The role of erbB2 signal transduction pathways in human breast cancer

The erbB2 receptor is expressed at very high levels in nearly 30% of human breast cancer patients and plays an important role in the transformation and the prognosis of breast cancer. While evidence accumulates to support the relationship between erbB2 overexpression and poor overall survival in human breast cancer, understanding of the biological consequence(s) of erbB2 overexpression remains elusive. Our recent discovery, cloning, sequencing, and expression of the erbB2 ligand (gp30) has allowed us to identify a number of related but distinct biological endpoints which appear responsive to signal transduction through the erbB2 receptor. These endpoints of growth, invasiveness, and differentiation have clear implications for the emergence, maintenance, and/or control of malignancy, and represent established endpoints in the assessment of malignant progression in breast cancer. Studies in vitro have shown that gp30 induces a biphasic growth effect (induction of growth at low concentrations and inhibition of growth at high concentrations) on cells with erbB2 over-expression. Strikingly, we have recently observed that the erbB2 signalling pathway can be modulated by estrogen acting through the estrogen receptor (ER). Conversely, we observed that down regulation of erbB2 by estrogen can be blocked by gp30 acting through the erbB2 receptor. Clearly, mechanistic aspects of the erbB2/ligand interaction need to be understood from a therapeutic standpoint, and may furthermore provide additional insights into treatment synergy for particular patients. We think that these studies will facilitate the emergence of erbB2-targeted therapy.