, Volume 22, Issue 10, pp 1205–1224 | Cite as

Etoposide and doxorubicin enhance the sensitivity of triple negative breast cancers through modulation of TRAIL-DR5 axis

  • Sarita Das
  • Neha Tripathi
  • Sumit Siddharth
  • Anmada Nayak
  • Deepika Nayak
  • Chinmayee Sethy
  • Prasad V. Bharatam
  • Chanakya Nath KunduEmail author


Death receptor 5 (DR5) is an important target for development of anticancer agents against triple-negative breast cancer (TNBC). Recently, we reported the molecular level details for the modulation of TRAIL-DR5 axis by quinacrine (QC) in breast cancer cells. In this work, the DR5 mediated anticancer potential of topoisomerase inhibitor etoposide (ET) and doxorubicin (DOX) against TNBC has been evaluated. ET and DOX enhanced the DR5 expression in TNBC cells, whereas non-topoisomerase inhibitors pifithrin-α (PIF) and dexamethasone (DEX) failed to do so. In the TRAIL pre-treated cells, ET and DOX induced higher apoptosis, indicating their synergistic effect with TRAIL. The molecular docking and molecular dynamics studies showed their ability to stabilize the TRAIL-DR5 complex, whereas PIF and DEX failed to do so. The binding energy for TRAIL-DR5 complexation in the ternary complexes containing ET (−111.08 kcal/mol) and DOX (−76.35 kcal/mol) were higher than reported binding energy of binary complex (−53.70 kcal/mol). The in silico and in vitro mutational studies highlighted the importance of DR5 residue SerB68 in mediating the receptor-drug interaction. ET and DOX failed to enhance apoptosis in DR5 knockdown (DR5-KD) cells. On the other hand, TRAIL+ET exhibited induction of DR5 and subsequent apoptosis in WT-DR5 overexpressed DR5-KD cells, by modulating the mitochondrial intrinsic apoptosis cascade. An induction of apoptosis and DR5 expression was noticed in xenograft mice and in TNBC patient-derived metastatic cells after TRAIL+ET treatment. Thus, data suggests ET and DOX act as DR5 agonistic ligands and enhance the cellular apoptosis in TNBC.


Etoposide Doxorubicin TNBC Death receptor TRAIL Molecular docking Molecular dynamics 



The study was supported partially by the Grants from Indian Council of Medical Research (ICMR), Government of India. SD, SS, and NT thanks DST–INSPIRE, ICMR and CSIR, respectively, for their fellowship.

Author contributions

SD, SS, AN, DN, CS and CNK designed the experimental research. SD, SS, AN, DN and CS performed the experimental work. PVB and NT designed the in silico work. NT performed the in silico work. SD, NT, SS, AN, DN, CS, PVB and CNK wrote the manuscript.

Compliance with ethical standards

Conflict of interest

Authors declare no conflict of interest in this study.

Supplementary material

10495_2017_1400_MOESM1_ESM.pdf (1.2 mb)
Supplementary material 1 (PDF 1255 KB)


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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Sarita Das
    • 1
  • Neha Tripathi
    • 2
  • Sumit Siddharth
    • 1
  • Anmada Nayak
    • 1
  • Deepika Nayak
    • 1
  • Chinmayee Sethy
    • 1
  • Prasad V. Bharatam
    • 2
  • Chanakya Nath Kundu
    • 1
    Email author
  1. 1.Cancer Biology Division, KIIT School of BiotechnologyKIIT UniversityBhubaneswarIndia
  2. 2.National Institute of Pharmaceutical Education and Research (NIPER)MohaliIndia

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