Abstract

BackgroundMelanoma is the most lethal form of skin cancer, but recent advances in molecularly targeted agents against the Ras/Raf/MAPK pathway demonstrate promise as effective therapies. Despite these advances, resistance remains an issue, as illustrated recently by the clinical experience with vemurafenib. Such acquired resistance appears to be the result of parallel pathway activation, such as PI3K, to overcome single-agent inhibition. In this report, we describe the cytotoxicity and anti-tumour activity of the novel MEK inhibitor, E6201, in a broad panel of melanoma cell lines (n = 31) of known mutational profile in vitro and in vivo. We further test the effectiveness of combining E6201 with an inhibitor of PI3K (LY294002) in overcoming resistance in these cell lines.ResultsThe majority of melanoma cell lines were either sensitive (IC50 < 500 nM, 24/31) or hypersensitive (IC50 < 100 nM, 18/31) to E6201. This sensitivity correlated with wildtype PTEN and mutant BRAF status, whereas mutant RAS and PI3K pathway activation were associated with resistance. Although MEK inhibitors predominantly exert a cytostatic effect, E6201 elicited a potent cytocidal effect on most of the sensitive lines studied, as evidenced by Annexin positivity and cell death ELISA. Conversely, E6201 did not induce cell death in the two resistant melanoma cell lines tested. E6201 inhibited xenograft tumour growth in all four melanoma cell lines studied to varying degrees, but a more pronounced anti-tumour effect was observed for cell lines that previously demonstrated a cytocidal response in vitro. In vitro combination studies of E6201 and LY294002 showed synergism in all six melanoma cell lines tested, as defined by a mean combination index < 1.ConclusionsOur data demonstrate that E6201 elicits a predominantly cytocidal effect in vitro and in vivo in melanoma cells of diverse mutational background. Resistance to E6201 was associated with disruption of PTEN and activation of downstream PI3K signalling. In keeping with these data we demonstrate that co-inhibition of MAPK and PI3K is effective in overcoming resistance inherent in melanoma.

Highlights

  • Melanoma is the most lethal form of skin cancer, but recent advances in molecularly targeted agents against the Rat sarcoma (Ras)/Raf/mitogen-activated protein kinase (MAPK) pathway demonstrate promise as effective therapies

  • In the 26 cell lines carrying mutations in BRAF, NRAS, or HRAS, sensitivity to E6201 was statistically associated with wildtype Phosphatase and tensin homolog (PTEN) status (p = 0.02)

  • Mutations or genotypes in which to test the effectiveness of E6201 in vitro and in vivo. From this genetically diverse panel, we demonstrate for the first time that sensitivity to MEK1/2 inhibition in vitro correlated with wildtype PTEN suggesting parallel signalling of the phosphoinositide 3-kinase (PI3K)/Protein kinase B (Akt)/mammalian target of rapamycin (mTOR) pathway may play a role in the resistance of melanoma cell lines to E6201 and MEK1/2 inhibitors in general

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Summary

Introduction

Melanoma is the most lethal form of skin cancer, but recent advances in molecularly targeted agents against the Ras/Raf/MAPK pathway demonstrate promise as effective therapies. Despite these advances, resistance remains an issue, as illustrated recently by the clinical experience with vemurafenib. Pharmacologic inhibitors of this pathway constitute a promising approach to the treatment of melanoma This was demonstrated recently by the specific inhibitor of mutated BRAF, vemurafenib (PLX4032), which produced a dramatic response in patients with BRAF-mutant metastatic melanoma, albeit tempered by the rapid emergence of resistance [6]. Specific targeting of the oncogenic kinase does not guarantee long term clinical success and this study and others [7,8,9] highlight the plasticity of oncogenic signalling in melanoma cells to overcome drug sensitivity

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