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<p>Metastasis remains the major cause of breast cancer (BC)-related death as developing an
effective therapeutic strategy for the treatment of metastatic breast cancer (MBC) is a major
clinical challenge. Fibroblast growth factor receptor (FGFR) is an emerging target for MBC as its
expression is amplified in metastases and FGFR1 can be upregulated in MBC cells through the
process of epithelial-mesenchymal transition (EMT). Inactivation of FGFR by tyrosine kinase
inhibitors (TKIs) has achieved great success in various types of cancer. However, FGFR TKI
resistance has become a concern in improving MBC patients’ outcomes. Therefore, it is critical to
develop advanced therapeutic interventions for improving patients’ survival. In this dissertation
work, we investigated novel therapeutic avenues to target FGFR1 in MBC.
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<p>To date, a variety of FGFR TKIs have been evaluated in clinical trials or clinically approved
for cancer treatment. However, the efficacies of FGFR TKIs in MBC remain unclear. Herein, we
evaluated the efficacies of several experimental and clinically approved FGFR TKIs using 3D
culture and in vivo model systems. Our results demonstrated that FGFR-targeted kinase inhibitors
are completely effective at blocking ligand-induced cell growth but fail to eliminate dormant BC
cells. Moreover, animals succumb to disease progression while on therapy. Therefore, we explored
broader approaches to inhibit FGFR1 expression in addition to blockade of its kinase activity.
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<p>Proteolysis targeting chimeras (PROTACs), heterobifunctional molecules inducing
degradation of protein of interest via proteasome machinery, have emerged as a powerful tool for
targeted cancer therapies. Together with our collaborators, we developed an array of FGFR
PROTACs. Here, we showed that FGFR PROTACs inhibited metastatic and drug-resistant BC
cell growth. Furthermore, our results identified potential FGFR PROTACs which induced FGFR1
degradation and blocked FGFR1 downstream signaling. Using 3D culture, FGFR PROTACs are
shown to target MBC aggressiveness. Hence, our data suggested that PROTAC-mediated FGFR1
degradation is a promising strategy for MBC therapies.
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<p>In addition to the aforementioned approaches, G-quadruplex (G4) is revealed highlighting
new possibilities for anticancer therapies. The Examination of the FGFR1 proximal promoter indicated sequences forming potential for G-quadruplex (G4) secondary structures. We found that
G4 stabilizing agents are able to block constitutive and EMT-induced expression of FGFR1.
Additionally, G4 stabilizers could effectively block ectopic FGFR1 expression derived from CMV
promoter driven constructs. Importantly, use of the clinical G4-targeting compound CX-5461
suppresses FGFR1 promoter activity, targets FGFR1 expression, and inhibited FGFR1
downstream signaling, resulting in eradication of dormant breast cancer cells. Finally, in vivo
application of CX-5461 reduced FGFR1 expression, blocked pulmonary tumor formation, and
prolonged animal survival. Overall, our findings indicated that targeting FGFR1 expression
through G4 stabilization may be a potential therapeutic strategy for MBC.</p>
<p>FGFR1 has attracted great attention as a therapeutic target in a variety of tumors. In this
dissertation work, we have identified the potential FGFR kinase-independent function which may
contribute to TKI resistance. Moreover, we have revealed novel therapeutic options to overcome
FGFR TKI resistance and achieve significant antitumor responses in MBC. In the future, our
innovative therapeutic strategies can serve as an influential tool to investigate the FGFR1
regulation and kinase-independent function during metastasis. </p>
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