MEK 抑制在甲状腺未分化癌的小鼠模型中诱导治疗性碘摄取。

MEK Inhibition Induces Therapeutic Iodine Uptake in a Murine Model of Anaplastic Thyroid Cancer.

机构信息

Institute for Biochemistry and Molecular Medicine, University of Bern, Bern, Switzerland.

Institute for Nuclear Medicine, Geneva University Hospitals, Geneva, Switzerland.

出版信息

J Nucl Med. 2019 Jul;60(7):917-923. doi: 10.2967/jnumed.118.216721. Epub 2018 Nov 21.

Abstract

Anaplastic thyroid carcinoma (ATC) is refractory to radioiodine therapy in part because of impaired iodine metabolism. We targeted the mitogen-activated protein kinase and phosphatidylinositol 3-kinase (PI3'K) pathways with the intent to induce radioiodine uptake for radioiodine treatment of ATC. Human ATC cells were used to evaluate the ability of pharmacologic inhibition of the mitogen-activated protein kinase and PI3'K pathways to induce radioiodine uptake. Thyrocyte-specific double-mutant BRAF PIK3CA mice were treated with a MEK inhibitor followed by radioiodine treatment, and tumor burden was monitored by ultrasound imaging. ATC cell lines showed an increase in sodium-iodine symporter transcription when treated with a MEK or BRAF inhibitor alone and in combination with PI3'K inhibitor. This translated into a dose-dependent elevation of iodine uptake after treatment with a MEK inhibitor alone and in combination with a PI3'K inhibitor. In vivo, MEK inhibition but not BRAF or PI3'K inhibition upregulated sodium-iodine symporter transcription. This translated into a stable reduction of tumor burden when mice were treated with a MEK inhibitor before radioiodine administration. This study confirms the ability of MEK inhibition to induce iodine uptake in in vitro and in vivo models of ATC. The approach of using a MEK inhibitor before radioiodine treatment could readily be translated into clinical practice and provide a much-needed therapeutic option for patients with ATC.

摘要

间变性甲状腺癌(ATC)对放射性碘治疗具有抗性,部分原因是碘代谢受损。我们靶向丝裂原活化蛋白激酶和磷脂酰肌醇 3-激酶(PI3'K)途径,意图诱导放射性碘摄取,用于 ATC 的放射性碘治疗。用人 ATC 细胞评估药物抑制丝裂原活化蛋白激酶和 PI3'K 途径诱导放射性碘摄取的能力。用 MEK 抑制剂治疗甲状腺细胞特异性双突变 BRAF PIK3CA 小鼠,然后进行放射性碘治疗,并通过超声成像监测肿瘤负担。当单独使用 MEK 或 BRAF 抑制剂以及与 PI3'K 抑制剂联合治疗时,ATC 细胞系的钠碘同向转运体转录增加。这转化为在用 MEK 抑制剂单独治疗以及与 PI3'K 抑制剂联合治疗后碘摄取的剂量依赖性增加。在体内,MEK 抑制而非 BRAF 或 PI3'K 抑制上调了钠碘同向转运体转录。当在用放射性碘治疗前用 MEK 抑制剂治疗小鼠时,这转化为肿瘤负担的稳定减少。这项研究证实了 MEK 抑制在 ATC 的体外和体内模型中诱导碘摄取的能力。在放射性碘治疗前使用 MEK 抑制剂的方法可以很容易地转化为临床实践,并为 ATC 患者提供急需的治疗选择。

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