1. Evaluation of Combined Chemotherapy and Genomic-Driven Targeted Therapy in Patient-Derived Xenografts Identifies New Therapeutic Approaches in Squamous Non-Small-Cell Lung Cancer Patients.
- Author
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Decaudin, Didier, Némati, Fariba, Masliah Planchon, Julien, Seguin-Givelet, Agathe, Lefevre, Marine, Etienne, Vesnie, Ahnine, Harry, Peretti, Quentin, Sourd, Laura, El-Botty, Rania, Huguet, Lea, Lagha, Sarah, Hegarat, Nadia, Roman-Roman, Sergio, Bièche, Ivan, Girard, Nicolas, and Montaudon, Elodie
- Subjects
THERAPEUTIC use of antineoplastic agents ,CELL metabolism ,ADENOCARCINOMA ,SQUAMOUS cell carcinoma ,GENOMICS ,ENZYME inhibitors ,CANCER patients ,XENOGRAFTS ,CELLULAR signal transduction ,IN vivo studies ,CANCER chemotherapy ,MICE ,DRUG efficacy ,ANIMAL experimentation ,GENETIC mutation ,LUNG cancer ,SEQUENCE analysis - Abstract
Simple Summary: Non-small-cell lung cancer is characterized by high morbidity and mortality. Currently, the precision medicine approach in the adenocarcinoma subtype of non-small-cell lung cancer aims to identify genomic alterations that can be targeted in individual patients and offer them appropriate treatment. Several biomarker-guided therapies have been approved, targeting genes frequently altered in adenocarcinoma, such as EGFR, BRAF, MET, ALK, ROS1, RET and NTRK. To overcome the emergence of resistance and increase the efficacy of these targeted therapies, the combination of chemotherapy and targeted therapy has been studied and validated in adenocarcinoma patients with EGFR mutations. This study proposes to examine whether this type of combined approach, which is difficult to study in clinical trials, could be more widely used by targeting other genetic alterations in the MAPK/PI3K pathways or against alterations in the CDNK2A gene in adenocarcinomas but also in squamous-cell carcinomas. The combination of chemotherapy and targeted therapy has been validated in non-small-cell lung cancer (NSCLC) patients with EGFR mutations. We therefore investigated whether this type of combined approach could be more widely used by targeting other genetic alterations present in NSCLC. PDXs were generated from patients with NSCLC adenocarcinomas (ADCs) and squamous-cell carcinomas (SCCs). Targeted NGS analyses identified various molecular abnormalities in the MAPK and PI3K pathways and in the cell cycle process in our PDX panel. The antitumor efficacy of targeted therapies alone or in combination with chemotherapy was then tested in vivo. We observed that trametinib, BKM120, AZD2014 and palbociclib increased the efficacy of each chemotherapy in SCC PDXs, in contrast to a non-insignificant or slight improvement in ADCs. Furthermore, we observed high efficacy of trametinib in KRAS-, HRAS- and NRAS-mutated tumors (ADCs and SCCs), suggesting that the MEK inhibitor may be useful in a wider population of NSCLC patients, not just those with KRAS-mutated ADCs. Our results suggest that the detection of pathogenic variants by NGS should be performed in all NSCLCs, and particularly in SCCs, to offer patients a more effective combination of chemotherapy and targeted therapy. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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