耐三苯氧胺乳腺癌异种移植瘤动物模型建立与评价

目的:建立耐三苯氧胺(TAM)人乳腺癌的裸鼠移植瘤模型,为研究和治疗乳腺癌对TAM耐药提供研究工具。方法:采用雌激素受体阳性,对TAM耐药的人乳腺癌细胞系LCC2,接种于BALB/c裸鼠皮下,观察肿瘤生长趋势,用免疫组化方法进行鉴定。结果:在接种细胞数大于5×106/只时,Matrigel能够显著促进移植瘤的生长。肿瘤组织病理学检测证实为浸润性导管癌,且Pgp和Her-2为阳性表达。结论:该方法建立的耐TAM人乳腺癌移植瘤模型,周期短,成瘤率高,保留了与细胞系相同的肿瘤生物学特征。     

复方浙贝颗粒联合三苯氧胺对LCC2移植瘤相关蛋白表达影响

目的:研究复方浙贝颗粒(CZBG)联合三苯氧胺(TAM)对LCC2移植瘤组织相关蛋白HER-2、GST-π、Caspase3表达的影响。方法:用耐TAM的人乳腺癌细胞系LCC2建立小鼠移植瘤模型。实验分模型对照组,TAM组,阿霉素(ADM)+TAM组,中剂量CZBG+TAM组,ADM+中剂量CZBG+TAM组,采用免疫组化法分别检测各组HER-2、GST-π、Caspase3的表达差异。结果:1与TAM组相比,中剂量CZBG+TAM组、ADM+中剂量CZBG+TAM组能下调HER-2表达(P0.05)。2与模型对照组相比,各治疗组GST-π表达均有所下降(P0.05);各治疗组之间的GST-π表达无统计学意义(P0.05)。3与模型对照组相比,中剂量CZBG+TAM组和ADM+中剂量CZBG+TAM组均能上调Caspase3表达(P0.05);中剂量CZBG+TAM组与模型对照组、TAM组、ADM+TAM组比较,Caspase3的表达均有统计学意义(P0.05)。结论:中剂量CZBG能够下调乳腺癌LCC2细胞移植瘤组织的HER-2表达,提高Caspase3活性,而对GST-π表达无明显影响。     

C-erbB2与乳腺癌三苯氧胺耐药细胞生长关系的研究

目的:探讨获得性三苯氧胺(TAM)抵抗乳腺癌细胞的生长调节途径及三苯氧胺(TAM)获得性抵抗的发生机制。方法:TAM诱导野生型人乳腺癌细胞系MCF-7/WT构建TAM抵抗的细胞系MCF-7/TAMR,RT-PCR、Western blot及免疫细胞化学方法比较MCF-7/TAMR与MCF-7/WT细胞系中C-erbB2 mRNA、蛋白表达及其活化状态的不同,用C-erbB2单克隆抗体herceptin对两种细胞系进行干预,观察细胞生长变化。结果:与MCF-7/WT细胞相比,MCF-7/TAMR细胞中CerbB-2的mRNA增加3倍(P＜0．05)．蛋白增加1．5倍(P＜0．05)．Herceptin处理MCF-7/TAMR细胞,明显抑制了细胞的生长。结论:表皮生长因子受体特异性配体的自分泌释放作用可能通过CerbB-2/MAPK途径引起MCF-7/TAMR细胞的生长。     

三苯氧胺对乳腺癌和宫颈癌细胞增殖的影响

目的：研究三苯氧胺(tamoxifen,TAM)对人乳腺癌Bcap-37和宫颈癌HeLa细胞增殖的影响并探讨其可能的机制。方法：采用细胞培养、细胞计数、MTT、流式细胞术和激光共聚焦显微镜技术。结果：TAM(10^-6mol／L)使Bcap-37细胞的生长曲线下移,使HeLa细胞的生长曲线上移。TAM(10^-8～10^-6mol／L)剂量依赖性的抑制Beap-37细胞的增殖,促进HeLa细胞的增殖作用。TAM(10^-6mol／L)使Bcap-37细胞发生凋亡,凋亡率达到97．5％,而使HeLa细胞周期由G1期加速向S期转化,G1期的DNA含量由对照组的55．5％下降到加药组的32．8％,S期的DNA含量由对照组的29．0％上升到加药组的49．4％。激光共聚焦检测到TAM(10^-6mol／L)可使Bcap-37细胞和HeLa细胞内的Ca^2 浓度显著升高。结论：TAM可以通过调节细胞周期各阶段DNA含量和胞内Ca^2 浓度水平,从而调节Bcap-37细胞和HeLa细胞的增殖活动,提示使用TAM治疗乳腺癌时可能会对子宫颈产生副作用。     

