Departments of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Mol Cancer Ther. 2012 Sep;11(9):1999-2009. doi: 10.1158/1535-7163.MCT-12-0017. Epub 2012 Jul 2.
Pancreatic ductal adenocarcinoma (PDAC) is a lethal malignancy, with most patients facing an adverse clinical outcome. Aberrant Notch pathway activation has been implicated in the initiation and progression of PDAC, specifically the aggressive phenotype of the disease. We used a panel of human PDAC cell lines as well as patient-derived PDAC xenografts to determine whether pharmacologic targeting of Notch pathway could inhibit PDAC growth and potentiate gemcitabine sensitivity. MRK-003, a potent and selective γ-secretase inhibitor, treatment resulted in the downregulation of nuclear Notch1 intracellular domain, inhibition of anchorage-independent growth, and reduction of tumor-initiating cells capable of extensive self-renewal. Pretreatment of PDAC cells with MRK-003 in cell culture significantly inhibited the subsequent engraftment in immunocompromised mice. MRK-003 monotherapy significantly blocked tumor growth in 5 of 9 (56%) PDAC xenografts. A combination of MRK-003 and gemcitabine showed enhanced antitumor effects compared with gemcitabine in 4 of 9 (44%) PDAC xenografts, reduced tumor cell proliferation, and induced both apoptosis and intratumoral necrosis. Gene expression analysis of untreated tumors indicated that upregulation of NF-κB pathway components was predictive of sensitivity to MRK-003, whereas upregulation in B-cell receptor signaling and nuclear factor erythroid-derived 2-like 2 pathway correlated with response to the combination of MRK-003 with gemcitabine. Our findings strengthen the rationale for small-molecule inhibition of Notch signaling as a therapeutic strategy in PDAC.
胰腺导管腺癌(PDAC)是一种致命的恶性肿瘤,大多数患者面临不良的临床结局。异常的 Notch 通路激活被认为与 PDAC 的发生和进展有关,特别是与疾病的侵袭性表型有关。我们使用一组人 PDAC 细胞系和患者来源的 PDAC 异种移植瘤来确定 Notch 通路的药物靶向是否可以抑制 PDAC 生长并增强吉西他滨的敏感性。MRK-003 是一种有效的、选择性的 γ-分泌酶抑制剂,治疗导致核 Notch1 细胞内结构域的下调,抑制锚定非依赖性生长,并减少能够广泛自我更新的肿瘤起始细胞。MRK-003 在细胞培养中的预处理显著抑制了随后在免疫缺陷小鼠中的植入。MRK-003 单药治疗显著阻断了 9 个 PDAC 异种移植瘤中的 5 个(56%)的肿瘤生长。与吉西他滨相比,MRK-003 与吉西他滨联合使用在 9 个 PDAC 异种移植瘤中的 4 个(44%)中显示出增强的抗肿瘤作用,减少肿瘤细胞增殖,并诱导细胞凋亡和肿瘤内坏死。未治疗肿瘤的基因表达分析表明,NF-κB 通路成分的上调预示着对 MRK-003 的敏感性,而 B 细胞受体信号和核因子红细胞衍生 2 样 2 通路的上调与 MRK-003 与吉西他滨联合使用的反应相关。我们的研究结果为 Notch 信号的小分子抑制作为 PDAC 的治疗策略提供了更强有力的依据。