Abstract

Radiation and cisplatin-based chemotherapy are major treatments for nasopharyngeal carcinoma (NPC). However, a major impediment for further improving the cure rate is the development of treatment resistance with an undetermined molecular mechanism in metastatic NPC cells. Our established, highly metastatic NPC cells have been reported to be more resistant to cisplatin chemotherapy. In the present study, we found that Ras association domain family member 6 (RASSF6) was downregulated in highly metastatic cells but upregulated in low metastatic cells in comparison to their parental cell line. Ectopic-expression of RASSF6 enhanced the sensitivity of highly metastatic NPC cells to cisplatin or radiation by enhancing apoptosis. RASSF6 depletion conversely reduced treatment sensitivity by decreasing the apoptosis rate. Over-expression of RASSF6 in highly metastatic NPC cells could enhance the phosphorylation of JNK when exposed to cisplatin or radiation treatment, while knocking down RASSF6 in low metastatic NPC cells could reduce the level of phospho-JNK when exposed to the same treatments. The activation of JNK signaling by RASSF6 and its subsequent sensitivity to apoptosis in NPC cells could be inhibited by applying the JNK inhibitor SP600125. In conclusion, the downregulation of RASSF6 in highly metastatic NPC cells contributed to their treatment resistance, and over-expression of RASSF6 conferred treatment sensitivity to highly metastatic NPC cells by activating JNK signaling. RASSF6 could be a valuable molecular marker for identifying sensitive metastatic NPC tumors during cisplatin treatment or radiotherapy.

Highlights

  • Nasopharyngeal carcinoma (NPC) is a common malignancy in southern China and south-east Asia that has the highest metastasis rate among head and neck cancers [1,2]

  • For those newly diagnosed with loco-regional advanced NPC, which accounts for approximately 70% of cases, concurrent chemo-radiotherapy is the standard for care, while cisplatin-base chemotherapy is the first-line chemotherapy regimen

  • Our study demonstrated that Ras association domain family member 6 (RASSF6) plays an important role in the cellular response to cisplatin and radiation treatment; RASSF6 could be used as a potential biomarker of NPC for predicting treatment response

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Summary

Introduction

Nasopharyngeal carcinoma (NPC) is a common malignancy in southern China and south-east Asia that has the highest metastasis rate among head and neck cancers [1,2]. NPC is relatively sensitive to radiation therapy and chemotherapy. Distant metastasis will eventually occur in approximately 20% of NPC patients after the standard treatment [3,4,5]. Metastatic lesions of this particular malignancy are more frequently resistant to further chemotherapy or radiation therapy due to undetermined mechanisms. Distant metastasis is currently the main reason for treatment failure in NPC [3,4,5]

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