1. PI3Kβ inhibition restores ALK inhibitor sensitivity in ALK-rearranged lung cancer
- Author
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Jari Räsänen, Schüler J, Wolfgang Sommergruber, Emmy W. Verschuren, Annabrita Hemmes, Krister Wennerberg, Adinolfi S, Sarang S. Talwelkar, Matti Kankainen, Aija Knuuttila, Mikko I. Mäyränpää, Nora Linnavirta, and Levonen A
- Subjects
MAPK/ERK pathway ,0303 health sciences ,medicine.drug_class ,Drug screens ,business.industry ,medicine.disease ,Tp53 mutation ,3. Good health ,ALK inhibitor ,03 medical and health sciences ,0302 clinical medicine ,In vivo ,Cell culture ,hemic and lymphatic diseases ,030220 oncology & carcinogenesis ,Cancer cell ,medicine ,Cancer research ,Lung cancer ,business ,030304 developmental biology - Abstract
For non-small cell lung cancer (NSCLC) patients with ALK-rearranged tumors, treatment with ALK inhibitors can improve outcomes. However, clinical resistance typically develops over time, and in the majority of cases resistance mechanisms are ALK-independent. We generated tumor cell cultures from multiple regions of an ALK-rearranged clinical tumor specimen, and deployed functional drug screens to identify modulators of resistance to ALK inhibitors. This identified a role for PI3Kβ and EGFR in regulating resistance to ALK inhibition. Furthermore, inhibition of ALK elicited activation of EGFR, and inhibition of PI3Kβ rescued EGFR-mediated ALK inhibitor resistance. In ALK-rearranged primary cultures, cell lines and in vivo xenograft models, combined inhibition of ALK and PI3Kβ prevented compensatory MAPK and PI3K-AKT pathway reactivation and selectively targeted the cancer cells. The combinatorial effect was seen even in the background of TP53 mutations and in epithelial-mesenchymal transformed cells. In conclusion, combinatorial ALK and PI3Kβ inhibitor treatment carries promise as a treatment for ALK-rearranged NSCLC.
- Published
- 2021