Data from Metformin Accelerates the Growth of BRAF<sup>V600E</sup>-Driven Melanoma by Upregulating VEGF-A

Abstract

<div>Abstract<p>The antidiabetic drug metformin has antitumor activity in a variety of cancers because it blocks cell growth by inhibiting TORC1. Here, we show that melanoma cells that are driven by oncogenic BRAF are resistant to the growth-inhibitory effects of metformin because RSK sustains TORC1 activity even when AMP-activated protein kinase (AMPK) is activated. We further show that AMPK targets the dual-specificity protein phosphatase DUSP6 for degradation and this increases ERK activity, which then upregulates the VEGF-A protein. Critically, this drives angiogenesis and accelerates the growth of BRAF-driven tumors in mice. Unexpectedly, however, when VEGF signaling is inhibited, instead of accelerating tumor growth, metformin inhibits tumor growth. Thus, we show that BRAF-driven melanoma cells are resistant to the antigrowth effects of AMPK and that AMPK mediates cell-autonomous and cell-nonautonomous effects that accelerate the growth of these cells <i>in vivo</i>.</p><p><b>Significance:</b> Metformin inhibits the growth of most tumor cells, but BRAF-mutant melanoma cells are resistant to metformin <i>in vitro</i>, and metformin accelerates their growth <i>in vivo</i>. Unexpectedly, VEGF inhibitors and metformin synergize to suppress the growth of BRAF-mutant tumors, revealing a combination of drugs that may be effective in these patients. <i>Cancer Discov; 2(4)</i>; 344–55. <i>©2012 AACR</i>.</p><p>This article is highlighted in the In This Issue feature, 288</p></div>