1. Kinome Reprogramming Is a Targetable Vulnerability in ESR1 Fusion-Driven Breast Cancer.
- Author
-
Kim, Beom-Jun, Anurag, Meenakshi, Lei, Jonathan, Young, Meggie, Holt, Matthew, Fandino, Diana, Vollert, Craig, Singh, Purba, Alzubi, Mohammad, Malovannaya, Anna, Dobrolecki, Lacey, Lewis, Michael, Li, Shunqiang, Foulds, Charles, Ellis, Matthew, and Gou, Xuxu
- Subjects
Animals ,Humans ,Female ,Breast Neoplasms ,Estrogen Receptor alpha ,Antineoplastic Agents ,Disease Models ,Animal ,Mutation - Abstract
UNLABELLED: Transcriptionally active ESR1 fusions (ESR1-TAF) are a potent cause of breast cancer endocrine therapy (ET) resistance. ESR1-TAFs are not directly druggable because the C-terminal estrogen/anti-estrogen-binding domain is replaced with translocated in-frame partner gene sequences that confer constitutive transactivation. To discover alternative treatments, a mass spectrometry (MS)-based kinase inhibitor pulldown assay (KIPA) was deployed to identify druggable kinases that are upregulated by diverse ESR1-TAFs. Subsequent explorations of drug sensitivity validated RET kinase as a common therapeutic vulnerability despite remarkable ESR1-TAF C-terminal sequence and structural diversity. Organoids and xenografts from a pan-ET-resistant patient-derived xenograft model that harbors the ESR1-e6>YAP1 TAF were concordantly inhibited by the selective RET inhibitor pralsetinib to a similar extent as the CDK4/6 inhibitor palbociclib. Together, these findings provide preclinical rationale for clinical evaluation of RET inhibition for the treatment of ESR1-TAF-driven ET-resistant breast cancer. SIGNIFICANCE: Kinome analysis of ESR1 translocated and mutated breast tumors using drug bead-based mass spectrometry followed by drug-sensitivity studies nominates RET as a therapeutic target. See related commentary by Wu and Subbiah, p. 3159.
- Published
- 2023