Department of Veterans Affairs, Vanderbilt-Ingram Cancer Center and Vanderbilt University School of Medicine, Nashville, Tennessee 37232, USA.
Clin Cancer Res. 2012 Apr 15;18(8):2184-98. doi: 10.1158/1078-0432.CCR-11-1122. Epub 2012 Feb 20.
The purpose of this preclinical study was to determine the effectiveness of RAF265, a multikinase inhibitor, for treatment of human metastatic melanoma and to characterize traits associated with drug response.
Advanced metastatic melanoma tumors from 34 patients were orthotopically implanted to nude mice. Tumors that grew in mice (17 of 34) were evaluated for response to RAF265 (40 mg/kg, every day) over 30 days. The relation between patient characteristics, gene mutation profile, global gene expression profile, and RAF265 effects on tumor growth, mitogen-activated protein/extracellular signal-regulated kinase (MEK)/extracellular signal-regulated kinase (ERK) phosphorylation, proliferation, and apoptosis markers was evaluated.
Nine of the 17 tumors that successfully implanted (53%) were mutant BRAF (BRAF(V600E/K)), whereas eight of 17 (47%) tumors were BRAF wild type (BRAF(WT)). Tumor implants from 7 of 17 patients (41%) responded to RAF265 treatment with more than 50% reduction in tumor growth. Five of the 7 (71%) responders were BRAF(WT), of which 1 carried c-KIT(L576P) and another N-RAS(Q61R) mutation, while only 2 (29%) of the responding tumors were BRAF(V600E/K). Gene expression microarray data from nonimplanted tumors revealed that responders exhibited enriched expression of genes involved in cell growth, proliferation, development, cell signaling, gene expression, and cancer pathways. Although response to RAF265 did not correlate with pERK1/2 reduction, RAF265 responders did exhibit reduced pMEK1, reduced proliferation based upon reduced Ki-67, cyclin D1 and polo-like kinase1 levels, and induction of the apoptosis mediator BCL2-like 11.
Orthotopic implants of patient tumors in mice may predict prognosis and treatment response for melanoma patients. A subpopulation of human melanoma tumors responds to RAF265 and can be characterized by gene mutation and gene expression profiles.
本临床前研究旨在确定 RAF265(一种多激酶抑制剂)治疗人类转移性黑色素瘤的有效性,并对与药物反应相关的特征进行分析。
将 34 名患者的晚期转移性黑色素瘤肿瘤原位植入裸鼠。在 34 名患者中,有 17 名(17/34)患者的肿瘤在小鼠体内生长,对其进行 RAF265(40mg/kg,每天一次)治疗 30 天的效果评估。评估了患者特征、基因突变谱、全基因表达谱与 RAF265 对肿瘤生长、丝裂原活化蛋白/细胞外信号调节激酶(MEK)/细胞外信号调节激酶(ERK)磷酸化、增殖和凋亡标志物的影响之间的关系。
成功植入的 17 个肿瘤中有 9 个(53%)为突变 BRAF(BRAF(V600E/K)),而 17 个肿瘤中有 8 个(47%)为 BRAF 野生型(BRAF(WT))。17 名患者中有 7 名(41%)的肿瘤植入物对 RAF265 治疗有超过 50%的肿瘤生长抑制反应。7 名应答者中有 5 名(71%)为 BRAF(WT),其中 1 名携带 c-KIT(L576P)突变,另 1 名携带 N-RAS(Q61R)突变,而仅有 2 名(29%)应答肿瘤为 BRAF(V600E/K)。非植入肿瘤的基因表达微阵列数据显示,应答者表现出参与细胞生长、增殖、发育、细胞信号转导、基因表达和癌症途径的基因表达增加。尽管 RAF265 应答与 pERK1/2 减少无关,但 RAF265 应答者确实表现出 pMEK1 减少、Ki-67、周期蛋白 D1 和 Polo 样激酶 1 水平降低导致的增殖减少,以及凋亡介质 BCL2 样 11 的诱导。
患者肿瘤的原位植入小鼠可能预测黑色素瘤患者的预后和治疗反应。人类黑色素瘤肿瘤的一个亚群对 RAF265 有反应,并可通过基因突变和基因表达谱进行特征分析。