No abstract

Cellular heterogeneity in cancer was observed decades ago by studies in mice which showed that distinct subpopulations of cells within a tumor mass are capable of driving tumorigenesis. Conceptualized from this finding was the stem-cell hypothesis for cancer, which suggests that only a specific subset of cancer cells within each tumor is responsible for tumor initiation and propagation, termed tumor initiating cells or cancer stem cells (CSCs). Recent data has been provided to support the existence of CSCs in human blood cell-derived cancers and solid organ tumors of the breast, brain, prostate, colon, and skin. Study of human pancreatic cancers has also revealed a specific subpopulation of cancer cells that possess the characteristics of CSCs. These pancreatic cancer stem cells express the cell surface markers CD44, CD24, and epithelial-specific antigen, and represent 0.5% to 1.0% of all pancreatic cancer cells. Along with the properties of self-renewal and multilineage differentiation, pancreatic CSCs display upregulation of important developmental genes that maintain self-renewal in normal stem cells, including Sonic hedgehog (SHH) and BMI-1. Signaling cascades that are integral in tumor metastasis are also upregulated in the pancreatic CSC. Understanding the biologic behavior and the molecular pathways that regulate growth, survival, and metastasis of pancreatic CSCs will help to identify novel therapeutic approaches to treat this dismal disease.

Transforming growth factor-β (TGFβ) signaling regulates cell proliferation, differentiation, and development. The binding of TGFβ to TGFβ receptor 2 (TGFBRII) induces the interaction between TGFβ receptor 1 (TGFBRI) and TGFBRII, leading to the phosphorylation and activation of transcriptional regulators SMAD2 and SMAD3. Using an siRNA screen of the human kinome and a live-cell reporter for TGFBR activity, we identified BUB1 (budding uninhibited by benzimidazoles-1), a Ser/Thr kinase, as an essential mediator of TGFβ signaling. BUB1 interacted with TGFBRI in response to stimulation with TGFβ and promoted the heterodimerization of TGFBRI and TGFBRII. Additionally, BUB1 interacted with TGFBRII, suggesting the formation of a ternary complex. Knocking down BUB1 prevented the recruitment of SMAD3 to the receptor complex, the phosphorylation of SMAD2/3 and their interaction with SMAD4, SMAD-dependent transcription, and TGFβ-mediated changes in cellular phenotype including epithelial-mesenchymal transition (EMT), migration, and invasion. Non-canonical signaling cascades of the TGFβ pathway mediated by the kinases AKT and p38 MAPK also mediated by BUB1, suggesting an upstream positioning for BUB1 in the TGFβ pathway. Although the substrate for BUB1 was elusive, its function in promoting TGFβ signaling was dependent on its kinase function: A small-molecule inhibitor of BUB1 kinase (2OH-BNPP1) and a kinase-deficient mutant of BUB1 abrogated TGFβ signaling and formation of the ternary complex in various normal and cancer cell lines. 2OH-BNPP1 administration to mice bearing lung carcinoma xenografts reduced the amount of phosphorylated SMAD2 in tumor tissue. These findings provide evidence for a role of BUB1 as a kinase in mediating TGFβ-dependent signaling beyond its established function in cell-cycle regulation and chromosome cohesion.

Purpose The emerging need for rational combination treatment approaches led us to test the concept that co-targeting MEK and CDK4/6 would prove efficacious in KRAS mutant (KRASmt) colorectal cancers, where upregulated CDK4 and hyperphosphorylated retinoblastoma (RB) typify the vast majority of tumors. Experimental Design Initial testing was carried out in the HCT-116 tumor model, which is known to harbor a KRAS mutation. Efficacy studies were then performed with five RB+ patient-derived colorectal xenograft models, genomically diverse with respect to KRAS, BRAF, and PIK3CA mutational status. Tolerance, efficacy, and pharmacodynamic evaluation of target modulation were evaluated in response to daily dosing with either agent alone or concurrent co-administration. Results Synergy was observed in vitro when HCT-116 cells were treated over a broad range of doses of trametinib and palbociclib. Subsequent in vivo evaluation of this model showed a higher degree of antitumor activity resulting from the combination compared to that achievable with single agent treatment. Testing of colorectal patient-derived xenograft (PDX) models further showed that combination of trametinib and palbociclib was well tolerated and resulted in objective responses in all KRASmt models tested. Stasis was observed in a KRAS/BRAF wild type and a BRAFmt model. Conclusions Combination of trametinib and palbociclib was well tolerated and highly efficacious in all three KRAS mutant CRC PDX models tested. Promising preclinical activity seen here supports clinical evaluation of this treatment approach to improve therapeutic outcome for metastatic colorectal cancer patients.

Patients with many types of malignancy commonly harbor quiescent disseminated tumor cells in bone marrow. These cells frequently resist chemotherapy and may persist for years before proliferating as recurrent metastases. To test for compounds that eliminate quiescent cancer cells, we established a new 384-well 3D spheroid model in which small numbers of cancer cells reversibly arrest in G1/G0 phase of the cell cycle when cultured with bone marrow stromal cells. Using dual-color bioluminescence imaging to selectively quantify viability of cancer and stromal cells in the same spheroid, we identified single compounds and combination treatments that preferentially eliminated quiescent breast cancer cells but not stromal cells. A treatment combination effective against malignant cells in spheroids also eliminated breast cancer cells from bone marrow in a mouse xenograft model. This research establishes a novel screening platform for therapies that selectively target quiescent tumor cells, facilitating identification of new drugs to prevent recurrent cancer.