Division of Biotechnology Review and Research 1, Office of Biotechnology Products, Office of Pharmaceutical Quality, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD, USA.
Division of Animal Bioengineering and Cellular Therapies, Office of New Animal Drug Evaluation, Center for Veterinary Medicine, U.S. Food and Drug Administration, Rockville, MD, USA.
Cell Cycle. 2024 Jan;23(1):43-55. doi: 10.1080/15384101.2024.2306760. Epub 2024 Jan 23.
Sunitinib resistance creates a major clinical challenge for the treatment of advanced clear cell renal cell carcinoma (ccRCC) and functional and metabolic changes linked to sunitinib resistance are not fully understood. We sought to characterize the molecular and metabolic changes induced by the development of sunitinib resistance in ccRCC by developing and characterizing two human ccRCC cell lines resistant to sunitinib. Consistent with the literature, sunitinib-resistant ccRCC cell lines presented an aberrant overexpression of Axl and PD-L1, as well as a metabolic rewiring characterized by enhanced OXPHOS and glutamine metabolism. Therapeutic challenges of sunitinib-resistant ccRCC cell lines in vitro using small molecule inhibitors targeting Axl, AMPK and p38, as well as using PD-L1 blocking therapeutic antibodies, showed limited CTL-mediated cytotoxicity in a co-culture model. However, the AMPK activator metformin appears to sensitize the effect of PD-L1 blocking therapeutic antibodies and to enhance CTLs' cytotoxic effects on ccRCC cells. These effects were not broadly observed with the Axl and the p38 inhibitors. Taken together, these data suggest that targeting certain pathways aberrantly activated by sunitinib resistance such as the AMPK/PDL1 axis might sensitize ccRCC to immunotherapies as a second-line therapeutic approach.
舒尼替尼耐药性给晚期透明细胞肾细胞癌(ccRCC)的治疗带来了重大的临床挑战,而与舒尼替尼耐药相关的功能和代谢变化尚不完全清楚。我们通过开发和鉴定两种对舒尼替尼耐药的人 ccRCC 细胞系,试图阐明舒尼替尼耐药诱导的分子和代谢变化。与文献一致的是,舒尼替尼耐药的 ccRCC 细胞系表现出 Axl 和 PD-L1 的异常过表达,以及代谢重编程,表现为增强的 OXPHOS 和谷氨酰胺代谢。在体外使用针对 Axl、AMPK 和 p38 的小分子抑制剂以及使用 PD-L1 阻断治疗性抗体对舒尼替尼耐药的 ccRCC 细胞系进行治疗的挑战表明,在共培养模型中,CTL 介导的细胞毒性有限。然而,AMPK 激活剂二甲双胍似乎能增强 PD-L1 阻断治疗性抗体的效果,并增强 CTL 对 ccRCC 细胞的细胞毒性作用。这些效果在 Axl 和 p38 抑制剂中并没有广泛观察到。综上所述,这些数据表明,针对舒尼替尼耐药性异常激活的某些途径,如 AMPK/PDL1 轴,可能会使 ccRCC 对免疫疗法敏感,作为二线治疗方法。