C—erbB2与乳腺癌三苯氧胺耐药细胞生长关系的研究

目的：探讨获得性三苯氧胺（TAM）抵抗乳腺癌细胞的生长调节途径及三苯氧胺（TAM）获得性抵抗的发生机制。方法：TAM诱导野生型人乳腺癌细胞系MCF-7/WT构建TAM抵抗的细胞系MCF-7／TAMR,RT—PCR、Westem blot及免疫细胞化学方法比较MCF-7／TAMR与MCF-7/WT细胞系中C—erbB2mRNA、蛋白表达及其活化状态的不同,用C—erbB2单克隆抗体herceptin对两种细胞系进行干预。观察细胞生长变化。结果：与MCF-7/WT细胞相比,MCF-7／TAMR细胞中cerbB-2的mRNA增加3倍（P〈0．05）,蛋白增加1．5倍（P〈0．05）。Herceptin处理MCF-7／TAMR细胞,明显抑制了细胞的生长。结论：表皮生长因子受体特异性配体的自分泌释放作用可能通过CerbB-2／MAPK途径引起MCF-7／TAMR细胞的生长。     

乳腺癌细胞表皮生长因子受体、HER-2对雌激素受体的调控及三苯氧胺耐药机制

雌激素受体(ER)在乳腺癌的发生和发展中起重要作用,抗雌激素治疗的内分泌治疗为重要的治疗方案,但易产生三苯氧胺(TAM)的耐药性而使治疗失效,原因之一可能是由于表皮生长因子受体(EGFR)和HER-2高表达引起ER磷酸化所致。本文概述了其中的分子机制和可能涉及的传导通路等。     

三苯氧胺联合顺铂及紫杉醇抑制MCF-7细胞增殖的研究

目的:研究三苯氧胺联合不同浓度的紫杉醇及顺铂对MCF-7细胞株增殖的影响.方法:流式细胞仪检测IC30及IC10两种不同剂量紫杉醇及顺铂与2×10-8MOL/L三苯氧胺联用对MCF-7细胞周期的影响,MTT法测定不同方法处理后MCF-7细胞的倍增时间.Annexin Ⅴ/PI双标法检测细胞凋亡.结果:未经处理的MCF-7细胞株G2/M期比例分别为14.2±11.4%,细胞倍增时间分别为24±4小时,凋亡率2±1.2%,死亡细胞比例1±0.5%;2×10-8MOL/L三苯氧胺与IC10剂量强度的紫杉醇+顺铂联用(L3-10)与IC10剂量的紫杉醇+顺铂(L2-10)组比较,处理后MCF-7细胞G2/M期比例分别为48.2±6.4%、47.3±8.6%,细胞倍增时间分别为42±5小时及41±5小时,凋亡率5±1.7%及6.8±2.6%.死亡细胞比例4±2.3%、2±1.8%.2×10-8MOL/L三苯氧胺与IC30剂量强度的紫杉醇+顺铂联用(L3-30)与IC30剂量强度的紫杉醇+顺铂(L2-30)比较,处理后MCF-7细胞G2/M期比例分别为50.9±8.1%、56.4±8.9%,细胞倍增时间分别为65±12小时及66±9小时,凋亡率13±3.6%及13±4.3%,死亡细胞比例4±3.0%、5±2.9%.细胞倍增时间及G2/M期比例与未处理组比较差别有统计学意义(p<0.05),但不同剂量强度的紫杉醇+顺铂组与相应联用2×10-8MOL/L三苯氧胺组比较细胞倍增时间及G2/M期比例均无统计学意义(p>0.05.结论:不同剂量顺铂、紫杉醇联合及二者与2×10-8MOL/>三苯氧胺联合均导致MCF-7细胞G2/M期阻滞及明显延长细胞倍增时间,但2×10-8MOL/L三苯氧胺与不同剂量紫杉醇+顺铂联用对抑制MCF-7的增殖抑制无明显的协同作用.     

