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Eukaryotic initiation factor 4E-binding protein as an oncogene in breast cancer

Eukaryotic initiation factor 4E-binding protein as an oncogene in breast cancer Background: Eukaryotic Initiation Factor 4E-Binding Protein (EIF4EBP1, 4EBP1) is overexpressed in many human cancers including breast cancer, yet the role of 4EBP1 in breast cancer remains understudied. Despite the known role of 4EBP1 as a negative regulator of cap-dependent protein translation, 4EBP1 is predicted to be an essential driving oncogene in many cancer cell lines in vitro, and can act as a driver of cancer cell proliferation. EIF4EBP1 is located within the 8p11-p12 genomic locus, which is frequently amplified in breast cancer and is known to predict poor prognosis and resistance to endocrine therapy. Methods: Here we evaluated the effect of 4EBP1 targeting using shRNA knock-down of expression of 4EBP1, as well as response to the mTORC targeted drug everolimus in cell lines representing different breast cancer subtypes, including breast cancer cells with the 8p11-p12 amplicon, to better define a context and mechanism for oncogenic 4EBP1. Results: Using a genome-scale shRNA screen on the SUM panel of breast cancer cell lines, we found 4EBP1 to be a strong hit in the 8p11 amplified SUM-44 cells, which have amplification and overexpression of 4EBP1. We then found that knock-down of 4EBP1 resulted in dramatic reductions in cell proliferation in 8p11 amplified breast cancer cells as well as in other luminal breast cancer cell lines, but had little or no effect on the proliferation of immortalized but non-tumorigenic human mammary epithelial cells. Kaplan-Meier analysis of EIF4EBP1 expression in breast cancer patients demonstrated that overexpression of this gene was associated with reduced relapse free patient survival across all breast tumor subtypes. Conclusions: These results are consistent with an oncogenic role of 4EBP1 in luminal breast cancer and suggests a role for this protein in cell proliferation distinct from its more well-known role as a regulator of cap-dependent translation. Keywords: EIF4EBP1, 4EBP1, 4E-BP1, PHAS-I, 8p11–12, 8p12–11, 8p11-p12, Chromosomal abnormality, Oncogene, Amplification, Driver, Breast cancer, Estrogen receptor Background region of the human genome, which occurs in ~ 20–30% Estrogen Receptor-positive (ER+) breast cancer accounts of metastatic ER+ breast cancers, is associated with resist- for ~ 70% of all breast cancers. Currently, this subtype of ance to endocrine therapy and poor prognosis [1]. breast cancer is treated with endocrine therapy as the Our laboratory and others have demonstrated the im- standard of care. However, resistance to endocrine therapy portance of the 8p11-p12 amplicon and many of its genes is a significant clinical problem and is a leading cause of in the development and pathogenesis of breast cancer [2– breast cancer mortality. Amplification of the 8p11-p12 33], including its role in endocrine resistance. The ampli- con is composed of four distinct regions, designated A1-A4, each of which contains a number of overexpressed * Correspondence: ethier@musc.edu Department of Pathology and Laboratory Medicine, Medical University of genes [5, 11]. At least 11 genes are associated with the A2 South Carolina, 171 Ashley Avenue, MSC 908, Charleston, SC 29425, USA region of the amplicon [5]. The Eukaryotic Initiation Fac- Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan tor 4E-Binding Protein (EIF4EBP1)sequenceislocated on Lucas Street, Charleston, SC 29425, USA Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Rutkovsky et al. BMC Cancer (2019) 19:491 Page 2 of 15 the short arm of chromosome 8: 38,030,502–38,060,365 findings, Kaplan-Meier analysis shows that high levels of (GRCh38.p7; current assembly) and is amplified along 4EBP1 correlates with worsened prognosis in ER+ co- with other A1 and A2 region genes. The protein product horts (ER+, ER+ Luminal A, and ER+ Luminal B) as well (herein referred to as 4EBP1) encoded by EIF4EBP1 is ca- as cohorts that received chemotherapy, tamoxifen, or nonically regarded as a translational repressor protein that endocrine therapy. Taken together, our findings suggest interacts with eukaryotic initiation factor 4E (eIF4E) and that 4EBP1 plays an important role in in breast cancer represses translation by inhibiting eIF4E from recruiting and may be particularly important in breast cancers with 40S ribosomal subunits during translation [34–36]. Upon the 8p11-p12 amplicon regardless of ER status. phosphorylation, 4EBP1 dissociates from eIF4E allowing for active cap-dependent translation [37–40]. Methods Interestingly, many human cancers [41, 42], and particu- Antibodies and inhibitors larly breast cancers with the 8p11-p12 amplicon overex- The mTOR inhibitor, Everolimus (RAD001), was pur- press 4EBP1 [43][44]. Since 4EBP1 inhibits translation, it chased from Selleckchem (S1120, A112024). The anti- is expected that overexpression of 4EBP1 would act as a bodies against 4EBP1 (9644), phospho-4EBP1 Ser65 tumor suppressor. However, overexpression of 4EBP1 re- (9451), phospho-4EBP1 Thr37/46 (2855), phospho-4EBP1 sults in high levels of phosphorylated 4EBP1 which may Thr70 (9455) were purchased from Cell Signaling. Anti- contribute to breast cancer development [43, 45][44–47]. body against β-actin (A5441) was purchased from Indeed, proteins that can regulate 4EBP1 phosphorylation, Sigma-Aldrich. The CyclinD1 (2978) and p27 Kip1 (3686) like Casein kinase 1 [48, 49], Glycogen synthase kinase antibodies were purchased from Cell Signaling. The ERα (GSK)-3β [50], G1 To S phase transition 2 (eRF3b) [51, antibody (sc-543) was purchased from Santa Cruz 52], Mammalian target of rapamycin complex 1 Biotechnology. (mTORC1) [39, 40, 53–60], Polo like kinase 1 (PLK1) [61–63], Family with sequence similarity 129 member A Cell culture (Niban) [64], PI3-kinase isoforms [65, 66], The SUM-44 (ER+), Cama-1 (ER+), and SUM-52 (ER-) Cyclin-dependent kinase 1 (CDK1) [59, 67–70], ATM cell lines represent luminal breast cancer and have the serine/threonine kinase (ATM) [71, 72], Mitogen activated 8p11-p12 genomic locus amplified. T47D (ER+), protein kinase (MAPK) [73, 74], Protein kinase B (AKT) HCC1500 (ER+), and MCF7 (ER+) cells are also luminal [75], and others [68, 74, 76] have been suggested as thera- but 8p11-p12 is not amplified. SUM-229 and SUM-149 peutic targets for cancer. Given the relationship between are triple-negative breast cancer cell lines. Normal breast expression of 4EBP1 in the 8p11-p12 amplicon and hyper- epithelial are represented by immortalized but non activation of mTORC1 observed in endocrine resistant -tumorigenic MCF10A and H16N2 cell lines. All cell breast cancers, PI3K/AKT/mTORC1 targeted therapies lines were maintained at 37 °C with 10% CO . SUM cell have been suggested for 4EBP1 expressing breast cancers lines and culture requirements for maintenance with [46, 77–81]. Furthermore, genes within the amplicon as Hams F12 cell culture medium (Hyclone SH30026FS, well as mTORC1, which phosphorylates 4EBP1, have been Thermo Fisher Scientific) with supplementation have shown to activate ER, potentially contributing to the abil- been previously described [82–84] (please refer to the ity of amplicon bearing breast cancer cells to circumvent SLKBase (https://sumlineknowledgebase.com/) for add- endocrine therapy. itional information about these cell lines). The Cama-1 Consequently, we set out to evaluate the effect of cell line (obtained from ATCC) and MCF7 cell line (ob- 4EBP1 targeting in ER+, 8p11-p12 expressing breast tained from the Michigan Cancer Foundation) were cancer cells as well as other breast cancer cell lines, and grown in Dulbecco’s Modified Eagle’s (DMEM) medium non-tumorigenic but immortalized human mammary (obtained from Thermo Fisher Scientific) containing epithelial cells. We first found that 4EBP1 is an essential 10% Fetal Bovine Serum (FBS) purchased from Gemini gene in the SUM-44 cells based on results of a Bioproducts (900–108) or Atlanta Biologicals (S11050). genome-scale shRNA screen, and then found that 4EBP1 The T47D cell line (obtained from ATCC) was grown in targeting reduced proliferation of not only amplicon Roswell Park Memorial Institute (RPMI) medium bearing cells (SUM-44, Cama-1, SUM-52) but also (Thermo Fisher Scientific) containing 10% FBS. The non-amplicon ER+ breast cancer cells as well (MCF7, MCF10A cells were obtained from Dr. Herb Soule at the T47D). This effect was also seen in ER-negative (ER-) Michigan Cancer Foundation [85] and were maintained 8p11-p12 cells (SUM-52) as well as non-amplicon bear- in serum-free Hams F12 supplemented with Bovine ing cells (SUM-229, SUM-149), but to a lesser extent. serum albumin (BSA) (126,579, Millipore), 5 μg/mL Insu- There was no effect of 4EBP1 targeting on the prolifera- lin (700-112P, Gemini Bioproducts), 1 μg/mL Hydrocorti- tion of immortalized but non-tumorigenic mammary sone (H-4001, Sigma-Aldrich), and 10 ng/mL Epidermal epithelial cells (MCF10A, H16N2). Consistent with our Growth Factor (E9644, Sigma-Aldrich) (SFIHE medium). Rutkovsky et al. BMC Cancer (2019) 19:491 Page 3 of 15 H16N2 cells [86, 87] (immortalized by human papilloma- Control cells without the addition of lentivirus were plated virus (HPV) E6 and E7 oncoproteins) were also grown in alongside lentivirus infected cells to ensure the appropriate SFIHE medium. When trypsinizing cells grown in concentration of antibiotic was used. Cells were continu- serum-free medium, 2% FBS was added for the first 24 h. ously maintained in the resistance marker. All further pa- The SUM cell lines were developed in the author’slabora- rameters were tested after four days of selection in tory and are routinely validated for identity by STR profil- Puromycin. ing. The remaining cell lines were obtained from ATCC and were used immediately upon arrival. All cell lines are Cell proliferation routinely tested for mycoplasma. Cells were plated in 