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Gaggianesi M, Mangiapane LR, Modica C, Pantina VD, Porcelli G, Di Franco S, Lo Iacono M, D’Accardo C, Verona F, Pillitteri I, Turdo A, Veschi V, Brancato OR, Muratore G, Pistone G, Bongiorno MR, Todaro M, De Maria R, Stassi G. Dual Inhibition of Myc Transcription and PI3K Activity Effectively Targets Colorectal Cancer Stem Cells. Cancers (Basel) 2022; 14:cancers14030673. [PMID: 35158939 PMCID: PMC8833549 DOI: 10.3390/cancers14030673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Revised: 12/16/2021] [Accepted: 01/25/2022] [Indexed: 12/04/2022] Open
Abstract
Simple Summary Compelling evidence has shown that cancer stem cells (CSCs) are responsible for high resistance to conventional anti-cancer therapies. Here, we demonstrate that the tumor microenvironment protects CR-CSCs from EGFR/HER2, BRAF and PI3K targeting, promoting CD44v6 and Myc expression. Alternatively, as a substitution for HER2 and BRAF, the Myc transcription inhibitor can overcome the protective effects of microenvironmental cytokines, impairing the survival of CR-CSCs. These data highlight the targeting of Myc and PI3K activity as a novel therapeutic strategy against advanced colorectal cancer. Abstract Despite advances in the curative approach, the survival rate of advanced colorectal cancer (CRC) patients is still poor, which is likely due to the emergence of cancer cell clones resistant to the available therapeutic options. We have already shown that CD44v6-positive CRC stem cells (CR-CSCs) are refractory toward standard anti-tumor therapeutic agents due to the activation of the PI3K pathway together with high HER2 expression levels. Tumor microenvironmental cytokines confer resistance to CR-CSCs against HER2/PI3K targeting by enhancing activation of the MAPK pathway. Here, we show that the CSC compartment, spared by BRAF inhibitor-based targeted therapy, is associated with increased expression levels of CD44v6 and Myc and retains boosted clonogenic activity along with residual tumorigenic potential. Inhibition of Myc transcription, downstream of the MAPK cascade components, and PI3K pathway activity was able to overcome the protective effects of microenvironmental cytokines, affecting the survival and the clonogenic activity of CR-CSCs, regardless of their mutational background. Likewise, the double targeting induced stabilization of mouse tumor avatars. Altogether, these data outline the rationale for dual kinase targeting of CR-CSCs to prevent their adaptive response, which would lead to disease progression.
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Affiliation(s)
- Miriam Gaggianesi
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Laura Rosa Mangiapane
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Chiara Modica
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Vincenzo Davide Pantina
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Gaetana Porcelli
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Simone Di Franco
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Melania Lo Iacono
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Caterina D’Accardo
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Francesco Verona
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Irene Pillitteri
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Alice Turdo
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Veronica Veschi
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Ornella Roberta Brancato
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Giampaolo Muratore
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
| | - Giuseppe Pistone
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Maria Rita Bongiorno
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Matilde Todaro
- Department of Health Promotion Sciences, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy; (L.R.M.); (G.P.); (C.D.); (F.V.); (A.T.); (G.P.); (M.R.B.); (M.T.)
| | - Ruggero De Maria
- Dipartimento di Medicina e Chirurgia Traslazionale, Facoltà di Medicina e Chirurgia, Università Cattolica del Sacro Cuore, 00168 Roma, Italy
- Fondazione Policlinico A Gemelli IRCCS, 00168 Roma, Italy
- Correspondence: (R.D.M.); (G.S.); Tel.: +39-06-3015-4914 (R.D.M.); +39-091-2389-0813 (G.S.)
| | - Giorgio Stassi
- Department of Surgical, Oncological and Stomatological Sciences (DICHIRONS), University of Palermo, 90127 Palermo, Italy; (M.G.); (C.M.); (V.D.P.); (S.D.F.); (M.L.I.); (I.P.); (V.V.); (O.R.B.); (G.M.)
- Correspondence: (R.D.M.); (G.S.); Tel.: +39-06-3015-4914 (R.D.M.); +39-091-2389-0813 (G.S.)
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