Abstract
BackgroundNovel therapies are needed for children with high-risk and relapsed neuroblastoma. We hypothesized that MAPK/ERK kinase (MEK) inhibition with the novel MEK1/2 inhibitor binimetinib would be effective in neuroblastoma preclinical models.MethodsLevels of total and phosphorylated MEK and extracellular signal-regulated kinase (ERK) were examined in primary neuroblastoma tumor samples and in neuroblastoma cell lines by Western blot. A panel of established neuroblastoma tumor cell lines was treated with increasing concentrations of binimetinib, and their viability was determined using MTT assays. Western blot analyses were performed to examine changes in total and phosphorylated MEK and ERK and to measure apoptosis in neuroblastoma tumor cells after binimetinib treatment. NF1 protein levels in neuroblastoma cell lines were determined using Western blot assays. Gene expression of NF1 and MEK1 was examined in relationship to neuroblastoma patient outcomes.ResultsBoth primary neuroblastoma tumor samples and cell lines showed detectable levels of total and phosphorylated MEK and ERK. IC50 values for cells sensitive to binimetinib ranged from 8 nM to 1.16 μM, while resistant cells did not demonstrate any significant reduction in cell viability with doses exceeding 15 μM. Sensitive cells showed higher endogenous expression of phosphorylated MEK and ERK. Gene expression of NF1, but not MEK1, correlated with patient outcomes in neuroblastoma, and NF1 protein expression also correlated with responses to binimetinib.ConclusionsNeuroblastoma tumor cells show a range of sensitivities to the novel MEK inhibitor binimetinib. In response to binimetinib, sensitive cells demonstrated complete loss of phosphorylated ERK, while resistant cells demonstrated either incomplete loss of ERK phosphorylation or minimal effects on MEK phosphorylation, suggesting alternative mechanisms of resistance. NF1 protein expression correlated with responses to binimetinib, supporting the use of NF1 as a biomarker to identify patients that may respond to MEK inhibition. MEK inhibition therefore represents a potential new therapeutic strategy for neuroblastoma.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2199-z) contains supplementary material, which is available to authorized users.
Highlights
Novel therapies are needed for children with high-risk and relapsed neuroblastoma
Neuroblastoma patient samples and tumor cell lines demonstrate RAS/mitogen-activated protein kinase (MAPK) pathway expression and activity To examine the expression of components of the RAS/ MAPK signaling pathway in neuroblastoma tumors, a cohort of patient tumor samples was analyzed by Western blot for total and phosphorylated MAPK/ERK kinase (MEK) and extracellular signal-regulated kinase (ERK)
To evaluate whether gene expression of RAS/MAPK pathway members was associated with neuroblastoma patient outcomes, we evaluated the associations of neurofibromatosis type 1 (NF1) and MEK1/2 gene expression with neuroblastoma patient outcomes using results from microarray analyses of neuroblastoma tumors
Summary
Novel therapies are needed for children with high-risk and relapsed neuroblastoma. High-risk cases are characterized by frequent relapses and tumors resistant to established treatment, and novel therapies are sorely needed for patients with high-risk and relapsed neuroblastoma. Since aberrant growth factor receptor expression and activity have been shown to contribute to neuroblastoma pathogenesis, downstream intracellular signaling pathways, including the RAS/mitogen-activated protein kinase (MAPK) pathway, represent potential therapeutic targets. Physiological activation of MEK1/2 and ERK1/2 is required for multiple normal cellular processes; overactivation of the pathway can lead to malignant transformation. Both MEK1 and MEK2 represent potential targets for therapeutic development due to their homology, narrow substrate specificities, and unique structural characteristics
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