RB1 活性的药物调节可减轻局部晚期直肠癌对新辅助化疗的耐药性。

Pharmacological modulation of RB1 activity mitigates resistance to neoadjuvant chemotherapy in locally advanced rectal cancer.

机构信息

Department of General Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong 510655, People's Republic of China.

Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong 510060, People's Republic of China.

出版信息

Proc Natl Acad Sci U S A. 2024 Feb 6;121(6):e2304619121. doi: 10.1073/pnas.2304619121. Epub 2024 Jan 30.

Abstract

Resistance to neoadjuvant chemotherapy leads to poor prognosis of locally advanced rectal cancer (LARC), representing an unmet clinical need that demands further exploration of therapeutic strategies to improve clinical outcomes. Here, we identified a noncanonical role of RB1 for modulating chromatin activity that contributes to oxaliplatin resistance in colorectal cancer (CRC). We demonstrate that oxaliplatin induces RB1 phosphorylation, which is associated with the resistance to neoadjuvant oxaliplatin-based chemotherapy in LARC. Inhibition of RB1 phosphorylation by CDK4/6 inhibitor results in vulnerability to oxaliplatin in both intrinsic and acquired chemoresistant CRC. Mechanistically, we show that RB1 modulates chromatin activity through the TEAD4/HDAC1 complex to epigenetically suppress the expression of DNA repair genes. Antagonizing RB1 phosphorylation through CDK4/6 inhibition enforces RB1/TEAD4/HDAC1 repressor activity, leading to DNA repair defects, thus sensitizing oxaliplatin treatment in LARC. Our study identifies a RB1 function in regulating chromatin activity through TEAD4/HDAC1. It also provides the combination of CDK4/6 inhibitor with oxaliplatin as a potential synthetic lethality strategy to mitigate oxaliplatin resistance in LARC, whereby phosphorylated RB1/TEAD4 can serve as potential biomarkers to guide the patient stratification.

摘要

新辅助化疗耐药导致局部晚期直肠癌(LARC)预后不良,这是未满足的临床需求,需要进一步探索治疗策略以改善临床结局。在这里,我们发现 RB1 具有调节染色质活性的非典型作用,有助于结直肠癌(CRC)对奥沙利铂的耐药性。我们证明奥沙利铂诱导 RB1 磷酸化,这与 LARC 中对新辅助奥沙利铂为基础的化疗的耐药性有关。CDK4/6 抑制剂抑制 RB1 磷酸化可导致内在和获得性化疗耐药 CRC 对奥沙利铂敏感。在机制上,我们表明 RB1 通过 TEAD4/HDAC1 复合物调节染色质活性,从而表观遗传地下调 DNA 修复基因的表达。通过 CDK4/6 抑制拮抗 RB1 磷酸化会增强 RB1/TEAD4/HDAC1 抑制物的活性,导致 DNA 修复缺陷,从而使 LARC 中的奥沙利铂治疗更加敏感。我们的研究确定了 RB1 通过 TEAD4/HDAC1 调节染色质活性的功能。它还提供了 CDK4/6 抑制剂与奥沙利铂联合作为减轻 LARC 中奥沙利铂耐药性的潜在合成致死策略,其中磷酸化 RB1/TEAD4 可作为潜在的生物标志物来指导患者分层。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c459/10861914/f9124791ef6a/pnas.2304619121fig01.jpg

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