Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Article
  • Published:

Extramammary Paget’s disease patient-derived xenografts harboring ERBB2 S310F mutation show sensitivity to HER2-targeted therapies

Abstract

Although the prognosis of advanced extramammary Paget’s disease (EMPD) is poor, there have been no preclinical research models for the development of novel therapeutics. This study aims to establish a preclinical research model for EMPD. We transplanted EMPD tissue into immunodeficient NOD/Scid mice. Histopathological and genetic analyses using a comprehensive cancer panel were performed. For in vivo preclinical treatments, trastuzumab, lapatinib, docetaxel, or eribulin were administered to patient-derived xenograft (PDX) models. Tissue transplanted from the EMPD patient was enlarged in NOD/Scid mice and was transplanted into further generations. Both the transplantation of PDX into nu/nu mice and the reanimation of the cryopreserved xenografted tumors in NOD/Scid mice were successful. We also established an EMPD-PDX-derived primary cell culture. Histopathologically, the xenografted tumors were positive for CK7, which was consistent with the patient’s tumors. Genetically, the pathogenic mutation ERBB2 S310F was detected in the patient’s tumors (primary intraepidermal lesion, metastatic lymph node) and was observed in the xenografted tumors even after continued passages. The xenografted tumors responded well to trastuzumab and lapatinib therapy. Also, cytotoxic agents (docetaxel and eribulin) were effective against the xenografted tumors. This PDX model (EMPD-PDX-H1) could be a powerful tool for the research and development of EMPD treatments.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Schematic of the study method.
Fig. 2: The clinical manifestations and immunohistopathological findings for the primary site, the metastatic lymph node, and EMPD-PDX-H1.
Fig. 3: EMPD-PDX-H1 tumors harbor ERBB2 gene mutations identical to those of the patient’s primary and metastatic tumors.
Fig. 4: HER2-targeted therapies suppress the tumor growth of EMPD-PDX-H1 harboring the ERBB2 S310F mutation.
Fig. 5: EMPD-PDX-H1 are sensitive to cytotoxic agents, including eribulin and docetaxel.

Similar content being viewed by others

References

  1. Paget SJ. On disease of the mammary areola preceding cancer of the mammary gland. St Bartholomew’s Hosp Rep. 1874;10:87–9.

    Google Scholar 

  2. Kanitakis J. Mammary and extramammary Paget’s disease. J Eur Acad Dermatol Venereol. 2007;21:581–90.

    Article  CAS  Google Scholar 

  3. Herrel LA, Weiss AD, Goodman M, Johnson TV, Osunkoya AO, Delman KA, et al. Extramammary Paget’s disease in males: survival outcomes in 495 patients. Ann Surg Oncol. 2015;22:1625–30.

    Article  Google Scholar 

  4. Karam A, Dorigo O. Treatment outcomes in a large cohort of patients with invasive Extramammary Paget’s disease. Gynecol Oncol. 2012;125:346–51.

    Article  Google Scholar 

  5. Hatta N, Yamada M, Hirano T, Fujimoto A, Morita R. Extramammary Paget’s disease: treatment, prognostic factors and outcome in 76 patients. Br J Dermatol. 2008;158:313–8.

    CAS  PubMed  Google Scholar 

  6. Hirakawa S, Detmar M, Kerjaschki D, Nagamatsu S, Matsuo K, Tanemura A, et al. Nodal lymphangiogenesis and metastasis: role of tumor-induced lymphatic vessel activation in extramammary Paget’s disease. Am J Pathol. 2009;175:2235–48.

    Article  Google Scholar 

  7. Ohara K, Fujisawa Y, Yoshino K, Kiyohara Y, Kadono T, Murata Y, et al. A proposal for a TNM staging system for extramammary Paget disease: retrospective analysis of 301 patients with invasive primary tumors. J Dermatol Sci. 2016;83:234–9.

    Article  Google Scholar 

  8. Oashi K, Tsutsumida A, Namikawa K, Tanaka R, Omata W, Yamamoto Y, et al. Combination chemotherapy for metastatic extramammary Paget disease. Br J Dermatol. 2014;170:1354–7.

    Article  CAS  Google Scholar 

  9. Tokuda Y, Arakura F, Uhara H. Combination chemotherapy of low-dose 5-fluorouracil and cisplatin for advanced extramammary Paget’s disease. Int J Clin Oncol. 2015;20:194–7.

    Article  CAS  Google Scholar 

  10. Yoshino K, Fujisawa Y, Kiyohara Y, Kadono T, Murata Y, Uhara H, et al. Usefulness of docetaxel as first-line chemotherapy for metastatic extramammary Paget’s disease. J Dermatol. 2016;43:633–7.

