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Chen Y, Sun H, Deng Y, Ma Y, Huang H, Liu Y, Zhang Y, Zhang H, Ye S, E M, Guo H, Wu M, Wu C, Pu X, Chen X, Liang C, Ou Q, Weng H, Wu X, Shao Y, Gu A, Lin T. The clinical and genomic distinctions of Class1/2/3 BRAF-mutant colorectal cancer and differential prognoses. Biomark Res 2023; 11:11. [PMID: 36694231 PMCID: PMC9875443 DOI: 10.1186/s40364-022-00443-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 12/15/2022] [Indexed: 01/26/2023] Open
Abstract
BRAF mutations are the oncogenic drivers in colorectal cancer and V600 mutations (Class1), which lead to RAS-independent active monomers, are the most common mutation types. BRAF non-V600 mutants can be further classified as RAS-independent active dimers (Class2) and RAS-dependent impaired kinase (Class3). We retrospectively reviewed the mutational profiles of 328 treatment-naïve colorectal tumors with BRAF mutations detected using capture-based hybrid next-generation sequencing targeting 400 + cancer-related genes. The clinical and genetic distinctions of patients harboring Class1/2/3 BRAF mutations were investigated, which revealed that tumors with Class1 BRAF mutations showed more unique genomic profiles than those with Class2/3 mutations. Also, by using an external dataset from cBioPortal, we demonstrated that patients with Class3 BRAF mutations had the best survival outcomes compared to the other two subgroups. These findings promoted the development of anti-BRAF strategies by distinguishing BRAF mutant subgroups.
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Affiliation(s)
- Yungchang Chen
- grid.54549.390000 0004 0369 4060Department of Medical Oncology, Sichuan Cancer Center, School of Medicine, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Sichuan 610041 Chengdu, China
| | - Hao Sun
- grid.190737.b0000 0001 0154 0904Department of Gastrointestinal Cancer Center, Chongqing University Cancer Hospital, 400030 Chongqing, China
| | - Yanhong Deng
- grid.488525.6Department of Medical Oncology, The Sixth Affiliated Hospital of Sun Yat-sen University, 510655 Guangzhou, China
| | - Yutong Ma
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China
| | - He Huang
- grid.488530.20000 0004 1803 6191Department of Medical Oncology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, 510060 Guangzhou, China
| | - Yang Liu
- grid.54549.390000 0004 0369 4060Department of Pathology, Sichuan Cancer Center, School of Medicine, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, 610041 Chengdu, China
| | - Yaru Zhang
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China
| | - Hongyu Zhang
- grid.452859.70000 0004 6006 3273Department of Medical Oncology, The Fifth Affiliated Hospital of Sun Yat-sen University, 519000 Zhuhai, China
| | - Sheng Ye
- grid.412615.50000 0004 1803 6239Department of Medical Oncology, The First Affiliated Hospital of Sun Yat-sen University, 510080 Guangzhou, China
| | - Mingyan E
- grid.412651.50000 0004 1808 3502Department of Radiation Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, 150040 Harbin, Heilongjiang China
| | - Hongqiang Guo
- grid.414008.90000 0004 1799 4638Department of Medical Oncology, The Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, 450008 Zhengzhou, China
| | - Mengmeng Wu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China
| | - Chunman Wu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China
| | - Xingxiang Pu
- grid.216417.70000 0001 0379 7164Department of Thoracic Medical Oncology, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, 283 Tongzipo Road, Yuelu District, 410013 Changsha, China
| | - Xinggui Chen
- grid.410560.60000 0004 1760 3078Department of Medical Oncology, Cancer Center, Affiliated Hospital of Guangdong Medical University, 524023 Zhanjiang, China
| | - Chaoyong Liang
- grid.256607.00000 0004 1798 2653Department of Medical Oncology, Guangxi Medical University Cancer Hospital, 530021 Nanning, China
| | - Qiuxiang Ou
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China
| | - Huawei Weng
- grid.488530.20000 0004 1803 6191Department of Medical Oncology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, 510060 Guangzhou, China
| | - Xue Wu
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China
| | - Yang Shao
- Geneseeq Research Institute, Nanjing Geneseeq Technology Inc, 210000 Nanjing, China ,grid.89957.3a0000 0000 9255 8984School of Public Health, Nanjing Medical University, 211166 Nanjing, China
