Skip to main content

Advertisement

Log in

FOXO3a nuclear localisation is associated with good prognosis in luminal-like breast cancer

  • Preclinical study
  • Published:
Breast Cancer Research and Treatment Aims and scope Submit manuscript

Abstract

Oestrogen receptor (ER)-positive breast cancer (BC) constitutes a heterogeneous group of tumours with regard to outcome and response to therapy. Accurate stratification of ER-positive BC according to risk of relapse and response to therapy will be achieved through an improved understanding of ER and ER-related biological pathways. Recent studies have identified Forkhead box O3a (FOXO3a) transcription factor as an intracellular mediator of ERα expression and as an important downstream target of the Akt/PI3K pathway indicating a biological and potential clinical role for FOXO3a in ER-positive BC. In this study, we investigated the clinical relevance and biological associations of FOXO3a protein expression, using tissue microarrays and immunohistochemistry, in a large series of patients with invasive breast cancer. FOXO3a protein expression showed both nuclear and/or cytoplasmic staining patterns. FOXO3a predominant nuclear expression was positively associated with biomarkers of good prognosis including PgR, FOXA1 and p27 expression. There was an inverse association with mitotic counts, MIB1 growth fraction, C-MYC and PIK3CA expression. With respect to patient outcome, FOXO3a nuclear localisation was associated with longer BC specific survival (P < 0.001) and longer distant metastasis free interval (P = 0.001), independently of the well-established breast cancer prognostic factors. In conclusion, our results demonstrate the biological and prognostic role of FOXO3a protein expression and its subcellular localisation in ER-positive/luminal-like BC possibly through its involvement in controlling cell proliferation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Murphy LC, Watson P (2002) Steroid receptors in human breast tumorigenesis and breast cancer progression. Biomed Pharmacother 56(2):65–77

    Article  PubMed  CAS  Google Scholar 

  2. Yang J-Y, Hung M-C (2009) A new fork for clinical application: targeting forkhead transcription factors in cancer. Clin Cancer Res 15(3):752–757

    Article  PubMed  CAS  Google Scholar 

  3. Tsai K-L, Sun Y-J, Huang C-Y, Yang J-Y, Hung M-C, Hsiao C-D (2007) Crystal structure of the human FOXO3a-DBD/DNA complex suggests the effects of post-translational modification. Nucleic Acids Res 35(20):6984–6994

    Article  PubMed  CAS  Google Scholar 

  4. Zou Y, Tsai W-B, Cheng C-J, Hsu C, Chung Y, Li P-C, Lin S-H, Hu M (2008) Forkhead box transcription factor FOXO3a suppresses estrogen-dependent breast cancer cell proliferation and tumorigenesis. Breast Cancer Res 10(1):R21

    Article  PubMed  Google Scholar 

  5. Guo S, Sonenshein GE (2004) Forkhead box transcription factor FOXO3a regulates estrogen receptor alpha expression and is repressed by the Her-2/neu/phosphatidylinositol 3-kinase/Akt signaling pathway. Mol Cell Biol 24(19):8681–8690

    Article  PubMed  CAS  Google Scholar 

  6. Brunet A, Bonni A, Zigmond MJ, Lin MZ, Juo P, Hu LS, Anderson MJ, Arden KC, Blenis J, Greenberg ME (1999) Akt promotes cell survival by phosphorylating and inhibiting a forkhead transcription factor. Cell 96(6):857–868

    Article  PubMed  CAS  Google Scholar 

  7. Vara JÁF, Casado E, de Castro J, Cejas P, Belda-Iniesta C, González-Barón M (2004) PI3K/Akt signalling pathway and cancer. Cancer Treat Rev 30(2):193–204

    Article  CAS  Google Scholar 

  8. Huang H, Tindall DJ (2007) Dynamic FoxO transcription factors. J Cell Sci 120(15):2479–2487

    Article  PubMed  CAS  Google Scholar 

  9. Yang J-Y, Zong CS, Xia W, Yamaguchi H, Ding Q, Xie X, Lang J-Y, Lai C-C, Chang C-J, Huang W-C et al (2008) ERK promotes tumorigenesis by inhibiting FOXO3a via MDM2-mediated degradation. Nat Cell Biol 10(2):138–148

    Article  PubMed  CAS  Google Scholar 

  10. Burgering BMT, Medema RH (2003) Decisions on life and death: FOXO Forkhead transcription factors are in command when PKB/Akt is off duty. J Leukoc Biol 73(6):689–701

