KEAP1 loss modulates sensitivity to kinase targeted therapy in lung cancer
Abstract
Inhibitors that target the receptor tyrosine kinase (RTK)/Ras/mitogen-activated protein kinase (MAPK) pathway have led to clinical responses in lung and other cancers, but some patients fail to respond and in those that do resistance inevitably occurs1-4. To understand intrinsic and acquired resistance to inhibition of MAPK signaling, we performed CRISPR-Cas9 gene deletion screens in the setting of BRAF, MEK, EGFR, and ALK inhibition. Loss of KEAP1, a negative regulator of NFE2L2/NRF2, modulated the response to BRAF, MEK, EGFR, and ALK inhibition in BRAF-, NRAS-, KRAS-, EGFR-, and ALK-mutant lung cancer cells. Treatment with inhibitors targeting the RTK/MAPK pathway increased reactive oxygen species (ROS) in cells with intact KEAP1, and loss of KEAP1 abrogated this increase. In addition, loss of KEAP1 altered cell metabolism to allow cells to proliferate in the absence of MAPK signaling. These observations suggest that alterations in the KEAP1/NRF2 pathway may promote survival in the presence of multiple inhibitors targeting the RTK/Ras/MAPK pathway.
Article and author information
Author details
Funding
National Cancer Institute (R01 CA130998)
- William C Hahn
Dana-Farber Cancer Institute Hale Center for Pancreatic Cancer
- Andrew J Aguirre
Perry S. Levy Endowed Fellowship
- Andrew J Aguirre
Harvard Catalyst and Harvard Clinical and Translational Science Center (UL1 TR001102)
- Andrew J Aguirre
National Cancer Institute (U01 CA176058)
- William C Hahn
National Cancer Institute (U01 CA199253)
- William C Hahn
Hope Funds for Cancer Research (Postdoctoral Fellowship HFCR-11-03-03)
- Elsa Beyer Krall
National Institutes of Health (Postdoctoral Fellowship F32 CA189306)
- Elsa Beyer Krall
Susan G. Komen Foundation (Postdoctoral Fellowship PDF12230602)
- Nina Ilic
Terri Brodeur Breast Cancer Foundation (Postdoctoral Fellowship)
- Nina Ilic
Pancreatic Cancer Action Network (Samuel Stroum Fellowship)
- Andrew J Aguirre
American Society of Clinical Oncology (Young Investigator Award)
- Andrew J Aguirre
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Ethics
Animal experimentation: Mice were maintained and handled in accordance with the Novartis Institutes for Biomedical Research (NIBR) Animal Care and Use Committee protocols and regulations.
Reviewing Editor
- Martin McMahon, University of Utah Medical Schoo, United States
Version history
- Received: June 21, 2016
- Accepted: January 31, 2017
- Accepted Manuscript published: February 1, 2017 (version 1)
- Version of Record published: February 13, 2017 (version 2)
- Version of Record updated: October 31, 2017 (version 3)
Copyright
© 2017, Krall et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.
Metrics
-
- 7,380
- Page views
-
- 1,601
- Downloads
-
- 103
- Citations
Article citation count generated by polling the highest count across the following sources: Scopus, Crossref, PubMed Central.
Download links
Downloads (link to download the article as PDF)
Open citations (links to open the citations from this article in various online reference manager services)
Cite this article (links to download the citations from this article in formats compatible with various reference manager tools)
Further reading
-
- Cancer Biology
Cancer stem cells (CSCs) undergo epithelial-mesenchymal transition (EMT) to drive metastatic dissemination in experimental cancer models. However, tumour cells undergoing EMT have not been observed disseminating into the tissue surrounding human tumour specimens, leaving the relevance to human cancer uncertain. We have previously identified both EpCAM and CD24 as CSC markers that, alongside the mesenchymal marker Vimentin, identify EMT CSCs in human oral cancer cell lines. This afforded the opportunity to investigate whether the combination of these three markers can identify disseminating EMT CSCs in actual human tumours. Examining disseminating tumour cells in over 12,000 imaging fields from 74 human oral tumours, we see a significant enrichment of EpCAM, CD24 and Vimentin co-stained cells disseminating beyond the tumour body in metastatic specimens. Through training an artificial neural network, these predict metastasis with high accuracy (cross-validated accuracy of 87-89%). In this study, we have observed single disseminating EMT CSCs in human oral cancer specimens, and these are highly predictive of metastatic disease.