Trastuzumab resistance emerges to be a major issue in anti-human epidermal growth factor receptor 2 (HER2) therapy for breast cancers. Here, we demonstrated that miR-21 expression was upregulated and its function was elevated in HER2 ؉ BT474, SKBR3, demonstrates therapeutic potential by sensitizing the malignancy to anti-HER2 treatment.Overexpression of human epidermal growth factor receptor 2 (HER2/NEU/c-ERBB2), 4 a member of the epidermal growth factor receptor (EGFR) family of 185 kDa, is found in 20 -35% of human breast cancers (1). Amplification of HER2 is linked to aggressive tumor behavior and poor clinical outcome with shorter disease-free intervals and overall survival in patients with early and advanced breast cancers (2). Tremendous efforts have been made to develop HER2-targeting cancer therapies, and a most successful strategy is the recombinant humanized anti-HER2 monoclonal antibody trastuzumab (Herceptin) that specifically binds to the extracellular domain of HER2 and blocks its function. Clinical application of trastuzumab in adjuvant and metastatic settings has been shown to prolong the survival of patients with HER2 ϩ breast cancers (3). However, the response rate to trastuzumab monotherapy is less than 35%, whereas ϳ60% of patients with HER2 ϩ cancers on regimens combining trastuzumab with microtubule stabilizing drugs do not respond to treatment (4). Moreover, most patients who achieve an initial response develop resistance to trastuzumab within 1 year (5). Therefore, identifying the mechanisms responsible for trastuzumab resistance is important for the development of new therapeutic strategies.A number of mechanisms have been suggested for trastuzumab resistance, including dysregulation of downstream signaling pathways and compensated signaling by other EGF family members or through alternative pathways (6). Among them, reduced PTEN expression is a strong indicator to predict trastuzumab resistance in breast cancer patients. Further mechanistic study showed that loss of PTEN function in HER2 ϩ cancer cells leads to trastuzumab resistance by enhancing downstream PI3K/AKT phosphorylation and thus preventing trastuzumab-mediated growth arrest (7). However, how PTEN expression is silenced in trastuzumab resistance remains illusive.Micro-RNAs (miRNAs) are a class of small non-coding RNAs of ϳ22 nucleotides in size that are endogenously expressed in mammalian cells. They regulate gene expression by repressing mRNA translation or cleaving target mRNA. As a new family of gene regulators, miRNAs are involved in modulating multiple cellular pathways, including cell proliferation, differentiation, and apoptosis, and thus may function as oncogenes or tumor suppressing genes (8). Among them, oncogenic miRNAs, including miR-17-92 (9), miR-19a (10), miR-21 (11), miR-26a (12), miR-141 (13), miR-216a (14), miR-217 (14), miR-* This work was supported by National Natural Science Foundation of China Grants 30772550, 30801376, 30830110, 30831160515, 30921140312, 30973505, and 30945201, the Sun-Yat-Sen Excellen...