| | - Anxin Gu
- grid.412651.50000 0004 1808 3502Department of Radiation Oncology, Harbin Medical University Cancer Hospital, 150 Haping Road, Nangang District, 150040 Harbin, Heilongjiang China
| | - Tongyu Lin
- grid.54549.390000 0004 0369 4060Department of Medical Oncology, Sichuan Cancer Center, School of Medicine, Sichuan Cancer Hospital and Institute, University of Electronic Science and Technology of China, No. 55, Section 4, South Renmin Road, Sichuan 610041 Chengdu, China ,grid.488530.20000 0004 1803 6191Department of Medical Oncology, State Key Laboratory of Oncology in Southern China, Collaborative Innovation Center of Cancer Medicine, Sun Yat-sen University Cancer Center, 510060 Guangzhou, China
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Extrinsic interactions in the microenvironment in vivo activate an antiapoptotic multidrug-resistant phenotype in CLL. Blood Adv 2021; 5:3497-3510. [PMID: 34432864 DOI: 10.1182/bloodadvances.2020003944] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 04/06/2021] [Indexed: 12/17/2022] Open
Abstract
The Bcl-2 inhibitor venetoclax has yielded exceptional clinical responses in chronic lymphocytic leukemia (CLL). However, de novo resistance can result in failure to achieve negative minimal residual disease and predicts poor treatment outcomes. Consequently, additional proapoptotic drugs, such as inhibitors of Mcl-1 and Bcl-xL, are in development. By profiling antiapoptotic proteins using flow cytometry, we find that leukemic B cells that recently emigrated from the lymph node (CD69+/CXCR4Low) in vivo are enriched for cell clusters simultaneously overexpressing multiple antiapoptotic proteins (Mcl-1High/Bcl-xLHigh/Bcl-2High) in both treated and treatment-naive CLL patients. These cells exhibited antiapoptotic resistance to multiple BH-domain antagonists, including inhibitors of Bcl-2, Mcl-1, and Bcl-xL, when tested as single agents in a flow cytometry-based functional assay. Antiapoptotic multidrug resistance declines ex vivo, consistent with resistance being generated in vivo by extrinsic microenvironmental interactions. Surviving "persister" cells in patients undergoing venetoclax treatment are enriched for CLL cells displaying the functional and molecular properties of microenvironmentally induced multidrug resistance. Overcoming this resistance required simultaneous inhibition of multiple antiapoptotic proteins, with potential for unwanted toxicities. Using a drug screen performed using patient peripheral blood mononuclear cells cultured in an ex vivo microenvironment model, we identify novel venetoclax drug combinations that induce selective cytotoxicity in multidrug-resistant CLL cells. Thus, we demonstrate that antiapoptotic multidrug-resistant CLL cells exist in patients de novo and show that these cells persist during proapoptotic treatment, such as venetoclax. We validate clinically actionable approaches to selectively deplete this reservoir in patients.
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3
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Validation of a multicellular tumor microenvironment system for modeling patient tumor biology and drug response. Sci Rep 2021; 11:5535. [PMID: 33692370 PMCID: PMC7946945 DOI: 10.1038/s41598-021-84612-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/09/2021] [Indexed: 02/06/2023] Open
Abstract
Lung cancer rates are rising globally and non-small cell lung cancer (NSCLC) has a five year survival rate of only 24%. Unfortunately, the development of drugs to treat cancer is severely hampered by the inefficiency of translating pre-clinical studies into clinical benefit. Thus, we sought to apply a tumor microenvironment system (TMES) to NSCLC. Using microvascular endothelial cells, lung cancer derived fibroblasts, and NSCLC tumor cells in the presence of in vivo tumor-derived hemodynamic flow and transport, we demonstrate that the TMES generates an in-vivo like biological state and predicts drug response to EGFR inhibitors. Transcriptomic and proteomic profiling indicate that the TMES recapitulates the in vivo and patient molecular biological state providing a mechanistic rationale for the predictive nature of the TMES. This work further validates the TMES for modeling patient tumor biology and drug response indicating utility of the TMES as a predictive tool for drug discovery and development and potential for use as a system for patient avatars.
