The Department of Tumor Biology, The Moffitt Cancer Center & Research Institute, Tampa, Florida.
Bascom Palmer Eye Institute, Sylvester Comprehensive Cancer Center and Interdisciplinary Stem Cell Institute, University of Miami Miller School of Medicine, Miami, Florida.
Clin Cancer Res. 2019 Sep 15;25(18):5686-5701. doi: 10.1158/1078-0432.CCR-18-3382. Epub 2019 Jun 21.
PURPOSE: The clinical use of MEK inhibitors in uveal melanoma is limited by the rapid acquisition of resistance. This study has used multiomics approaches and drug screens to identify the pan-HDAC inhibitor panobinostat as an effective strategy to limit MEK inhibitor resistance. Mass spectrometry-based proteomics and RNA-Seq were used to identify the signaling pathways involved in the escape of uveal melanoma cells from MEK inhibitor therapy. Mechanistic studies were performed to evaluate the escape pathways identified, and the efficacy of the MEK-HDAC inhibitor combination was demonstrated in multiple models of uveal melanoma. RESULTS: We identified a number of putative escape pathways that were upregulated following MEK inhibition, including the PI3K/AKT pathway, ROR1/2, and IGF-1R signaling. MEK inhibition was also associated with increased GPCR expression, particularly the endothelin B receptor, and this contributed to therapeutic escape through ET-3-mediated YAP signaling. A screen of 289 clinical grade compounds identified HDAC inhibitors as potential candidates that suppressed the adaptive YAP and AKT signaling that followed MEK inhibition. , the MEK-HDAC inhibitor combination outperformed either agent alone, leading to a long-term decrease of tumor growth in both subcutaneous and liver metastasis models and the suppression of adaptive PI3K/AKT and YAP signaling. CONCLUSIONS: Together, our studies have identified GPCR-mediated YAP activation and RTK-driven AKT signaling as key pathways involved in the escape of uveal melanoma cells from MEK inhibition. We further demonstrate that HDAC inhibition is a promising combination partner for MEK inhibitors in advanced uveal melanoma.
目的:MEK 抑制剂在葡萄膜黑色素瘤中的临床应用受到耐药性快速获得的限制。本研究采用多组学方法和药物筛选,确定泛组蛋白去乙酰化酶抑制剂帕比司他作为一种有效策略,以限制 MEK 抑制剂耐药。基于质谱的蛋白质组学和 RNA-Seq 用于鉴定与葡萄膜黑色素瘤细胞逃避 MEK 抑制剂治疗相关的信号通路。进行了机制研究以评估鉴定的逃逸途径,并在多种葡萄膜黑色素瘤模型中证明了 MEK-HDAC 抑制剂联合的疗效。
结果:我们鉴定了许多假定的逃逸途径,这些途径在 MEK 抑制后上调,包括 PI3K/AKT 通路、ROR1/2 和 IGF-1R 信号。MEK 抑制还与 GPCR 表达增加有关,特别是内皮素 B 受体,这通过 ET-3 介导的 YAP 信号导致治疗逃逸。对 289 种临床级化合物的筛选确定了组蛋白去乙酰化酶抑制剂作为潜在的候选药物,可抑制 MEK 抑制后适应性 YAP 和 AKT 信号。该研究表明,MEK-HDAC 抑制剂联合治疗优于单独使用任何一种药物,导致皮下和肝转移模型中的肿瘤生长长期减少,并抑制适应性 PI3K/AKT 和 YAP 信号。
结论:总之,我们的研究鉴定了 GPCR 介导的 YAP 激活和 RTK 驱动的 AKT 信号作为葡萄膜黑色素瘤细胞逃避 MEK 抑制的关键途径。我们进一步证明,组蛋白去乙酰化酶抑制是晚期葡萄膜黑色素瘤中 MEK 抑制剂的有前途的联合治疗伙伴。
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