Abstract

BackgroundSorafenib, a multi-kinase inhibitor, is used as a standard therapy for advanced hepatocellular carcinoma (HCC). However, complete remission has not been achieved and the molecular basis of HCC resistance to sorafenib remains largely unknown. Previous studies have shown that fibroblast growth factor 19 (FGF19) expression correlates with tumor progression and poor prognosis of HCC. Here, we demonstrate the novel role of FGF19 in HCC resistance to sorafenib therapy.MethodsFGF19 Knockdown cells were achieved by lentiviral-mediated interference, and FGFR4 knockout cells were achieved by CRISPR-Cas9. Protein levels of FGF19, FGFR4 and c-PARP in various HCC cell lines were measured by Western blotting analysis. Cell viability was determined by MTS assay, apoptosis was determined by DAPI nuclear staining and Western blot of c-PRAP, and ROS generation was determined by DCFH-DA staining and electrochemical biosensor.ResultsWe showed that FGF19, when overexpressed, inhibited the effect of sorafenib on ROS generation and apoptosis in HCC. In contrast, loss of FGF19 or its receptor FGFR4 led to a remarkable increase in sorafenib-induced ROS generation and apoptosis. In addition, knockdown of FGF19 in sorafenib-resistant HCC cells significantly enhanced the sensitivity to sorafenib. Importantly, targeting FGF19/FGFR4 axis by ponatinib, a third-generation inhibitor of chronic myeloid leukemia, overcomes HCC resistance of sorafenib by enhancing ROS-associated apoptosis in sorafenib-treated HCC.ConclusionOur results provide the first evidence that inhibition of FGF19/FGFR4 signaling significantly overcomes sorafenib resistance in HCC. Co-treatment of ponatinib and sorafinib may represent an effective therapeutic approach for eradicating HCC.

Highlights

  • Sorafenib, a multi-kinase inhibitor, is used as a standard therapy for advanced hepatocellular carcinoma (HCC)

  • Cell viability was determined by MTS assays (a); Apoptosis was determined by DAPI staining (b) and Western blot of c-PARP (c); reactive oxidative species (ROS) generation was determined by DCFH-DA staining (d); and O2− generation was determined by electrochemical biosensor (e)

  • Apoptosis was determined by DAPI staining (c); ROS generation was determined by DCFH-DA staining (d); and O2− generation was determined by electrochemical biosensor (e)

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Summary

Introduction

A multi-kinase inhibitor, is used as a standard therapy for advanced hepatocellular carcinoma (HCC). Complete remission has not been achieved and the molecular basis of HCC resistance to sorafenib remains largely unknown. We demonstrate the novel role of FGF19 in HCC resistance to sorafenib therapy. Hepatocellular carcinoma (HCC) is the sixth common malignancies worldwide and the third leading cause of cancer-associated mortality [1,2,3,4,5]. Advances in diagnostic techniques and instrumentation of oncology have improved the early diagnosis of HCC, the median survival of patients with this disease is still low. A number of molecular targeted drugs have been illustrated to be promising agents in prolonging the overall survival of patients with advanced HCC. FGFR4 is the predominant FGFR isoform in FGFRs in human hepatocytes

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