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Targeting melanoma's MCL1 bias unleashes the apoptotic potential of BRAF and ERK1/2 pathway inhibitors.

Accepted version
Peer-reviewed

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Authors

Sale, Matthew J 
Minihane, Emma 
Monks, Noel R 
Gilley, Rebecca 
Richards, Frances M  ORCID logo  https://orcid.org/0000-0001-7947-7853

Abstract

BRAF and MEK1/2 inhibitors are effective in melanoma but resistance inevitably develops. Despite increasing the abundance of pro-apoptotic BIM and BMF, ERK1/2 pathway inhibition is predominantly cytostatic, reflecting residual pro-survival BCL2 family activity. Here, we show that uniquely low BCL-XL expression in melanoma biases the pro-survival pool towards MCL1. Consequently, BRAF or MEK1/2 inhibitors are synthetic lethal with the MCL1 inhibitor AZD5991, driving profound tumour cell death that requires BAK/BAX, BIM and BMF, and inhibiting tumour growth in vivo. Combination of ERK1/2 pathway inhibitors with BCL2/BCL-w/BCL-XL inhibitors is stronger in CRC, correlating with a low MCL1:BCL-XL ratio; indeed the MCL1:BCL-XL ratio is predictive of ERK1/2 pathway inhibitor synergy with MCL1 or BCL2/BCL-w/BCL-XL inhibitors. Finally, AZD5991 delays acquired BRAFi/MEKi resistance and enhances the efficacy of an ERK1/2 inhibitor in a model of acquired BRAFi + MEKi resistance. Thus combining ERK1/2 pathway inhibitors with MCL1 antagonists in melanoma could improve therapeutic index and patient outcomes.

Description

Keywords

Animals, Apoptosis, Cell Line, Tumor, Cell Survival, Drug Resistance, Neoplasm, Humans, MAP Kinase Signaling System, Macrocyclic Compounds, Melanoma, Mice, Molecular Targeted Therapy, Myeloid Cell Leukemia Sequence 1 Protein, Protein Kinase Inhibitors, Proto-Oncogene Proteins B-raf, bcl-X Protein

Journal Title

Nat Commun

Conference Name

Journal ISSN

2041-1723
2041-1723

Volume Title

10

Publisher

Springer Science and Business Media LLC

Rights

All rights reserved
Sponsorship
Cancer Research UK (CB4270)
This study was funded by an AstraZeneca- Cambridge Cancer Centre Collaborative Award (S.J.C., M.J.S., D.I.J. & F.M.R.), Cancer Research UK grants A14867 (S.J.C. & E.O.) and A15678 (D.I.J. and F.M.R), a Cambridge Trusts PhD studentship (E.M. & S.J.C.), Institute Strategic Programme Grants BB/J004456/1 and BB/P013384/1 from BBSRC (S.J.C., K.B. & R.G.) and AstraZeneca