Successful treatment of p53 mutant, triple-negative breast cancers (TNBC) remains a daunting challenge. Doxorubicin (DOXO) and cisplatin (CDDP) are standard-of-care treatments for TNBC, but eventually fail due to acquired drug resistance and toxicity. Therefore, new treatments for overcoming drug resistance and toxicity in p53 mutant, TNBC are badly needed. Unlike p53, p73, a member of the p53 family, is usually not mutated in cancers and has been shown to regulate p53 mediated apoptotic signaling in p53 deficient cancers. Therefore, identification of anticancer agents that can activate p73 in p53-deficient cancers may provide a chemotherapeutic approach for treatment of p53 mutant cancers. Here we report on the reconstitution of the p53 tumor suppressor pathway in a p53-independent manner via p73 with combination treatments of alpha-TEA, a small bioactive lipid, plus DOXO or CDDP.

p53 mutant, TNBC cell lines, MDA-MB-231, BT-20 and MDA-MB-468 were used to evaluate the anticancer effect of chemotherapeutic drugs and alpha-TEA using Annexin V (FITC)/PI staining, western blot analyses, RT-PCR and siRNA knockdown techniques.

Combination treatments of alpha-TEA plus DOXO or CDDP act cooperatively to induce apoptosis, caspase-8 and -9 cleavage, p73, phospho-c-Ab1 and phospho-JNK protein expression, and increase expression of p53 downstream mediators; namely, death receptor-5 (DR5), CD95/APO-1 (Fas), Bax and Noxa, as well as Yap nuclear translocation, plus reduce expression of Bcl-2. Knockdown of p73, c-Abl, JNK or Yap using siRNAs show that: (i) p73 plays a critical role in combination treatment enhanced apoptosis and the expression of pro- and anti-apoptotic mediators, and (ii) c-Abl, JNK and Yap are upstream mediators of p73 in combination treatment responses.

Data show that alpha-TEA in combination with DOXO or CDDP synergistically enhances apoptosis in TNBC via targeting p53 mediated genes in a p73 dependent manner and that p73 responses are downstream of c-Abl, JNK and Yap.

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