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通过 AKT 非依赖性 PKC 介导的 GSK3β磷酸化获得对弥漫型胃癌中 FGFR 抑制剂的耐药性。

Acquired Resistance to FGFR Inhibitor in Diffuse-Type Gastric Cancer through an AKT-Independent PKC-Mediated Phosphorylation of GSK3β.

机构信息

Cancer Science Institute of Singapore, National University of Singapore, Singapore.

Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore.

出版信息

Mol Cancer Ther. 2018 Jan;17(1):232-242. doi: 10.1158/1535-7163.MCT-17-0367. Epub 2017 Oct 4.

Abstract

Preclinical models of diffuse-type gastric cancer (DGC) that reliably predict clinical activity of novel compounds are lacking. To overcome the problem of poor tumor cellularity in DGC, we used cells from malignant ascites to establish DGC patient-derived xenograft (PDX) models that recapitulate the primary cancer. Cells in PDX model GAGA6 with amplification were sensitive to AZD4547, a potent FGFR inhibitor that is being clinically evaluated for FGFR-aberrant cancer types. Intermittent treatment of GAGA6 tumors with AZD4547 gave rise to PDX tumors with acquired resistance to AZD4547, GAGA6-R. Surprisingly, there were no mutations in the gene in GAGA6-R, negating gatekeeper mutations as a mechanism of drug resistance. Phosphorylation of FGFR2 and downstream signaling molecules AKT/PKB and MAPK/ERK remained inhibited by AZD4547. Further analysis of signaling pathways identified AKT-independent phosphorylation and inhibition of GSK3β as a mechanism of drug resistance in GAGA6-R cells. Treatment of GAGA6-R cells with protein kinase C (PKC) inhibitor H7 in combination with AZD4547 led to dephosphorylation and activation of GSK3β with concomitant downregulation of MCL-1 and BCL-XL. Combined treatment with AZD4547 and H7 synergistically enhanced cell death in GAGA6-R but not GAGA6 cells. Furthermore, midostaurin, a multikinase inhibitor with PKC-inhibiting activity, in part reversed resistance of GAGA6-R tumor to AZD4547 Our results suggest that upon challenge with FGFR inhibitors, FGFR2-amplified tumors that are highly dependent on FGFR2 signaling for survival rapidly develop resistance by switching to a PKC-mediated inhibition of GSK3β to gain a survival advantage. .

摘要

缺乏能够可靠预测新型化合物临床活性的弥漫型胃癌(DGC)的临床前模型。为了克服 DGC 中肿瘤细胞含量低的问题,我们使用来自恶性腹水的细胞建立了能够重现原发性癌症的 DGC 患者来源的异种移植(PDX)模型。在扩增的 PDX 模型 GAGA6 中,细胞对正在临床评估用于 FGFR 异常癌症类型的强效 FGFR 抑制剂 AZD4547 敏感。用 AZD4547 间歇性治疗 GAGA6 肿瘤导致获得对 AZD4547 耐药的 PDX 肿瘤,即 GAGA6-R。令人惊讶的是,GAGA6-R 中没有 基因的突变,否定了作为耐药机制的守门突变。FGFR2 及其下游信号分子 AKT/PKB 和 MAPK/ERK 的磷酸化仍然被 AZD4547 抑制。对信号通路的进一步分析确定了 AKT 非依赖性磷酸化和 GSK3β 的抑制是 GAGA6-R 细胞耐药的机制。用蛋白激酶 C(PKC)抑制剂 H7 与 AZD4547 联合处理 GAGA6-R 细胞导致 GSK3β 的去磷酸化和激活,同时下调 MCL-1 和 BCL-XL。AZD4547 和 H7 的联合治疗在 GAGA6-R 但不在 GAGA6 细胞中协同增强细胞死亡。此外,多激酶抑制剂米哚妥林(midostaurin)具有 PKC 抑制活性,部分逆转了 GAGA6-R 肿瘤对 AZD4547 的耐药性。我们的结果表明,在受到 FGFR 抑制剂的挑战后,高度依赖 FGFR2 信号存活的 FGFR2 扩增肿瘤通过切换到 PKC 介导的 GSK3β 抑制来获得生存优势,从而迅速产生耐药性。

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