Regulation of hepatocyte growth factor activator inhibitor 2 by hypoxia in breast cancer.

  • Generali D
  • Fox S
  • Berruti A
 et al. 
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PURPOSE: To examine the in vitro regulation of hepatocyte growth factor activator inhibitor type 2 (HAI-2) in breast cancer cells and the in vivo predictive role for the efficacy of chemoendocrine primary therapy in patients with breast cancer. MATERIALS AND METHODS: HAI-2 regulation was studied in a panel of breast cancer cell lines comparing normoxia to hypoxia. The effect of HIF-1alpha RNAi on HAI-2 expression was evaluated in these cells. HAI-2 was examined in breast cancer using in situ hybridization and immunohistochemistry. The HAI-2 predictive role was assessed in T(2-4) N(0-1) breast cancers (n = 177) enrolled in a neoadjuvant randomized trial comparing epirubicin versus epirubicin + tamoxifen. RESULTS: HAI-2 mRNA and protein were regulated by hypoxia in the c-erbB2-positive cell lines, SKBR3 and BT474, and controlled by HIF-1alpha in these cells. Immunohistochemistry confirmed this profile with high expression of HAI-2 in c-erbB2-positive breast cancer. HAI-2 was correlated with T status (P < 0.004), node involvement (P = 0.01), and c-erbB2 expression (P = 0.05). HAI-2 also correlated with hypoxia markers such as carbonic anhydrase IX expression (P = 0.01) and HIF-1alpha. Additionally, high levels of HAI-2 were a significant predictor for poor clinical complete response to preoperative epirubicin in univariate (P = 0.01) and multivariate analyses (P = 0.016). No correlation with disease-free survival and survival was observed. CONCLUSION: HAI-2 expression in breast cancer correlated with tumor aggressiveness in vivo. It is a HIF target in c-erbB2-positive cells and it is an independent negative predictive factor of efficacy of anthracycline therapy. The interaction of HAI-2 with the hepatocyte growth factor activation pathway may be a useful site for therapeutic intervention.

Author-supplied keywords

  • Anoxia
  • Antigens, Neoplasm
  • Breast Neoplasms
  • Carbonic Anhydrases
  • Cell Line, Tumor
  • Disease-Free Survival
  • Female
  • Gene Expression Regulation, Enzymologic
  • Gene Expression Regulation, Neoplastic
  • Humans
  • Immunohistochemistry
  • In Situ Hybridization
  • Membrane Glycoproteins
  • RNA Interference
  • Receptor, ErbB-2
  • Up-Regulation
  • biosynthesis
  • enzymology
  • metabolism
  • pathology

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  • Daniele Generali

  • Stephen B Fox

  • Alfredo Berruti

  • John W Moore

  • Maria Pia Brizzi

  • Nilay Patel

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