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黑色素瘤中抗癌药物的遗传和非遗传耐药性的进化可预测性。

Evolutionary predictability of genetic versus nongenetic resistance to anticancer drugs in melanoma.

机构信息

Laboratory for Molecular Cancer Biology, Center for Cancer Biology, VIB, Leuven, Belgium; Laboratory for Molecular Cancer Biology, Department of Oncology, KU Leuven, Leuven, Belgium.

Ronald O. Perelman Department of Dermatology and Department of Pathology, NYU Grossman School of Medicine, New York, NY, USA.

出版信息

Cancer Cell. 2021 Aug 9;39(8):1135-1149.e8. doi: 10.1016/j.ccell.2021.05.015. Epub 2021 Jun 17.

Abstract

Therapy resistance arises from heterogeneous drug-tolerant persister cells or minimal residual disease (MRD) through genetic and nongenetic mechanisms. A key question is whether specific molecular features of the MRD ecosystem determine which of these two distinct trajectories will eventually prevail. We show that, in melanoma exposed to mitogen-activated protein kinase therapeutics, emergence of a transient neural crest stem cell (NCSC) population in MRD concurs with the development of nongenetic resistance. This increase relies on a glial cell line-derived neurotrophic factor-dependent signaling cascade, which activates the AKT survival pathway in a focal adhesion kinase (FAK)-dependent manner. Ablation of the NCSC population through FAK inhibition delays relapse in patient-derived tumor xenografts. Strikingly, all tumors that ultimately escape this treatment exhibit resistance-conferring genetic alterations and increased sensitivity to extracellular signal-regulated kinase inhibition. These findings identify an approach that abrogates the nongenetic resistance trajectory in melanoma and demonstrate that the cellular composition of MRD deterministically imposes distinct drug resistance evolutionary paths.

摘要

耐药性是通过遗传和非遗传机制由异质性药物耐受持久细胞或微小残留疾病(MRD)引起的。一个关键问题是,MRD 生态系统的特定分子特征是否决定了这两种截然不同的轨迹最终将占主导地位。我们表明,在黑色素瘤暴露于丝裂原活化蛋白激酶治疗药物后,MRD 中短暂神经嵴干细胞(NCSC)群体的出现与非遗传耐药的发展一致。这种增加依赖于胶质细胞系衍生的神经营养因子依赖性信号级联,该级联以粘着斑激酶(FAK)依赖性方式激活 AKT 存活途径。通过 FAK 抑制消除 NCSC 群体可延迟患者来源的肿瘤异种移植物的复发。引人注目的是,所有最终逃避这种治疗的肿瘤都表现出赋予耐药性的遗传改变,并增加了对细胞外信号调节激酶抑制的敏感性。这些发现确定了一种方法,可以消除黑色素瘤中的非遗传耐药轨迹,并表明 MRD 的细胞组成确定性地施加了不同的药物耐药进化路径。

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