三苯氧胺和雌二醇对大鼠子宫雌激素受体的竞争性结合作用

利用改进的葡聚糖活性炭饱和分析法（ＤＣＣ法）,对卵巢切除大鼠注射雌二醇（Ｅ组）或同时注射雌二醇和三苯氧胺（Ｅ＋Ｔ组）后６ｈ至６４ｄ,进行子宫ＥＲ含量测定,发现,Ｅ＋Ｔ组比Ｅ组的ＥＲ值小并且增加缓慢;Ｅ组的ＥＲ值在注射后３０ｄ达到最大值而且数值超过对照组（Ｃ组）。计算机曲线拟合Ｅ组或Ｅ＋Ｔ组与Ｃ组的ＥＲ比值求得：Ｅ组开始注射雌二醇时ＥＲ水平为Ｃ组的２．０３３倍,即＝２．０３３,恢复过程的时间常数τ＇为５１．５５ｄ,３￣Ｈ－雌二醇与ＥＲ结合过程的时间常数τ为１３．０ｄ;Ｅ＋Ｔ组的＝１．３１５,τ＇＝３８．７６ｄ,τ＝２１．５５ｄ,说明同时给予三苯氧胺和雌二醇情况下,三苯氧胺有抑制雌二醇诱导ＥＲ水平升高的作用,并减缓３￣Ｈ－雌二醇与ＥＲ的结合过程。另外,还求得Ｅ＋Ｔ组中三苯氧胺和ＥＲ和结合率约占４３．７％,表明三苯氧胺与雌二醇对ＥＲ有竞争性结合作用。     

三本氧胺和雌二醇对大鼠子宫雌激素受体的竞争性结合作用

利用改进的葡聚糖活性炭饱和分析法,对卵巢切除大鼠注射雌二醇或同时注射雌二醇和三苯氧胺后６ｈ和６４ｄ,进行子宫ＥＲ含量测定,发现,Ｅ＋Ｔ组比Ｅ组的ＥＲ值小并且增加缓慢;Ｅ组的ＥＲ值在注射后３０ｄ达到最大值而且数值超过对照组。计算机曲线拟合Ｅ组或Ｅ＋Ｔ组与Ｃ组的ＥＲ比值 得：Ｅ组开始注射雌二醇时ＥＲ水平为Ｃ组的２．０３３倍,即Ｒ＾０Ｔ＝２．０３３,恢复过程的时间常数τ为５１．５５ｄ,＾３Ｈ－雌二醇与Ｅ     

胰腺癌裸鼠皮下异种移植动物模型建立研究

目的:用人体胰腺癌细胞株,建立小鼠胰腺癌细胞株(pGHAM-1)移植性胰腺癌模型,并研究其生物学特性。方法:将pGHAM-1细胞培养后配成1×107/ml,取0.2mL接种于小鼠皮下。于接种后20、30、40天观察肿瘤的生长、转移及腹水量。接种40天后处死动物,解剖取出移植瘤,用游标卡尺测量肿瘤大小,再进行HE染色的组织病理学检查,免疫组织化学检测血管内皮细胞生长因子(VEGF)及肿瘤转移相关蛋白(nm23-H1)的表达。结果:分别于20、30、40天测量肿瘤体积为84.1±21.9 mm3,413.7±208.4 mm3,2187.3±1882.8 mm3,后者与10 d前比较差异均具有统计学意义(P<0.01)。HE染色结果显示肿瘤组织呈条索状或小梁状排列,肿瘤组织与正常组织交界处有少量淋巴细胞浸润,肿瘤组织中血管生成罕见。免疫组织结果显示VEGF和nm23-H1蛋白在肿瘤组织中均呈阴性表达。结论:异位裸鼠人胰腺癌移植瘤模型易复制,时间短,成功率高,为胰腺癌体内研究提供了理想的动物模型。     

Proteomics of xenografted human breast cancer indicates novel targets related to tamoxifen resistance

Tamoxifen is the most frequently used drug for hormone therapy of breast cancer patients, even though a high percentage of women are (or become) refractory to this treatment. The proteins involved in tamoxifen resistance of breast tumor cells as well as the mechanisms by which they interact, are still unknown. Some years ago, we established the xenograft breast tumor 3366, sensitive to tamoxifen and the 3366/TAM, resistant to tamoxifen, derived after two years of in vivo passages of the parental 3366 under tamoxifen treatment. Here, we compare the protein expression levels of both xenografts. 2-DE of proteins from total cell extracts showed very high reproducibility among tumors from each group (tamoxifen sensitive and tamoxifen resistant). The heuristic clustering analysis of these gels pooled them correctly in both groups. Twelve proteins were found up-regulated in the tamoxifen-resistant line, while nine were down-regulated. The proteins differentially expressed were identified by MS and sequence database analysis. Biological functions of these proteins are related to cell-cell adhesion and interaction, signal transduction, DNA and protein synthesis machinery, mitochondrial respiratory chain, oxidative stress processes and apoptosis. Three of the identified proteins (ALG-2 interacting protein and two GDP-dissociation inhibitors) could be directly involved in the resistance phenomenon.     

