Abstract. The Luminal A subtype of breast cancer expresses the estrogen receptor (ER)-α and progesterone receptor (PR), but not the human epidermal growth factor receptor (HER)-2 oncogene. This subtype of breast cancer responds to endocrine therapy involving the use of selective estrogen receptor modulators and/or inhibitors of estrogen biosynthesis. However, these therapeutic agents are frequently associated with long-term systemic toxicity and acquired tumor resistance, emphasizing the need to identify non-toxic alternative treatments for chemo-endocrine therapy responsive breast cancer. The present study utilized the human mammary carcinoma-derived, ER + /PR + /HER-2 -MCF-7 cell line as a model of the Luminal A subtype of breast cancer to examine the growth inhibitory effect of the Chinese nutritional herb Epimedium grandiflorum (EG) and determine the mechanisms underlying this effect. MCF-7 cells maintained in a serum-depleted culture medium retained their ability to grow in response to 17β-estradiol (E 2 ). Treatment of the MCF-7 cells with EG resulted in dose-dependent inhibition of E 2 -promoted growth. Mechanistically, EG inhibited E 2 -promoted cell cycle progression through G 1 stage arrest and modulated the cellular metabolism of E 2 , increasing the formation of the anti-proliferative metabolites 2-hydroxyestrone and estriol. Long-term treatment of MCF-7 cells with EG inhibited E 2 -promoted anchorage independent growth, a surrogate in vitro biomarker of tumorigenesis. In conclusion, the results of the present study demonstrate the growth inhibitory effects of EG on MCF-7 cells and identified clinically relevant mechanistic leads for its anti-tumorigenic efficacy.
IntroductionMetastatic breast cancer is one of the leading causes of breast-cancer associated mortality in the United States, and the American Cancer Society (Atlanta, GA, USA) projections for breast cancer incidence and mortality rates estimate 246,660 newly diagnosed cases of invasive breast cancer and 40,450 metastatic breast cancer-associated mortalities in women in 2017 (1). These figures emphasize the requirement for a more precise molecular classification of breast cancer for subtype-specific targeted therapy, in addition to the necessity to identify novel, non-toxic and efficacious modalities as alternatives for cancer prevention and therapy.The global gene expression profiling of breast cancer has led to the identification of molecularly distinct subtypes. Patients with the molecular subtype Luminal A express estrogen receptor-α (ER)-α and progesterone receptor (PR), and they lack the expression of human epidermal growth factor receptor-2 (HER-2). Patients with this subtype respond to endocrine-based targeted therapy, such as selective ER modulators and specific small molecule inhibitors of estrogen biosynthesis (2-4). However, long-term endocrine-based therapy has been associated with adverse systemic toxicity, acquired tumor resistance and the emergence of drug resistant cancer stem cells that compromise therapeutic efficacy and ...