Inhibiting insulin and mTOR signaling by afatinib and crizotinib combination fosters broad cytotoxic effects in cutaneous malignant melanoma

Current treatment modalities for disseminated cutaneous malignant melanoma (CMM) improve survival, however disease progression commonly ensues. In a previous study we identified afatinib and crizotinib in combination as a novel potential therapy for CMM independent of BRAF/NRAS mutation status. Here...

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Veröffentlicht in:Cell death & disease 2020-10, Vol.11 (10), p.882-882, Article 882
Hauptverfasser: Das, Ishani, Chen, Huiqin, Maddalo, Gianluca, Tuominen, Rainer, Rebecca, Vito W., Herlyn, Meenhard, Hansson, Johan, Davies, Michael A., Egyházi Brage, Suzanne
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container_issue 10
container_start_page 882
container_title Cell death & disease
container_volume 11
creator Das, Ishani
Chen, Huiqin
Maddalo, Gianluca
Tuominen, Rainer
Rebecca, Vito W.
Herlyn, Meenhard
Hansson, Johan
Davies, Michael A.
Egyházi Brage, Suzanne
description Current treatment modalities for disseminated cutaneous malignant melanoma (CMM) improve survival, however disease progression commonly ensues. In a previous study we identified afatinib and crizotinib in combination as a novel potential therapy for CMM independent of BRAF/NRAS mutation status. Herein, we elucidate the underlying mechanisms of the combination treatment effect to find biomarkers and novel targets for development of therapy that may provide clinical benefit by proteomic analysis of CMM cell lines and xenografts using mass spectrometry based analysis and reverse phase protein array. Identified candidates were validated using immunoblotting or immunofluorescence. Our analysis revealed that mTOR/Insulin signaling pathways were significantly decreased by the afatinib and crizotinib combination treatment. Both in vitro and in vivo analyses showed that the combination treatment downregulated pRPS6KB1 and pRPS6, downstream of mTOR signaling, and IRS-1 in the insulin signaling pathway, specifically ablating IRS-1 nuclear signal. Silencing of RPS6 and IRS-1 alone had a similar effect on cell death, which was further induced when IRS-1 and RPS6 were concomitantly silenced in the CMM cell lines. Silencing of IRS-1 and RPS6 resulted in reduced sensitivity towards combination treatment. Additionally, we found that IRS-1 and RPS6KB1 expression levels were increased in advanced stages of CMM clinical samples. We could demonstrate that induced resistance towards combination treatment was reversible by a drug holiday. CD171/L1CAM, mTOR and PI3K-p85 were induced in the combination resistant cells whereas AXL and EPHA2, previously identified mediators of resistance to MAPK inhibitor therapy in CMM were downregulated. We also found that CD171/L1CAM and mTOR were increased at progression in tumor biopsies from two matched cases of patients receiving targeted therapy with BRAFi. Overall, these findings provide insights into the molecular mechanisms behind the afatinib and crizotinib combination treatment effect and leverages a platform for discovering novel biomarkers and therapy regimes for CMM treatment.