Aromatase inhibitors and xenograft studies

Aromatase inhibitors (AIs) have become the front-line choice for treatment of ER+ breast cancer. Nevertheless, although patients are responsive initially, they may acquire resistance and become unresponsive to further treatment. In addition, approximately 25% of breast cancers do not express the estrogen receptor (ERα) and consequently, are innately resistant to endocrine therapy. We have investigated the mechanisms associated with this lack of treatment response using xenograft models. We found that in cells and tumors that acquired resistance to the AI letrozole therapy, expression of the ER was reduced whereas growth factor signally was enhanced, including a marked increase in HER2 expression. Treatment with trastuzumab (HER2 antibody) resulted in a significant down-regulation of HER2 and p-MAPK as well as restoration of ERα expression. Thus, when trastuzumab was added to letrozole treatment at the time of tumor progression, there was significantly prolonged tumor suppression compared to trastuzumab or letrozole alone. This suggests that inhibition of both HER2 and ERα signaling pathways are required for overcoming resistance and restoring treatment sensitivity. ER negative tumors are innately resistant to endocrine therapy. Repression of the ERα has been found to be due to epigenetic modifications such as increased methylation and histone deacetylation. We found that entinostat (ENT), a histone deacetylase inhibitor (HDACi), activated not only expression of ERα but also aromatase in MDA-MB-231 ER-negative breast cancer cells, resulting in their ability to respond to estrogen and letrozole. Treatment with ENT in combination with letrozole significantly reduced tumor growth rate in xenografts compared to control tumors (p < 0.001). ENT plus letrozole treatment also prevented the colonization and growth of MDA-MB-231 cells in the lung with a significant reduction (p < 0.03) in both visible and microscopic foci. These results provide a strong indication for possible use of AIs in combination with HDAC inhibitors for the treatment of ER-negative breast cancer.     

Letrozole versus tamoxifen in the treatment of advanced breast cancer and as neoadjuvant therapy

Letrozole, a third generation aromatase inhibitor, has been compared with tamoxifen in the treatment of advanced breast cancer and as neoadjuvant therapy. In a first-line trial in advanced disease, 939 post menopausal women were randomised double blind to receive treatment with letrozole 2.5 mg daily or tamoxifen 20 mg daily. Letrozole was significantly superior in terms of median time to progression (9.4 months versus 6.1 months, P = 0.0001), objective response (30% versus 20%, P = 0.0006), and clinical benefit (49% versus 38%, P = 0.0001). Superiority of letrozole was independent of disease site, receptor status, or prior adjuvant anti-oestrogen therapy. In an extended phase of this trial, 200 patients were crossed over to tamoxifen after letrozole, compared with 197 crossed over to letrozole after tamoxifen. Median overall survival was 34 months for letrozole versus 30 months for tamoxifen (not significant).

In a similar randomised double-blind neoadjuvant trial, 337 post menopausal patients with large ER/or PgR positive T2–T4 cancers, either requiring mastectomy or locally advanced, were randomised to preoperative letrozole or tamoxifen for 4 months prior to surgery. Overall response was 55% for letrozole versus 36% for tamoxifen (P < 0.001). Conservative surgery was possible in 45% of patients treated with letrozole versus 35% with tamoxifen (P = 0.022).

In both trials, both treatments were well tolerated with no significant differences in side effects.

These results indicate that letrozole is more active than tamoxifen both as neoadjuvant therapy and as first-line treatment in advanced disease. They support the importance of current adjuvant trials comparing the two treatments.     

Growth suppression of MCF-7 cancer cell-derived xenografts in nude mice by caveolin-1

Caveolin-1 is an essential structural constituent of caveolae membrane domains that has been implicated in mitogenic signaling and oncogenesis. However, the exact functional role of caveolin-1 still remains controversial. In this report, utilizing MCF-7 human breast adenocarcinoma cells stably transfected with caveolin-1 (MCF-7/cav-1 cells), we demonstrate that caveolin-1 expression dramatically inhibits invasion and migration of these cells. Importantly, in vivo experiments employing xenograft tumor models demonstrated that expression of caveolin-1 results in significant growth inhibition of breast tumors. Moreover, a dramatic delay in tumor progression was observed in MCF-7/cav-1 cells as compared with MCF-7 cells. Histological analysis of tumor sections demonstrated a marked decrease in the percentage of proliferating tumor cells (Ki-67 assay) along with an increase in apoptotic tumor cells (TUNEL assay) in MCF-7/cav-1-treated animals. Our current findings provide for the first time in vivo evidence that caveolin-1 can indeed function as a tumor suppressor in human breast adenocarcinoma derived from MCF-7 cells rather than as a tumor promoter.     

