Department of Radiation Oncology, Kimmel Cancer Center, Thomas Jefferson University, Philadelphia, PA 19107, USA.
Mol Cancer Ther. 2013 May;12(5):696-704. doi: 10.1158/1535-7163.MCT-12-0868. Epub 2013 Feb 26.
Crizotinib (PF02341066) is a tyrosine kinase inhibitor of anaplastic lymphoma kinase (ALK) that has been shown to selectively inhibit growth of cancer cells that harbor the EML4-ALK fusion found in a subset of patients with non-small cell lung cancer (NSCLC). While in clinical trials, PF02341066 has shown a significant therapeutic benefit as a single agent; the effectiveness of combining it with other therapeutic modalities including ionizing radiation remains unknown. To further elucidate the role of PF02341066 in tumor inhibition, we examined its effects alone and in combination with radiation on downstream signaling, apoptosis, and radiosensitivity in two NSCLC cell lines in vitro: H3122, which harbors the EML4-ALK fusion, and H460, which does not. We also examined the in vivo effects of PF02341066 in H3122 mouse xenografts. In the H3122 cell line, PF02341066 inhibited phosphorylation of ALK and its downstream effectors: AKT, ERK, and STAT3. H3122 cells treated with a combination of PF02341066 and radiation showed an increase in cellular apoptosis and were sensitized to radiation therapy (dose enhancement ratio, 1.43; P < 0.0001). Moreover, in an H3122 xenograft model, the combined treatment resulted in greater tumor growth inhibition than either treatment alone (P < 0.05). None of these effects was observed in the EML4-ALK-negative H460 cells. Our findings indicate that PF02341066 acts as a radiation sensitizer in cells harboring the EML4-ALK fusion, providing a rationale for a clinical trial combining ALK inhibitor with radiation in the NSCLCs expressing ALK.
克唑替尼(PF02341066)是一种间变性淋巴瘤激酶(ALK)的酪氨酸激酶抑制剂,已被证明能够选择性地抑制具有非小细胞肺癌(NSCLC)亚组患者中存在的 EML4-ALK 融合的癌细胞的生长。在临床试验中,PF02341066 作为单一药物表现出显著的治疗益处;与其他治疗方式(包括电离辐射)联合使用的效果仍然未知。为了进一步阐明 PF02341066 在肿瘤抑制中的作用,我们研究了它单独使用以及与辐射联合使用对两种 NSCLC 细胞系(H3122,其具有 EML4-ALK 融合,以及 H460,其不具有)的下游信号转导、凋亡和放射敏感性的影响。我们还研究了 PF02341066 在 H3122 小鼠异种移植中的体内作用。在 H3122 细胞系中,PF02341066 抑制了 ALK 及其下游效应物:AKT、ERK 和 STAT3 的磷酸化。用 PF02341066 和辐射联合处理的 H3122 细胞显示细胞凋亡增加,并对放射治疗敏感(剂量增强比,1.43;P < 0.0001)。此外,在 H3122 异种移植模型中,联合治疗导致肿瘤生长抑制大于单独治疗(P < 0.05)。这些效应都没有在 EML4-ALK 阴性的 H460 细胞中观察到。我们的研究结果表明,PF02341066 在携带 EML4-ALK 融合的细胞中作为放射增敏剂发挥作用,为在表达 ALK 的 NSCLC 中联合使用 ALK 抑制剂和放射治疗提供了一个理论依据。