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4
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Babiker HM, Byron SA, Hendricks WPD, Elmquist WF, Gampa G, Vondrak J, Aldrich J, Cuyugan L, Adkins J, De Luca V, Tibes R, Borad MJ, Marceau K, Myers TJ, Paradiso LJ, Liang WS, Korn RL, Cridebring D, Von Hoff DD, Carpten JD, Craig DW, Trent JM, Gordon MS. E6201, an intravenous MEK1 inhibitor, achieves an exceptional response in BRAF V600E-mutated metastatic malignant melanoma with brain metastases. Invest New Drugs 2018; 37:636-645. [PMID: 30264293 DOI: 10.1007/s10637-018-0668-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 09/14/2018] [Indexed: 12/16/2022]
Abstract
Malignant melanoma (MM) exhibits a high propensity for central nervous system dissemination with ~50% of metastatic MM patients developing brain metastases (BM). Targeted therapies and immune checkpoint inhibitors have improved overall survival for MM patients with BM. However, responses are usually of short duration and new agents that effectively penetrate the blood brain barrier (BBB) are needed. Here, we report a MM patient with BM who experienced an exceptional response to E6201, an ATP-competitive MEK1 inhibitor, on a Phase 1 study, with ongoing near-complete response and overall survival extending beyond 8 years. Whole exome and transcriptome sequencing revealed a high mutational burden tumor (22 mutations/Megabase) with homozygous BRAF V600E mutation. Correlative preclinical studies demonstrated broad activity for E6201 across BRAF V600E mutant melanoma cell lines and effective BBB penetration in vivo. Together, these results suggest that E6201 may represent a potential new treatment option for BRAF-mutant MM patients with BM.
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Affiliation(s)
- Hani M Babiker
- Early Phase Clinical Trials Program, University of Arizona Cancer Center, 1515 N. Campbell Ave, Tucson, AZ, 85724, USA.
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA.
- Honor Health Research Institute, 10510 N. 92nd Street, #200, Scottsdale, AZ, 85258, USA.
| | - Sara A Byron
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - William P D Hendricks
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - William F Elmquist
- Department of Pharmaceutics, University of Minnesota, 308 SE Harvard Street, Minneapolis, MN, 55455, USA
| | - Gautham Gampa
- Department of Pharmaceutics, University of Minnesota, 308 SE Harvard Street, Minneapolis, MN, 55455, USA
| | - Jessica Vondrak
- Early Phase Clinical Trials Program, University of Arizona Cancer Center, 1515 N. Campbell Ave, Tucson, AZ, 85724, USA
| | - Jessica Aldrich
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Lori Cuyugan
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Jonathan Adkins
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Valerie De Luca
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
- Arizona State University, 427 E. Tyler Mall #320, Tempe, AZ, 85281, USA
| | - Raoul Tibes
- Honor Health Research Institute, 10510 N. 92nd Street, #200, Scottsdale, AZ, 85258, USA
| | - Mitesh J Borad
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
- Mayo Clinic, 13400 E. Shea Blvd., Scottsdale, AZ, 85259, USA
| | - Katie Marceau
- Honor Health Research Institute, 10510 N. 92nd Street, #200, Scottsdale, AZ, 85258, USA
| | - Thomas J Myers
- Spirita Oncology, LLC, 2450 Holcombe Blvd., Suite J, Houston, TX, 77021, USA
| | - Linda J Paradiso
- Spirita Oncology, LLC, 2450 Holcombe Blvd., Suite J, Houston, TX, 77021, USA
| | - Winnie S Liang
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Ronald L Korn
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
- Honor Health Research Institute, 10510 N. 92nd Street, #200, Scottsdale, AZ, 85258, USA
- Imaging Endpoints, 9700 N. 91st St, STE B-200, Scottsdale, AZ, 85258, USA
| | - Derek Cridebring
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Daniel D Von Hoff
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
- Honor Health Research Institute, 10510 N. 92nd Street, #200, Scottsdale, AZ, 85258, USA
| | - John D Carpten
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - David W Craig
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Jeffrey M Trent
- Translational Genomics Research Institute, 445 N. Fifth Street, Phoenix, AZ, 85004, USA
| | - Michael S Gordon
- Honor Health Research Institute, 10510 N. 92nd Street, #200, Scottsdale, AZ, 85258, USA
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5
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Jayappa KD, Portell CA, Gordon VL, Capaldo BJ, Bekiranov S, Axelrod MJ, Brett LK, Wulfkuhle JD, Gallagher RI, Petricoin EF, Bender TP, Williams ME, Weber MJ. Microenvironmental agonists generate de novo phenotypic resistance to combined ibrutinib plus venetoclax in CLL and MCL. Blood Adv 2017; 1:933-946. [PMID: 29034364 PMCID: PMC5637393 DOI: 10.1182/bloodadvances.2016004176] [Citation(s) in RCA: 67] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/10/2017] [Indexed: 12/15/2022] Open
