RRC ID 56034
Author Wang C, Jin H, Gao D, Lieftink C, Evers B, Jin G, Xue Z, Wang L, Beijersbergen RL, Qin W, Bernards R.
Title Phospho-ERK is a biomarker of response to a synthetic lethal drug combination of sorafenib and MEK inhibition in liver cancer.
Journal J Hepatol
Abstract BACKGROUND & AIMS:Treatment of liver cancer remains challenging because of a paucity of drugs that target critical dependencies. Sorafenib is a multikinase inhibitor that is approved as the standard therapy for patients with advanced hepatocellular carcinoma, but it only provides limited survival benefit. In this study we aimed to identify potential combination therapies to improve the clinical response to sorafenib.
METHODS:To investigate the cause of the limited therapeutic effect of sorafenib, we performed a CRISPR-Cas9 based synthetic lethality screen to search for kinases whose knockout synergizes with sorafenib. Synergistic effects of sorafenib and selumetinib on cell apoptosis and phospho-ERK (p-ERK) were analyzed by caspase-3/7 apoptosis assay and western blot, respectively. p-ERK was measured by immunochemical analysis using a tissue microarray containing 78 liver cancer specimens. The in vivo effects of the combination were also measured in two xenograft models.
RESULT:We found that suppression of ERK2 (MAPK1) sensitizes several liver cancer cell lines to sorafenib. Drugs inhibiting the MEK (MEK1/2 [MAP2K1/2]) or ERK (ERK1/2 [MAPK1/3]) kinases reverse unresponsiveness to sorafenib in vitro and in vivo in a subset of liver cancer cell lines characterized by high levels of active p-ERK, through synergistic inhibition of ERK kinase activity.
CONCLUSION:Our data provide a combination strategy for treating liver cancer and suggest that tumors with high basal p-ERK levels, which are seen in approximately 30% of liver cancers, are most likely to benefit from such combinatorial treatment.
LAY SUMMARY:Sorafenib is approved as the standard therapy for patients with advanced hepatocellular carcinoma, but only provides limited survival benefit. Herein, we found that inhibition of the kinase ERK2 increases the response to sorafenib in liver cancer. Our data indicate that a combination of sorafenib and a MEK inhibitor is most likely to be effective in tumors with high basal phospho-ERK levels.
Volume 69(5)
Pages 1057-1065
Published 2018-11-1
DOI 10.1016/j.jhep.2018.07.004
PII S0168-8278(18)32184-6
PMID 30030148
MeSH Antineoplastic Combined Chemotherapy Protocols / therapeutic use* Biomarkers Drug Synergism Extracellular Signal-Regulated MAP Kinases / antagonists & inhibitors Extracellular Signal-Regulated MAP Kinases / metabolism* Humans Liver Neoplasms / drug therapy* Mitogen-Activated Protein Kinase Kinases / antagonists & inhibitors* Phosphorylation Sorafenib / administration & dosage*
IF 18.946
Times Cited 19
Human and Animal Cells HuH-7