Abstract
Simple SummaryCyclin-dependent kinases 4 and 6 (CDK4/6) are key enzymes controlling the cell cycle. CDK4/6 inhibitors are being tested in multiple clinical trials for a range of cancers including melanoma, and a deeper understanding of how they interact with other therapies is vital for their clinical development. Beyond the cell cycle, CDK4/6 regulates cell metabolism, which is a critical factor determining response to standard-of-care mitogen-activated protein kinase (MAPK) pathway therapies in melanoma. Here, we show that CDK4/6 inhibitors increase glutamine and fatty acid-oxidation-dependent mitochondrial metabolism in melanoma cells, but they do not alter the metabolic response to MAPK inhibitors. These observations shed light on how CDK4/6 inhibitors impinge on the regulation of metabolism and how they interact with other therapies in the setting of melanoma.Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors are being tested in numerous clinical trials and are currently employed successfully in the clinic for the treatment of breast cancers. Understanding their mechanism of action and interaction with other therapies is vital in their clinical development. CDK4/6 regulate the cell cycle via phosphorylation and inhibition of the tumour suppressor RB, and in addition can phosphorylate many cellular proteins and modulate numerous cellular functions including cell metabolism. Metabolic reprogramming is observed in melanoma following standard-of-care BRAF/MEK inhibition and is involved in both therapeutic response and resistance. In preclinical models, CDK4/6 inhibitors overcome BRAF/MEK inhibitor resistance, leading to sustained tumour regression; however, the metabolic response to this combination has not been explored. Here, we investigate how CDK4/6 inhibition reprograms metabolism and if this alters metabolic reprogramming observed upon BRAF/MEK inhibition. Although CDK4/6 inhibition has no substantial effect on the metabolic phenotype following BRAF/MEK targeted therapy in melanoma, CDK4/6 inhibition alone significantly enhances mitochondrial metabolism. The increase in mitochondrial metabolism in melanoma cells following CDK4/6 inhibition is fuelled in part by both glutamine metabolism and fatty acid oxidation pathways and is partially dependent on p53. Collectively, our findings identify new p53-dependent metabolic vulnerabilities that may be targeted to improve response to CDK4/6 inhibitors.
Highlights
IntroductionThe high frequency of Cyclin-dependent kinase 4 and 6 (CDK4/6) pathway activation in cancer more broadly has led to the development of CDK4/6 inhibitors, such as palbociclib, ribociclib and abemaciclib [9], and the therapeutic effects of palbociclib have been studied in the context of BRAF inhibitor resistance in melanoma
Calculation of the mean GI50 revealed high sensitivity of both cell lines to each individual drug (Figure S1c), with slight differences in the sensitivity to vemurafenib and palbociclib observed between the cell lines (A375 cells are less sensitive to palbociclib, whilst the WM266.4 cells are less sensitive to vemurafenib)
We have previously shown that palbociclib in combination with a BRAF inhibitor enhances the anti-proliferative effects of each drug [11], and we have extended these observations to include the BRAF/MEK inhibitor combination, alone or in combination with palbociclib
Summary
The high frequency of CDK4/6 pathway activation in cancer more broadly has led to the development of CDK4/6 inhibitors, such as palbociclib, ribociclib and abemaciclib [9], and the therapeutic effects of palbociclib have been studied in the context of BRAF inhibitor resistance in melanoma. BRAF inhibitor-resistant tumours remain sensitive to palbociclib treatment [7,10], while palbociclib in combination with a BRAF inhibitor induces rapid and sustained tumour regression in vivo without acquired resistance [11].
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