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BEX2 Is Overexpressed in a Subset of Primary Breast Cancers and Mediates Nerve Growth Factor/Nuclear Factor-B Inhibition of Apoptosis in Breast Cancer Cell Lines

¹ Cancer Genomics Program, Department of Oncology, University of Cambridge, Hutchison/Medical Research Council Research Center, Cambridge, United Kingdom and ² Department of Histopathology, Nottingham City Hospital NHS Trust and University of Nottingham, Nottingham, United Kingdom

Requests for reprints: Carlos Caldas or Ali Naderi, Cancer Genomics Program, Department of Oncology, University of Cambridge, Hutchison/MRC Research Center, Hills Road, Cambridge CB2 2XZ, United Kingdom. Phone: 44-1223-404420; Fax: 44-1223-331753; E-mail: cc234{at}cam.ac.uk or an258{at}cam.ac.uk.

We have identified a novel subtype of estrogen receptor (ER)-positive breast cancers with improved outcome after tamoxifen treatment and characterized by overexpression of the gene BEX2. BEX2 and its homologue BEX1 have highly correlated expression and are part of a cluster enriched for ER response and apoptosis genes. BEX2 expression is induced after estradiol (E2) treatment with a peak at 3 h, suggesting BEX2 is an estrogen-regulated gene. BEX2 belongs to a family of genes, including BEX1, NGFRAP1 (alias BEX3), BEXL1 (alias BEX4), and NGFRAP1L1 (alias BEX5). Both BEX1 and NGFRAP1 interact with p75NTR and modulate nerve growth factor (NGF) signaling through nuclear factor-B (NF-B) to regulate cell cycle, apoptosis, and differentiation in neural tissues. In breast cancer cells, NGF inhibits C2-induced apoptosis through binding of p75NTR and NF-B activation. Here, we show that BEX2 expression is necessary and sufficient for the NGF-mediated inhibition (through NF-B activation) of C2-induced apoptosis. We also show that BEX2 modulates apoptosis of breast cancer cells in response to E2 (50 nmol/L) and tamoxifen (5 and 10 µmol/L). Furthermore, BEX2 overexpression enhances the antiproliferative effect of tamoxifen at pharmacologic dose (1 µmol/L). These data suggest that a NGF/BEX2/NF-B pathway is involved in regulating apoptosis in breast ancer cells and in modulating response to tamoxifen in primary tumors. [Cancer es 2007;67(14):6725–36]