Signal Transduction Team, The Institute of Cancer Research, Royal Marsden Hospital, London, UK.
Cancer Discov. 2013 Feb;3(2):158-67. doi: 10.1158/2159-8290.CD-12-0386. Epub 2012 Dec 14.
UNLABELLED: We generated cell lines resistant to BRAF inhibitors and show that the EGF receptor (EGFR)-SRC family kinase (SFK)-STAT3 signaling pathway was upregulated in these cells. In addition to driving proliferation of resistant cells, this pathway also stimulated invasion and metastasis. EGFR inhibitors cooperated with BRAF inhibitors to block the growth of the resistant cells in vitro and in vivo, and monotherapy with the broad specificity tyrosine kinase inhibitor dasatinib blocked growth and metastasis in vivo. We analyzed tumors from patients with intrinsic or acquired resistance to vemurafenib and observed increased EGFR and SFK activity. Furthermore, dasatinib blocked the growth and metastasis of one of the resistant tumors in immunocompromised mice. Our data show that BRAF inhibitor-mediated activation of EGFR-SFK-STAT3 signaling can mediate resistance in patients with BRAF-mutant melanoma. We describe 2 treatments that seem to overcome this resistance and could deliver therapeutic efficacy in patients with drug-resistant BRAF-mutant melanoma. SIGNIFICANCE: Therapies that target the driver oncogenes in cancer can achieve remarkable responses if patients are stratified for treatment. However, as with conventional therapies, patients often develop acquired resistance to targeted therapies, and a proportion of patients are intrinsically resistant and fail to respond despite the presence of an appropriate driver oncogene mutation. We found that the EGFR/SFK pathway mediated resistance to vemurafenib in BRAF -mutant melanoma and that BRAF and EGFR or SFK inhibition blocked proliferation and invasion of these resistant tumors, providing potentially effective therapeutic options for these patients.
未加标签:我们生成了对 BRAF 抑制剂有抗性的细胞系,并表明这些细胞中 EGF 受体(EGFR)-SRC 家族激酶(SFK)-STAT3 信号通路被上调。除了驱动耐药细胞的增殖外,该通路还刺激了侵袭和转移。EGFR 抑制剂与 BRAF 抑制剂协同作用,在体外和体内阻断耐药细胞的生长,并且广谱酪氨酸激酶抑制剂达沙替尼的单药治疗在体内阻断了生长和转移。我们分析了对vemurafenib 具有内在或获得性耐药的患者的肿瘤,并观察到 EGFR 和 SFK 活性增加。此外,达沙替尼在免疫功能低下的小鼠中阻断了其中一个耐药肿瘤的生长和转移。我们的数据表明,BRAF 抑制剂介导的 EGFR-SFK-STAT3 信号的激活可以介导 BRAF 突变黑色素瘤患者的耐药性。我们描述了 2 种似乎可以克服这种耐药性的治疗方法,并可以为耐药性 BRAF 突变黑色素瘤患者提供治疗效果。
意义:如果对患者进行分层治疗,针对癌症驱动致癌基因的治疗方法可以产生显著的反应。然而,与传统疗法一样,患者通常会对靶向治疗产生获得性耐药,并且尽管存在适当的驱动致癌基因突变,一部分患者仍然具有内在耐药性并且无法响应。我们发现 EGFR/SFK 通路介导了 vemurafenib 在 BRAF 突变黑色素瘤中的耐药性,并且 BRAF 和 EGFR 或 SFK 抑制阻断了这些耐药肿瘤的增殖和侵袭,为这些患者提供了潜在有效的治疗选择。
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