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SIGNATURE-DRIVEN REPURPOSING OF MIDOSTAURIN FOR COMBINATION WITH MEK1/2 AND KRASG12C INHIBITORS IN LUNG CANCER

Authors: Irati Macaya; Marta Roman; Connor Welch; Rodrigo Entrialgo-Cadierno; Marina Salmon; Alba Santos; Iker Feliu; +25 Authors

SIGNATURE-DRIVEN REPURPOSING OF MIDOSTAURIN FOR COMBINATION WITH MEK1/2 AND KRASG12C INHIBITORS IN LUNG CANCER

Abstract

Abstract Resistance mechanisms compromise response to single targeted therapies, favoring the idea that combinatorial strategies are key to circumvent this clinical problem. Combinatorial strategies for cancers driven by oncogenic KRAS based on MEK1/2 or KRASG12C inhibitors have so far incorporated abrogation of KRAS proximal effectors involved in oncogenesis or treatment resistance. However, the antitumor effect is highly determined by compensatory mechanisms specifically arising in certain cell types or tumor subgroups. A potential strategy to find drug combinations spanning a large percentage of mutant KRAS lung cancers may capitalize on the common, distal gene expression output elicited by oncogenic KRAS. Here, integrating a signature-driven drug repurposing approach and a pairwise pharmacological screen, we identify a synergistic drug combination consisting of multityrosine kinase PKC and MEK1/2 inhibitors. The drug combination functions in a genotype specific manner, elicits a cytotoxic response both in vitro and in vivo models, and in part involves inhibition of AURKB. Furthermore, we show that the KRASG12C inhibitor Sotorasib can replace the MEK inhibitor with similar cellular and molecular results, including antitumor effect in a genetically engineered mouse model of lung cancer driven by KRasG12C. Proteome profiling links dysregulation of MYC expression to the effect of PKC inhibitor-based drug combinations. Furthermore, we demonstrate that MYC overexpression functions as a resistance mechanism to MEK1/2 and KRASG12C inhibitors. Our study provides a rational framework to nominate drugs entering combinatorial strategies and unveils novel MEK1/2- and KRASG12C-based therapies for lung cancer.

Country
Spain
Keywords

MEK1/2, Lung Neoplasms, Science, Q, Drug Repositioning, Staurosporine, Materias Investigacion::Ciencias de la Salud::Oncología, Article, Proto-Oncogene Proteins p21(ras), Drug Combinations, Targeted therapies, Cell Line, Tumor, Mutation, Humans, MEK1/2 inhibitorss, Midostaurin, Lung cancer, Protein Kinase Inhibitors, KRASG12C inhibitors, Cancer

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
views
OpenAIRE UsageCountsViews provided by UsageCounts
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18
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38
53
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