Abstract

KRAS-mutated colorectal cancers (CRCs) are resistant to cetuximab treatment. The multifunctional Y-box binding protein 1 (YB-1) is overexpressed in CRC and is associated with chemoresistance. In this study, the effects of oncogenic mutated KRAS(G12V) and KRAS(G13D) on YB-1 phosphorylation were investigated in CRC cells. The effects of the inhibition of p90 ribosomal S6 kinase (RSK) on YB-1 phosphorylation, cell proliferation and survival were tested with and without treatment with 5-fluorouracil using pharmacological inhibitors and siRNA. YB-1 phosphorylation status and subcellular distribution in CRC patient tissues were determined by immunofluorescence staining and confocal microscopy. Endogenous expression of mutated KRAS(G13D) and conditional expression of KRAS(G12V) significantly stimulated YB-1 phosphorylation via RSK and were associated with cetuximab resistance. Inhibition of YB-1 by targeting RSK stimulated the Akt signaling pathway, and this stimulation occurred independently of KRAS mutational status. Akt activation interfered with the antiproliferative effect of the RSK inhibitor. Consequently, dual targeting of RSK and Akt efficiently inhibited cell proliferation in KRAS(G13D)-mutated HCT116 and KRAS wild-type SW48 cells. Treatment with 5-fluorouracil (5-FU) significantly enhanced YB-1 phosphorylation in KRAS(G13D)-mutated HCT116 cells but not in KRAS wild-type SW48 cells. Dual targeting of Akt and RSK sensitized HCT116 cells to 5-FU by stimulating 5-FU-induced apoptosis and inhibiting repair of 5-FU-induced DNA damage. YB-1 was highly phosphorylated in CRC patient tumor tissues and was mainly localized in the nucleus. Together, dual targeting of RSK and Akt may be an alternative molecular targeting approach to cetuximab for treating CRC in which YB-1 is highly phosphorylated.

Highlights

  • Colorectal cancer (CRC) is the second most commonly diagnosed cancer in women and the third most common cancer in men, and colorectal cancers (CRCs) is one of the leading causes of cancer death [1]

  • The present study investigated the effect of cetuximab on the proliferation of CRC cells expressing wild-type KRAS and two distinct KRAS mutations in codon (G12V) and codon (G13D)

  • A proliferation assay was used to examine the sensitivity of KRAS wild-type SW48 cells, KRAS(G12V)-mutated SW480 cells and KRAS(G13D)-mutated HCT116 cells to cetuximab

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Summary

Introduction

Colorectal cancer (CRC) is the second most commonly diagnosed cancer in women and the third most common cancer in men, and CRC is one of the leading causes of cancer death [1]. The first-line treatment for advanced CRC is 5-fluorouracil (5-FU)-based chemotherapy in combination with other cytotoxic drugs, such as leucovorin and oxaliplatin. Another approach for treating CRC is Cancers 2019, 11, 562; doi:10.3390/cancers11040562 www.mdpi.com/journal/cancers. Administration of cetuximab is limited to patients with KRAS wild-type tumors because KRAS mutations are predictive markers for resistance to EGFR-targeted therapy [4,5,6]. Response rates of only 30–60% for 5-FU-based drug regimens have been reported [10,11] This lack of therapy response in advanced CRC patients indicates the need for additional investigations for effective targeted therapy approaches to overcome resistance to conventional therapies

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