12-well plates at [1E5 cells/well], washed with 1X Phosphate Buffered Saline (PBS), then Generation of EIF4EBP1 knockdown cells 0.5 mL HEPES/MgCl buffer (Isoton) was added to each Lentivirus was produced in 293FT cells which were dish and agitated for 5 min. Cell swelling was confirmed transfected in Opti-MEM with Lipofectamine 2000, and 50 uL ZAP (Bretol Solution) was added and incu- pLKO.1-puro gene-targeting plasmid, and Mission bated for 10 min with agitation. Cells were visualized to packaging mix (Sigma-Aldrich) under optimal condi- confirm bursting and nuclei release, 10 mL NaCl- tions. Collected virus was filtered through a 0.2 um Formalin Solution was added to prevent deterioration, filter before storage at − 80 °C. Efficient viral titer and read using a Coulter Acuvette. The Coulter Counter production was confirmed by a Lenti-X p24 Rapid was set to count nuclei between 4 and 8 um diameter Titer Kit (Takara) and 4EBP1 western blot. All BSL-2 through a 100 um aperture. Each sample was counted safety protocols were performed during production, twice and then averaged. The counts were multiplied by storage, and continued use. Optimization was per- 20 to obtain the total number of nuclei, and background formed with listed (Table 1) 4EBP1-targeting plasmids counts with NaCl-Formalin were performed with wherein TRCN0000040206 (4EBP sh_1) and analysis. TRCN0000298904 (4EBP_sh_2) produced efficient knockdown and were used for subsequent studies. Statistical analysis These were obtained from the shRNA Technology Growth results were analyzed using a two-way ANOVA Shared Resource (Hollings Cancer Center, the Medical model with an interaction effect between day and condi- University of South Carolina). tion. Each cell line was analyzed individually and all ana- Cells were reverse transfected with lentivirus, with ap- lyses were done on the log scale. Differences between propriate growth medium, and polybrene. Virus was re- conditions were exponentiated to obtain fold change es- moved 24 h later and cells were fed with media. Cells timates. Significance testing was completed using began selection with appropriate concentration of antibiotics Tukey’s honestly significant difference method to main- 48 h following transfection. Antibiotic concentration at 2 μg/ tain a family-wise alpha of 0.05 within each cell line. ml Puromycin (invivoGen) was sufficient to ensure selection. TheSUM-44celllinerequires3 μg/ml Puromycin selection. Immunoblotting Cells were continuously maintained on ice and harvested using Radioimmunoprecipitation assay (RIPA) buffer (Sig- Table 1 . ma-Aldrich) supplemented with a protease inhibitor cock- Plasmid Genotype Region Sequence tail (Millipore, #539131) and PhosSTOP (Roche). shLACZ pLKO.1-puro::LACZ n/a CGCT Bradford Protein Assay was used to fit samples to a stand- AAATACTGGCAGGCGTT ard curve and determine protein concentrations prior to Sh4EBP1 pLKO.1- CDS CCGG SDS-PAGE. After transfer, PVDF membrane was blocked #1 puro::EIF4EBP1 CGGTGAAGAGTCACAGT 1 h with 5% skim milk in 1X TBST at room temperature TRCN0000040206 TTGA and incubated overnight with antibody per the manufac- CTCGAGTCAAACTGTGA CTCTTCACCGTTTTTG turer’s instructions. The membrane was visualized with Sh4EBP1 pLKO.1- 3UTR CCGGGCCAGGCCTTATGAAA SuperSignal West Pico Chemiluminescent Substrate #2 puro::EIF4EBP1 GTGATCTCGAGATCACTTTC (Thermo Fisher Scientific). The membrane was developed TRCN0000040203 ATAAGGCCTGGCTTTTTG using the Li-COR Odyssey Fc. Sh4EBP1 pLKO.1- 3UTR CCGGGCCAGGCCTTATGAAA #3 puro::EIF4EBP1 GTGATCTCGAGATCACTTTC Flow cytometry of live cells TRCN0000310343 ATAAGGCCTGGCTTTTTG Cells were trypsinized, counted, and analyzed at [1E6 Sh4EBP1 pLKO.1- CDS CCGG cells/mL]. Vybrant DyeCycle Orange (V35005, Thermo #4 puro::EIF4EBP1 CGGTGAAGAGTCACAG TRCN0000298904 TTTGACTCGAGTCAAACTGT Scientific) was used according to the manufacturer’s GACTCTTCACCGTTTTTG protocol for live cell-cycle analysis. Conditions were Rutkovsky et al. BMC Cancer (2019) 19:491 Page 4 of 15 optimized to a final stain concentration of 5 μMin 1X cBioPortal database analysis PBS in all cell lines tested. Cells were promptly analyzed The cBioPortal(http://www.cbioportal.org/)[89, 90]was using a BSL2 FACSAria Cell Sorter. Verity ModFit LT used to generate the overall survival curve (shown in 4.1 was used to analyze and visualize the generated data. Fig. 1b) for breast tumors with and without A2 8p11-p12 region alterations using The Cancer Genome Atlas (TCGA) provisional data. The Amplification fre- KM plotter database analysis quency of 4EBP1 in the TCGA or the Molecular Tax- The KM plotter for breast cancer (http://kmplot.com) onomy of Breast Cancer International Consortium [88] was used on all releases available from the database (METABRIC) breast data cohorts were also determined accessed spring 2018. Restricted analyses of different pop- using the cBioPortal. Data was accessed spring 2018. ulations are indicated and altered the number of breast cancer patients with available survival data as shown by Results the number at risk. The determined and represented prog- Frequency and prognostic significance of 4EBP1 nostic values by relapse free survival (RFS) of EIF4EBP1 in amplification in breast cancer all analyses were more than 500 samples, indicating highly EIF4EBP1, the gene that encodes the 4EBP1 protein, re- reliable analysis using all parameters presented. The JetSet sides within the 8p11-p12 genomic locus. It is frequently best probe set for EIF4EBP1 (probe ID: 221539_at) was amplified in endocrine resistant luminal breast cancers, used for all analyses. Patients were divided into a high and rarely coincides with PIK3CA mutations, and is asso- low expression group by median mRNA expression ciated with poor prognosis. The frequency of values, all possible cutoff values between the lower and EIF4EBP1 amplification across all breast cancer sub- upper quartiles were computed and the best performing types is approximately 13% according to data from threshold was determined by using auto select the best The Cancer Genome Atlas (TCGA) and 14% accord- cutoff. RFS was plotted using suggested quality controls. ing to data from the Molecular Taxonomy of Breast This excluded biased arrays, removed redundant samples, Cancer International Consortium (METABRIC) [91] and checked proportional hazards assumptions. The cut- (Fig. 1a & b). Furthermore, we found that expression off values, probe expression range, false discovery rate analysis of the TCGA provisional data shows that (FDR), and p-value were extracted from the KM plotter high expression of the genes in the A2 region of the webpage and each analysis is represented. 8p11-p12 amplicon, which includes EIF4EBP1, BRF2, Fig. 1 EIF4EBP1 is amplified in human breast cancer and correlates with reduced overall survival. (a) Amplification data from The Cancer Genome Atlas (TCGA) and (b) the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). (c) Expression analysis using TCGA provisional data shows that high expression of A2 genes: BRF2, RAB11FIP1, EIF4EBP1, ASH2L, LSM1, BAG4, DDHD2, PLPP5, NSD3, FGFR1, TACC1, ADAM9, and ADAM32 correlates with reduced overall survival Rutkovsky et al. BMC Cancer (2019) 19:491 Page 5 of 15 RAB11FIP1, ASH2L, LSM1, BAG4, DDHD2, PLPP5, 1 uM of the inhibitor everolimus (Affinitor). To assess NSD3, FGFR1, TACC1, ADAM9, and ADAM32, corre- proliferation, the total number of cells was quantitated lates with reduced overall survival (Fig. 1c). for each group at day 1, prior to treatment, and on day 4, 72 h after exposure to everolimus. Treatment with 4EBP1 is highly expressed and phosphorylated in 8p11- everolimus significantly reduced the proliferation of all p12 breast cancer cells three cell lines, however the fold-change observed for To investigate the significance of 4EBP1 overexpression in the SUM-44 cells and the Cama-1 cells (0.49 and 0.43 breast cancer, we employed a set of human breast cancer respectively) were significantly greater than the fold cell lines representing ER+ and ER- samples, including change observed in the SUM-52 cells (0.9). The differ- SUM-44, SUM-52, and Cama-1 (ER+, amplicon bearing), ence in response to everolimus between the SUM-52 MCF-7, T47D, and HCC1500 (ER+, non-amplicon bear- cells and the other two cell lines was significant with a ing), and SUM-229, as well as two non-tumorigenic but p-value of < 0.0001. (Fig. 2b). This result suggests that immortalized mammary epithelial cell lines, MCF10A, ER expression plays a role in the responsiveness of and H16N2 cells. As expected, SUM-44, Cama-1, and breast cancer cells to everolimus. SUM-52 expressed high levels of 4EBP1 due to the ampli- fication of the EIF4EBP1 gene, whereas MCF10A and 4EBP1 is essential to breast cancer cell lines H16N2 did not express any more or less 4EBP1 protein Our laboratory recently completed a genomic scale than the T47D, HCC1500, MCF7, or SUM-229 cell lines shRNA screen for the entire panel of SUM breast cancer (Fig. 2a). High levels of phosphorylated 4EBP1 were also cell lines, and some of the results from these screens readily detected in the SUM-44, Cama-1 and SUM-52 have been reported elsewhere [92] and can be found at cells compared to the other cell lines tested (Fig. 2a). The SUM Breast Cancer Cell Line Knowledge Base 4EBP1 is thought to be phosphorylated by mTORC1 (SLKBase) (https://sumlineknowledgebase.com/)[93]. in a hierarchical fashion [39, 40]. Our findings that Interestingly, despite the fact that the SUM-44 cells have 4EBP1 expression and phosphorylation levels are high been shown to overexpress several genes from the on multiple residues in SUM-44, Cama-1, and SUM-52 8p11-p12 amplicon that can behave as transforming on- cells, as well as our observation of high levels of cogenes in vitro, EIF4EBP1 was the strongest hit among phospho-S6 (not shown) suggest active mTORC1 signal- all 8p11 amplified genes in this RNA interference screen. ing in these 8p11-p12 models. Therefore, we tested the The DepMap [111, 112, 113] crispr (Avana) gene