Abstract
Limited therapeutic options are available for advanced-stage hepatocellular carcinoma owing to its poor diagnosis. Drug resistance to sorafenib, the only available targeted agent, is commonly reported. The comprehensive elucidation of the mechanisms underlying sorafenib resistance may thus aid in the development of more efficacious therapeutic agents. To clarify the signaling changes contributing to resistance, we applied quantitative phosphoproteomics to analyze the differential phosphorylation changes between parental and sorafenib-resistant HuH-7 cells. Consequently, an average of ~1500 differential phosphoproteins were identified and quantified, among which 533 were significantly upregulated in resistant cells. Further bioinformatic integration via functional categorization annotation, pathway enrichment and interaction linkage analysis led to the discovery of alterations in pathways associated with cell adhesion and motility, cell survival and cell growth and the identification of a novel target, EphA2, in resistant HuH-7R cells. In vitro functional analysis indicated that the suppression of EphA2 function impairs cell proliferation and motility and, most importantly, overcomes sorafenib resistance. The attenuation of sorafenib resistance may be achieved prior to its development through the modulation of EphA2 and the subsequent inhibition of Akt activity. Binding analyses and in silico modeling revealed a ligand mimic lead compound, prazosin, that could abate the ligand-independent oncogenic activity of EphA2. Finally, data obtained from in vivo animal models verified that the simultaneous inhibition of EphA2 with sorafenib treatment can effectively overcome sorafenib resistance and extend the projected survival of resistant tumor-bearing mice. Thus our findings regarding the targeting of EphA2 may provide an effective approach for overcoming sorafenib resistance and may contribute to the management of advanced hepatocellular carcinoma.
Highlights
Hepatocellular carcinoma (HCC) is one of the most common cancer types worldwide and is responsible for approximately 600,000 deaths each year[1,2]
Our results clearly suggest that the combination of ephrin type-A receptor 2 (EphA2) targeting with sorafenib treatment represents a promising option for the reversal of drug resistance in HCC
One of the key pathways involved in the growth and proliferation of HCC is mitogen-activated protein kinase (MAPK) signaling, which is frequently upregulated in cancer cells
Summary
Hepatocellular carcinoma (HCC) is one of the most common cancer types worldwide and is responsible for approximately 600,000 deaths each year[1,2]. In view of the limited progress in systemic therapy, the development of Official journal of the Korean Society for Biochemistry and Molecular Biology. Chen et al Experimental & Molecular Medicine (2020) 52:497–513 significant initial response to sorafenib eventually develop progressive disease and drug resistance, which remains a major obstacle in the successful treatment of advanced HCC. Some studies have shown that the phosphoinositide 3-kinase (PI3)K/Akt pathway is activated as a mechanism to overcome sorafenib-induced cell death[10]. Given the limited current therapeutic options for progressive HCC and the uncertain application of the proposed models, there is still an urgent need to elucidate the molecular pathways involved in the development of drug resistance and identify effective targets that could provide benefits to patients beyond sorafenib therapy
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