Abstract
De novo resistance and rapid recurrence often characterize responses of B-cell malignancies to ibrutinib (IBR), indicating a need to develop drug combinations that block compensatory survival signaling and give deeper, more durable responses. To identify such combinations, we previously performed a combinatorial drug screen and identified the Bcl-2 inhibitor venetoclax (VEN) as a promising partner for combination with IBR in Mantle Cell Lymphoma (MCL). We have opened a multi-institutional clinical trial to test this combination. However, analysis of primary samples from patients with MCL as well as chronic lymphocytic leukemia (CLL) revealed unexpected heterogeneous de novo resistance even to the IBR+VEN combination. In the current study, we demonstrate that resistance to the combination can be generated by microenvironmental agonists: IL-10, CD40L and, most potently, CpG-oligodeoxynucleotides (CpG-ODN), which is a surrogate for unmethylated DNA and a specific agonist for TLR9 signaling. Incubation with these agonists caused robust activation of NF-κB signaling, especially alternative NF-κB, which led to enhanced expression of the anti-apoptotic proteins Mcl-1, Bcl-xL, and survivin, thus decreasing dependence on Bcl-2. Inhibitors of NF-κB signaling blocked overexpression of these anti-apoptotic proteins and overcame resistance. Inhibitors of Mcl-1, Bcl-xL, or survivin also overcame this resistance, and showed synergistic benefit with the IBR+VEN combination. We conclude that microenvironmental factors, particularly the TLR9 agonist, can generate de novo resistance to the IBR+VEN combination in CLL and MCL cells. This signaling pathway presents targets for overcoming drug resistance induced by extrinsic microenvironmental factors in diverse B-cell malignancies.
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Affiliation(s)
- Kallesh D Jayappa
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Craig A Portell
- Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Cancer Center, University of Virginia, Charlottesville, VA, United States
| | - Vicki L Gordon
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, United States
| | - Brian J Capaldo
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA, United States
| | - Stefan Bekiranov
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA, United States
| | - Mark J Axelrod
- Gilead Sciences, 199 E. Blaine St., Seattle, WA, United States
| | - L Kyle Brett
- Utica Park Clinic, Medical Oncology, 1245 S Utica Ave Suite #100, Tulsa, OK, United States
| | - Julia D Wulfkuhle
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, United States
| | - Rosa I Gallagher
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, United States
| | - Emanuel F Petricoin
- Center for Applied Proteomics and Molecular Medicine, George Mason University, Manassas, VA, United States
| | - Timothy P Bender
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Beirne B. Carter Center for Immunology Research, Charlottesville, VA, United States
| | - Michael E Williams
- Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Cancer Center, University of Virginia, Charlottesville, VA, United States
| | - Michael J Weber
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, VA, United States
- Cancer Center, University of Virginia, Charlottesville, VA, United States
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6
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de Langen AJ, Smit EF. Therapeutic approach to treating patients with BRAF-mutant lung cancer: latest evidence and clinical implications. Ther Adv Med Oncol 2016; 9:46-58. [PMID: 28203297 DOI: 10.1177/1758834016670555] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Lung adenocarcinoma is known for its high rate of somatic mutations and genomic rearrangements. The identification of epidermal growth factor receptor (EGFR) mutations and anaplastic lymphoma kinase (ALK) rearrangements that sensitize tumors to specific drugs has changed the therapeutic approach and prognosis in these molecularly-defined subgroups. Several other key genetic alterations have been identified, of which BRAF mutations are found in 4% of non-small cell lung cancer (NSCLC) cases. Targeted drugs against BRAF and downstream MEK were recently approved for the treatment of BRAF-positive melanoma and have entered clinical evaluation in NSCLC. In this review we discuss the latest evidence on the treatment of BRAF-mutated NSCLC, including tumor biology, targeted treatment with BRAF and MEK inhibitors, therapeutic resistance and strategies to overcome resistance.
