IGF-I receptors (IGF-IR) and their aberrant signaling cascade contribute to the pathogenesis of several solid cancers. Pituitary adenomas express IGF-IR and present with overactivation of the IGF-IR pathway. The aim of the study was to identify the potential antiproliferative action of small molecule inhibitors targeting IGF-IR signaling cascade in pituitary adenomas. The IGF-IR tyrosine kinase inhibitor NVP-TAE226, the PI3K/mTOR inhibitor NVP_BEZ235 and the allosteric mTOR inhibitor everolimus were used on acromegalic (n=11) and nonfunctioning pituitary adenomas (NFPA; n=15) in primary cell culture. Changes in cell viability were determined by thymidine incorporation and a nonradioactive colorimetric assay. TAE226at the 100nM concentration suppressed cell viability by more than 20% in 9 out of 15 NFPA and in 10 acromegalic tumors, while at 10nM it was efficacious in 8 NFPA and 4 acromegalic tumors. Inhibiting the PI3K pathway in the same tumors, using BEZ235 suppressed cell viability at 10nM concentration in all NFPA and in two acromegalic tumors. In contrast, mTOR inhibition with everolimus was efficacious in all but one acromegalic cases, but in only 4 out of 15 NFPA. IGF-IR inhibition in acromegalic tumors in vitro was accompanied by increased GH secretion, which was evidenced when GH got normalized to cell viability assay counts. Similar GH increase was observed after mTOR but not in the same extend after PI3K inhibition (P=0.043), indicating a previously unsuspected role for the mTOR pathway on GH synthesis. Altogether, these data indicate a tumor specific dependency to the different IGF-IR signaling branches, with NFPA being sensitive to PI3K inhibition and acromegalic tumors to the mTOR inhibition. Targeting IGF-IR pathways have a potential as antiproliferative agents for the treatment of NFPA. In contrast their potent antiproliferative action in acromegalic tumors is compromised by the concomitant increase in GH secretion.
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