essen- effect of mTOR pathway inhibition on cell proliferation tiality screens also predict 4EBP1 as a driver of cancer of the 8p11-p12 cell lines. Cells were plated in equal cell lines including all of the breast cancer cell line number and on day 1 after plating, cells were exposed to models currently represented within the portal (https:// Fig. 2 4EBP1 is highly expressed and phosphorylated in 8p11-p12 breast cancer cells. (a) Western blot of 4EBP1 and phospho-4EBP1 on residues Thr 37/37, Thr 70, and Ser 65 in SUM-44 (ER+), Cama-1 (ER+), and SUM-52 (ER-) cells with amplification of the 8p11-p12 genomic locus (8p11-12 CNA) as well as T47D (ER+), HCC1500 (ER+), MCF7 (ER+), and SUM-229 (ER-) cells without amplification of the 8p11-p12 genomic locus. Immortalized but non-tumorigenic breast epithelial cells are represented by MCF10A and H16N2 cells. (b) Cell proliferation was assessed in SUM-44, Cama-1, and SUM-52 cells in the presence or absence of 1 μM everolimus treatment for 72 h. Error bars represent standard deviation among replicates and p values are for the difference in cell proliferation in control versus treated cells. The p-value for the difference between the effect in SUM-52 cells and the other cell lines is <0.0001 Rutkovsky et al. BMC Cancer (2019) 19:491 Page 6 of 15 depmap.org/portal/)[94] Therefore, we performed ex- cells (Fig. 4c) or H16N2 cells (Fig. 4d). These results in- periments to validate the importance of 4EBP1 knock- dicate that downregulation of 4EBP1 in non-tumorigenic down in SUM-44 cells and extended that to other breast breast epithelial cell lines, at least to the same levels as cancer cell lines. To gain a broader understanding of was achieved in the breast cancer cell lines does not 4EBP1 in different settings, we performed experiments affect the proliferative capacity of these cells. to assess the effect of 4EBP1 knock-down on prolifera- tion of cell lines that represent different subtypes of Downregulation of 4EBP1 in ER+ 8p11-p12 breast cancer breast cancer. cells causes cell cycle arrest To determine the effect of directly targeting 4EBP1 in Previous studies suggest that 4EBP1 regulates cell cycle breast cancer cells, we first tested the two ER+ 8p11-p12 progression [59, 61, 68, 101–104]. To better understand cell lines, SUM-44 and Cama-1, and used lentiviral vec- the cellular effects of 4EBP1 knockdown, SUM-44 and tors for two different shRNAs against EIF4EBP1. shRNA Cama-1 cells were assessed by flow cytometry to evalu- targeting lacZ was used as a control. Fig. 3 shows that ate cell cycle progression. An increase in the number of both shRNAs were effective at reducing levels of 4EBP1 cells in G1 cell-cycle in both SUM-44 (Fig. 5a) and protein, and there was a concomitant decrease in the Cama-1 cells (Fig. 5 b) was observed with EIF4EBP1 levels of phosphorylated 4EBP1 (Fig. 3 a & b). We then knockdown when compared to control cells. These re- measured proliferation of cells expressing EIF4EBP1 sults show that knockdown of 4EBP1 promotes G1 cell shRNA compared to control cells. Cells were evaluated cycle arrest. by counting the number of nuclei at day 1 and day 4 To study the cell cycle arrest induced by 4EBP1 after plating. The data shown in Fig. 3 c and d show that knock-down further, we evaluated the protein expression there as a significant increase in cell number in the LacZ levels of key cell cycle regulators. We found that Cyclin control cells over the 4-day culture period, there was lit- D1 protein levels were decreased in SUM-44 and tle or no proliferation in the sh4EBP1 groups in either Cama-1 cells following EIF4EBP1 knockdown (Fig. 5c& cell line. Indeed, there was a significant reduction in cell d). Additionally, we observed a slight increase in p27 number over the 4 day period in the SUM-44 cells (fold levels in the EIF4EBP1 knockdown cells compared to change = 0.5, p < 0.001, 0.002), whereas in the Cama-1 control cells (Fig. 5c & d). The alterations of Cyclin D1 cells, there was a smaller (approximately 0.8 fold) but and p27 expression that we found are consistent with still significant difference in cell number over the same the cell cycle arrest phenotype that we observed in period (p < 0.002, and 0.07). The largest and most statis- 4EBP1 knockdown cells. tically significant difference was detected in the day 4 cell counts between control LacZ cells and the sh4EBP1 4EBP1 knockdown inhibits proliferation of ER- 8p11-p12 cells in both cell lines, with fold-differences of approxi- amplified breast cancer cells − 9 mately 4 and 6-fold, and p-values ranging from 10 to Because we saw only a small effect of everolimus on –14 10 The full ANOVA analysis of the data for all groups the proliferation of the ER- 8p11-p12 SUM-52 breast and all time points are shown in Additional file 3:Table S1. cancer cell line, we also wanted to test the effect of Prior studies from our lab and others have demon- EIF4EBP1 knockdown on these cells. Using the same strated the effects of genes associated with the 8p11-p12 two shRNAs targeted to EIF4EBP1 as we used on the amplicon on ERα expression [1, 28–31, 100]. Therefore, previous cell lines, we knocked down 4EBP1 mRNA we next evaluated ERα expression in the SUM-44 and in the SUM-52 cells and likewise, saw a reduction in Cama-1 EIF4EBP1 knockdown cell lines and found that 4EBP1 protein levels (Fig. 6a). EIF4EBP1 knockdown ERα levels were reduced (Fig. 3 a & b) compared to con- in SUM-52 cells resulted in a dramatic reduction in trol cells expressing lacZ shRNA. These findings show proliferation of SUM-52 cells, similar to what we ob- that reducing 4EBP1 levels impairs proliferation of the served with the two ER+ cell lines. In LacZ control ER+ 8p11-p12 breast cancer cell models and results in cells, there was a highly significant increase in cell downregulation of ERα. number between days 1 and 4, whereas in the We next wanted to evaluate the potential effects of sh4EBP1 cells, there was a slight reduction in cell 4EBP1 targeting in non-tumorigenic human breast epi- number in the sh1 group and a slight increase in cell thelial cells. 4EBP1 was knocked down in MCF10A number is the sh2 group. These differences most (Fig. 4a) and H16N2 cells (Fig. 4b). Cell proliferation likely reflect different levels of knockdown achieved was then measured by counting the total number of cell with the two vectors. Of greatest importance is the nuclei present at day 1 and day 4 after plating. All popu- three to four-fold difference in the number of cells lations increased in number significantly over four days per dish at the 4 day time point between the shLacZ and no statistically significant differences were observed and sh4EBP1 groups again with p-values on the order − 14 between control and EIF4EBP1 knockdown in MCF10A of 10 .(Fig. 6b). We also probed these control and Rutkovsky et al. BMC Cancer (2019) 19:491 Page 7 of 15 Fig. 3 4EBP1 knockdown inhibits proliferation of ER+ 8p11-p12 breast cancer cells. (a) Western blot of 4EBP1, phospho-4EBP1 on residues Thr 37/ 46, and ERα in SUM-44 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (b) Western blot of 4EBP1, phospho-4EBP1 on residues Thr 37/46, and ERα in Cama-1 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell proliferation was assessed in SUM-44 and (d) Cama-1 control and EIF4EBP1 knockdown cells on day 1 and day 4 in culture following selection in puromycin containing media. Error bars represent standard deviation among replicates and p-values represent the statistical comparison between each corresponding group knockdown cells for Cyclin D1 and p27 expression. non-amplicon bearing models, MCF7 (ER+) (Additional We saw a similar effect on these two proteins as in file 1: Figure S1 a), T47D (ER+) (Additional file 1:Figure the SUM-44 and Cama-1 cells where Cyclin D1 levels S1, b), SUM-229 (ER-) (Additional file 2: Figure S2 a), and were decreased and p27 levels were increased (Fig. 6a). SUM-149 (ER-) (Additional file 2: Figure S2 b). These We also evaluated the effect of 4EBP1 knockdown on the experiments showed that knockdown of 4EBP1 in MCF7 Rutkovsky et al. BMC Cancer (2019) 19:491 Page 8 of 15 Fig. 4 4EBP1 knockdown does not affect proliferation of MCF10A and H16N2 non-transformed breast epithelial cells. (a) Western blot of 4EBP1 in MCF10A cells and (b) H16N2 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell proliferation was assessed in MCF10A and (d) H16N2 control and EIF4EBP1 knockdown cells on day 1 and day 4 in culture following selection in puromycin-containing medium. Error bars represent standard deviation among replicates and p-values represent significance between each corresponding group Rutkovsky et al. BMC Cancer (2019) 19:491 Page 9 of 15 Fig. 5 4EBP1 knockdown leads to G0/G1 arrest in ER+ 8p11-p12 breast cancer cells. (a) Cell cycle analysis of SUM-44 and (b) Cama-1 cells shows that 4EBP1 knockdown results in an accumulation of cells in G0/G1 with an associated decrease in cells in S-phase. (c) Western blot of cyclin D1 and p27 in SUM-44 and (d) Cama-1 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2) Fig. 6 4EBP1 knockdown inhibits proliferation of ER- 8p11-p12 breast cancer cells. (a) Western blot of 4EBP1, phospho-4EBP1 on residues Thr 37/ 46, ERα, cyclin D1, and p27 in SUM-52 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (b) Cell proliferation was assessed in SUM-52 control and EIF4EBP1 knockdown cells on day 1 and day 4 in culture after selection in puromycin-containing medium. Error bars represent standard deviation among replicates and significance is the comparison between each corresponding group Rutkovsky et al. BMC Cancer (2019) 19:491 Page 10 of 15 and T47D also significantly inhibited proliferation 4EBP1 overexpression in breast cancer development and (Additional file 1: Figure S1 c & d). By contrast, 4EBP1 response to therapy. knock-down in the triple negative SUM-149 and SUM-229 cells was less effective at reducing proliferation Discussion of these cells (Additional file 2: Figure S2 c & d). We and others