Abstract
Autocrine VEGF signaling is critical for sustaining prostate and other cancer stem cells (CSCs), and it is a potential therapeutic target, but we observed that CSCs isolated from prostate tumors are resistant to anti-VEGF (bevacizumab) and anti-VEGFR (sunitinib) therapy. Intriguingly, resistance is mediated by VEGF/neuropilin signaling, which is not inhibited by bevacizumab and sunitinib, and it involves the induction of P-Rex1, a Rac GEF, and consequent Rac1-mediated ERK activation. This induction of P-Rex1 is dependent on Myc. CSCs isolated from the PTEN(pc-/-) transgenic model of prostate cancer exhibit Rac1-dependent resistance to bevacizumab. Rac1 inhibition or P-Rex1 downregulation increases the sensitivity of prostate tumors to bevacizumab. These data reveal that prostate tumors harbor cells with stem cell properties that are resistant to inhibitors of VEGF/VEGFR signaling. Combining the use of available VEGF/VEGFR-targeted therapies with P-Rex1 or Rac1 inhibition should improve the efficacy of these therapies significantly.
Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.
Publication types
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Research Support, N.I.H., Extramural
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Research Support, U.S. Gov't, Non-P.H.S.
MeSH terms
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Adenocarcinoma / drug therapy
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Adenocarcinoma / metabolism*
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Angiogenesis Inhibitors / pharmacology
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Animals
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Bevacizumab / pharmacology
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Carcinogenesis / metabolism
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Cell Line, Tumor
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Cell Survival / drug effects
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Drug Resistance, Neoplasm*
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Gene Expression Regulation, Neoplastic
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Guanine Nucleotide Exchange Factors / physiology*
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Humans
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Indoles / pharmacology
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Inhibitory Concentration 50
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Male
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Mice, Inbred NOD
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Mice, SCID
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Molecular Targeted Therapy
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Neoplastic Stem Cells / drug effects
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Neoplastic Stem Cells / physiology
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Prostatic Neoplasms / drug therapy
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Prostatic Neoplasms / metabolism*
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Pyrroles / pharmacology
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Receptors, Vascular Endothelial Growth Factor / antagonists & inhibitors
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Sunitinib
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Vascular Endothelial Growth Factor A / antagonists & inhibitors
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Xenograft Model Antitumor Assays
Substances
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Angiogenesis Inhibitors
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Guanine Nucleotide Exchange Factors
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Indoles
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PREX1 protein, human
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Pyrroles
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VEGFA protein, human
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Vascular Endothelial Growth Factor A
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Bevacizumab
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Receptors, Vascular Endothelial Growth Factor
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Sunitinib