BACKGROUND
Uterine serous carcinoma (USC) is a subtype of endometrial cancer associated with chemoresistance and poor outcome. Overexpression of tubulin-β-III and p-glycoprotein has been linked to paclitaxel resistance in many cancers but has been undercharacterized among USC. Epothilones have demonstrated activity in certain paclitaxel-resistant malignancies. In this study, we clarify in USC relative to ovarian serous carcinomas (OSC) the relationships between tubulin-β-III and p-glycoprotein expression, clinical outcome, and in vitro chemoresponsiveness to epothilone B, ixabepilone and paclitaxel.
METHODS
Tubulin-β-III and p-glycoprotein were quantified by real time polymerase chain reaction (qRT-PCR) in 48 fresh-frozen tissue samples and 13 cell lines. Copy number was correlated with immunohistochemistry and overall survival. IC50 was determined using viability and metabolic assays. Impact of tubulin-β-III knockdown on IC50 was assessed with siRNAs.
RESULTS
USC overexpressed tubulin-β-III but not p-glycoprotein relative to OSC in both fresh-frozen tissues (552.9±106.7 versus 202.0±43.99, p=0.01) and cell lines (1701.0±.376.4 versus 645.1±157.9, p=0.02). Tubulin-β-III immunohistochemistry reflected qRT-PCR copy number and overexpression stratified patients by overall survival (copy number ≤400: 615 days; copy number >400: 165 days, p=0.049); p-glycoprotein did not predict clinical outcome. USC remained exquisitely sensitive to patupilone in vitro despite tubulin-β-III overexpression (IC50, USC 0.245±0.11 nM versus IC50, OSC 1.01±0.13 nM, p=0.006).
CONCLUSIONS
Tubulin-β-III overexpression in USC discriminates poor prognosis, serves as a marker for sensitivity to epothilones, and may contribute to paclitaxel resistance. Immunohistochemistry reliably identifies tumors with overexpression of tubulin-β-III, and a subset of individuals likely to respond to patupilone and ixabepilone. Epothilones warrant clinical investigation for treatment of USC.