have determined that a number of onco- genes reside within the 8p11-p12 region and are ampli- EIF4EBP1 expression levels correlate with reduced relapse fied in human breast cancer. Genes found within this free survival in human breast cancer region such as WHSC1L1 [11], DDHD2 [11], LSM1 [10, To determine the overall impact of EIF4EBP1 on sur- 11, 18], BAG4 [10, 11], and KAT6A [16, 28] have all been vival and to assess whether treatment affects the out- shown to have transforming properties in vitro. Of sig- comes, we used the online Kaplan-Meier plotter nificance, the 8p11-p12 amplicon is implicated in endo- database tool (kmplot.com) to assess the relationship be- crine resistance [1]. Consistent with this implication, tween EIF4EBP1 gene expression and relapse free sur- NSD3 (aka WHSC1L1) was shown to drive high levels of vival. This tool uses gene expression data from Gene ER expression, and to enhance proliferation in an estro- Expression Omnibus (GEO), the European Genome- gen independent manner [29]. Reminiscent of this find- phenome Archive (EGA), and The Cancer Genome Atlas ing, hyperactive mTOR is often observed in endocrine (TCGA) [88].The JetSet probe set for EIF4EBP1 (probe resistant cells and can activate ERα [95–99]. Interest- ID: 221539_at) was used for all analyses. We found that ingly, the EIF4EBP1 gene which encodes the mTOR ef- high EIF4EBP1 gene expression significantly correlated fector protein 4EBP1 is located on the short arm of with reduced relapse free survival not only in ER+ popu- chromosome 8 within the 8p11 region of the amplicon. lations (Fig. 7a), including when separated by luminal A It is highly overexpressed but rarely mutated in breast (Fig. 7b) and luminal B (Fig. 7c) subtypes, but also across cancer, regardless of amplification, and has been sug- all subtypes (Fig. 7d). Furthermore, this was also true gested to be an essential driving gene in many cancer post treatment with chemotherapy (Fig. 7e) and follow- cell lines in vitro which we [93]and others have wit- ing either tamoxifen (Fig. 7f) or other endocrine therapy nessed [94]using genome-wide gene essentiality screens. (Fig. 7g). Altogether, these analyses point to a role of Consequently, our study initially aimed to determine Fig. 7 Kaplan-Meier analysis of breast cancer outcomes in patients with and without overexpression of 4EBP1. KM plotter analysis of EIF4EBP1 (probe ID: 221539_at) gene expression and overall survival in (a) ER+ populations (b) separated by luminal A (c) luminal B subtypes (d) all subtypes (no parameters selected) (e) post treatment with chemotherapy (f) tamoxifen or (g) endocrine therapy Rutkovsky et al. BMC Cancer (2019) 19:491 Page 11 of 15 whether 4EBP1 overexpression influences proliferation current clinical trial is underway to determine if the phos- in ER+ 8p11-p12 amplicon positive breast cancer cells. phorylation status of 4EBP1 can be used to predict everoli- Our findings show that 4EBP1 is a critical protein for lu- mus response in breast tumors (NCT00855114). minal breast cancer cell proliferation regardless of Direct targeting of 4EBP1 or targeting of multiple up- amplicon and/or ER status. However, shRNA mediated stream kinases that target 4EBP1 may provide additional knockdown of 4EBP1 in non-transformed mammary epi- benefit. Recently, several kinases were identified to phos- thelial cells did not affect proliferation. It is possible that phorylate 4EBP1 in both mTOR dependent as well as in- complete knock-out of 4EBP1 in non-tumorigenic breast dependent manners [41, 42]. Of note, GSK3β epithelial cells could affect their proliferative capacity, phosphorylation of 4EBP1 plays a similar role as mTOR, but our results indicate that the changes in 4EBP1 whereby phosphorylation decreases 4EBP1 association expression in luminal breast cancer cells achieved by with eIF4E [50]. Contrary to this observation, CDK1 is a shRNA knockdown is sufficient to profoundly affect mitotic kinase that also phosphorylates 4EBP1 [67, 70]. their proliferative capacity. Consistent with the idea However, phosphorylation by CDK1 does not alter the that 4EBP1 has a potential role in regulating ERα ex- cap-dependent translation functions of 4EBP1. Interest- pression, as well as a potential role outside of ERα ingly, a phospho-deficient mutant of 4EBP1 that is resist- regulation, we found that downregulation of 4EBP1 ant to phosphorylation by CDK1 partially reverses rodent reduces not only ERα expression but also affects Cyc- cell transformation. It is suggested that 4EBP1 phosphor- lin D1 expression and p27 expression. These observa- ylation by CDK1 could result in a gain of function, which tions are consistent with the reduced proliferation opposes the canonical form of regulation set forth by and cell cycle arrest phenotypes that we report in our studies evaluating mTOR-mediated inhibition of 4EBP1 present study. There is no indication that Cyclin D1 through phosphorylation. Regulation of phosphorylated or p27 levels would change in non-transformed cells 4EBP1 especially the intertwined dynamics between because cell proliferation was not compromised with CDK1 and mTOR should be further explored, as CDK1 4EBP1 knockdown in these models. Future studies can phosphorylate mTOR and co-localize with phosphor- should further explore the relationship between ylated 4EBP1 [59]. Whether the distinct effects of the dif- 4EBP1 and Cyclin D1 in cancer cells and non-trans- ferent phosphorylation states of 4EBP1, determined by formed cells. There is a consistently demonstrated oc- distinct phosphorylation events driven by individual ki- currence between co-amplification of genomic loci nases, affects 4EBP1’s ability to drive breast cancer pro- harboring 4EBP1 (EIF4EBP1) and Cyclin D1 (CCND1) gression or endocrine resistance would be of significant in breast cancer patients such as the recent report by interest for future studies particular in the context of Giltnane and colleagues [27], so further studies therapeutic interventions. should assess how these two oncogenes together can influence cell cycle states, meiotic progression, and Conclusions the regulation of aneuploidy. Because 4EBP1 is re- EIF4EBP1 is a candidate oncogene in breast cancer be- quired for coupling mTORC1 signaling to Cyclin D1 cause it is commonly amplified and overexpressed, and expression [101] and translational inhibition can re- is part of a genomic region that, when amplified, confers sult in the loss of cell cycle regulators like the poor prognosis for patients. Overexpression of 4EBP1 D-cyclins [105], we plan to determine the predictive drives proliferation of luminal breast cancer cells by value of 4EBP1 levels to CDK inhibition in breast tu- mechanisms involving cell cycle regulators such as cyclin mors, especially in the context of dual inhibition with D1 and the cdk inhibitor p27. In some cells, 4EBP1 PI3K/AKT/mTOR inhibitors. phosphorylation occurs with high level activity of the Amplification of EIF4EBP1 leads to increased 4EBP1 ex- mTORC pathway, which also is common in estrogen-re- pression and phosphorylation suggesting that mechanisms ceptor positive breast cancer, and indeed, knockdown of are in place to promote 4EBP1 mediated translation and EIF4EBP1 results in reduced expression of ERα. Based post-translational regulation during breast cancer initiation on these results, we conclude that 4EBP1, and particu- and progression. Consequently, targeting of 4EBP1 either larly phosphorylated 4EBP1 plays a dominant role in directly or via inhibition of mTOR could relieve repressive breast cancer by mechanisms distinct from its role in effects of phosphorylated 4EBP1 on translation as well as regulating cap-dependent translation. any capacity of 4EBP1 to stabilize mTORC1 [106]orother proteins like p21 [107]. Several Phase II clinical trials have Additional files evaluated use of mTOR inhibitors for ER+ breast cancer [108–110]. While promising, results from trials in patients Additional file 1: Figure S1 4EBP1 knockdown inhibits proliferation of MCF7 and T47D breast cancer cells. (a) Western blot of 4EBP1 in MCF7 with ER+ breast cancer who experience aromatase inhibitor cells and (b) T47D cells engineered with either control shRNA to lacZ or failure were only somewhat successful [108]. However, a Rutkovsky et al. BMC Cancer (2019) 19:491 Page 12 of 15 Therapeutics, Medical University of South Carolina, 173 Ashley Avenue, BSB two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell 358, MSC 509, Charleston, SC 29425, USA. Hollings Cancer Center, Medical proliferation was assessed in MCF7 and (d) T47D control and EIF4EBP1 University of South Carolina, 86 Jonathan Lucas Street, Charleston, SC 29425, knockdown cells on day 1 and day 4 in culture. Error bars represent USA. Department of Computational Medicine and Bioinformatics, University standard deviation among replicates and p-values represent the of Michigan, 500 S. State Street, Ann Arbor, MI 48109, USA. Department of comparison between each corresponding group. (TIF 2538 kb) Regenerative Medicine and Cell Biology, Medical University of South Additional file 2: Figure S2 4EBP1 knockdown slows proliferation of Carolina, 173 Ashley Avenue, BSB 601, MSC 508, Charleston, SC 29425, USA. SUM-229 and SUM-149 breast cancer cells. (a) Western blot of 4EBP1 in Department of Public Health Sciences, Medical University of South Carolina, SUM-229 cells and (b) SUM-149 cells engineered with either control 135 Cannon Street Suite 303 MSC 835, Charleston, USA. shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell proliferation was assessed in SUM-229 and (d) SUM-149 control Received: 26 November 2018 Accepted: 1 May 2019 and EIF4EBP1 knockdown cells on day 1 and day 4 in culture. 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Eukaryotic initiation factor 4E-binding protein as an oncogene in breast cancer

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Springer Journals
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Copyright © 2019 by The Author(s).
