Background
Adrenocortical carcinoma (ACC) is a rare but aggressive malignancy with no effective therapy for patients with locally advanced and metastatic disease. The current study aimed to evaluate expression and function of TOP2A in human adrenocortical neoplasm, and anticancer activity of agents that target TOP2A.
Methods
TOP2A mRNA and protein expression levels were evaluated in 112 adrenocortical tissue samples. In vitro siRNA knockdown of TOP2A in ACC cell lines (NCI-H295R and SW13) was used to determine its effect on cellular proliferation, cell cycle, anchorage-independent growth and cellular invasion. We screened 14 TOP2A inhibitors for their anticancer activity in ACC cell lines.
Results
TOP2A mRNA expression was significantly higher in ACC than in benign and normal adrenocortical tissue samples (p < 0.001); likewise, TOP2A protein expression was significantly higher in benign and malignant samples than in normal samples (p < 0.05). TOP2A mRNA expression was enhanced up to 2.5-fold in ACC cell lines after decitabine treatment. Knockdown of TOP2A gene expression decreased cell proliferation, anchorage-independent growth and invasion (p < 0.05). Aclarubicin, TOP2A inhibitor, had potent antiproliferative activity out of 11 active TOP2 inhibitors, which significantly decreased proliferation and tumor spheroid size in ACC cell lines (p< 0.05).
Conclusions
Our data indicate that most TOP2A inhibitors are effective compounds for ACC, with aclarubicin having best anticancer activity. Thus, TOP2A inhibitors should be tested in future clinical trials for patients with locally advanced and metastatic ACC and that expression of TOP2A may be enhanced by the use of demethylation agents.