Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts.
Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.
Cancer Discov. 2018 Jan;8(1):59-73. doi: 10.1158/2159-8290.CD-17-0461. Epub 2017 Oct 20.
Acquired drug resistance is a major factor limiting the effectiveness of targeted cancer therapies. Targeting tumors with kinase inhibitors induces complex adaptive programs that promote the persistence of a fraction of the original cell population, facilitating the eventual outgrowth of inhibitor-resistant tumor clones. We show that the addition of a newly identified CDK7/12 inhibitor, THZ1, to targeted therapy enhances cell killing and impedes the emergence of drug-resistant cell populations in diverse cellular and cancer models. We propose that targeted therapy induces a state of transcriptional dependency in a subpopulation of cells poised to become drug tolerant, which THZ1 can exploit by blocking dynamic transcriptional responses, promoting remodeling of enhancers and key signaling outputs required for tumor cell survival in the setting of targeted therapy. These findings suggest that the addition of THZ1 to targeted therapies is a promising broad-based strategy to hinder the emergence of drug-resistant cancer cell populations. CDK7/12 inhibition prevents active enhancer formation at genes, promoting resistance emergence in response to targeted therapy, and impedes the engagement of transcriptional programs required for tumor cell survival. CDK7/12 inhibition in combination with targeted cancer therapies may serve as a therapeutic paradigm for enhancing the effectiveness of targeted therapies. .
获得性耐药是限制靶向癌症疗法有效性的主要因素。用激酶抑制剂靶向肿瘤会诱导复杂的适应性程序,促进原始细胞群体的一部分持续存在,从而促进抑制剂耐药肿瘤克隆的最终生长。我们表明,将新鉴定的 CDK7/12 抑制剂 THZ1 添加到靶向治疗中,可增强细胞杀伤作用,并阻止在各种细胞和癌症模型中出现耐药细胞群体。我们提出,靶向治疗诱导了一组准备对药物产生耐受性的细胞的转录依赖性状态,THZ1 可以通过阻断动态转录反应、促进增强子重塑以及在靶向治疗环境中促进肿瘤细胞存活所需的关键信号输出来利用这种状态。这些发现表明,将 THZ1 添加到靶向治疗中是一种很有前途的广泛策略,可以阻止耐药性癌细胞群体的出现。CDK7/12 抑制阻止了基因上活性增强子的形成,促进了对靶向治疗的耐药性出现,并阻碍了肿瘤细胞存活所需的转录程序的参与。CDK7/12 抑制与靶向癌症疗法联合使用可能成为增强靶向疗法有效性的治疗范例。