Therapeutic targeting of nemo-like kinase in primary and acquired endocrine-resistant breast cancer

Xian Wang, Jamunarani Veeraraghavan, Chia Chia Liu, Xixi Cao, Lanfang Qin, Jin Ah Kim, Ying Tan, Suet Kee Loo, Yiheng Hu, Ling Lin, Sanghoon Lee, Martin J. Shea, Tamika Mitchell, Shunqiang Li, Matthew J. Ellis, Susan G. Hilsenbeck, Rachel Schiff, Xiao Song Wang

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Purpose: Endocrine resistance remains a major clinical challenge in estrogen receptor (ER)-positive breast cancer. Despite the encouraging results from clinical trials for the drugs targeting known survival signaling, relapse is still inevitable. There is an unmet need to discover new drug targets in the unknown escape pathways. Here, we report Nemo-like kinase (NLK) as a new actionable kinase target that endows previously uncharacterized survival signaling in endocrine-resistant breast cancer. Experimental Design: The effects of NLK inhibition on the viability of endocrine-resistant breast cancer cell lines were examined by MTS assay. The effect of VX-702 on NLK activity was verified by kinase assay. The modulation of ER and its coactivator, SRC-3, by NLK was examined by immunoprecipitation, kinase assay, luciferase assay, and RNAsequencing. The therapeutic effects of VX-702 and everolimus were tested on cell line- and patientderived xenograft (PDX) tumor models. Results: NLK overexpression endows reduced endocrine responsiveness and is associated with worse outcome of patients treated with tamoxifen. Mechanistically, NLK may function, at least in part, via enhancing the phosphorylation of ERa and its key coactivator, SRC-3, to modulate ERa transcriptional activity. Through interrogation of a kinase profiling database, we uncovered and verified a highly selective dual p38/NLK inhibitor, VX-702. Coadministration of VX-702 with the mTOR inhibitor, everolimus, demonstrated a significant therapeutic effect in cell line-derived xenograft and PDX tumor models of acquired or de novo endocrine resistance. Conclusions: Together, this study reveals the potential of therapeutic modulation of NLK for the management of the endocrineresistant breast cancers with active NLK signaling.

Original languageEnglish
Pages (from-to)2648-2662
Number of pages15
JournalClinical Cancer Research
Issue number9
StatePublished - May 1 2021


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