    Article  CAS  Google Scholar 

  11. Kato M, Yoshino K, Maeda T, Nagai K, Oaku S, Hiura A, et al. Single-agent taxane is useful in palliative chemotherapy for advanced extramammary Paget’s disease; a case series. Br J Dermatol. 2019;181:831–2.

    Article  CAS  Google Scholar 

  12. Hirai I, Tanese K, Nakamura Y, Ishii M, Kawakami Y, Funakoshi T. Combination cisplatin-epirubicin-paclitaxel therapy for metastatic extramammary Paget’s disease. Oncologist. 2019;24:e394–6.

    Article  CAS  Google Scholar 

  13. Karam A, Berek JS, Stenson A, Rao J, Dorigo O. HER-2/neu targeting for recurrent vulvar Paget’s disease: a case report and literature review. Gynecol Oncol. 2008;111:568–71.

    Article  CAS  Google Scholar 

  14. Takahagi S, Noda H, Kamegashira A, Madokoro N, Hori I, Shindo H, et al. Metastatic extramammary Paget’s disease treated with paclitaxel and trastuzumab combination chemotherapy. J Dermatol. 2009;36:457–61.

    Article  CAS  Google Scholar 

  15. Vornicova O, Hershkovitz D, Yablonski-Peretz T, Ben-Itzhak O, Keidar Z, Bar-Sela G. Treatment of metastatic extramammary Paget’s disease associated with adnexal adenocarcinoma, with anti-HER2 drugs based on genomic alteration ERBB2 S310F. Oncologist. 2014;19:1006–7.

    Article  Google Scholar 

  16. Bertotti A, Migliardi G, Galimi F, Sassi F, Torti D, Isella C, et al. A molecularly annotated platform of patient-derived xenografts (“xenopatients”) identifies HER2 as an effective therapeutic target in cetuximab-resistant colorectal cancer. Cancer Discov. 2011;1:508–23.

    Article  CAS  Google Scholar 

  17. Hidalgo M, Amant F, Biankin AV, Budinská E, Byrne AT, Caldas C, et al. Patient-derived xenograft models: an emerging platform for translational cancer research. Cancer Discov. 2014;4:998–1013.

    Article  CAS  Google Scholar 

  18. Koga Y, Ochiai A. Systematic review of patient-derived xenograft models for preclinical studies of anti-cancer drugs in solid tumors. Cells. 2019;8:E418.

    Article  Google Scholar 

  19. Nishi M, Tashiro M, Yoshida H. Stimulation of growth by both androgen and estrogen of the EMP-K1 transplantable tumor with androgen and estrogen receptors from human extramammary Paget’s disease in nude mice. J Natl Cancer Inst. 1992;84:519–23.

    Article  CAS  Google Scholar 

  20. Twelves C, Cortes J, Vahdat L, Olivo M, He Y, Kaufman PA, et al. Efficacy of eribulin in women with metastatic breast cancer: a pooled analysis of two phase 3 studies. Breast Cancer Res Treat. 2014;148:553–61.

    Article  CAS  Google Scholar 

  21. Richter CE, Hui P, Buza N, Silasi DA, Azodi M, Santin AD, et al. HER-2/NEU overexpression in vulvar Paget disease: the Yale experience. J Clin Pathol. 2010;63:544–7.

    Article  CAS  Google Scholar 

  22. Tanaka R, Sasajima Y, Tsuda H, Namikawa K, Tsutsumida A, Otsuka F, et al. Human epidermal growth factor receptor 2 protein overexpression and gene amplification in extramammary Paget disease. Br J Dermatol. 2013;168:1259–66.

    Article  CAS  Google Scholar 

  23. Tanaka R, Sasajima Y, Tsuda H, Namikawa K, Takahashi A, Tsutsumida A, et al. Concordance of the HER2 protein and gene status between primary and corresponding lymph node metastatic sites of extramammary Paget disease. Clin Exp Metastasis. 2016;33:687–97.

    Article  CAS  Google Scholar 

  24. Zhang G, Zhou S, Zhong W, Hong L, Wang Y, Lu S, et al. Whole-exome sequencing reveals frequent mutations in chromatin remodeling genes in mammary and extramammary Paget’s diseases. J Invest Dermatol. 2019;139:789–95.

    Article  CAS  Google Scholar 

  25. Kiniwa Y, Yasuda J, Saito S, Saito R, Motoike IN, Danjoh I, et al. Identification of genetic alterations in extramammary Paget disease using whole exome analysis. J Dermatol Sci. 2019;94:229–35.

    Article  CAS  Google Scholar 

  26. Tate JG, Bamford S, Jubb HC, Sondka Z, Beare DM, Bindal N, et al. COSMIC: the catalogue of somatic mutations in cancer. Nucleic Acids Res. 2019;47:D941–7.