doi_str_mv 10.1038/s41419-020-03097-2
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In a previous study we identified afatinib and crizotinib in combination as a novel potential therapy for CMM independent of BRAF/NRAS mutation status. Herein, we elucidate the underlying mechanisms of the combination treatment effect to find biomarkers and novel targets for development of therapy that may provide clinical benefit by proteomic analysis of CMM cell lines and xenografts using mass spectrometry based analysis and reverse phase protein array. Identified candidates were validated using immunoblotting or immunofluorescence. Our analysis revealed that mTOR/Insulin signaling pathways were significantly decreased by the afatinib and crizotinib combination treatment. Both in vitro and in vivo analyses showed that the combination treatment downregulated pRPS6KB1 and pRPS6, downstream of mTOR signaling, and IRS-1 in the insulin signaling pathway, specifically ablating IRS-1 nuclear signal. Silencing of RPS6 and IRS-1 alone had a similar effect on cell death, which was further induced when IRS-1 and RPS6 were concomitantly silenced in the CMM cell lines. Silencing of IRS-1 and RPS6 resulted in reduced sensitivity towards combination treatment. Additionally, we found that IRS-1 and RPS6KB1 expression levels were increased in advanced stages of CMM clinical samples. We could demonstrate that induced resistance towards combination treatment was reversible by a drug holiday. CD171/L1CAM, mTOR and PI3K-p85 were induced in the combination resistant cells whereas AXL and EPHA2, previously identified mediators of resistance to MAPK inhibitor therapy in CMM were downregulated. We also found that CD171/L1CAM and mTOR were increased at progression in tumor biopsies from two matched cases of patients receiving targeted therapy with BRAFi. 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In a previous study we identified afatinib and crizotinib in combination as a novel potential therapy for CMM independent of BRAF/NRAS mutation status. Herein, we elucidate the underlying mechanisms of the combination treatment effect to find biomarkers and novel targets for development of therapy that may provide clinical benefit by proteomic analysis of CMM cell lines and xenografts using mass spectrometry based analysis and reverse phase protein array. Identified candidates were validated using immunoblotting or immunofluorescence. Our analysis revealed that mTOR/Insulin signaling pathways were significantly decreased by the afatinib and crizotinib combination treatment. Both in vitro and in vivo analyses showed that the combination treatment downregulated pRPS6KB1 and pRPS6, downstream of mTOR signaling, and IRS-1 in the insulin signaling pathway, specifically ablating IRS-1 nuclear signal. Silencing of RPS6 and IRS-1 alone had a similar effect on cell death, which was further induced when IRS-1 and RPS6 were concomitantly silenced in the CMM cell lines. Silencing of IRS-1 and RPS6 resulted in reduced sensitivity towards combination treatment. Additionally, we found that IRS-1 and RPS6KB1 expression levels were increased in advanced stages of CMM clinical samples. We could demonstrate that induced resistance towards combination treatment was reversible by a drug holiday. CD171/L1CAM, mTOR and PI3K-p85 were induced in the combination resistant cells whereas AXL and EPHA2, previously identified mediators of resistance to MAPK inhibitor therapy in CMM were downregulated. We also found that CD171/L1CAM and mTOR were increased at progression in tumor biopsies from two matched cases of patients receiving targeted therapy with BRAFi. Overall, these findings provide insights into the molecular mechanisms behind the afatinib and crizotinib combination treatment effect and leverages a platform for discovering novel biomarkers and therapy regimes for CMM treatment.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>33082316</pmid><doi>10.1038/s41419-020-03097-2</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-2019-8072</orcidid><orcidid>https://orcid.org/0000-0002-0524-2346</orcidid><orcidid>https://orcid.org/0000-0003-0839-0739</orcidid><orcidid>https://orcid.org/0000-0003-2297-6488</orcidid><orcidid>https://orcid.org/0000-0002-0977-0912</orcidid><oa>free_for_read</oa></addata></record>
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ispartof Cell death & disease, 2020-10, Vol.11 (10), p.882-882, Article 882
issn 2041-4889
2041-4889
language eng
recordid cdi_swepub_primary_oai_swepub_ki_se_467205
source MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; SWEPUB Freely available online; Springer Nature OA Free Journals; Nature Free; PubMed Central
subjects 1-Phosphatidylinositol 3-kinase
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631/67/1059/602
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Afatinib - pharmacology
Antibodies
Antineoplastic Agents - pharmacology
Axl protein
Biochemistry
Biomarkers
Biomedical and Life Sciences
Cancer och onkologi
Cell Biology
Cell Culture
Cell death
Crizotinib - pharmacology
Cytotoxicity
Drug Resistance, Neoplasm - drug effects
EphA2 protein
Farmakologi och toxikologi
Humans
Immunoblotting
Immunofluorescence
Immunology
Insulin
Insulin receptor substrate 1
Klinisk medicin
Life Sciences
MAP kinase
Mass spectroscopy
Medicin och hälsovetenskap
Medicinska och farmaceutiska grundvetenskaper
Melanoma
Melanoma - drug therapy
Melanoma, Cutaneous Malignant
Molecular modelling
Protein arrays
Protein Kinase Inhibitors - pharmacology
Proto-Oncogene Proteins B-raf - metabolism
Signal transduction
Signal Transduction - drug effects
Skin cancer
Skin Neoplasms - drug therapy
Targeted cancer therapy
TOR protein
TOR Serine-Threonine Kinases - drug effects
Xenografts
title Inhibiting insulin and mTOR signaling by afatinib and crizotinib combination fosters broad cytotoxic effects in cutaneous malignant melanoma
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