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Inhibition of MEK and PI3K/mTOR suppresses tumor growth but does not cause tumor regression in patient-derived xenografts of RAS-mutant colorectal carcinomas.
Clin Cancer Res ; 18(9): 2515-25, 2012 May 01.
Article en En | MEDLINE | ID: mdl-22392911
ABSTRACT

PURPOSE:

Gene mutations along the Ras pathway (KRAS, NRAS, BRAF, PIK3CA) occur in approximately 50% of colorectal cancers (CRC) and correlate with poor response to anti-EGF receptor (EGFR) therapies. We assessed the effects of mitogen-activated protein (MAP)/extracellular signal-regulated kinase (ERK) kinase (MEK) and phosphoinositide 3-kinase (PI3K)/mTOR inhibitors, which neutralize the major Ras effectors, in patient-derived xenografts from RAS/RAF/PIK3CA-mutant metastatic CRCs (mCRC). EXPERIMENTAL

DESIGN:

Forty mCRC specimens harboring KRAS, NRAS, BRAF, and/or PIK3CA mutations were implanted in nonobese diabetic/severe combined immunodeficient (NOD/SCID) mice. Each xenograft was expanded into four treatment arms placebo, the MEK inhibitor AZD6244, the PI3K/mTOR inhibitor, BEZ235, or AZD6244 + BEZ235. Cases initially treated with placebo crossed over to AZD6244, BEZ235, and the anti-EGFR monoclonal antibody cetuximab.

RESULTS:

At the 3-week evaluation time point, cotreatment of established tumors with AZD6244 + BEZ235 induced disease stabilization in the majority of cases (70%) but did not lead to overt tumor regression. Monotherapy was less effective, with BEZ235 displaying higher activity than AZD6244 (disease control rates, DCRs AZD6244, 27.5%; BEZ235, 42.5%). Triple therapy with cetuximab provided further advantage (DCR, 88%). The extent of disease control declined at the 6-week evaluation time point (DCRs AZD6244, 13.9%; BEZ235, 16.2%; AZD6244 + BEZ235, 34%). Cross-analysis of mice harboring xenografts from the same original tumor and treated with each of the different modalities revealed subgroups with preferential sensitivity to AZD6244 (12.5%), BEZ235 (35%), or AZD6244 + BEZ235 (42.5%); another subgroup (10%) showed equivalent response to any treatment.

CONCLUSIONS:

The prevalent growth-suppressive effects produced by MEK and PI3K/mTOR inhibition suggest that this strategy may retard disease progression in patients. However, data offer cautionary evidence against the occurrence of durable responses.
Asunto(s)

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Genes ras / 1-Fosfatidilinositol 4-Quinasa / Quinasas de Proteína Quinasa Activadas por Mitógenos / Serina-Treonina Quinasas TOR / Neoplasias Hepáticas / Mutación Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Animals / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Cancer Res Asunto de la revista: NEOPLASIAS Año: 2012 Tipo del documento: Article País de afiliación: Italia

Texto completo: 1 Base de datos: MEDLINE Asunto principal: Neoplasias Colorrectales / Genes ras / 1-Fosfatidilinositol 4-Quinasa / Quinasas de Proteína Quinasa Activadas por Mitógenos / Serina-Treonina Quinasas TOR / Neoplasias Hepáticas / Mutación Tipo de estudio: Clinical_trials / Observational_studies / Risk_factors_studies Límite: Aged / Aged80 / Animals / Female / Humans / Male / Middle aged Idioma: En Revista: Clin Cancer Res Asunto de la revista: NEOPLASIAS Año: 2012 Tipo del documento: Article País de afiliación: Italia