MTORC1-mediated translational elongation limits intestinal tumour initiation and growth.

Abstract

Inactivation of APC is a strongly predisposing event in the development of colorectal cancer1,2, prompting us to search for vulnerabilities specific to cells that have lost APC function. Signalling through the mTOR pathway is known to be required for epithelial cell proliferation and tumour growth3-5 and the current paradigm suggests that a critical function of mTOR activity is to upregulate translational initiation through phosphorylation of 4EBP16,7. This model predicts that the mTOR inhibitor rapamycin, which does not efficiently inhibit 4EBP18, would be ineffective in limiting cancer progression in APC deficient lesions. Here we show that mTORC1 activity is absolutely required for the proliferation of APC deficient (but not wild type) enterocytes, revealing an unexpected opportunity for therapeutic intervention. Although APC deficient cells show the expected increases in protein synthesis, our studies reveals that it is translation elongation, and not initiation, which is the rate-limiting component. Mechanistically, mTORC1 mediated inhibition of eEF2 kinase is required for the proliferation of APC deficient cells. Importantly, treatment of established APC deficient adenomas with rapamycin (which can target eEF2 through the mTORC1 – S6K – eEF2K axis) causes tumour cells to undergo growth arrest and differentiation. Taken together our data suggest that inhibition of translation elongation using existing, clinically approved drugs such as the Rapalogs, would provide clear therapeutic benefit for patients at high-risk of developing colorectal cancer.