Suppression of interferon gene expression overcomes resistance to MEK inhibition in KRAS-mutant colorectal cancer

Oncogene. 2019 Mar;38(10):1717-1733. doi: 10.1038/s41388-018-0554-z. Epub 2018 Oct 23.

Abstract

Despite showing clinical activity in BRAF-mutant melanoma, the MEK inhibitor (MEKi) trametinib has failed to show clinical benefit in KRAS-mutant colorectal cancer. To identify mechanisms of resistance to MEKi, we employed a pharmacogenomic analysis of MEKi-sensitive versus MEKi-resistant colorectal cancer cell lines. Strikingly, interferon- and inflammatory-related gene sets were enriched in cell lines exhibiting intrinsic and acquired resistance to MEK inhibition. The bromodomain inhibitor JQ1 suppressed interferon-stimulated gene (ISG) expression and in combination with MEK inhibitors displayed synergistic effects and induced apoptosis in MEKi-resistant colorectal cancer cell lines. ISG expression was confirmed in patient-derived organoid models, which displayed resistance to trametinib and were resensitized by JQ1 co-treatment. In in vivo models of colorectal cancer, combination treatment significantly suppressed tumor growth. Our findings provide a novel explanation for the limited response to MEK inhibitors in KRAS-mutant colorectal cancer, known for its inflammatory nature. Moreover, the high expression of ISGs was associated with significantly reduced survival of colorectal cancer patients. Excitingly, we have identified novel therapeutic opportunities to overcome intrinsic and acquired resistance to MEK inhibition in colorectal cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Azepines / administration & dosage*
  • Azepines / pharmacology
  • Cell Line, Tumor
  • Colorectal Neoplasms / drug therapy*
  • Colorectal Neoplasms / genetics
  • Colorectal Neoplasms / metabolism
  • Drug Resistance, Neoplasm / drug effects*
  • Drug Synergism
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects
  • Gene Regulatory Networks / drug effects*
  • Humans
  • Interferons / metabolism*
  • Mice
  • Mutation
  • Organoids / drug effects
  • Proto-Oncogene Proteins p21(ras) / genetics
  • Pyridones / administration & dosage*
  • Pyridones / pharmacology
  • Pyrimidinones / administration & dosage*
  • Pyrimidinones / pharmacology
  • Triazoles / administration & dosage*
  • Triazoles / pharmacology
  • Xenograft Model Antitumor Assays

Substances

  • (+)-JQ1 compound
  • Azepines
  • KRAS protein, human
  • Pyridones
  • Pyrimidinones
  • Triazoles
  • trametinib
  • Interferons
  • Proto-Oncogene Proteins p21(ras)