Background
Kinase inhibition in the mitogen activated protein kinase (MAPK)
pathway is a standard therapy for cancer patients with activating BRAF
mutations. However, the anti-tumorigenic effect and clinical benefit are
only transient, and tumors are prone to treatment resistance and relapse. To
elucidate mechanistic insights into drug resistance, we have established an
in vitro cellular model of MAPK inhibitor resistance in malignant
melanoma.
Methods
The cellular model evolved in response to clinical dosage of the
BRAF inhibitor, vemurafenib, PLX4032. We conducted transcriptomic expression
profiling using RNA-Seq and RT-qPCR arrays. Pathways of melanogenesis, MAPK
signaling, cell cycle, and metabolism were significantly enriched among the
set of differentially expressed genes of vemurafenib-resistant cells vs
control. The underlying mechanism of treatment resistance and pathway
rewiring was uncovered to be based on non-genomic adaptation and validated
in two distinct melanoma models, SK-MEL-28 and A375. Both cell lines have
activating BRAF mutations and display metastatic potential.
Results
Downregulation of dual specific phosphatases, tumor suppressors,
and negative MAPK regulators reengages mitogenic signaling. Upregulation of
growth factors, cytokines, and cognate receptors triggers signaling pathways
circumventing BRAF blockage. Further, changes in amino acid and one-carbon
metabolism support cellular proliferation despite MAPK inhibitor treatment.
In addition, treatment-resistant cells upregulate pigmentation and
melanogenesis, pathways which partially overlap with MAPK signaling.
Upstream regulator analysis discovered significant perturbation in oncogenic
forkhead box and hypoxia inducible factor family transcription factors.
Conclusions
The established cellular models offer mechanistic insight into
cellular changes and therapeutic targets under inhibitor resistance in
malignant melanoma. At a systems biology level, the MAPK pathway undergoes
major rewiring while acquiring inhibitor resistance. The outcome of this
transcriptional plasticity is selection for a set of transcriptional master
regulators, which circumvent upstream targeted kinases and provide
alternative routes of mitogenic activation. A fine-woven network of
redundant signals maintains similar effector genes allowing for tumor cell
...