Cholesterol Depletion Modulates Drug Resistance Pathways to Sensitize Resistant Breast Cancer Cells to Tamoxifen

Anticancer Res. 2022 Jan;42(1):565-579. doi: 10.21873/anticanres.15514.

Abstract

Background: Cancer drug resistance poses a significant risk of relapse and mortality. Adjuvant tamoxifen use has significantly reduced breast cancer mortality; however, many patients relapse due to acquired resistance. We aim to assess the potential of a cholesterol depletor (acetyl plumbagin) combined with tamoxifen to reduce cholesterol accumulation and cancer drug resistance.

Materials and methods: Cell viability, apoptosis and cholesterol staining was assessed following combination treatment. Gene and protein expression in cancer drug resistance and lipoprotein signalling pathways were assessed using RT2 Profiler™ PCR arrays and STRING networks.

Results: Combined treatment led to an increase in apoptosis and reduced intracellular cholesterol in MCF-7 and long-term estrogen deprived (LTED) cells compared to single compound treatments. Furthermore, the combination treatment perturbed several cholesterol-related and cancer-drug resistance pathways.

Conclusion: The present study demonstrates the efficacy of tamoxifen combined with acetyl plumbagin in potentially disrupting the PI3K/Akt/PKB and Akt/mTORC1 signalling pathways in MCF-7 cells, reducing breast cancer cell proliferation and resistance.

Keywords: Breast cancer; acetyl plumbagin; cholesterol; drug resistance; tamoxifen.

MeSH terms

  • Antineoplastic Agents, Hormonal / pharmacology
  • Apoptosis / drug effects
  • Breast Neoplasms / drug therapy*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / metabolism
  • Breast Neoplasms / pathology
  • Cell Movement / drug effects
  • Cell Proliferation / drug effects
  • Cholesterol / metabolism*
  • Drug Resistance, Neoplasm / genetics
  • Estrogens / genetics
  • Estrogens / metabolism
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Lipoproteins / genetics*
  • Lipoproteins / metabolism
  • MCF-7 Cells
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / genetics
  • Neoplasm Recurrence, Local / metabolism
  • Neoplasm Recurrence, Local / pathology
  • Phosphatidylinositol 3-Kinases / genetics
  • Proto-Oncogene Proteins c-akt / genetics
  • Receptors, Estrogen / genetics
  • Tamoxifen / adverse effects
  • Tamoxifen / pharmacology*

Substances

  • Antineoplastic Agents, Hormonal
  • Estrogens
  • Lipoproteins
  • Receptors, Estrogen
  • Tamoxifen
  • Cholesterol
  • Proto-Oncogene Proteins c-akt