Loss of repressor element 1 silencing transcription factor (REST) occurs in 20% of breast cancers and correlates with a poor patient prognosis. However, the molecular basis for enhanced malignancy in tumors lacking REST (RESTless) is only partially understood. We used multiplatform array data from the Cancer Genome Atlas to identify consistent changes in key signaling pathways. Of the proteins screened in the reverse-phase protein array, we found that insulin receptor substrate 1 (IRS1) is the most highly upregulated protein in RESTless breast tumors. Analysis of breast tumor cell lines showed that REST directly represses IRS1, and cells lacking REST have increased levels of IRS1 mRNA and protein. We find that the upregulation of IRS1 function is both necessary and sufficient for enhanced signaling and growth in breast cancer cells lacking REST. IRS1 overexpression is sufficient to phenocopy the enhanced activation of the signaling hubs AKT and mitogen-activated protein kinase (MAPK) of MCF7 cells lacking REST. Loss of REST renders MCF7 and MDA-MB-231 breast tumor cells dependent on IRS1 activity for colony formation in soft agar. Inhibition of the type 1 insulin-like growth factor receptor (IGF1R) reduces the enhanced signaling, growth, and migration in breast tumor cells that occur upon REST loss. We show that loss of REST induces a pathogenic program that works through the IGF1R/IRS1 pathway.
We recently identified a novel subset of breast cancers that lack the repressor element 1 (RE-1) silencing transcription factor (REST). Loss of REST occurs in ϳ20% of all human breast cancers (termed RESTless), regardless of hormone receptor status (1). Patients with tumors lacking REST function have decreased disease-free survival and an aggressive disease course compared to those of patients with tumors expressing REST (RESTfl) (1). MCF7 cells lacking REST give rise to significantly more tumors in mouse xenografts and correlate with enhanced soft-agar colony formation in vitro, illustrating that REST acts as a bona fide tumor suppressor for breast epithelia (2).REST represses ϳ2,000 target genes by recruiting chromatinmodifying complexes to RE-1 sites in the regulatory region of its target genes (3-10). REST was first identified as a breast tumor suppressor in a screen for factors whose loss conferred anchorageindependent growth in human mammary epithelial cells (11). Knockdown of REST in MCF7 cells increases clonogenicity, enhances cell proliferation, and suppresses apoptosis (2, 12). However, the mechanisms by which REST regulates these oncogenic pathways are only partially understood (1, 2).An understanding of the mechanisms that promote tumor growth and metastasis is key to developing effective treatment programs for patients. We previously developed a biomarker assay that identifies a subgroup of aggressive tumors based on immunohistological staining and a gene signature comprised of 24 REST target genes (1). However, there is no targeted therapeutic approach to treat this set of tumors. To identify key effectors ...