Overexpression of Forkhead Box Protein M1 (FOXM1) in Ovarian Cancer Correlates with Poor Patient Survival and Contributes to Paclitaxel Resistance
Open accessAbstract
AIM: Deregulation of FOXM1 has been documented in various cancers. The aim of this study was to evaluate the role of FOXM1 in ovarian cancer tumorigenesis and paclitaxel resistance. EXPERIMENTAL DESIGN: Expression of FOXM1 was examined in 119 clinical samples by immunohistochemistry and correlated with clinicopathological parameters. Effects of FOXM1 knockdown on ovarian cancer cell migration, invasion and mitotic catastrophe were also studied. qPCR and ChIP-qPCR were used to establish KIF2C as a novel FOXM1 target gene implicated in chemoresistance. RESULTS: High nuclear FOXM1 expression in ovarian cancer patient samples was significantly associated with advanced stages (P = 0.035), shorter overall (P = 0.019) and disease-free (P = 0.014) survival. Multivariate analysis confirmed FOXM1 expression as an independent prognostic factor for ovarian cancer. FOXM1 knockdown significantly inhibited migration and invasion of ovarian cancer cells and enhanced paclitaxel-mediated cell death and mitotic catastrophe in a p53-independent manner. Bioinformatics analysis suggested a number of potential transcription targets of FOXM1. One of the potential targets, KIF2C, exhibited similar expression pattern to FOXM1 in chemosensitive and chemoresistant cells in response to paclitaxel treatment. FOXM1 could be detected at the promoter of KIF2C and FOXM1 silencing significantly down-regulated KIF2C. CONCLUSION: Our findings suggest that FOXM1 is associated with poor patient outcome and contributes to paclitaxel resistance by blocking mitotic catastrophe. KIF2C is identified as a novel FOXM1 transcriptional target that may be implicated in the acquisition of chemoresistance. FOXM1 should be further investigated as a potential prognostic marker and therapeutic target for ovarian cancer.
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The FOXM1 signaling pathway is activated in 84% high-grade serous ovarian cancer and linked to platinum resistance.
“Notably, the FOXM1 signaling pathway is activated in 84% high-grade serous ovarian cancer [61] and linked to platinum resistance [62, 63].”
From Identification of a novel gene signature predicting response to first-line chemotherapy in BRCA wild-type high-grade serous ovarian cancer patients (2022) · cites this paper as [62]
Citation [61] is attached to the claim that the FOXM1 pathway is activated in 84% of high-grade serous ovarian cancers; the platinum-resistance statement has separate citations. The Results section reports FOXM1 staining across ovarian tumour types and a nonsignificant trend for serous and high-grade cancers, but does not report pathway activation in 84% of high-grade serous cases. Searches for “84%” and high-grade serous pathway activation found no supporting passage in our copy. (LLM, conf=0.76)
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Cites
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“Specifically, the spliceosome-associated factor CTNNBL1, has been related to proliferation and invasion in HGSOC, at least partially through regulation of FOXM1 splicing [60], Notably, the FOXM1 signaling pathway is activated in 84% high-grade serous ovarian cancer [61] and linked to platinum resistance [62, 63].”
Background
- Authors
- Zhao, F., Siu, M. K. Y., Jiang, L., Tam, K. F., Ngan, H. Y. S., Le, X. F., Wong, O. G. W., Wong, E. S. Y., Gomes, A. R., Bella, L., Khongkow, P., Lam, E. W.-F., & Cheung, A. N. Y.
- Affiliations
- Imperial College London (GB)
- University of Hong Kong (HK)
- Sichuan University (CN)
- Corresponding author
- Lam, Eric W-F
- Venue
- PLoS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2014-11-20
- Volume
- 9
- Issue
- 11
- Pages
- e113478
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4239070
- OpenAlex
- W1971577144
- Cited by
- 88
- References
- 2
- Citations by year
- 2026: 3 · 2025: 3 · 2024: 7 · 2023: 4 · 2022: 6 · 2021: 11 · 2020: 4 · 2019: 9 · 2018: 11 · 2017: 13 · 2016: 8 · 2015: 8 · 2013: 1
- FWCI
- 11.74
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- PLoS ONE (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- The HKU Scholars Hub (University of Hong Kong) (submittedVersion, cc-by-nc-nd)
- Spiral (Imperial College London) (submittedVersion, other-oa)
- Funders
- Cancer Research UK
- Breast Cancer Campaign
- Engineering and Physical Sciences Research Council (1234732)
- Biotechnology and Biological Sciences Research Council (BBS/B/03785)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Ovarian cancer diagnosis and treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › FOXO transcription factor regulation
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Reproductive Biology and Fertility
- Keywords
- FOXM1, ovarian cancer, paclitaxel resistance, chemoresistance, KIF2C, mitotic catastrophe, prognostic factors, cell migration and invasion, transcription factor target genes, p53-independent cell death, tumor stage
- MeSH terms
- Forkhead Box Protein M1, Antineoplastic Agents, Phytogenic, Cell Movement, Female, Follow-Up Studies, Humans, Immunohistochemistry, Neoplasm Staging, Ovarian Neoplasms, Prognosis, Down-Regulation, Kinesins, Apoptosis, Paclitaxel, Disease-Free Survival, Drug Resistance, Neoplasm, Cell Line, Tumor, Forkhead Transcription Factors, Kaplan-Meier Estimate, G2 Phase Cell Cycle Checkpoints, Real-Time Polymerase Chain Reaction
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