三氧化二砷克服雷帕霉素诱导的AKT和ERK信号反馈激活,增强对乳腺癌的抗肿瘤作用。
Arsenic trioxide overcomes rapamycin-induced feedback activation of AKT and ERK signaling to enhance the anti-tumor effects in breast cancer.
作者信息
Guilbert Cynthia, Annis Matthew G, Dong Zhifeng, Siegel Peter M, Miller Wilson H, Mann Koren K
机构信息
Lady Davis Institute for Medical Research, McGill University, Montreal, Canada.
Rosalind and Morris Goodman Cancer Research Centre, McGill University, Montreal, Canada.
出版信息
PLoS One. 2013 Dec 31;8(12):e85995. doi: 10.1371/journal.pone.0085995. eCollection 2013.
Inhibitors of the mammalian target of rapamycin (mTORi) have clinical activity; however, the benefits of mTOR inhibition by rapamycin and rapamycin-derivatives (rapalogs) may be limited by a feedback mechanism that results in AKT activation. Increased AKT activity resulting from mTOR inhibition can be a result of increased signaling via the mTOR complex, TORC2. Previously, we published that arsenic trioxide (ATO) inhibits AKT activity and in some cases, decreases AKT protein expression. Therefore, we propose that combining ATO and rapamycin may circumvent the AKT feedback loop and increase the anti-tumor effects. Using a panel of breast cancer cell lines, we find that ATO, at clinically-achievable doses, can enhance the inhibitory activity of the mTORi temsirolimus. In all cell lines, temsirolimus treatment resulted in AKT activation, which was decreased by concomitant ATO treatment only in those cell lines where ATO enhanced growth inhibition. Treatment with rapalog also results in activated ERK signaling, which is decreased with ATO co-treatment in all cell lines tested. We next tested the toxicity and efficacy of rapamycin plus ATO combination therapy in a MDA-MB-468 breast cancer xenograft model. The drug combination was well-tolerated, and rapamycin did not increase ATO-induced liver enzyme levels. In addition, combination of these drugs was significantly more effective at inhibiting tumor growth compared to individual drug treatments, which corresponded with diminished phospho-Akt and phospho-ERK levels when compared with rapamycin-treated tumors. Therefore, we propose that combining ATO and mTORi may overcome the feedback loop by decreasing activation of the MAPK and AKT signaling pathways.
哺乳动物雷帕霉素靶蛋白抑制剂(mTORi)具有临床活性;然而,雷帕霉素和雷帕霉素衍生物(雷帕霉素类似物)对mTOR的抑制作用可能会受到导致AKT激活的反馈机制的限制。mTOR抑制导致的AKT活性增加可能是通过mTOR复合物TORC2信号增强的结果。此前,我们发表过三氧化二砷(ATO)可抑制AKT活性,在某些情况下,还会降低AKT蛋白表达。因此,我们提出联合使用ATO和雷帕霉素可能会规避AKT反馈回路并增强抗肿瘤效果。使用一组乳腺癌细胞系,我们发现,在临床可达到的剂量下,ATO可增强mTORi替西罗莫司的抑制活性。在所有细胞系中,替西罗莫司处理均导致AKT激活,仅在那些ATO增强生长抑制作用的细胞系中同时给予ATO处理可降低AKT激活。雷帕霉素类似物处理也会导致ERK信号激活,但在所有测试的细胞系中,联合ATO处理可降低ERK信号激活程度。接下来,我们在MDA-MB-468乳腺癌异种移植模型中测试了雷帕霉素加ATO联合疗法的毒性和疗效。该药物组合耐受性良好,雷帕霉素并未增加ATO诱导的肝酶水平。此外,与单独使用药物治疗相比,这些药物联合使用在抑制肿瘤生长方面显著更有效,与雷帕霉素治疗的肿瘤相比,这与磷酸化Akt和磷酸化ERK水平降低相对应。因此,我们提出联合使用ATO和mTORi可能通过降低MAPK和AKT信号通路的激活来克服反馈回路。