Androgen and oestrogen receptor co-expression determines the efficacy of hormone receptor-mediated radiosensitisation in breast cancer

Br J Cancer. 2022 Sep;127(5):927-936. doi: 10.1038/s41416-022-01849-9. Epub 2022 May 26.

Abstract

Purpose: Radiation therapy (RT) and hormone receptor (HR) inhibition are used for the treatment of HR-positive breast cancers; however, little is known about the interaction of the androgen receptor (AR) and estrogen receptor (ER) in response to RT in AR-positive, ER-positive (AR+/ER+) breast cancers. Here we assessed radiosensitisation of AR+/ER+ cell lines using pharmacologic or genetic inhibition/degradation of AR and/or ER.

Methods: Radiosensitisation was assessed with AR antagonists (enzalutamide, apalutamide, darolutamide, seviteronel, ARD-61), ER antagonists (tamoxifen, fulvestrant) or using knockout of AR.

Results: Treatment with AR antagonists or ER antagonists in combination with RT did not result in radiosensitisation changes (radiation enhancement ratios [rER]: 0.76-1.21). Fulvestrant treatment provided significant radiosensitisation of CAMA-1 and BT-474 cells (rER: 1.06-2.0) but not ZR-75-1 cells (rER: 0.9-1.11). Combining tamoxifen with enzalutamide did not alter radiosensitivity using a 1 h or 1-week pretreatment (rER: 0.95-1.14). Radiosensitivity was unchanged in AR knockout compared to Cas9 cells (rER: 1.07 ± 0.11), and no additional radiosensitisation was achieved with tamoxifen or fulvestrant compared to Cas9 cells (rER: 0.84-1.19).

Conclusion: While radiosensitising in AR + TNBC, AR inhibition does not modulate radiation sensitivity in AR+/ER+ breast cancer. The efficacy of ER antagonists in combination with RT may also be dependent on AR expression.

MeSH terms

  • Androgen Receptor Antagonists / pharmacology
  • Androgen Receptor Antagonists / therapeutic use
  • Androgens
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / radiotherapy
  • Cell Line, Tumor
  • Estrogen Receptor Antagonists / therapeutic use
  • Female
  • Fulvestrant / therapeutic use
  • Humans
  • Naphthalenes
  • Piperidines
  • Pyrrolidines
  • Radiation Tolerance* / drug effects
  • Radiation Tolerance* / genetics
  • Receptors, Androgen* / genetics
  • Receptors, Androgen* / metabolism
  • Receptors, Estrogen* / genetics
  • Receptors, Estrogen* / metabolism
  • Tamoxifen / pharmacology
  • Tamoxifen / therapeutic use
  • Thiazoles
  • Triazoles

Substances

  • ARD-61
  • Androgen Receptor Antagonists
  • Androgens
  • Estrogen Receptor Antagonists
  • Naphthalenes
  • Piperidines
  • Pyrrolidines
  • Receptors, Androgen
  • Receptors, Estrogen
  • Thiazoles
  • Triazoles
  • Tamoxifen
  • Fulvestrant
  • seviteronel