    Article  PubMed  CAS  Google Scholar 

  11. Burgering BMT, Kops GJPL (2002) Cell cycle and death control: long live Forkheads. Trends Biochem Sci 27(7):352–360

    Article  PubMed  CAS  Google Scholar 

  12. Alvarez B, Martinez-A C, Burgering BMT, Carrera AC (2001) Forkhead transcription factors contribute to execution of the mitotic programme in mammals. Nature 413(6857):744–747

    Article  PubMed  CAS  Google Scholar 

  13. Hu MCT, Lee D-F, Xia W, Golfman LS, Ou-Yang F, Yang J-Y, Zou Y, Bao S, Hanada N, Saso H et al (2004) I[kappa]B kinase promotes tumorigenesis through inhibition of Forkhead FOXO3a. Cell 117(2):225–237

    Article  PubMed  CAS  Google Scholar 

  14. Accili D, Arden KC (2004) FoxOs at the crossroads of cellular metabolism, differentiation, and transformation. Cell 117(4):421–426

    Article  PubMed  CAS  Google Scholar 

  15. Stahl M, Dijkers PF, Kops GJPL, Lens SMA, Coffer PJ, Burgering BMT, Medema RH (2002) The Forkhead transcription factor FoxO regulates transcription of p27Kip1 and Bim in response to IL-2. J Immunol 168(10):5024–5031

    PubMed  CAS  Google Scholar 

  16. Kops GJPL, Dansen TB, Polderman PE, Saarloos I, Wirtz KWA, Coffer PJ, Huang T-T, Bos JL, Medema RH, Burgering BMT (2002) Forkhead transcription factor FOXO3a protects quiescent cells from oxidative stress. Nature 419(6904):316–321

    Article  PubMed  CAS  Google Scholar 

  17. Miyamoto K, Araki KY, Naka K, Arai F, Takubo K, Yamazaki S, Matsuoka S, Miyamoto T, Ito K, Ohmura M et al (2007) Foxo3a is essential for maintenance of the hematopoietic stem cell pool. Cell Stem Cell 1(1):101–112

    Article  PubMed  CAS  Google Scholar 

  18. Tothova Z, Kollipara R, Huntly BJ, Lee BH, Castrillon DH, Cullen DE, McDowell EP, Lazo-Kallanian S, Williams IR, Sears C et al (2007) FoxOs are critical mediators of hematopoietic stem cell resistance to physiologic oxidative stress. Cell 128(2):325–339

    Article  PubMed  CAS  Google Scholar 

  19. You H, Yamamoto K, Mak TW (2006) Regulation of transactivation-independent proapoptotic activity of p53 by FOXO3a. Proc Natl Acad Sci USA 103(24):9051–9056

    Article  PubMed  CAS  Google Scholar 

  20. Myatt SS, Lam EWF (2007) The emerging roles of forkhead box (Fox) proteins in cancer. Nat Rev Cancer 7(11):847–859

    Article  PubMed  CAS  Google Scholar 

  21. Krol J, Francis RE, Albergaria A, Sunters A, Polychronis A, Coombes RC, Lam EWF (2007) The transcription factor FOXO3a is a crucial cellular target of gefitinib (Iressa) in breast cancer cells. Mol Cancer Ther 6(12):3169–3179

    Article  PubMed  CAS  Google Scholar 

  22. Sunters A, Fernandez de Mattos S, Stahl M, Brosens JJ, Zoumpoulidou G, Saunders CA, Coffer PJ, Medema RH, Coombes RC, Lam EWF (2003) FoxO3a transcriptional regulation of Bim controls apoptosis in paclitaxel-treated breast cancer cell lines. J Biol Chem 278(50):49795–49805

    Article  PubMed  CAS  Google Scholar 

  23. Sunters A, Madureira PA, Pomeranz KM, Aubert M, Brosens JJ, Cook SJ, Burgering BMT, Coombes RC, Lam EW-F (2006) Paclitaxel-induced nuclear translocation of FOXO3a in breast cancer cells is mediated by c-Jun NH2-terminal kinase and Akt. Cancer Res 66(1):212–220

    Article  PubMed  CAS  Google Scholar 

  24. El-Rehim DMA, Ball G, Pinder SE, Rakha E, Paish C, Robertson JFR, Macmillan D, RWB I, Ellis aO (2005) High-throughput protein expression analysis using tissue microarray technology of a large well-characterised series identifies biologically distinct classes of breast cancer confirming recent cDNA expression analyses. Int J Cancer 116(3):340–350

