Invasive lobular carcinoma (ILC) is the second most common type of breast cancer following invasive ductal carcinoma (IDC) and accounts for 10-15% of all cases. Unlike the masses or lumps formed by IDCs, ILCs grow as small, dis-cohesive cells in a single-file pattern within dense layers of extracellular matrix. Paradoxically, while patients with ILC display favorable prognostic and predictive factors (ER+, PR+, HER2-, low Ki67), their long-term response to endocrine therapy is worse than patients with IDC. Despite such histological and clinical differences, ILC has remained a gravely understudied subtype of breast cancer. Thus, there is urgent need to investigate molecular drivers of ILC progression in order to develop more effective therapeutic strategies and improve patient outcome. To this end, we used the Nanostring platform to measure the expression of 577 copy number variation-associated genes in 131 primary ILC tumors and identified two candidate drivers that exhibit higher expression in tumors from patients with recurrent versus non-current disease: CTTN (cortical actin binding protein) and QSOX1 (quiescin sulfhydryl oxidase). In follow-up studies, we observed high CTTN and QSOX1 expression in human ILC cell lines, tumors and patient-derived xenografts. In addition, QSOX1 expression was further increased in ILC ovarian metastases compared to their matched primary tumors. In functional in vitro studies, RNAi-mediated inhibition of CTTN led to decreased adhesion and haptotaxis to Collagen I, while QSOX1 knockdown diminished the growth of human ILC cell lines. We are currently assessing the in vivo therapeutic utility of CTTN and QSOX1 inhibition in tumor growth and metastasis using human ILC cell line and patient-derived xenograft mouse models. This study greatly advances our understanding of ILC disease mechanisms and identifies novel therapeutic targets towards improving the clinical outcome of patients with this understudied subtype of breast cancer.

Citation Format: Nilgun Tasdemir, Matthew Sikora, Zhu Li, Kevin Levine, Ahmed Basudan, Soumya Luthra, Esther Elishaev, Uma Chandran, George C. Tseng, Rachel Jankowitz, David J. Dabbs, Priscilla McAuliffe, Nancy E. Davidson, Steffi Oesterreich. Investigating drivers of disease progression in invasive lobular carcinoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 2841. doi:10.1158/1538-7445.AM2017-2841