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The FGFR1 is a therapeutic target under investigation in multiple solid tumors and clinical trials of selective tyrosine kinase inhibitors (TKI) are underway. Treatment with a single TKI represents a logical step toward personalized cancer therapy, but intrinsic and acquired resistance mechanisms limit their long-term benefit. In this study, we deployed RNAi-based functional genomic screens to identify protein kinases controlling the intrinsic sensitivity of FGFR1-dependent lung cancer and head and neck squamous cell cancer (HNSCC) cells to ponatinib, a multikinase FGFR-active inhibitor. We identified and validated a synthetic lethal interaction between MTOR and ponatinib in non–small cell lung carcinoma cells. In addition, treatment with MTOR-targeting shRNAs and pharmacologic inhibitors revealed that MTOR is an essential protein kinase in other FGFR1-expressing cancer cells. The combination of FGFR inhibitors and MTOR or AKT inhibitors resulted in synergistic growth suppression in vitro. Notably, tumor xenografts generated from FGFR1-dependent lung cancer cells exhibited only modest sensitivity to monotherapy with the FGFR-specific TKI, AZD4547, but when combined with the MTOR inhibitor, AZD2014, significantly attenuated tumor growth and prolonged survival. Our findings support the existence of a signaling network wherein FGFR1-driven ERK and activated MTOR/AKT represent distinct arms required to induce full transformation. Furthermore, they suggest that clinical efficacy of treatments for FGFR1-driven lung cancers and HNSCC may be achieved by combining MTOR inhibitors and FGFR-specific TKIs. Cancer Res; 75(20); 4398–406. ©2015 AACR.

Supplementary Methods, Figures S1-S12, Tables S1-S2. Figure S1. Overview of workflow for the synthetic lethal and essential gene screens. Figure S2. Procedure for isolating and barcoding PCR-amplified shRNA sequences. Figure S3. Growth inhibition of H157 cells by ponatinib in combination with MTOR inhibitor, AZD8055. Figure S4. Relative sensitivity of cancer cell lines to MTOR inhibitor AZD8055 using a cell proliferation assay. Figure S5. Dose response curves for growth inhibition of cancer cell lines by rapamycin. Figure S6. Growth inhibition by FGFR inhibitors in combination with MTOR inhibitor, AZD8055. Figure S7. Synergistic growth inhibition of CCL30 HNSCC cells by AZD4547 and AZD8055. Figure S8. Growth inhibition of Colo699 and H1581 cells by AZD4547 and rapamycin. Figure S9. Signal pathway inhibition by FGFR TKIs and rapamycin alone, and in combination. Figure S10. Growth inhibition by AKT inhibitors alone and combined with ponatinib on Colo699 cells. Figure S11. Combination ponatinib and AKT inhibitor GSK690693 yields synergistic in vitro growth inhibition. Figure S12. Combination AZD4547 and AZD2014 provides superior growth inhibition of Colo699 xenografts. Table S1. Primers used for sample preparation for Illumina sequencing. Table S2. Ranking of Synthetic Lethal Hits with ponatinib Treatment.

As vaccination against Coronavirus 2019 (COVID-19) remains a worldwide initiative, so does describing its associated adverse effects. While there have been many reports detailing various dermatologic adverse events, autoimmune bullous disorders following vaccination are less well described.1 Pemphigus vulgaris (PV) is an autoimmune bullous disease of the skin and mucous membranes that has many known triggers, including vaccination.2 To our knowledge, there are at least six cases of pemphigus vulgaris developing following SARS-Cov-2 vaccination.3 Here we describe a case of new onset PV following COVID-19 vaccination with the mRNA-1273 (Moderna) vaccine. Because this disease carries significant morbidity and mortality, we hope this report serves as a reminder that while vaccination remains a global priority, continued documentation and recognition of novel vaccination side effects by clinicians is essential.

The FGFR1 is a therapeutic target under investigation in multiple solid tumors and clinical trials of selective tyrosine kinase inhibitors (TKI) are underway. Treatment with a single TKI represents a logical step toward personalized cancer therapy, but intrinsic and acquired resistance mechanisms limit their long-term benefit. In this study, we deployed RNAi-based functional genomic screens to identify protein kinases controlling the intrinsic sensitivity of FGFR1-dependent lung cancer and head and neck squamous cell cancer (HNSCC) cells to ponatinib, a multikinase FGFR-active inhibitor. We identified and validated a synthetic lethal interaction between MTOR and ponatinib in non–small cell lung carcinoma cells. In addition, treatment with MTOR-targeting shRNAs and pharmacologic inhibitors revealed that MTOR is an essential protein kinase in other FGFR1-expressing cancer cells. The combination of FGFR inhibitors and MTOR or AKT inhibitors resulted in synergistic growth suppression in vitro. Notably, tumor xenografts generated from FGFR1-dependent lung cancer cells exhibited only modest sensitivity to monotherapy with the FGFR-specific TKI, AZD4547, but when combined with the MTOR inhibitor, AZD2014, significantly attenuated tumor growth and prolonged survival. Our findings support the existence of a signaling network wherein FGFR1-driven ERK and activated MTOR/AKT represent distinct arms required to induce full transformation. Furthermore, they suggest that clinical efficacy of treatments for FGFR1-driven lung cancers and HNSCC may be achieved by combining MTOR inhibitors and FGFR-specific TKIs. Cancer Res; 75(20); 4398–406. ©2015 AACR.