Abstract

<div>Abstract<p>Hyperactivated extracellular signal-regulated kinase (ERK) signaling is common in human cancer and is often the result of activating mutations in BRAF, RAS, and upstream receptor tyrosine kinases. To characterize the mitogen-activated protein kinase/ERK kinase (MEK)/ERK dependence of lung cancers harboring <i>BRAF</i> kinase domain mutations, we screened a large panel of human lung cancer cell lines (<i>n</i> = 87) and tumors (<i>n</i> = 916) for <i>BRAF</i> mutations. We found that non–small cell lung cancers (NSCLC) cells with both V600E and non-V600E BRAF mutations were selectively sensitive to MEK inhibition compared with those harboring mutations in <i>epidermal growth factor receptor</i> (<i>EGFR</i>), <i>KRAS</i>, or <i>ALK</i> and <i>ROS</i> kinase fusions. Supporting its classification as a “driver” mutation in the cells in which it is expressed, MEK inhibition in <sup>V600E</sup>BRAF NSCLC cells led to substantial induction of apoptosis, comparable with that seen with EGFR kinase inhibition in <i>EGFR</i> mutant NSCLC models. Despite high basal ERK phosphorylation, <i>EGFR</i> mutant cells were uniformly resistant to MEK inhibition. Conversely, <i>BRAF</i> mutant cell lines were resistant to EGFR inhibition. These data, together with the nonoverlapping pattern of <i>EGFR</i> and <i>BRAF</i> mutations in human lung cancer, suggest that these lesions define distinct clinical entities whose treatment should be guided by prospective real-time genotyping. To facilitate such an effort, we developed a mass spectrometry-based genotyping method for the detection of hotspot mutations in <i>BRAF, KRAS</i>, and <i>EGFR</i>. Using this assay, we confirmed that <i>BRAF</i> mutations can be identified in a minority of NSCLC tumors and that patients whose tumors harbor <i>BRAF</i> mutations have a distinct clinical profile compared with those whose tumors harbor kinase domain mutations in <i>EGFR</i>. [Cancer Res 2008;68(22):9375–83]</p></div>

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