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Affiliation(s)
- Adrianus J de Langen
- Department of Pulmonary Diseases, VU University Medical Center, De Boelelaan 1117, 1007 MB Amsterdam, The Netherlands
| | - Egbert F Smit
- Department of Pulmonary Diseases, VU University Medical Center, and Department of Thoracic Oncology, Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
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7
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Turski ML, Vidwans SJ, Janku F, Garrido-Laguna I, Munoz J, Schwab R, Subbiah V, Rodon J, Kurzrock R. Genomically Driven Tumors and Actionability across Histologies: BRAF-Mutant Cancers as a Paradigm. Mol Cancer Ther 2016; 15:533-47. [PMID: 27009213 DOI: 10.1158/1535-7163.mct-15-0643] [Citation(s) in RCA: 52] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 01/04/2016] [Indexed: 11/16/2022]
Abstract
The diagnosis, classification, and management of cancer are traditionally dictated by the site of tumor origin, for example, breast or lung, and by specific histologic subtypes of site-of-origin cancers (e.g., non-small cell versus small cell lung cancer). However, with the advent of sequencing technologies allowing for rapid, low cost, and accurate sequencing of clinical samples, new observations suggest an expanded or different approach to the diagnosis and treatment of cancer-one driven by the unique molecular features of the tumor. We discuss a genomically driven strategy for cancer treatment using BRAF as an example. Several key points are highlighted: (i) molecular aberrations can be shared across cancers; (ii) approximately 15% of all cancers harbor BRAF mutations; and (iii) BRAF inhibitors, while approved only for melanoma, have reported activity across numerous cancers and related disease types bearing BRAF aberrations. However, BRAF-mutated colorectal cancer has shown poor response rate to BRAF inhibitor monotherapy, striking a cautionary note. Yet, even in this case, emerging data suggest BRAF-mutated colorectal cancers can respond well to BRAF inhibitors, albeit when administered in combination with other agents that impact resistance pathways. Taken together, these data suggest that molecular aberrations may be the basis for a new nosology for cancer. Mol Cancer Ther; 15(4); 533-47. ©2016 AACR.
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Affiliation(s)
| | | | - Filip Janku
- Department of Investigational Cancer Therapeutics - a Phase I Clinical Trials Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Javier Munoz
- Banner MD Anderson Cancer Center, Gilbert, Arizona
| | - Richard Schwab
- Center for Personalized Cancer Therapy, Moores Cancer Center, University of California, San Diego, California
| | - Vivek Subbiah
- Department of Investigational Cancer Therapeutics - a Phase I Clinical Trials Program, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jordi Rodon
- Vall d'Hebron Institut d'Oncologia and Universitat Autonoma of Barcelona, Barcelona, Spain
| | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, Moores Cancer Center, University of California, San Diego, California.
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8
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Roller DG, Capaldo B, Bekiranov S, Mackey AJ, Conaway MR, Petricoin EF, Gioeli D, Weber MJ. Combinatorial drug screening and molecular profiling reveal diverse mechanisms of intrinsic and adaptive resistance to BRAF inhibition in V600E BRAF mutant melanomas. Oncotarget 2016; 7:2734-53. [PMID: 26673621 PMCID: PMC4823068 DOI: 10.18632/oncotarget.6548] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2015] [Accepted: 11/21/2015] [Indexed: 12/28/2022] Open
Abstract
Over half of BRAFV600E melanomas display intrinsic resistance to BRAF inhibitors, in part due to adaptive signaling responses. In this communication we ask whether BRAFV600E melanomas share common adaptive responses to BRAF inhibition that can provide clinically relevant targets for drug combinations. We screened a panel of 12 treatment-naïve BRAFV600E melanoma cell lines with MAP Kinase pathway inhibitors in pairwise combination with 58 signaling inhibitors, assaying for synergistic cytotoxicity. We found enormous diversity in the drug combinations that showed synergy, with no two cell lines having an identical profile. Although the 6 lines most resistant to BRAF inhibition showed synergistic benefit from combination with lapatinib, the signaling mechanisms by which this combination generated synergistic cytotoxicity differed between the cell lines. We conclude that adaptive responses to inhibition of the primary oncogenic driver (BRAFV600E) are determined not only by the primary oncogenic driver but also by diverse secondary genetic and epigenetic changes ("back-seat drivers") and hence optimal drug combinations will be variable. Because upregulation of receptor tyrosine kinases is a major source of drug resistance arising from diverse adaptive responses, we propose that inhibitors of these receptors may have substantial clinical utility in combination with inhibitors of the MAP Kinase pathway.
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Affiliation(s)
- Devin G. Roller
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, 22908 USA
| | - Brian Capaldo
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA, 22908 USA
| | - Stefan Bekiranov
- Department of Biochemistry and Molecular Genetics, University of Virginia, Charlottesville, VA, 22908 USA
| | - Aaron J. Mackey
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22908 USA
| | - Mark R. Conaway
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, 22908 USA
| | - Emanuel F. Petricoin
- Center for Applied Proteomics and Molecular Medicine, School of Systems Biology, College of Science, George Mason University, Manassas, VA 20110, USA
| | - Daniel Gioeli
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, 22908 USA
| | - Michael J. Weber
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia, Charlottesville, VA, 22908 USA
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