Endopeptidases / metabolism
  • Atrasentan
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Cell Hypoxia
  • Cell Line, Tumor
  • Cell Movement / drug effects*
  • Cobalt / pharmacology
  • Endothelin A Receptor Antagonists*
  • Endothelin-1 / metabolism
  • Endothelin-Converting Enzymes
  • Female
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism
  • Metalloendopeptidases / metabolism
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Pyrrolidines / pharmacology*
  • Pyrrolidines / therapeutic use
  • Receptor, Endothelin A / metabolism
  • Time Factors
  • Up-Regulation


  • Antineoplastic Agents
  • Endothelin A Receptor Antagonists
  • Endothelin-1
  • HIF1A protein, human
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • Pyrrolidines
  • Receptor, Endothelin A
  • Cobalt
  • Aspartic Acid Endopeptidases
  • Metalloendopeptidases
  • Endothelin-Converting Enzymes
  • cobaltous chloride
  • Atrasentan