Subject
Biomedicine; Cancer Research; Oncology; Surgical Oncology; Health Promotion and Disease Prevention; Biomedicine, general; Medicine/Public Health, general
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1471-2407
DOI
10.1186/s12885-019-5667-4
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Abstract

Background: Eukaryotic Initiation Factor 4E-Binding Protein (EIF4EBP1, 4EBP1) is overexpressed in many human cancers including breast cancer, yet the role of 4EBP1 in breast cancer remains understudied. Despite the known role of 4EBP1 as a negative regulator of cap-dependent protein translation, 4EBP1 is predicted to be an essential driving oncogene in many cancer cell lines in vitro, and can act as a driver of cancer cell proliferation. EIF4EBP1 is located within the 8p11-p12 genomic locus, which is frequently amplified in breast cancer and is known to predict poor prognosis and resistance to endocrine therapy. Methods: Here we evaluated the effect of 4EBP1 targeting using shRNA knock-down of expression of 4EBP1, as well as response to the mTORC targeted drug everolimus in cell lines representing different breast cancer subtypes, including breast cancer cells with the 8p11-p12 amplicon, to better define a context and mechanism for oncogenic 4EBP1. Results: Using a genome-scale shRNA screen on the SUM panel of breast cancer cell lines, we found 4EBP1 to be a strong hit in the 8p11 amplified SUM-44 cells, which have amplification and overexpression of 4EBP1. We then found that knock-down of 4EBP1 resulted in dramatic reductions in cell proliferation in 8p11 amplified breast cancer cells as well as in other luminal breast cancer cell lines, but had little or no effect on the proliferation of immortalized but non-tumorigenic human mammary epithelial cells. Kaplan-Meier analysis of EIF4EBP1 expression in breast cancer patients demonstrated that overexpression of this gene was associated with reduced relapse free patient survival across all breast tumor subtypes. Conclusions: These results are consistent with an oncogenic role of 4EBP1 in luminal breast cancer and suggests a role for this protein in cell proliferation distinct from its more well-known role as a regulator of cap-dependent translation. Keywords: EIF4EBP1, 4EBP1, 4E-BP1, PHAS-I, 8p11–12, 8p12–11, 8p11-p12, Chromosomal abnormality, Oncogene, Amplification, Driver, Breast cancer, Estrogen receptor Background region of the human genome, which occurs in ~ 20–30% Estrogen Receptor-positive (ER+) breast cancer accounts of metastatic ER+ breast cancers, is associated with resist- for ~ 70% of all breast cancers. Currently, this subtype of ance to endocrine therapy and poor prognosis [1]. breast cancer is treated with endocrine therapy as the Our laboratory and others have demonstrated the im- standard of care. However, resistance to endocrine therapy portance of the 8p11-p12 amplicon and many of its genes is a significant clinical problem and is a leading cause of in the development and pathogenesis of breast cancer [2– breast cancer mortality. Amplification of the 8p11-p12 33], including its role in endocrine resistance. The ampli- con is composed of four distinct regions, designated A1-A4, each of which contains a number of overexpressed * Correspondence: ethier@musc.edu Department of Pathology and Laboratory Medicine, Medical University of genes [5, 11]. At least 11 genes are associated with the A2 South Carolina, 171 Ashley Avenue, MSC 908, Charleston, SC 29425, USA region of the amplicon [5]. The Eukaryotic Initiation Fac- Hollings Cancer Center, Medical University of South Carolina, 86 Jonathan tor 4E-Binding Protein (EIF4EBP1)sequenceislocated on Lucas Street, Charleston, SC 29425, USA Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Rutkovsky et al. BMC Cancer (2019) 19:491 Page 2 of 15 the short arm of chromosome 8: 38,030,502–38,060,365 findings, Kaplan-Meier analysis shows that high levels of (GRCh38.p7; current assembly) and is amplified along 4EBP1 correlates with worsened prognosis in ER+ co- with other A1 and A2 region genes. The protein product horts (ER+, ER+ Luminal A, and ER+ Luminal B) as well (herein referred to as 4EBP1) encoded by EIF4EBP1 is ca- as cohorts that received chemotherapy, tamoxifen, or nonically regarded as a translational repressor protein that endocrine therapy. Taken together, our findings suggest interacts with eukaryotic initiation factor 4E (eIF4E) and that 4EBP1 plays an important role in in breast cancer represses translation by inhibiting eIF4E from recruiting and may be particularly important in breast cancers with 40S ribosomal subunits during translation [34–36]. Upon the 8p11-p12 amplicon regardless of ER status. phosphorylation, 4EBP1 dissociates from eIF4E allowing for active cap-dependent translation [37–40]. Methods Interestingly, many human cancers [41, 42], and particu- Antibodies and inhibitors larly breast cancers with the 8p11-p12 amplicon overex- The mTOR inhibitor, Everolimus (RAD001), was pur- press 4EBP1 [43][44]. Since 4EBP1 inhibits translation, it chased from Selleckchem (S1120, A112024). The anti- is expected that overexpression of 4EBP1 would act as a bodies against 4EBP1 (9644), phospho-4EBP1 Ser65 tumor suppressor. However, overexpression of 4EBP1 re- (9451), phospho-4EBP1 Thr37/46 (2855), phospho-4EBP1 sults in high levels of phosphorylated 4EBP1 which may Thr70 (9455) were purchased from Cell Signaling. Anti- contribute to breast cancer development [43, 45][44–47]. body against β-actin (A5441) was purchased from Indeed, proteins that can regulate 4EBP1 phosphorylation, Sigma-Aldrich. The CyclinD1 (2978) and p27 Kip1 (3686) like Casein kinase 1 [48, 49], Glycogen synthase kinase antibodies were purchased from Cell Signaling. The ERα (GSK)-3β [50], G1 To S phase transition 2 (eRF3b) [51, antibody (sc-543) was purchased from Santa Cruz 52], Mammalian target of rapamycin complex 1 Biotechnology. (mTORC1) [39, 40, 53–60], Polo like kinase 1 (PLK1) [61–63], Family with sequence similarity 129 member A Cell culture (Niban) [64], PI3-kinase isoforms [65, 66], The SUM-44 (ER+), Cama-1 (ER+), and SUM-52 (ER-) Cyclin-dependent kinase 1 (CDK1) [59, 67–70], ATM cell lines represent luminal breast cancer and have the serine/threonine kinase (ATM) [71, 72], Mitogen activated 8p11-p12 genomic locus amplified. T47D (ER+), protein kinase (MAPK) [73, 74], Protein kinase B (AKT) HCC1500 (ER+), and MCF7 (ER+) cells are also luminal [75], and others [68, 74, 76] have been suggested as thera- but 8p11-p12 is not amplified. SUM-229 and SUM-149 peutic targets for cancer. Given the relationship between are triple-negative breast cancer cell lines. Normal breast expression of 4EBP1 in the 8p11-p12 amplicon and hyper- epithelial are represented by immortalized but non activation of mTORC1 observed in endocrine resistant -tumorigenic MCF10A and H16N2 cell lines. All cell breast cancers, PI3K/AKT/mTORC1 targeted therapies lines were maintained at 37 °C with 10% CO . SUM cell have been suggested for 4EBP1 expressing breast cancers lines and culture requirements for maintenance with [46, 77–81]. Furthermore, genes within the amplicon as Hams F12 cell culture medium (Hyclone SH30026FS, well as mTORC1, which phosphorylates 4EBP1, have been Thermo Fisher Scientific) with supplementation have shown to activate ER, potentially contributing to the abil- been previously described [82–84] (please refer to the ity of amplicon bearing breast cancer cells to circumvent SLKBase (https://sumlineknowledgebase.com/) for add- endocrine therapy. itional information about these cell lines). The Cama-1 Consequently, we set out to evaluate the effect of cell line (obtained from ATCC) and MCF7 cell line (ob- 4EBP1 targeting in ER+, 8p11-p12 expressing breast tained from the Michigan Cancer Foundation) were cancer cells as well as other breast cancer cell lines, and grown in Dulbecco’s Modified Eagle’s (DMEM) medium non-tumorigenic but immortalized human mammary (obtained from Thermo Fisher Scientific) containing epithelial cells. We first found that 4EBP1 is an essential 10% Fetal Bovine Serum (FBS) purchased from Gemini gene in the SUM-44 cells based on results of a Bioproducts (900–108) or Atlanta Biologicals (S11050). genome-scale shRNA screen, and then found that 4EBP1 The T47D cell line (obtained from ATCC) was grown in targeting reduced proliferation of not only amplicon Roswell Park Memorial Institute (RPMI) medium bearing cells (SUM-44, Cama-1, SUM-52) but also (Thermo Fisher Scientific) containing 10% FBS. The non-amplicon ER+ breast cancer cells as well (MCF7, MCF10A cells were obtained from Dr. Herb Soule at the T47D). This effect was also seen in ER-negative (ER-) Michigan Cancer Foundation [85] and were maintained 8p11-p12 cells (SUM-52) as well as non-amplicon bear- in serum-free Hams F12 supplemented with Bovine ing cells (SUM-229, SUM-149), but to a lesser extent. serum albumin (BSA) (126,579, Millipore), 5 μg/mL Insu- There was no effect of 4EBP1 targeting on the prolifera- lin (700-112P, Gemini Bioproducts), 1 μg/mL Hydrocorti- tion of immortalized but non-tumorigenic mammary sone (H-4001, Sigma-Aldrich), and 10 ng/mL Epidermal epithelial cells (MCF10A, H16N2). Consistent with our Growth Factor (E9644, Sigma-Aldrich) (SFIHE medium). Rutkovsky et al. BMC Cancer (2019) 19:491 Page 3 of 15 H16N2 cells [86, 87] (immortalized by human papilloma- Control cells without the addition of lentivirus were plated virus (HPV) E6 and E7 oncoproteins) were also grown in alongside lentivirus infected cells to ensure the appropriate SFIHE medium. When trypsinizing cells grown in concentration of antibiotic was used. Cells were continu- serum-free medium, 2% FBS was added for the first 24 h. ously maintained in the resistance marker. All further pa- The SUM cell lines were developed in the author’slabora- rameters were tested after four days of selection in tory and are routinely validated for identity by STR profil- Puromycin. ing. The remaining cell lines were obtained from ATCC and were used immediately upon arrival. All cell lines are Cell proliferation routinely tested for mycoplasma. Cells were plated in 12-well plates at [1E5 cells/well], washed with 1X Phosphate Buffered Saline (PBS), then Generation of EIF4EBP1 knockdown cells 0.5 mL