Prognostic significance of autophagy related genes in estrogen receptor positive tamoxifen treated breast cancer

Resistance to Tamoxifen constitutes a major therapeutic challenge in treating hormone sensitive breast cancer. The induction of autophagy has been shown to be involved as one of the mechanism responsible for Tamoxifen resistance. Autophagy related gene (ATG) members are the regulators and effectors of Macroautophagy process in the cellular systems. In this study, we evaluated the prognostic significance of ATGs in Tamoxifen treated breast cancer. The "Kaplan- Meier plotter" database was utilized to analyze the relevance and significance of ATGs mRNA expression to Relapse Free Survival in breast cancer patients. We used the data of patients who are Estrogen receptor positive and are treated with Tamoxifen. Hazard ratio and log-rank p-value were calculated using KM survival plots for various ATGs. Overexpressed ATG3, ATG 5, ATG 8B and PIK3R4 resulted in a poor prognosis. A gene signature of these ATGs predicts deteriorated RFS (p-value=8.3e-05 and HR=1.84 (1.35-2.51) and Distant Metastasis Free Survival (p value = 0.0027 and HR=2.03 (1.27-3.26). We report the distinct prognostic values of ATGs in patients of breast cancer treated with Tamoxifen. Thus, better understandings of the induction of autophagy pathway may potentially form the basis for use of autophagy inhibitors in the Tamoxifen treated breast cancer.     

Prolylcarboxypeptidase regulates proliferation, autophagy, and resistance to 4-hydroxytamoxifen-induced cytotoxicity in estrogen receptor-positive breast cancer cells

Endocrine therapy with tamoxifen (TAM) significantly improves outcomes for patients with estrogen receptor-positive breast cancer. However, intrinsic (de novo) or acquired resistance to TAM occurs in a significant proportion of treated patients. To identify genes involved in resistance to TAM, we introduced full-length cDNA expression library into estrogen receptor-positive MCF7 cells and exposed them to a cytotoxic dose of 4-hydroxytamoxifen (4OHTAM). Four different library inserts were isolated from surviving clones. Re-introduction of the genes individually into naive MCF7 cells made them resistant to 4OHTAM. Cells overexpressing these genes had an increase in acidic autophagic vacuoles induced by 4OHTAM, suggesting their role in autophagy. One of them, prolylcarboxypeptidase (PRCP), was investigated further. Overexpression of PRCP increased cell proliferation, boosted several established markers of autophagy, including expression of LC3-2, sequestration of monodansylcadaverine, and proteolysis of BSA in an ER-α dependent manner, and increased resistance to 4OHTAM. Conversely, knockdown of endogenous PRCP in MCF7 cells increased cell sensitivity to 4OHTAM and at the same time decreased cell proliferation and expression of LC3-2, sequestration of monodansylcadaverine, and proteolysis of BSA. Inhibition of enzymatic activity of PRCP enhanced 4OHTAM-induced cytotoxicity in MCF7 cells. Cells with acquired resistance to 4OHTAM exhibited increased PRCP activity, although inhibition of PRCP prevented development of 4OHTAM resistance in parental MCF7 cells and restored response to 4OHTAM in MCF7 cells with acquired resistance to 4OHTAM. Thus, we have for the first time identified PRCP as a resistance factor for 4OHTAM resistance in estrogen receptor-positive breast cancer cells.     

High-density array analysis of DNA methylation in Tamoxifen-resistant breast cancer cell lines