    Article  CAS  Google Scholar 

  27. Greulich H, Kaplan B, Mertins P, Chen TH, Tanaka KE, Yun SH, et al. Functional analysis of receptor tyrosine kinase mutations in lung cancer identifies oncogenic extracellular domain mutations of ERBB2. Proc Natl Acad Sci USA. 2012;109:14476–81.

    Article  CAS  Google Scholar 

  28. Ma CX, Bose R, Gao F, Freedman RA, Telli ML, Kimmick G, et al. Neratinib efficacy and circulating tumor DNA detection of HER2 mutations in HER2 nonamplified metastatic breast cancer. Clin Cancer Res. 2017;23:5687–95.

    Article  CAS  Google Scholar 

  29. Kavuri SM, Jain N, Galimi F, Cottino F, Leto SM, Migliardi G, et al. HER2 activating mutations are targets for colorectal cancer treatment. Cancer Discov. 2015;5:832–41.

    Article  CAS  Google Scholar 

  30. Hyman DM, Piha-Paul SA, Won H, Won H, Rodon J, Saura C, et al. HER kinase inhibition in patients with HER2- and HER3-mutant cancers. Nature. 2018;554:189–94.

    Article  CAS  Google Scholar 

  31. Towle MJ, Nomoto K, Asano M, Kishi Y, Yu MJ, Littlefield BA. Broad spectrum preclinical antitumor activity of eribulin (Halaven(R)): optimal effectiveness under intermittent dosing conditions. Anticancer Res. 2012;32:1611–9.

    CAS  PubMed  Google Scholar 

  32. Takeichi T, Okuno Y, Matsumoto T, Tsunoda N, Suzuki K, Tanahashi K, et al. Frequent FOXA1-Activating Mutations in Extramammary Paget’s Disease. Cancers (Basel). 2020;12:820.

    Article  CAS  Google Scholar 

  33. Yanagi T, Krajewska M, Matsuzawa S, Reed JC. PCTAIRE1 phosphorylates p27 and regulates mitosis in cancer cells. Cancer Res. 2014;74:5795–807.

    Article  CAS  Google Scholar 

  34. Ivanics T, Bergquist JR, Liu G, Kim MP, Kang Y, Katz MH, et al. Patient-derived xenograft cryopreservation and reanimation outcomes are dependent on cryoprotectant type. Lab Invest. 2018;98:947–56.

    Article  CAS  Google Scholar 

  35. Yanagi T, Watanabe M, Hata H, Kitamura S, Imafuku K, Yanagi H, et al. Loss of TRIM29 alters keratin distribution to promote cell invasion in squamous cell carcinoma. Cancer Res. 2018;78:6795–806.

    Article  CAS  Google Scholar 

  36. Wolff AC, Hammond MEH, Allison KH, Harvey BE, Mangu PB, Bartlett JMS, et al. Human epidermal growth factor receptor 2 testing in breast cancer: American society of clinical oncology/college of American pathologists clinical practice guideline focused update. J Clin Oncol. 2018;36:2105–22.

    Article  CAS  Google Scholar 

  37. Wainberg ZA, Anghel A, Desai AJ, Ayala R, Luo T, Safran B, et al. Lapatinib, a dual EGFR and HER2 kinase inhibitor, selectively inhibits HER2-amplified human gastric cancer cells and is synergistic with trastuzumab in vitro and in vivo. Clin Cancer Res. 2010;16:1509–19.

    Article  CAS  Google Scholar 

  38. Nonagase Y, Yonesaka K, Kawakami H, Watanabe S, Haratani K, Takahama T, et al. Heregulin-expressing HER2-positive breast and gastric cancer exhibited heterogeneous susceptibility to the anti-HER2 agents lapatinib, trastuzumab and T-DM1. Oncotarget. 2016;7:84860–71.

    Article  Google Scholar 

  39. Hendrikx JJ, Lagas JS, Song JY, Rosing H, Schellens JHM, Beijnen JH, et al. Ritonavir inhibits intratumoral docetaxel metabolism and enhances docetaxel antitumor activity in an immunocompetent mouse breast cancer model. Int J Cancer. 2016;138:758–69.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

We thank Ms. Yuko Tateda for her technical assistance. This work was supported in part by KAKENHI grant #18K08259 to TY from the Ministry of Education, Culture, Sports, Science and Technology in Japan.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Teruki Yanagi.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Maeda, T., Kitamura, S., Nishihara, H. et al. Extramammary Paget’s disease patient-derived xenografts harboring ERBB2 S310F mutation show sensitivity to HER2-targeted therapies. Oncogene 39, 5867–5875 (2020). https://doi.org/10.1038/s41388-020-01404-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41388-020-01404-x

This article is cited by

Search

Quick links