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Due to a usually late diagnosis, drug resistance and early metastases, pancreatic ductal adenocarcinoma (PDAC) is the seventh leading cause of global cancer deaths. Thus, there is an urgent need to develop new therapeutic concepts. Two different approaches have in recent years become the focus of intense research: (1) targeting cancer-associated metabolic rearrangements, and (2) targeting genetic vulnerabilities with combination therapy. Both concepts potentially have advantages such as increased efficacy, which decreases the likelihood of therapy-resistance, and reduced side effects, that are often associated with high concentrations of chemotherapeutic drugs. Autophagy is an evolutionary conserved signalling pathway that regulates cellular homeostasis. Regarding cancer, autophagy can either promote or suppress tumor growth. However, mouse models that allow genetic regulation of autophagy in established tumor tissue are not yet established. Therefore, we analysed new inducible shRNA mouse models targeting Atg5 or Atg7 with regard to functionality and toxicity. Both, shRNA Atg5- and shRNA Atg7-mediated knockdown anteceded functional autophagy impairment, and revealed unexpected profound phenotypic differences. Knockdown of Atg5 neither impaired the animal nor caused any grossly or microscopically detectable organ damage, whereas knockdown of Atg7 caused pancreatic destruction and eventually death. It is currently unclear whether mice died as a result of exocrine or endocrine collapse or due to a combination of both. The presented mouse models are highly potent RNAi mice that allow widespread and regulable inhibition of autophagy upon administration of doxycycline and provide a valuable and versatile toolbox for future autophagy and cancer research. In PDAC, argininosuccinate synthase 1 (ASS1) deficiency has been associated with higher recurrence rates, shorter disease-free survival, and shorter overall survival. During cancer development, rate-limiting enzymes of de novo arginine synthesis, like ASS1 or OTC, are downregulated via epigenetic silencing of their respective promotor. Known as ‘arginine auxotrophy‘, loss of these essential enzymes results in dependence on extracellular arginine. Based on this assumption, sensitivity of various cell lines to arginine deprivation was reported. However, the underlying mechanism is still unclear and the anti-tumor effects of the monotherapy are not sufficient to completely abrogate cancer cells. Therefore, the effects of arginine deprivation via rhArgI-PEG5000 were investigated in murine and human PDAC cells. In this study, we highlighted that arginine deprivation induced profound alterations such as autophagosome accumulation, induction of senescence and the ISR in pancreatic cancer cells. These alterations are potential genetic vulnerabilities that can be targeted by additional means to induce tumor cell death.
Identification of new drug targets in adrenocortical carcinoma through targeted mRNA analysis
(2021)
Adrenocortical carcinomas (ACC) are aggressive tumors associated with a heterogeneous but generally poor prognosis and limited treatment options for advanced stages. Despite promising molecular insights and improved understanding of ACC biology, efficient targeted therapies have not been identified yet. Thus, this study aims to identify potential new drug targets for a future personalized therapeutic approach.
RNA was isolated from 104 formalin-fixed paraffin-embedded tumor samples from ACC patients, 40 of those 104 cases proved to be suitable for further mRNA analyses according to the quality check of the extracted RNA. Gene expression of 84 known cancer drug targets was evaluated by quantitative real-time PCR using 5 normal adrenal glands as reference. Protein expression was investigated for selected candidate drug targets by immunohistochemistry in 104 ACC samples, 11 adenomas and 6 normal adrenal glands. Efficacy of an available inhibitor of the most promising candidate was tested by functional in vitro experiments in two ACC cell lines (NCI-H295R and MUC1) alone or in combination with other drugs.
Most frequently overexpressed genes were TOP2A, IGF2, CDK1, CDK4, PLK4 and PLK1. Nuclear immunostaining of CDK1, CDK4 and PLK1 significantly correlated with the respective mRNA expression. CDK4 was chosen as the most promising candidate for functional validation as it is actionable by FDA-approved CDK4/6 inhibitors. ACC samples with copy number gains at CDK4 locus presented significantly higher CDK4 expression levels. The CDK4/6 inhibitor palbociclib showed a concentration- and time- dependent reduction of cell viability in vitro, which was more pronounced in NCI-H295R than in MUC1 cells. This was in line with higher CDK4 expression at western blot analysis in NCI-H295R cells. Furthermore, palbociclib was applied in combination with dual IGFR/IR inhibitor linsitinib showing a synergistic effect on reducing cell viability. In conclusion, this proof-of-principle study confirmed RNA profiling to be useful to discover potential drug targets. Detected drug targets are suitable to be investigated by immunohistochemistry in the clinical setting. Moreover, CDK4/6 inhibitors are promising candidates for treatment of a subset of patients with tumors presenting CDK4 copy number gains and/or overexpression, while linsitinib might be an interesting combination partner in patients with both IGF2 and IGF1R overexpression.
These results are intended as a basis for a validation study in a prospective cohort, further evaluation in vivo in suitable mouse models or testing in patients with ACC in clinical trials are needed and might improve the future management of patients with ACC in terms of precision medicine.