Abstract

BackgroundGenetic alterations, including the overexpression of epidermal growth factor receptor (EGFR), play a crucial role in ovarian carcinogenesis. To date, EGFR targeting has shown limited antitumor effects in ovarian cancer when administered as monotherapy. We previously identified platelet-activating factor receptor (PAFR) as being overexpressed in ovarian cancer and found that its ligand PAF evoked EGFR phosphorylation. To determine whether PAFR targeting can enhance the antitumor efficacy of EGFR inhibition, we investigated the effects of a PAFR antagonist (WEB2086) in conjunction with an EGFR inhibitor (AG1478).MethodsThe expression of EGFR and PAFR in CAOV-3 and SKOV-3 ovarian cancer cell lines was measured by Western blot and immunocytochemistry. Synergy was determined using isobologram analysis. The effects of combined PAFR and EGFR targeting on both cells were assessed by using CCK-8, transwell, flow cytometry, western blot analysis. In vivo studies were conducted using CAOV-3 cells xenografted in nu/nu mice.ResultsTreatment with combination WEB2086 and AG1478 resulted in significantly greater inhibition of proliferation and invasion compared to either drug alone. When examining equipotent combinations of WEB2086 and AG1478 to determine potential synergy, a combination index (CI) of 0.49 was identified for CAOV-3 cells and a CI of 0.58 for SKOV-3 cells indicating synergy. This co-inhibition induced significantly more apoptosis and arrested the cells at G0/G1 phase in both cell lines. The activation of PAFR and/or EGFR induced phosphorylation of the mTOR, AKT, and MAPK pathways. Combined PAFR and EGFR targeting synergistically diminished the expression of PAFR and EGFR phosphorylation and downstream signaling. In vivo studies further verified the antitumor effects of combined PAFR and EGFR targeting in a CAOV-3 xenograft model.ConclusionsThese results suggest that WEB2086 and AG1478 are synergistic in ovarian cancer cells with high expression of both PAFR and EGFR. The presented approach may have important therapeutic implications in the treatment of ovarian cancer patients.

Highlights

  • Genetic alterations, including the overexpression of epidermal growth factor receptor (EGFR), play a crucial role in ovarian carcinogenesis

  • These results suggest that A specific PAFR antagonist (WEB2086) and An EGFR-specific tyrosine kinase inhibitor (AG1478) are synergistic in ovarian cancer cells with high expression of both platelet-activating factor receptor (PAFR) and Epidermal growth factor receptor (EGFR)

  • The inhibitory effects of combined use of the PAFR antagonist WEB2086 and the EGFR inhibitor AG1478 were tested in two ovarian cancer cell lines, CAOV-3 and SKOV-3 cells

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Summary

Introduction

Genetic alterations, including the overexpression of epidermal growth factor receptor (EGFR), play a crucial role in ovarian carcinogenesis. EGFR targeting has shown limited antitumor effects in ovarian cancer when administered as monotherapy. Epidermal growth factor receptor (EGFR) is involved in the development and progression of several human cancers, including ovarian cancer. EGFR plays a role in various pro-survival and anti-apoptotic pathways in cancer cells [5,6,7]. Recent clinical trials targeting EGFR with cetuximab [11,12,13], matuzumab [14,15], gefitinib [16], and erlotinib [17,18] in epithelial ovarian cancer patients have shown only modest clinical responsiveness. The modest responses of EGFR blockade when monoclonal antibodies or tyrosine kinase inhibitors are administered as single agents could be attributed to compensation by other signaling pathways [19]

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