1. MEK1/2 inhibitor withdrawal reverses acquired resistance driven by BRAFV600E amplification whereas KRASG13D amplification promotes EMT-chemoresistance
- Author
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Kathryn Balmanno, Mark J. Arends, Julio Saez-Rodriguez, Matthew J. Sale, Katarzyna Wojdyla, David Oxley, David J. Adams, Simon J. Cook, Rebecca Gilley, Rebecca E. McIntyre, Jayeta Saxena, Karen Howarth, Anna Woroniuk, Pilar Caro, Eiko Ozono, Paul D. Smith, Gareth Hughes, Susan Ashton, and Jonathan R. Dry
- Subjects
Male ,0301 basic medicine ,endocrine system diseases ,MAP Kinase Kinase 2 ,MAP Kinase Kinase 1 ,General Physics and Astronomy ,Apoptosis ,02 engineering and technology ,Drug resistance ,medicine.disease_cause ,Neoplasms ,skin and connective tissue diseases ,lcsh:Science ,Mitogen-Activated Protein Kinase 1 ,Mitogen-Activated Protein Kinase 3 ,Multidisciplinary ,Chemistry ,021001 nanoscience & nanotechnology ,3. Good health ,Gene Expression Regulation, Neoplastic ,Cancer therapeutic resistance ,Female ,KRAS ,0210 nano-technology ,G1 phase ,Proto-Oncogene Proteins B-raf ,Programmed cell death ,Epithelial-Mesenchymal Transition ,MAP Kinase Signaling System ,Science ,Kinases ,Antineoplastic Agents ,Article ,General Biochemistry, Genetics and Molecular Biology ,Proto-Oncogene Proteins p21(ras) ,03 medical and health sciences ,Cell Line, Tumor ,medicine ,Humans ,Epithelial–mesenchymal transition ,Protein Kinase Inhibitors ,neoplasms ,Cell growth ,Gene Amplification ,Growth factor signalling ,Zinc Finger E-box-Binding Homeobox 1 ,General Chemistry ,digestive system diseases ,030104 developmental biology ,Withholding Treatment ,Drug Resistance, Neoplasm ,Cell culture ,Cancer research ,Benzimidazoles ,lcsh:Q - Abstract
Acquired resistance to MEK1/2 inhibitors (MEKi) arises through amplification of BRAFV600E or KRASG13D to reinstate ERK1/2 signalling. Here we show that BRAFV600E amplification and MEKi resistance are reversible following drug withdrawal. Cells with BRAFV600E amplification are addicted to MEKi to maintain a precise level of ERK1/2 signalling that is optimal for cell proliferation and survival, and tumour growth in vivo. Robust ERK1/2 activation following MEKi withdrawal drives a p57KIP2-dependent G1 cell cycle arrest and senescence or expression of NOXA and cell death, selecting against those cells with amplified BRAFV600E. p57KIP2 expression is required for loss of BRAFV600E amplification and reversal of MEKi resistance. Thus, BRAFV600E amplification confers a selective disadvantage during drug withdrawal, validating intermittent dosing to forestall resistance. In contrast, resistance driven by KRASG13D amplification is not reversible; rather ERK1/2 hyperactivation drives ZEB1-dependent epithelial-to-mesenchymal transition and chemoresistance, arguing strongly against the use of drug holidays in cases of KRASG13D amplification., Colorectal cancer cells can acquire resistance to MEK inhibition due to BRAF or KRAS amplification. Here, the authors show that while MEK inhibitor withdrawal in BRAF mutant cells restores sensitivity to the inhibitor through the loss of BRAF amplification mediated by a p57-dependent mechanism, drug withdrawal from KRAS mutant cells does not restore sensitivity but results in EMT and chemoresistance.
- Published
- 2019
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