    Article  Google Scholar 

  25. Elston CW, Ellis IO (1991) Pathological prognostic factors in breast-cancer. 1. The value of histological grade in breast-cancer—experience from a large study with long-term follow-up. Histopathology 19(5):403–410

    Article  PubMed  CAS  Google Scholar 

  26. Galea MH, Blamey RW, Elston CE, Ellis IO (1992) The Nottingham prognostic index in primary breast-cancer. Breast Cancer Res Treat 22(3):207–219

    Article  PubMed  CAS  Google Scholar 

  27. Habashy HO, Powe DG, Rakha EA, Ball G, Paish C, Gee J, Nicholson RI, Ellis IO (2008) Forkhead-box A1 (FOXA1) expression in breast cancer and its prognostic significance. Eur J Cancer 44(11):1541–1551

    Article  PubMed  CAS  Google Scholar 

  28. El-Rehim DMA, Pinder SE, Paish CE, Bell J, Blamey R, Robertson JFR, Nicholson RI, Ellis IO (2004) Expression of luminal and basal cytokeratins in human breast carcinoma. J Pathol 203(2):661–671

    Article  Google Scholar 

  29. Rakha EA, El-Sayed ME, Powe DG, Green AR, Habashy H, Grainge MJ, Robertson JFR, Blamey R, Gee J, Nicholson RI et al (2008) Invasive lobular carcinoma of the breast: response to hormonal therapy and outcomes. Eur J Cancer 44(1):73–83

    Article  PubMed  Google Scholar 

  30. Habashy H, Powe D, Rakha E, Ball G, Macmillan R, Green A, Ellis I (2010) The prognostic significance of PELP1 expression in invasive breast cancer with emphasis on the ER-positive luminal-like subtype. Breast Cancer Res Treat 120:603–612

    Article  PubMed  CAS  Google Scholar 

  31. Aleskandarany M, Rakha E, Ahmed M, Powe D, Paish E, Macmillan R, Ellis I, Green A (2010) PIK3CA expression in invasive breast cancer: a biomarker of poor prognosis. Breast Cancer Res Treat 122(1):45–53

    Article  PubMed  CAS  Google Scholar 

  32. McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM (2005) Reporting recommendations for tumor marker prognostic studies. J Clin Oncol 23(36):9067–9072

    Article  PubMed  Google Scholar 

  33. McShane LM, Altman DG, Sauerbrei W, Taube SE, Gion M, Clark GM (2006) REporting recommendations for tumor MARKer prognostic studies (REMARK). Breast Cancer Res Treat 100(2):229–235

    Article  PubMed  Google Scholar 

  34. Loi S (2008) Molecular analysis of hormone receptor positive (luminal) breast cancers—what have we learnt? Eur J Cancer 44(18):2813–2818

    Article  PubMed  CAS  Google Scholar 

  35. Bardou V-J, Arpino G, Elledge RM, Osborne CK, Clark GM (2003) Progesterone receptor status significantly improves outcome prediction over estrogen receptor status alone for adjuvant endocrine therapy in two large breast cancer databases. J Clin Oncol 21(10):1973–1979

    Article  PubMed  CAS  Google Scholar 

  36. Thorat MA, Marchio C, Morimiya A, Savage K, Nakshatri H, Reis-Filho JS, Badve S (2007) FOXA1 expression in breast cancer is associated with luminal subtype and good prognosis. J Clin Pathol 61:327–332

    Article  PubMed  Google Scholar 

  37. Delpuech O, Griffiths B, East P, Essafi A, Lam EWF, Burgering B, Downward J, Schulze A (2007) Induction of Mxi1-SR{alpha} by FOXO3a contributes to repression of Myc-dependent gene expression. Mol Cell Biol 27(13):4917–4930

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

We thank the Ministry of Higher Education (Egypt) for funding H. O. Habashy, M. Ahmed, M. Aleskandarany and E. Rakha.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ian O. Ellis.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Habashy, H.O., Rakha, E.A., Aleskandarany, M. et al. FOXO3a nuclear localisation is associated with good prognosis in luminal-like breast cancer. Breast Cancer Res Treat 129, 11–21 (2011). https://doi.org/10.1007/s10549-010-1161-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10549-010-1161-z

Keywords

Navigation