Inhibitory Effects of Mild Hyperthermia plus Docetaxel Therapy on ER(+/–) Breast Cancer Cells and Action Mechanisms

The purpose of this study was to verify that a combination of mild hyperthermia and docetaxel chemotherapy produces synergistic antitumor effects and to explore the action mechanisms of this treatment approach.The effects of docetaxel on the proliferation of cells from the estrogen receptor(ER)-positive human breast cancer cell line MCF-7 and the ER-negative human breast cancer cell line MDA-MB-453 were examined by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide(MTT)assay,and effective experimental concentrations of docetaxel were determined.The effects of mild hyperthermia plus docetaxel therapy on apoptosis rate in the MCF-7 and MDA-MB-453 human breast cancer cell lines were analyzed by using flow cytometry with Annexin-V fluorescein isothiocyanate(FITC)/propidium iodide(PI)staining.The effects of these combined treatments on cell cycle progression in the MCF-7 and MDA-MB-453 human breast cancer cell lines were examined by using flow cytometry.The effects of these combined treatments on the expression of apoptosis-related proteins and proteins in the mitogen-activated protein kinase(MAPK)pathways were analyzed by using Western blotting.The effects of these combined treatments on the expression of the heat shock protein 70(HSP70)and the multi-drug resistance(MDR)gene product P-glycoprotein(Pgp)were examined by using Western blotting.The results showed that the half-maximal inhibitory concentration(IC50)of docetaxel for MCF-7 and MDA-MB-453 cells was 19.57±1.12 and 21.64±2.31μmol/L respectively.Mild hyperthermia with docetaxel therapy could increase apoptosis rate in the MCF-7 and MDA-MB-453cells.Apoptosis rate in MCF-7 and MDA-MB-453 cells was increased from(23.66±3.59)%and(18.51±3.17)%in docetaxel treatment group to(47.12±6.73)%and(55.16±7.42)%in mild hyperthermia plus docetaxel group,indicating that the mild hyperthermia and docetaxel therapeutic approaches exhibited significant synergistic antitumor effects.Treatments of mild hyperthermia plus docetaxel induced G2/M cell cycle arrest in the MCF-7 and MDA-MB-453 cells.Western blotting demonstrated that proteins in the MAPK pathway were expressed at higher levels in docetaxel-treated cells following mild hypothermia than those in cells treated with docetaxel alone.As compared with blank control group,cells from the mild hyperthermia plus docetaxel group exhibited significantly decreased B-cell lymphoma 2(Bcl-2)protein expression but slightly increased Bcl-2-associated X protein(Bax)expression.Western blotting results revealed that HSP70 and Pgp expression levels were significantly increased following mild hypothermia.It was concluded that treatments of mild hyperthermia plus docetaxel inhibited the proliferation of human breast cancer cells,promoted apoptosis of breast cancer cells,and produced synergistic antitumor effects.