HEPES/MgCl buffer (Isoton) was added to each Lentivirus was produced in 293FT cells which were dish and agitated for 5 min. Cell swelling was confirmed transfected in Opti-MEM with Lipofectamine 2000, and 50 uL ZAP (Bretol Solution) was added and incu- pLKO.1-puro gene-targeting plasmid, and Mission bated for 10 min with agitation. Cells were visualized to packaging mix (Sigma-Aldrich) under optimal condi- confirm bursting and nuclei release, 10 mL NaCl- tions. Collected virus was filtered through a 0.2 um Formalin Solution was added to prevent deterioration, filter before storage at − 80 °C. Efficient viral titer and read using a Coulter Acuvette. The Coulter Counter production was confirmed by a Lenti-X p24 Rapid was set to count nuclei between 4 and 8 um diameter Titer Kit (Takara) and 4EBP1 western blot. All BSL-2 through a 100 um aperture. Each sample was counted safety protocols were performed during production, twice and then averaged. The counts were multiplied by storage, and continued use. Optimization was per- 20 to obtain the total number of nuclei, and background formed with listed (Table 1) 4EBP1-targeting plasmids counts with NaCl-Formalin were performed with wherein TRCN0000040206 (4EBP sh_1) and analysis. TRCN0000298904 (4EBP_sh_2) produced efficient knockdown and were used for subsequent studies. Statistical analysis These were obtained from the shRNA Technology Growth results were analyzed using a two-way ANOVA Shared Resource (Hollings Cancer Center, the Medical model with an interaction effect between day and condi- University of South Carolina). tion. Each cell line was analyzed individually and all ana- Cells were reverse transfected with lentivirus, with ap- lyses were done on the log scale. Differences between propriate growth medium, and polybrene. Virus was re- conditions were exponentiated to obtain fold change es- moved 24 h later and cells were fed with media. Cells timates. Significance testing was completed using began selection with appropriate concentration of antibiotics Tukey’s honestly significant difference method to main- 48 h following transfection. Antibiotic concentration at 2 μg/ tain a family-wise alpha of 0.05 within each cell line. ml Puromycin (invivoGen) was sufficient to ensure selection. TheSUM-44celllinerequires3 μg/ml Puromycin selection. Immunoblotting Cells were continuously maintained on ice and harvested using Radioimmunoprecipitation assay (RIPA) buffer (Sig- Table 1 . ma-Aldrich) supplemented with a protease inhibitor cock- Plasmid Genotype Region Sequence tail (Millipore, #539131) and PhosSTOP (Roche). shLACZ pLKO.1-puro::LACZ n/a CGCT Bradford Protein Assay was used to fit samples to a stand- AAATACTGGCAGGCGTT ard curve and determine protein concentrations prior to Sh4EBP1 pLKO.1- CDS CCGG SDS-PAGE. After transfer, PVDF membrane was blocked #1 puro::EIF4EBP1 CGGTGAAGAGTCACAGT 1 h with 5% skim milk in 1X TBST at room temperature TRCN0000040206 TTGA and incubated overnight with antibody per the manufac- CTCGAGTCAAACTGTGA CTCTTCACCGTTTTTG turer’s instructions. The membrane was visualized with Sh4EBP1 pLKO.1- 3UTR CCGGGCCAGGCCTTATGAAA SuperSignal West Pico Chemiluminescent Substrate #2 puro::EIF4EBP1 GTGATCTCGAGATCACTTTC (Thermo Fisher Scientific). The membrane was developed TRCN0000040203 ATAAGGCCTGGCTTTTTG using the Li-COR Odyssey Fc. Sh4EBP1 pLKO.1- 3UTR CCGGGCCAGGCCTTATGAAA #3 puro::EIF4EBP1 GTGATCTCGAGATCACTTTC Flow cytometry of live cells TRCN0000310343 ATAAGGCCTGGCTTTTTG Cells were trypsinized, counted, and analyzed at [1E6 Sh4EBP1 pLKO.1- CDS CCGG cells/mL]. Vybrant DyeCycle Orange (V35005, Thermo #4 puro::EIF4EBP1 CGGTGAAGAGTCACAG TRCN0000298904 TTTGACTCGAGTCAAACTGT Scientific) was used according to the manufacturer’s GACTCTTCACCGTTTTTG protocol for live cell-cycle analysis. Conditions were Rutkovsky et al. BMC Cancer (2019) 19:491 Page 4 of 15 optimized to a final stain concentration of 5 μMin 1X cBioPortal database analysis PBS in all cell lines tested. Cells were promptly analyzed The cBioPortal(http://www.cbioportal.org/)[89, 90]was using a BSL2 FACSAria Cell Sorter. Verity ModFit LT used to generate the overall survival curve (shown in 4.1 was used to analyze and visualize the generated data. Fig. 1b) for breast tumors with and without A2 8p11-p12 region alterations using The Cancer Genome Atlas (TCGA) provisional data. The Amplification fre- KM plotter database analysis quency of 4EBP1 in the TCGA or the Molecular Tax- The KM plotter for breast cancer (http://kmplot.com) onomy of Breast Cancer International Consortium [88] was used on all releases available from the database (METABRIC) breast data cohorts were also determined accessed spring 2018. Restricted analyses of different pop- using the cBioPortal. Data was accessed spring 2018. ulations are indicated and altered the number of breast cancer patients with available survival data as shown by Results the number at risk. The determined and represented prog- Frequency and prognostic significance of 4EBP1 nostic values by relapse free survival (RFS) of EIF4EBP1 in amplification in breast cancer all analyses were more than 500 samples, indicating highly EIF4EBP1, the gene that encodes the 4EBP1 protein, re- reliable analysis using all parameters presented. The JetSet sides within the 8p11-p12 genomic locus. It is frequently best probe set for EIF4EBP1 (probe ID: 221539_at) was amplified in endocrine resistant luminal breast cancers, used for all analyses. Patients were divided into a high and rarely coincides with PIK3CA mutations, and is asso- low expression group by median mRNA expression ciated with poor prognosis. The frequency of values, all possible cutoff values between the lower and EIF4EBP1 amplification across all breast cancer sub- upper quartiles were computed and the best performing types is approximately 13% according to data from threshold was determined by using auto select the best The Cancer Genome Atlas (TCGA) and 14% accord- cutoff. RFS was plotted using suggested quality controls. ing to data from the Molecular Taxonomy of Breast This excluded biased arrays, removed redundant samples, Cancer International Consortium (METABRIC) [91] and checked proportional hazards assumptions. The cut- (Fig. 1a & b). Furthermore, we found that expression off values, probe expression range, false discovery rate analysis of the TCGA provisional data shows that (FDR), and p-value were extracted from the KM plotter high expression of the genes in the A2 region of the webpage and each analysis is represented. 8p11-p12 amplicon, which includes EIF4EBP1, BRF2, Fig. 1 EIF4EBP1 is amplified in human breast cancer and correlates with reduced overall survival. (a) Amplification data from The Cancer Genome Atlas (TCGA) and (b) the Molecular Taxonomy of Breast Cancer International Consortium (METABRIC). (c) Expression analysis using TCGA provisional data shows that high expression of A2 genes: BRF2, RAB11FIP1, EIF4EBP1, ASH2L, LSM1, BAG4, DDHD2, PLPP5, NSD3, FGFR1, TACC1, ADAM9, and ADAM32 correlates with reduced overall survival Rutkovsky et al. BMC Cancer (2019) 19:491 Page 5 of 15 RAB11FIP1, ASH2L, LSM1, BAG4, DDHD2, PLPP5, 1 uM of the inhibitor everolimus (Affinitor). To assess NSD3, FGFR1, TACC1, ADAM9, and ADAM32, corre- proliferation, the total number of cells was quantitated lates with reduced overall survival (Fig. 1c). for each group at day 1, prior to treatment, and on day 4, 72 h after exposure to everolimus. Treatment with 4EBP1 is highly expressed and phosphorylated in 8p11- everolimus significantly reduced the proliferation of all p12 breast cancer cells three cell lines, however the fold-change observed for To investigate the significance of 4EBP1 overexpression in the SUM-44 cells and the Cama-1 cells (0.49 and 0.43 breast cancer, we employed a set of human breast cancer respectively) were significantly greater than the fold cell lines representing ER+ and ER- samples, including change observed in the SUM-52 cells (0.9). The differ- SUM-44, SUM-52, and Cama-1 (ER+, amplicon bearing), ence in response to everolimus between the SUM-52 MCF-7, T47D, and HCC1500 (ER+, non-amplicon bear- cells and the other two cell lines was significant with a ing), and SUM-229, as well as two non-tumorigenic but p-value of < 0.0001. (Fig. 2b). This result suggests that immortalized mammary epithelial cell lines, MCF10A, ER expression plays a role in the responsiveness of and H16N2 cells. As expected, SUM-44, Cama-1, and breast cancer cells to everolimus. SUM-52 expressed high levels of 4EBP1 due to the ampli- fication of the EIF4EBP1 gene, whereas MCF10A and 4EBP1 is essential to breast cancer cell lines H16N2 did not express any more or less 4EBP1 protein Our laboratory recently completed a genomic scale than the T47D, HCC1500, MCF7, or SUM-229 cell lines shRNA screen for the entire panel of SUM breast cancer (Fig. 2a). High levels of phosphorylated 4EBP1 were also cell lines, and some of the results from these screens readily detected in the SUM-44, Cama-1 and SUM-52 have been reported elsewhere [92] and can be found at cells compared to the other cell lines tested (Fig. 2a). The SUM Breast Cancer Cell Line Knowledge Base 4EBP1 is thought to be phosphorylated by mTORC1 (SLKBase) (https://sumlineknowledgebase.com/)[93]. in a hierarchical fashion [39, 40]. Our findings that Interestingly, despite the fact that the SUM-44 cells have 4EBP1 expression and phosphorylation levels are high been shown to overexpress several genes from the on multiple residues in SUM-44, Cama-1, and SUM-52 8p11-p12 amplicon that can behave as transforming on- cells, as well as our observation of high levels of cogenes in vitro, EIF4EBP1 was the strongest hit among phospho-S6 (not shown) suggest active mTORC1 signal- all 8p11 amplified genes in this RNA interference screen. ing in these 8p11-p12 models. Therefore, we tested the The DepMap [111, 112, 113] crispr (Avana) gene essen- effect of mTOR pathway inhibition on cell proliferation tiality screens also predict 4EBP1 as a driver of cancer of the 8p11-p12 cell lines. Cells were plated in equal cell lines including all of the breast cancer cell line number and on day 1 after plating, cells were exposed to models currently represented within the portal (https:// Fig. 2 4EBP1 is highly expressed