Division of Clinical Studies, The Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK.
Cancer Cell. 2012 Jul 10;22(1):117-30. doi: 10.1016/j.ccr.2012.06.001.
The ALK(F1174L) mutation is associated with intrinsic and acquired resistance to crizotinib and cosegregates with MYCN in neuroblastoma. In this study, we generated a mouse model overexpressing ALK(F1174L) in the neural crest. Compared to ALK(F1174L) and MYCN alone, co-expression of these two oncogenes led to the development of neuroblastomas with earlier onset, higher penetrance, and enhanced lethality. ALK(F1174L)/MYCN tumors exhibited increased MYCN dosage due to ALK(F1174L)-induced activation of the PI3K/AKT/mTOR and MAPK pathways, coupled with suppression of MYCN pro-apoptotic effects. Combined treatment with the ATP-competitive mTOR inhibitor Torin2 overcame the resistance of ALK(F1174L)/MYCN tumors to crizotinib. Our findings demonstrate a pathogenic role for ALK(F1174L) in neuroblastomas overexpressing MYCN and suggest a strategy for improving targeted therapy for ALK-positive neuroblastoma.
ALK(F1174L) 突变与克唑替尼的内在和获得性耐药相关,并与神经母细胞瘤中的 MYCN 共分离。在这项研究中,我们生成了一种在神经嵴中过表达 ALK(F1174L)的小鼠模型。与单独的 ALK(F1174L)和 MYCN 相比,这两种癌基因的共表达导致神经母细胞瘤的发病更早、侵袭性更强、致死率更高。ALK(F1174L)/MYCN 肿瘤由于 ALK(F1174L)诱导的 PI3K/AKT/mTOR 和 MAPK 通路的激活以及对 MYCN 促凋亡作用的抑制而导致 MYCN 剂量增加。与 ATP 竞争性 mTOR 抑制剂 Torin2 联合治疗克服了 ALK(F1174L)/MYCN 肿瘤对克唑替尼的耐药性。我们的研究结果表明,ALK(F1174L)在过表达 MYCN 的神经母细胞瘤中具有致病性作用,并为改善针对 ALK 阳性神经母细胞瘤的靶向治疗提供了一种策略。