It is becoming increasingly apparent that
HOX genes are frequently dysregulated in different malignancies [
15‐
17] including renal [
7], bladder [
18], prostate [
19,
20], lung [
21] and ovarian cancer [
9‐
11] (this study). The exact pattern of
HOX expression varies for different malignancies and the significance of this is worthy of further investigation. Possible explanations may lie in the original expression of
HOX genes in the embryonic cells, in which case the
HOX expression profile would influence the phenotype of each cancer. There is clear evidence for this in ovarian cancer where the expression of
HOXA9,
HOXA10 or
HOXA11 confer a serous, endometrioid-like and mucinous-like phenotype respectively [
9]. It is also clear that the over-expression of some HOX genes is directly related to the degree of malignancy, for example elevated expression of
HOXC8 is correlated with the loss of differentiation of prostate tumours [
20], although our data indicate that
HOXC8 is actually expressed at a lower level in the ovarian cancer lines SK-OV3 and OV-90 as compared to normal ovarian tissue. In addition, loss of
HOXA5 and
HOXA9 expression is generally associated with an increased resistance to apoptosis and tumour survival [
22], although both of these genes are expressed at relatively high levels in SK-OV3 compared to normal ovarian tissue and OV-90. However, recent studies have shown that
HOXA9 expression increases considerably in advanced stages of ovarian cancer, indicating that it may have a different function as the disease progresses [
23]. The other
HOX genes that are notably upregulated in SK-OV3 cells (but generally not OV-90 cells) have previously been shown to be upregulated in other cancers, including
HOXA13 [
24],
HOXB5 [
23],
HOXB9 [
25] and
HOXD9 [
26].
One difficulty in interpreting this data is that, in general, there is a high level of redundancy in
HOX function which may mask the contribution of any of these individual genes to a malignant phenotype. Hence a post-translational approach may reveal more about global
HOX functions in cancer. The HXR9 peptide blocks the binding of HOX proteins to their PBX co-factor and in doing so alters the way in which they bind to DNA and hence changes the regulation of their target genes [
6,
7]. HXR9 causes melanoma and renal cancer cells to undergo apoptosis, and here we have shown that the SK-OV3 cell line derived from an ovarian tumour responds in the same way, indicating that the HOX/PBX interaction is a potential target in ovarian cancer therapy. Interestingly, HXR9 does not induce cell death in OV-90 cells that generally do not show dysregulated HOX expression.
The role of
HOX genes in early development is highly conserved [
2]. They may also have a common role in malignant cells, as evidenced by a common sensitivity to HXR9 and in similar transcriptional responses, including the upregulation of
cFos. This change in
cFos expression was previously shown to be responsible, at least in part, for the induction of apoptosis [
6]. Recent studies have shown that
cFos transcriptionally represses the key anti-apoptotic gene
c-FLIP(L), greatly sensitising prostate cancer cells to TRAIL-induced apoptosis [
27,
28].