The use of platinum complexes for the therapy of breast cancer is an emerging new treatment modality. To gain insight into the mechanisms underlying cisplatin resistance in breast cancer, we used estrogen receptor-positive MCF-7 cells as a model system. We generated cisplatin-resistant MCF-7 cells and determined the functional status of epidermal growth factor receptor (EGFR), MAPK, and AKT signaling pathways by phosphoreceptor tyrosine kinase and phospho-MAPK arrays. The cisplatinresistant MCF-7 cells are characterized by increased EGFR phosphorylation, high levels of AKT1 kinase activity, and ERK1 phosphorylation. In contrast, the JNK and p38 MAPK modules of the MAPK signaling pathway were inactive. These conditions were associated with inactivation of the p53 pathway and increased BCL-2 expression. We investigated the expression of genes encoding the ligands for the ERBB signaling cascade and found a selective up-regulation of amphiregulin expression, which occurred at later stages of cisplatin resistance development. Amphiregulin is a specific ligand of the EGFR (ERBB1) and a potent mitogen for epithelial cells. After exposure to cisplatin, the resistant MCF-7 cells secreted amphiregulin protein over extended periods of time, and knockdown of amphiregulin expression by specific short interfering RNA resulted in a nearly complete reversion of the resistant phenotype. To demonstrate the generality and importance of our findings, we examined amphiregulin expression and cisplatin resistance in a variety of human breast cancer cell lines and found a highly significant correlation. In contrast, amphiregulin levels did not significantly correlate with cisplatin resistance in a panel of lung cancer cell lines. We have thus identified a novel function of amphiregulin for cisplatin resistance in human breast cancer cells.The use of platinum complexes for the therapy of breast carcinomas is an emerging new treatment modality that has recently been introduced into the clinical setting (reviewed in Ref. 1). Breast cancer is a family of diseases that consists of major categories, including HER-2-positive breast cancer; "triple-negative" tumors that are ER 3 -negative, progesterone receptor-negative, and HER-2-negative; and hormonally sensitive breast cancers. The estrogen receptor-expressing (ER-positive) breast cancers are the most prevalent (2). For the therapy of HER2-overexpressing metastatic breast cancer, platinum complexes have been used in combination with paclitaxel and trastuzumab, a humanized monoclonal IgG 1 that binds the extracellular domain of the ERBB2 (HER-2/neu) receptor (3). For the treatment of HER-2-positive locally advanced breast cancer, a combination of docetaxel, cisplatin, and trastuzumab has been used as primary systemic therapy (4). Several ongoing phase II studies explore the use of platinum salts for the therapy of breast cancer, including "triple-negative" (ER-, progesterone receptor-, and HER-2-negative) breast carcinomas.Cisplatin enters the cells predominantly by passive diffusion, where ...