Roughly two-thirds of all breast cancers are ERα-positive and can be treated with the antiestrogen, Tamoxifen, however resistance occurs in 33% of women who take the drug for more than 5 y. Aberrant DNA methylation, an epigenetic mechanism that alters gene expression in cancer, is thought to play a role in this resistance. To develop an understanding of Tamoxifen-resistance and identify novel pathways and targets of aberrant methylation, DNA from MCF-7 breast cancer cells and Tamoxifen-resistant derivatives, TMX2–11 and TMX2–28, were analyzed using the Illumina HumanMethylation450 BeadChip. Normalizing against MCF-7 values, ERα-positive TMX2–11 had 4000 hypermethylated sites and ERα-negative TMX2–28 had over 33?000. Analysis of CpG sites altered in both TMX2–11 and TMX2–28 revealed that the Tamoxifen-resistant cell lines share 3000 hypermethylated and 200 hypomethylated CpGs. ZNF350 and MAGED1, two genes hypermethylated in both cell lines, were examined in greater detail. Treatment with 5-aza-2′deoxycitidine caused a significant reduction in promoter methylation of both ZNF350 and MAGED1 and a corresponding increase in expression in TMX2–28. A similar relationship between methylation and expression was not detected in TMX2–11. Our findings are indicative of the variable responses to methylation-targeted breast cancer therapy and highlight the need for biomarkers that accurately predict treatment outcome.     

High-density array analysis of DNA methylation in Tamoxifen-resistant breast cancer cell lines

Roughly two-thirds of all breast cancers are ERα-positive and can be treated with the antiestrogen, Tamoxifen, however resistance occurs in 33% of women who take the drug for more than 5 y. Aberrant DNA methylation, an epigenetic mechanism that alters gene expression in cancer, is thought to play a role in this resistance. To develop an understanding of Tamoxifen-resistance and identify novel pathways and targets of aberrant methylation, DNA from MCF-7 breast cancer cells and Tamoxifen-resistant derivatives, TMX2–11 and TMX2–28, were analyzed using the Illumina HumanMethylation450 BeadChip. Normalizing against MCF-7 values, ERα-positive TMX2–11 had 4000 hypermethylated sites and ERα-negative TMX2–28 had over 33 000. Analysis of CpG sites altered in both TMX2–11 and TMX2–28 revealed that the Tamoxifen-resistant cell lines share 3000 hypermethylated and 200 hypomethylated CpGs. ZNF350 and MAGED1, two genes hypermethylated in both cell lines, were examined in greater detail. Treatment with 5-aza-2′deoxycitidine caused a significant reduction in promoter methylation of both ZNF350 and MAGED1 and a corresponding increase in expression in TMX2–28. A similar relationship between methylation and expression was not detected in TMX2–11. Our findings are indicative of the variable responses to methylation-targeted breast cancer therapy and highlight the need for biomarkers that accurately predict treatment outcome.     

Reversal of tamoxifen resistant breast cancer by low dose estrogen therapy

Currently, the standard of care for estrogen receptor (ER)-positive breast cancer is 5 years of tamoxifen (TAM) or an aromatase inhibitor (AI) such as anastrozole. New studies indicate that extending antiestrogen therapy beyond 5 years with sequential regimens will improve disease-free survival. Based on the emerging concept that longer therapies are better, we have developed sequential models of tamoxifen-resistant breast cancer in vivo to mimic the clinical scenario of long-term antiestrogen therapy. The goal of the current study was to investigate the consequences of long-term treatment with tamoxifen on the growth of breast tumors in athymic mice. The results demonstrate that there are distinct phases of resistance to tamoxifen that correlate with time of treatment and expression of HER2/neu mRNA. In the treatment phase, 17β-estradiol (E₂) stimulated growth, while TAM inhibited growth of MCF-7 tumors (MCF-7E₂). The withdrawal of treatment, mimicking the use of an AI, completely prevented growth. In Phase I resistance, the tumors (MCF-7TAMST) were growth-stimulated by either E₂ or TAM, but inhibited by no treatment, fulvestrant, or E₂ + fulvestrant. Phase II-resistant tumors (MCF-7TAMLT) were treated for more than 5 years and growth-stimulated by TAM. However, no treatment, fulvestrant, or E₂ completely inhibited growth. Interestingly, the few tumors (MCF-7TAMLT) that survived in response to E₂ were robustly re-stimulated by E₂ after transplantation into new generations of athymic mice. These E₂-stimulated tumors (MCF-7TAME) were inhibited by TAM in a dose-dependent similar to their parental tumors (MCF-7E₂). In addition, the MCF-7TAME tumors were inhibited by either no treatment or fulvestrant. HER2/neu and HER3 mRNAs were over-expressed in TAM-stimulated MCF-7TAMLT tumors and remained high in E₂-stimulated MCF-7TAME tumors. The data indicate that complete reversal of resistance to TAM can be achieved with the use of low dose E₂ therapy. Also, these data suggest that over-expression of HER2/neu alone is insufficient to predict resistance to TAM. Based on the results, we suggest using an alternating treatment regimen, cycling antiestrogen with estrogen therapy to avoid drug-resistance.