The oncogenic activity of the overexpressed HER2 tyrosine kinase receptor requires its localization in the plasma membrane. The antitumor effect of anti-HER2 antibodies (Abs) is mainly dependent on receptor downregulation and comprises p27 Kip1 -mediated G 1 cell cycle arrest. However, one major limitation of anti-HER2 therapy is the reversibility of tumor growth inhibition after discontinuation of treatment caused by the mitogenic signaling associated with cell surface receptor re-expression. We found that the level of
Key words: HER2; receptor internalization; p27Kip1 ; G 1 arrestThe neu (c-ErbB-2, HER2) proto-oncogene, encoding a 185 kDa RTK, is a member of the EGF receptor family, which includes ErbB-1 (HER1, EGFR), ErbB-3 (HER3) and ErbB-4 (HER4). 1 Activation of RTKs is dependent on ligand-mediated homodimerization and subsequent autophosphorylation and transphosphorylation of the intracellular kinase domains of the paired receptors. However, HER2 may be activated even in the absence of a direct ligand because it forms heterodimeric complexes with its family members HER1, HER3 and HER4 2-7 upon ligand binding to the ectodomain of these receptors. Once recruited into these heterodimeric complexes, HER2 can modulate ligand-mediated receptor internalization to the recycling route and amplify signal transduction. 7-10 The transforming ability of HER2 has been associated with enhanced cell survival and mitogenic signaling pathways. Amplification of HER2 is observed in cancers of the breast, 11-15 ovary, 12,16 lung 17 and stomach; 18 and its overexpression predicts poor prognosis in several human cancers. 11,16,19 -23 At the molecular level, HER2 overexpression can deregulate the G 1 -S transition by downregulating p27Kip1 and stimulating the cyclin E-cdk2 complex. 24 The crucial role of p27 Kip1 in HER2-mediated transformation is consistent with clinical observations that a decreased p27Kip1 protein level in breast cancer is associated with poor prognosis. 25 The key role of HER2 in signaling cell proliferation and transformation made it an attractive therapeutic target in HER2-overexpressing human tumors. MAbs directed against the HER2 ectodomain could specifically inhibit the growth of tumor cells overexpressing HER2. 26 -30 The major mechanism of anti-HER2-mediated inhibition of cell transformation is suppression of HER2 expression on the cell surface 28,31-34 due to Ab-simulated endocytosis of the receptor via coated pits. 35,36 Indeed, retention of nascent HER2 in the endoplasmic reticulum reversed the HER2-mediated transformation associated with cell surface localization. 37 One such potent anti-HER2 Ab, 4D5, 38 was humanized; 39 and the resulting Ab, HCT, is clinically used for the therapy of HER2-overexpressing metastatic breast cancers. 40,41 HCT, like its parental Ab 4D5, markedly downregulates HER2 expression by stimulating receptor endocytosis 42 and thereby arrests cells in the G 1 phase of the cycle via p27 Kip1 . 24,43 However, monotherapy with HCT has limited antitumor effects 44 and requir...