RANK is a poor prognosis marker and a therapeutic target in ER-negative postmenopausal breast cancer

Ciscar, Marina; Trinidad, Eva M; Perez-Chacon, Gema; Alsaleem, Mansour; Jimenez, Maria; Jimenez-Santos, Maria J; Perez-Montoyo, Hector; Sanz‐Moreno, Adrian; Vethencourt, Andrea; Toss, Michael; Petit, Anna; Soler-Monso, Maria T; Lopez, Victor; Gomez-Miragaya, Jorge; Gomez-Aleza, Clara; Dobrolecki, Lacey E; Lewis, Michael T; Bruna, Alejandra; Mouron, Silvana; Quintela-Fandino, Miguel; Al-Shahrour, Fatima; Martinez-Aranda, Antonio; Sierra, Angels; Green, Andrew R; Rakha, Emad; Gonzalez-Suarez, Eva

Abstract

Despite strong preclinical data, the therapeutic benefit of the RANKL inhibitor, denosumab, in breast cancer patients, beyond the bone, is unclear. Aiming to select patients who may benefit from denosumab, we hereby analyzed RANK and RANKL protein expression in more than 2000 breast tumors (777 estrogen receptor-negative, ER-) from four independent cohorts. RANK protein expression was more frequent in ER- tumors, where it associated with poor outcome and poor response to chemotherapy. In ER- breast cancer patient-derived orthoxenografts (PDXs), RANKL inhibition reduced tumor cell proliferation and stemness, regulated tumor immunity and metabolism, and improved response to chemotherapy.
Intriguingly, tumor RANK protein expression associated with poor prognosis in postmenopausal breast cancer patients, activation of NFKB signaling and modulation of immune and metabolic pathways, suggesting that RANK signaling increases after menopause. Our results demonstrate that RANK expression is an independent biomarker of poor prognosis in postmenopausal ER- breast cancer patients and support the therapeutic benefit of RANK pathway inhibitors, such as denosumab, in breast cancer patients with RANK+ ER- tumors after menopause.

Citation

Ciscar, M., Trinidad, E. M., Perez-Chacon, G., Alsaleem, M., Jimenez, M., Jimenez-Santos, M. J., …Gonzalez-Suarez, E. (2023). RANK is a poor prognosis marker and a therapeutic target in ER-negative postmenopausal breast cancer. EMBO Molecular Medicine, Article e16715. https://doi.org/10.15252/emmm.202216715

• Journal Article Type: Article
• Acceptance Date: Feb 8, 2023
• Online Publication Date: Mar 7, 2023
• Publication Date: Mar 7, 2023
• Deposit Date: Mar 10, 2023
• Journal: EMBO Molecular Medicine
• Print ISSN: 1757-4676
• Electronic ISSN: 1757-4684
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Article Number: e16715
• DOI: https://doi.org/10.15252/emmm.202216715
• Keywords: Molecular Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/18236709
• Publisher URL: https://www.embopress.org/doi/full/10.15252/emmm.202216715