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Supplementary Figures from AZD9496: An Oral Estrogen Receptor Inhibitor That Blocks the Growth of ER-Positive and <i>ESR1</i>-Mutant Breast Tumors in Preclinical Models

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posted on 2023-03-30, 23:48 authored by Hazel M. Weir, Robert H. Bradbury, Mandy Lawson, Alfred A. Rabow, David Buttar, Rowena J. Callis, Jon O. Curwen, Camila de Almeida, Peter Ballard, Michael Hulse, Craig S. Donald, Lyman J.L. Feron, Galith Karoutchi, Philip MacFaul, Thomas Moss, Richard A. Norman, Stuart E. Pearson, Michael Tonge, Gareth Davies, Graeme E. Walker, Zena Wilson, Rachel Rowlinson, Steve Powell, Claire Sadler, Graham Richmond, Brendon Ladd, Ermira Pazolli, Anne Marie Mazzola, Celina D'Cruz, Chris De Savi
<p>Supplementary Figure 1 contains a Western blot showing the amount of estrogen receptor remaining after treatment of MCF-7 cells with AZD9496, fulvestrant and estradiol alongside GAPDH protein levels as an internal gel loading control; Supplementary Figure 2 shows the rate of decreased detection by mass spectrometry of an estrogen receptor heavy isotype labelled peptide over time after treatment of cells with AZD9496, fulvestrant and tamoxifen and the calculated half life; Supplementary Figure 3 shows the degradation of estrogen receptor α by AZD9496, fulvestrant and estradiol in the presence of +/- 10 μM proteosomal inhibitor MG132; Supplementary Figure 4 contains a Western blot showing the re-emergence over 48 hours of estrogen receptor α following removal of AZD9496, fulvestrant and estradiol compounds from MCF-7 cells; Supplementary Figure 5 shows a bar chart of the measured estradiol levels in the blood of mice over 42 days after implantation of the mice with estrogen pellets to support growth of the MCF-7 cells as a tumour in mice; Supplementary Figure 6 shows the effects of AZD9496, fulvestrant and tamoxifen on mRNA levels of estrogen receptor regulated genes in vitro and in vivo; Supplementary Figure 7 shows the levels of estrogen receptor α protein remaining in tumours from the HCC1428 LTED model after treatment with AZD9496 and fulvestrant.</p>

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ARTICLE ABSTRACT

Fulvestrant is an estrogen receptor (ER) antagonist administered to breast cancer patients by monthly intramuscular injection. Given its present limitations of dosing and route of administration, a more flexible orally available compound has been sought to pursue the potential benefits of this drug in patients with advanced metastatic disease. Here we report the identification and characterization of AZD9496, a nonsteroidal small-molecule inhibitor of ERα, which is a potent and selective antagonist and downregulator of ERα in vitro and in vivo in ER-positive models of breast cancer. Significant tumor growth inhibition was observed as low as 0.5 mg/kg dose in the estrogen-dependent MCF-7 xenograft model, where this effect was accompanied by a dose-dependent decrease in PR protein levels, demonstrating potent antagonist activity. Combining AZD9496 with PI3K pathway and CDK4/6 inhibitors led to further growth-inhibitory effects compared with monotherapy alone. Tumor regressions were also seen in a long-term estrogen-deprived breast model, where significant downregulation of ERα protein was observed. AZD9496 bound and downregulated clinically relevant ESR1 mutants in vitro and inhibited tumor growth in an ESR1-mutant patient-derived xenograft model that included a D538G mutation. Collectively, the pharmacologic evidence showed that AZD9496 is an oral, nonsteroidal, selective estrogen receptor antagonist and downregulator in ER+ breast cells that could provide meaningful benefit to ER+ breast cancer patients. AZD9496 is currently being evaluated in a phase I clinical trial. Cancer Res; 76(11); 3307–18. ©2016 AACR.