and phosphorylated in 8p11-p12 breast cancer cells. (a) Western blot of 4EBP1 and phospho-4EBP1 on residues Thr 37/37, Thr 70, and Ser 65 in SUM-44 (ER+), Cama-1 (ER+), and SUM-52 (ER-) cells with amplification of the 8p11-p12 genomic locus (8p11-12 CNA) as well as T47D (ER+), HCC1500 (ER+), MCF7 (ER+), and SUM-229 (ER-) cells without amplification of the 8p11-p12 genomic locus. Immortalized but non-tumorigenic breast epithelial cells are represented by MCF10A and H16N2 cells. (b) Cell proliferation was assessed in SUM-44, Cama-1, and SUM-52 cells in the presence or absence of 1 μM everolimus treatment for 72 h. Error bars represent standard deviation among replicates and p values are for the difference in cell proliferation in control versus treated cells. The p-value for the difference between the effect in SUM-52 cells and the other cell lines is <0.0001 Rutkovsky et al. BMC Cancer (2019) 19:491 Page 6 of 15 depmap.org/portal/)[94] Therefore, we performed ex- cells (Fig. 4c) or H16N2 cells (Fig. 4d). These results in- periments to validate the importance of 4EBP1 knock- dicate that downregulation of 4EBP1 in non-tumorigenic down in SUM-44 cells and extended that to other breast breast epithelial cell lines, at least to the same levels as cancer cell lines. To gain a broader understanding of was achieved in the breast cancer cell lines does not 4EBP1 in different settings, we performed experiments affect the proliferative capacity of these cells. to assess the effect of 4EBP1 knock-down on prolifera- tion of cell lines that represent different subtypes of Downregulation of 4EBP1 in ER+ 8p11-p12 breast cancer breast cancer. cells causes cell cycle arrest To determine the effect of directly targeting 4EBP1 in Previous studies suggest that 4EBP1 regulates cell cycle breast cancer cells, we first tested the two ER+ 8p11-p12 progression [59, 61, 68, 101–104]. To better understand cell lines, SUM-44 and Cama-1, and used lentiviral vec- the cellular effects of 4EBP1 knockdown, SUM-44 and tors for two different shRNAs against EIF4EBP1. shRNA Cama-1 cells were assessed by flow cytometry to evalu- targeting lacZ was used as a control. Fig. 3 shows that ate cell cycle progression. An increase in the number of both shRNAs were effective at reducing levels of 4EBP1 cells in G1 cell-cycle in both SUM-44 (Fig. 5a) and protein, and there was a concomitant decrease in the Cama-1 cells (Fig. 5 b) was observed with EIF4EBP1 levels of phosphorylated 4EBP1 (Fig. 3 a & b). We then knockdown when compared to control cells. These re- measured proliferation of cells expressing EIF4EBP1 sults show that knockdown of 4EBP1 promotes G1 cell shRNA compared to control cells. Cells were evaluated cycle arrest. by counting the number of nuclei at day 1 and day 4 To study the cell cycle arrest induced by 4EBP1 after plating. The data shown in Fig. 3 c and d show that knock-down further, we evaluated the protein expression there as a significant increase in cell number in the LacZ levels of key cell cycle regulators. We found that Cyclin control cells over the 4-day culture period, there was lit- D1 protein levels were decreased in SUM-44 and tle or no proliferation in the sh4EBP1 groups in either Cama-1 cells following EIF4EBP1 knockdown (Fig. 5c& cell line. Indeed, there was a significant reduction in cell d). Additionally, we observed a slight increase in p27 number over the 4 day period in the SUM-44 cells (fold levels in the EIF4EBP1 knockdown cells compared to change = 0.5, p < 0.001, 0.002), whereas in the Cama-1 control cells (Fig. 5c & d). The alterations of Cyclin D1 cells, there was a smaller (approximately 0.8 fold) but and p27 expression that we found are consistent with still significant difference in cell number over the same the cell cycle arrest phenotype that we observed in period (p < 0.002, and 0.07). The largest and most statis- 4EBP1 knockdown cells. tically significant difference was detected in the day 4 cell counts between control LacZ cells and the sh4EBP1 4EBP1 knockdown inhibits proliferation of ER- 8p11-p12 cells in both cell lines, with fold-differences of approxi- amplified breast cancer cells − 9 mately 4 and 6-fold, and p-values ranging from 10 to Because we saw only a small effect of everolimus on –14 10 The full ANOVA analysis of the data for all groups the proliferation of the ER- 8p11-p12 SUM-52 breast and all time points are shown in Additional file 3:Table S1. cancer cell line, we also wanted to test the effect of Prior studies from our lab and others have demon- EIF4EBP1 knockdown on these cells. Using the same strated the effects of genes associated with the 8p11-p12 two shRNAs targeted to EIF4EBP1 as we used on the amplicon on ERα expression [1, 28–31, 100]. Therefore, previous cell lines, we knocked down 4EBP1 mRNA we next evaluated ERα expression in the SUM-44 and in the SUM-52 cells and likewise, saw a reduction in Cama-1 EIF4EBP1 knockdown cell lines and found that 4EBP1 protein levels (Fig. 6a). EIF4EBP1 knockdown ERα levels were reduced (Fig. 3 a & b) compared to con- in SUM-52 cells resulted in a dramatic reduction in trol cells expressing lacZ shRNA. These findings show proliferation of SUM-52 cells, similar to what we ob- that reducing 4EBP1 levels impairs proliferation of the served with the two ER+ cell lines. In LacZ control ER+ 8p11-p12 breast cancer cell models and results in cells, there was a highly significant increase in cell downregulation of ERα. number between days 1 and 4, whereas in the We next wanted to evaluate the potential effects of sh4EBP1 cells, there was a slight reduction in cell 4EBP1 targeting in non-tumorigenic human breast epi- number in the sh1 group and a slight increase in cell thelial cells. 4EBP1 was knocked down in MCF10A number is the sh2 group. These differences most (Fig. 4a) and H16N2 cells (Fig. 4b). Cell proliferation likely reflect different levels of knockdown achieved was then measured by counting the total number of cell with the two vectors. Of greatest importance is the nuclei present at day 1 and day 4 after plating. All popu- three to four-fold difference in the number of cells lations increased in number significantly over four days per dish at the 4 day time point between the shLacZ and no statistically significant differences were observed and sh4EBP1 groups again with p-values on the order − 14 between control and EIF4EBP1 knockdown in MCF10A of 10 .(Fig. 6b). We also probed these control and Rutkovsky et al. BMC Cancer (2019) 19:491 Page 7 of 15 Fig. 3 4EBP1 knockdown inhibits proliferation of ER+ 8p11-p12 breast cancer cells. (a) Western blot of 4EBP1, phospho-4EBP1 on residues Thr 37/ 46, and ERα in SUM-44 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (b) Western blot of 4EBP1, phospho-4EBP1 on residues Thr 37/46, and ERα in Cama-1 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell proliferation was assessed in SUM-44 and (d) Cama-1 control and EIF4EBP1 knockdown cells on day 1 and day 4 in culture following selection in puromycin containing media. Error bars represent standard deviation among replicates and p-values represent the statistical comparison between each corresponding group knockdown cells for Cyclin D1 and p27 expression. non-amplicon bearing models, MCF7 (ER+) (Additional We saw a similar effect on these two proteins as in file 1: Figure S1 a), T47D (ER+) (Additional file 1:Figure the SUM-44 and Cama-1 cells where Cyclin D1 levels S1, b), SUM-229 (ER-) (Additional file 2: Figure S2 a), and were decreased and p27 levels were increased (Fig. 6a). SUM-149 (ER-) (Additional file 2: Figure S2 b). These We also evaluated the effect of 4EBP1 knockdown on the experiments showed that knockdown of 4EBP1 in MCF7 Rutkovsky et al. BMC Cancer (2019) 19:491 Page 8 of 15 Fig. 4 4EBP1 knockdown does not affect proliferation of MCF10A and H16N2 non-transformed breast epithelial cells. (a) Western blot of 4EBP1 in MCF10A cells and (b) H16N2 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell proliferation was assessed in MCF10A and (d) H16N2 control and EIF4EBP1 knockdown cells on day 1 and day 4 in culture following selection in puromycin-containing medium. Error bars represent standard deviation among replicates and p-values represent significance between each corresponding group Rutkovsky et al. BMC Cancer (2019) 19:491 Page 9 of 15 Fig. 5 4EBP1 knockdown leads to G0/G1 arrest in ER+ 8p11-p12 breast cancer cells. (a) Cell cycle analysis of SUM-44 and (b) Cama-1 cells shows that 4EBP1 knockdown results in an accumulation of cells in G0/G1 with an associated decrease in cells in S-phase. (c) Western blot of cyclin D1 and p27 in SUM-44 and (d) Cama-1 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2) Fig. 6 4EBP1 knockdown inhibits proliferation of ER- 8p11-p12 breast cancer cells. (a) Western blot of 4EBP1, phospho-4EBP1 on residues Thr 37/ 46, ERα, cyclin D1, and p27 in SUM-52 cells engineered with either control shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (b) Cell proliferation was assessed in SUM-52 control and EIF4EBP1 knockdown cells on day 1 and day 4 in culture after selection in puromycin-containing medium. Error bars represent standard deviation among replicates and significance is the comparison between each corresponding group Rutkovsky et al. BMC Cancer (2019) 19:491 Page 10 of 15 and T47D also significantly inhibited proliferation 4EBP1 overexpression in breast cancer development and (Additional file 1: Figure S1 c & d). By contrast, 4EBP1 response to therapy. knock-down in the triple negative SUM-149 and SUM-229 cells was less effective at reducing proliferation Discussion of these cells (Additional file 2: Figure S2 c & d). We and others have determined that a number of onco- genes reside within the 8p11-p12 region and are ampli- EIF4EBP1 expression levels correlate with reduced relapse fied in human breast cancer. Genes found within this free survival in human breast cancer region such as WHSC1L1 [11], DDHD2 [11], LSM1 [10, To determine the overall impact of EIF4EBP1 on sur- 11, 18], BAG4 [10, 11], and KAT6A [16, 28] have all been vival and to assess whether treatment affects the out- shown to have transforming properties in vitro. Of sig- comes, we used the online Kaplan-Meier plotter nificance, the 8p11-p12 