Selective degradation of FGFR1/2 overcomes antiestrogen resistance in ER+ breast cancer with FGFR1/2 alterations

Cancer Lett. 2025 Jun 1:619:217668. doi: 10.1016/j.canlet.2025.217668. Epub 2025 Mar 22.

Abstract

FGFR1 amplification and FGFR1/2 activating mutations have been associated with antiestrogen resistance in estrogen receptor-positive (ER+) breast cancer. However, there are no approved FGFR1-targeted therapies for breast cancers harboring these alterations. In this study, we investigated the selective degradation of FGFR1/2 using the proteolysis-targeting chimera (PROTAC) DGY-09-192 as a novel therapeutic strategy in ER + breast cancers harboring FGFR1/2 somatic alterations. Treatment of ER+/FGFR1-amplified breast cancer cells and patient-derived xenografts with DGY-09-192 resulted in sustained degradation of FGFR1 in a proteasome-dependent manner and suppressed downstream signal transduction. The combination of DGY-09-192 and the ERα degrader fulvestrant resulted in complete cell growth arrest and tumor regression of ER+/FGFR1-amplified patients-derived xenografts. In addition, we tested the effect of DGY-09-192 on breast cancer cells expressing FGFR1N546K and FGFR2K659E hotspot kinase domain mutations as well as ER-negative breast cancer cells harboring FGFR2 gene amplification. Treatment with DGY-09-192 resulted in the degradation of mutant FGFR1/2 and blocked mutant receptor-induced signal transduction and antiestrogen resistance. Collectively, our study suggests that degradation of FGFR1/2, in combination with antiestrogens, can be leveraged as a therapeutic strategy in ER + breast cancers harboring FGFR1/2 driver alterations.

Keywords: Breast cancer; Endocrine resistance; FGFR1; FGFR2; Gene alteration; Proteolysis-targeting chimera; Targeted therapy.

MeSH terms

  • Animals
  • Breast Neoplasms* / drug therapy
  • Breast Neoplasms* / genetics
  • Breast Neoplasms* / metabolism
  • Breast Neoplasms* / pathology
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Drug Resistance, Neoplasm* / drug effects
  • Drug Resistance, Neoplasm* / genetics
  • Estrogen Receptor Modulators* / pharmacology
  • Estrogen Receptor alpha / metabolism
  • Female
  • Fulvestrant / pharmacology
  • Humans
  • MCF-7 Cells
  • Mice
  • Mutation
  • Proteolysis / drug effects
  • Receptor, Fibroblast Growth Factor, Type 1* / genetics
  • Receptor, Fibroblast Growth Factor, Type 1* / metabolism
  • Receptor, Fibroblast Growth Factor, Type 2* / genetics
  • Receptor, Fibroblast Growth Factor, Type 2* / metabolism
  • Receptors, Estrogen / metabolism
  • Signal Transduction / drug effects
  • Xenograft Model Antitumor Assays

Substances

  • Receptor, Fibroblast Growth Factor, Type 1
  • Receptor, Fibroblast Growth Factor, Type 2
  • FGFR1 protein, human
  • FGFR2 protein, human
  • Fulvestrant
  • Receptors, Estrogen
  • Estrogen Receptor Modulators
  • Estrogen Receptor alpha