Prevention of cancer dormancy by Fbxw7 ablation eradicates disseminated tumor cells

JCI Insight. 2019 Feb 21;4(4):e125138. doi: 10.1172/jci.insight.125138.


Dormant cancer cells known as disseminated tumor cells (DTCs) are often present in bone marrow of breast cancer patients. These DTCs are thought to be responsible for the incurable recurrence of breast cancer. The mechanism underlying the long-term maintenance of DTCs remains unclear, however. Here, we show that Fbxw7 is essential for the maintenance of breast cancer dormancy. Genetic ablation of Fbxw7 in breast cancer cells disrupted the quiescence of DTCs, rendering them proliferative, in mouse xenograft and allograft models. Fbxw7-deficient DTCs were significantly depleted by treatment with paclitaxel, suggesting that cell proliferation induced by Fbxw7 ablation sensitized DTCs to chemotherapy. The combination of Fbxw7 ablation and chemotherapy reduced the number of DTCs even when applied after tumor cell dissemination. Mice injected with Fbxw7-deficient cancer cells survived longer after tumor resection and subsequent chemotherapy than did those injected with wild-type cells. Furthermore, database analysis revealed that breast cancer patients whose tumors expressed FBXW7 at a high level had a poorer prognosis than did those with a low FBXW7 expression level. Our results suggest that a wake-up strategy for DTCs based on Fbxw7 inhibition might be of value in combination with conventional chemotherapy for the treatment of breast cancer.

Keywords: Breast cancer; Cell cycle; Oncology; Ubiquitin-proteosome system.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents, Phytogenic / pharmacology
  • Antineoplastic Agents, Phytogenic / therapeutic use
  • Bone Marrow / pathology
  • Bone Marrow Cells / pathology
  • Breast / pathology
  • Breast Neoplasms / drug therapy
  • Breast Neoplasms / mortality
  • Breast Neoplasms / pathology*
  • Cell Line, Tumor / transplantation
  • Cell Proliferation
  • Cohort Studies
  • Datasets as Topic
  • Disease Models, Animal
  • Drug Resistance, Neoplasm / genetics
  • F-Box-WD Repeat-Containing Protein 7 / genetics
  • F-Box-WD Repeat-Containing Protein 7 / metabolism*
  • Female
  • Gene Expression Regulation, Neoplastic
  • Gene Knockout Techniques
  • Humans
  • Kaplan-Meier Estimate
  • MCF-7 Cells
  • Mice
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / prevention & control*
  • Paclitaxel / pharmacology
  • Paclitaxel / therapeutic use
  • Prognosis
  • Spheroids, Cellular
  • Xenograft Model Antitumor Assays


  • Antineoplastic Agents, Phytogenic
  • F-Box-WD Repeat-Containing Protein 7
  • FBXW7 protein, human
  • Fbxw7 protein, mouse
  • Paclitaxel