Maximizing the efficacy of MAPK-targeted treatment in PTENLOF/BRAFMUT melanoma through PI3K and IGF1R inhibition.
By: Barbara Herkert, Audrey Kauffmann, Sandra Mollé, Christian Schnell, Thomas Ferrat, Hans Voshol, Janina Juengert, Hélène Erasimus, Grégory Marszalek, Malika Kazic-Legueux, Eric Billy, David A Ruddy, Mark D Stump, Daniel Guthy, Mitko Ristov, Keith Calkins, Sauveur-Michel Maira, William R Sellers, Francesco Hofmann, Michael Hall, Saskia M Brachmann

Oncology, Novartis Institutes for Biomedical Research.
2015-11-19; doi: 10.1158/0008-5472.CAN-14-3358
Abstract

The introduction of MAPK pathway inhibitors paved the road for significant advancements in the treatment of BRAF mutant (BRAF(MUT)) melanoma. However, even BRAF/MEK inhibitor combination therapy has failed to offer a curative treatment option, most likely because these pathways constitute a codependent signaling network. Concomitant PTEN loss-of-function (PTEN(LOF)) occurs in approximately 40% of BRAF(MUT) melanomas. In this study, we sought to identify the nodes of the PTEN/PI3K pathway that would be amenable to combined therapy with MAPK pathway inhibitors for the treatment of PTEN(LOF)/BRAF(MUT) melanoma. Large-scale compound sensitivity profiling revealed that PTEN(LOF) melanoma cell lines were sensitive to PI3Kbeta inhibitors, albeit only partially. An unbiased shRNA screen (7500 genes, 20 RNAs/gene) across 11 cell lines in the presence of a PI3Kbeta inhibitor identified an adaptive response involving the IGF1R-PI3Kalpha axis. Combined inhibition of the MAPK pathway, PI3Kbeta and PI3Kalpha or IGF1R synergistically sustained pathway blockade, induced apoptosis, and inhibited tumor growth in PTEN(LOF)/BRAF(MUT) melanoma models. Notably, combined treatment with the IGF1R inhibitor, but not the PI3Kalpha inhibitor, failed to elevate glucose or insulin signaling. Taken together, our findings provide a strong rationale for testing combinations of panPI3K, PI3Kbeta+IGF1R, and MAPK pathway inhibitors in PTEN(LOF)/BRAF(MUT) melanoma patients to achieve maximal response.



Copyright © 2015, American Association for Cancer Research.

PMID:26577700






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