amplicon is implicated in endo- database tool (kmplot.com) to assess the relationship be- crine resistance [1]. Consistent with this implication, tween EIF4EBP1 gene expression and relapse free sur- NSD3 (aka WHSC1L1) was shown to drive high levels of vival. This tool uses gene expression data from Gene ER expression, and to enhance proliferation in an estro- Expression Omnibus (GEO), the European Genome- gen independent manner [29]. Reminiscent of this find- phenome Archive (EGA), and The Cancer Genome Atlas ing, hyperactive mTOR is often observed in endocrine (TCGA) [88].The JetSet probe set for EIF4EBP1 (probe resistant cells and can activate ERα [95–99]. Interest- ID: 221539_at) was used for all analyses. We found that ingly, the EIF4EBP1 gene which encodes the mTOR ef- high EIF4EBP1 gene expression significantly correlated fector protein 4EBP1 is located on the short arm of with reduced relapse free survival not only in ER+ popu- chromosome 8 within the 8p11 region of the amplicon. lations (Fig. 7a), including when separated by luminal A It is highly overexpressed but rarely mutated in breast (Fig. 7b) and luminal B (Fig. 7c) subtypes, but also across cancer, regardless of amplification, and has been sug- all subtypes (Fig. 7d). Furthermore, this was also true gested to be an essential driving gene in many cancer post treatment with chemotherapy (Fig. 7e) and follow- cell lines in vitro which we [93]and others have wit- ing either tamoxifen (Fig. 7f) or other endocrine therapy nessed [94]using genome-wide gene essentiality screens. (Fig. 7g). Altogether, these analyses point to a role of Consequently, our study initially aimed to determine Fig. 7 Kaplan-Meier analysis of breast cancer outcomes in patients with and without overexpression of 4EBP1. KM plotter analysis of EIF4EBP1 (probe ID: 221539_at) gene expression and overall survival in (a) ER+ populations (b) separated by luminal A (c) luminal B subtypes (d) all subtypes (no parameters selected) (e) post treatment with chemotherapy (f) tamoxifen or (g) endocrine therapy Rutkovsky et al. BMC Cancer (2019) 19:491 Page 11 of 15 whether 4EBP1 overexpression influences proliferation current clinical trial is underway to determine if the phos- in ER+ 8p11-p12 amplicon positive breast cancer cells. phorylation status of 4EBP1 can be used to predict everoli- Our findings show that 4EBP1 is a critical protein for lu- mus response in breast tumors (NCT00855114). minal breast cancer cell proliferation regardless of Direct targeting of 4EBP1 or targeting of multiple up- amplicon and/or ER status. However, shRNA mediated stream kinases that target 4EBP1 may provide additional knockdown of 4EBP1 in non-transformed mammary epi- benefit. Recently, several kinases were identified to phos- thelial cells did not affect proliferation. It is possible that phorylate 4EBP1 in both mTOR dependent as well as in- complete knock-out of 4EBP1 in non-tumorigenic breast dependent manners [41, 42]. Of note, GSK3β epithelial cells could affect their proliferative capacity, phosphorylation of 4EBP1 plays a similar role as mTOR, but our results indicate that the changes in 4EBP1 whereby phosphorylation decreases 4EBP1 association expression in luminal breast cancer cells achieved by with eIF4E [50]. Contrary to this observation, CDK1 is a shRNA knockdown is sufficient to profoundly affect mitotic kinase that also phosphorylates 4EBP1 [67, 70]. their proliferative capacity. Consistent with the idea However, phosphorylation by CDK1 does not alter the that 4EBP1 has a potential role in regulating ERα ex- cap-dependent translation functions of 4EBP1. Interest- pression, as well as a potential role outside of ERα ingly, a phospho-deficient mutant of 4EBP1 that is resist- regulation, we found that downregulation of 4EBP1 ant to phosphorylation by CDK1 partially reverses rodent reduces not only ERα expression but also affects Cyc- cell transformation. It is suggested that 4EBP1 phosphor- lin D1 expression and p27 expression. These observa- ylation by CDK1 could result in a gain of function, which tions are consistent with the reduced proliferation opposes the canonical form of regulation set forth by and cell cycle arrest phenotypes that we report in our studies evaluating mTOR-mediated inhibition of 4EBP1 present study. There is no indication that Cyclin D1 through phosphorylation. Regulation of phosphorylated or p27 levels would change in non-transformed cells 4EBP1 especially the intertwined dynamics between because cell proliferation was not compromised with CDK1 and mTOR should be further explored, as CDK1 4EBP1 knockdown in these models. Future studies can phosphorylate mTOR and co-localize with phosphor- should further explore the relationship between ylated 4EBP1 [59]. Whether the distinct effects of the dif- 4EBP1 and Cyclin D1 in cancer cells and non-trans- ferent phosphorylation states of 4EBP1, determined by formed cells. There is a consistently demonstrated oc- distinct phosphorylation events driven by individual ki- currence between co-amplification of genomic loci nases, affects 4EBP1’s ability to drive breast cancer pro- harboring 4EBP1 (EIF4EBP1) and Cyclin D1 (CCND1) gression or endocrine resistance would be of significant in breast cancer patients such as the recent report by interest for future studies particular in the context of Giltnane and colleagues [27], so further studies therapeutic interventions. should assess how these two oncogenes together can influence cell cycle states, meiotic progression, and Conclusions the regulation of aneuploidy. Because 4EBP1 is re- EIF4EBP1 is a candidate oncogene in breast cancer be- quired for coupling mTORC1 signaling to Cyclin D1 cause it is commonly amplified and overexpressed, and expression [101] and translational inhibition can re- is part of a genomic region that, when amplified, confers sult in the loss of cell cycle regulators like the poor prognosis for patients. Overexpression of 4EBP1 D-cyclins [105], we plan to determine the predictive drives proliferation of luminal breast cancer cells by value of 4EBP1 levels to CDK inhibition in breast tu- mechanisms involving cell cycle regulators such as cyclin mors, especially in the context of dual inhibition with D1 and the cdk inhibitor p27. In some cells, 4EBP1 PI3K/AKT/mTOR inhibitors. phosphorylation occurs with high level activity of the Amplification of EIF4EBP1 leads to increased 4EBP1 ex- mTORC pathway, which also is common in estrogen-re- pression and phosphorylation suggesting that mechanisms ceptor positive breast cancer, and indeed, knockdown of are in place to promote 4EBP1 mediated translation and EIF4EBP1 results in reduced expression of ERα. Based post-translational regulation during breast cancer initiation on these results, we conclude that 4EBP1, and particu- and progression. Consequently, targeting of 4EBP1 either larly phosphorylated 4EBP1 plays a dominant role in directly or via inhibition of mTOR could relieve repressive breast cancer by mechanisms distinct from its role in effects of phosphorylated 4EBP1 on translation as well as regulating cap-dependent translation. any capacity of 4EBP1 to stabilize mTORC1 [106]orother proteins like p21 [107]. Several Phase II clinical trials have Additional files evaluated use of mTOR inhibitors for ER+ breast cancer [108–110]. While promising, results from trials in patients Additional file 1: Figure S1 4EBP1 knockdown inhibits proliferation of MCF7 and T47D breast cancer cells. (a) Western blot of 4EBP1 in MCF7 with ER+ breast cancer who experience aromatase inhibitor cells and (b) T47D cells engineered with either control shRNA to lacZ or failure were only somewhat successful [108]. However, a Rutkovsky et al. BMC Cancer (2019) 19:491 Page 12 of 15 Therapeutics, Medical University of South Carolina, 173 Ashley Avenue, BSB two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell 358, MSC 509, Charleston, SC 29425, USA. Hollings Cancer Center, Medical proliferation was assessed in MCF7 and (d) T47D control and EIF4EBP1 University of South Carolina, 86 Jonathan Lucas Street, Charleston, SC 29425, knockdown cells on day 1 and day 4 in culture. Error bars represent USA. Department of Computational Medicine and Bioinformatics, University standard deviation among replicates and p-values represent the of Michigan, 500 S. State Street, Ann Arbor, MI 48109, USA. Department of comparison between each corresponding group. (TIF 2538 kb) Regenerative Medicine and Cell Biology, Medical University of South Additional file 2: Figure S2 4EBP1 knockdown slows proliferation of Carolina, 173 Ashley Avenue, BSB 601, MSC 508, Charleston, SC 29425, USA. SUM-229 and SUM-149 breast cancer cells. (a) Western blot of 4EBP1 in Department of Public Health Sciences, Medical University of South Carolina, SUM-229 cells and (b) SUM-149 cells engineered with either control 135 Cannon Street Suite 303 MSC 835, Charleston, USA. shRNA to lacZ or two individual shRNAs to EIF4EBP1 (4EBP sh_1 or sh_2). (c) Cell proliferation was assessed in SUM-229 and (d) SUM-149 control Received: 26 November 2018 Accepted: 1 May 2019 and EIF4EBP1 knockdown cells on day 1 and day 4 in culture. Error bars represent standard deviation among replicates and signficance is shown between each corresponding group. (TIF 2688 kb) References Additional file 3: GrowthResults_2–15-19.xlsx Results and statistical 1. Turner N, et al. FGFR1 amplification drives endocrine therapy resistance and analysis of experiments in which EIF4EBP1 was knocked down in three is a therapeutic target in breast cancer. Cancer Res. 2010;70:2085–94. breast cancer cell lines. (XLSX 16 kb) https://doi.org/10.1158/0008-5472.CAN-09-3746. 2. van 't Veer LJ, et al. Gene expression profiling predicts clinical outcome of Abbreviations breast cancer. Nature. 2002;415:530–6. https://doi.org/10.1038/415530a. 4EBP1: Eukaryotic Initiation Factor 4E-Binding Protein; EIF4EBP1: Eukaryotic 3. Courjal F, et al. Mapping of DNA amplifications at 15 chromosomal Initiation Factor 4E-Binding Protein; ER: Estrogen receptor alpha; RFS: Relapse localizations in 1875 breast tumors: definition of phenotypic groups. 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Published: May 23, 2019

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