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      Disruption of the Interaction of RAS with PI 3-Kinase Induces Regression of EGFR-Mutant-Driven Lung Cancer

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          Summary

          RAS family GTPases contribute directly to the regulation of type I phosphoinositide 3-kinases (PI3Ks) via RAS-binding domains in the PI3K catalytic p110 subunits. Disruption of this domain of p110α impairs RAS-mutant-oncogene-driven tumor formation and maintenance. Here, we test the effect of blocking the interaction of RAS with p110α on epidermal growth factor receptor (EGFR)-mutant-driven lung tumorigenesis. Disrupting the RAS-PI3K interaction inhibits activation of both AKT and RAC1 in EGFR-mutant lung cancer cells, leading to reduced growth and survival, and inhibits EGFR-mutant-induced tumor onset and promotes major regression of established tumors in an autochthonous mouse model of EGFR-mutant-induced lung adenocarcinoma. The RAS-PI3K interaction is thus an important signaling node and potential therapeutic target in EGFR-mutant lung cancer, even though RAS oncogenes are not themselves mutated in this setting, suggesting different strategies for tackling tyrosine kinase inhibitor resistance in lung cancer.

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          Highlights

          • Disrupting the interaction of PI 3-kinase with RAS impairs EGF activation of AKT and RAC

          • Mice bred with RAS-binding-domain-defective PI 3-kinase and activated EGFR mutant

          • Abrogating RAS binding to PI 3-kinase blocks EGFR-induced lung tumor initiation

          • Blocking the RAS-PI 3-kinase interaction induces regression of EGFR-induced tumors

          Abstract

          The interaction between RAS and PI 3-kinase is essential for RAS-mutant-induced carcinogenesis. Murillo et al. show that in EGFR-mutant-driven lung cancer, disruption of the interaction of PI 3-kinase with normal RAS proteins blocks tumor initiation and promotes regression of existing tumors, highlighting an unexpected vulnerability of EGFR-driven lung cancer.

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          Most cited references13

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          New driver mutations in non-small-cell lung cancer.

          Treatment decisions for patients with lung cancer have historically been based on tumour histology. Some understanding of the molecular composition of tumours has led to the development of targeted agents, for which initial findings are promising. Clearer understanding of mutations in relevant genes and their effects on cancer cell proliferation and survival, is, therefore, of substantial interest. We review current knowledge about molecular subsets in non-small-cell lung cancer that have been identified as potentially having clinical relevance to targeted therapies. Since mutations in EGFR and KRAS have been extensively reviewed elsewhere, here, we discuss subsets defined by so-called driver mutations in ALK, HER2 (also known as ERBB2), BRAF, PIK3CA, AKT1, MAP2K1, and MET. The adoption of treatment tailored according to the genetic make-up of individual tumours would involve a paradigm shift, but might lead to substantial therapeutic improvements. Copyright © 2011 Elsevier Ltd. All rights reserved.
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            Phosphatidylinositol-3-OH kinase as a direct target of Ras.

            Ras (p21ras) interacts directly with the catalytic subunit of phosphatidylinositol-3-OH kinase in a GTP-dependent manner through the Ras effector site. In vivo, dominant negative Ras mutant N17 inhibits growth factor induced production of 3' phosphorylated phosphoinositides in PC12 cells, and transfection of Ras, but not Raf, into COS cells results in a large elevation in the level of these lipids. Therefore Ras can probably regulate phosphatidylinositol-3-OH kinase, providing a point of divergence in signalling pathways downstream of Ras.
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              Rociletinib in EGFR-mutated non-small-cell lung cancer.

              Non-small-cell lung cancer (NSCLC) with a mutation in the gene encoding epidermal growth factor receptor (EGFR) is sensitive to approved EGFR inhibitors, but resistance develops, mediated by the T790M EGFR mutation in most cases. Rociletinib (CO-1686) is an EGFR inhibitor active in preclinical models of EGFR-mutated NSCLC with or without T790M. In this phase 1-2 study, we administered rociletinib to patients with EGFR-mutated NSCLC who had disease progression during previous treatment with an existing EGFR inhibitor. In the expansion (phase 2) part of the study, patients with T790M-positive disease received rociletinib at a dose of 500 mg twice daily, 625 mg twice daily, or 750 mg twice daily. Key objectives were assessment of safety, side-effect profile, pharmacokinetics, and preliminary antitumor activity of rociletinib. Tumor biopsies to identify T790M were performed during screening. Treatment was administered in continuous 21-day cycles. A total of 130 patients were enrolled. The first 57 patients to be enrolled received the free-base form of rociletinib (150 mg once daily to 900 mg twice daily). The remaining patients received the hydrogen bromide salt (HBr) form (500 mg twice daily to 1000 mg twice daily). A maximum tolerated dose (the highest dose associated with a rate of dose-limiting toxic effects of less than 33%) was not identified. The only common dose-limiting adverse event was hyperglycemia. In an efficacy analysis that included patients who received free-base rociletinib at a dose of 900 mg twice daily or the HBr form at any dose, the objective response rate among the 46 patients with T790M-positive disease who could be evaluated was 59% (95% confidence interval [CI], 45 to 73), and the rate among the 17 patients with T790M-negative disease who could be evaluated was 29% (95% CI, 8 to 51). Rociletinib was active in patients with EGFR-mutated NSCLC associated with the T790M resistance mutation. (Funded by Clovis Oncology; ClinicalTrials.gov number, NCT01526928.).
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                Author and article information

                Contributors
                Journal
                Cell Rep
                Cell Rep
                Cell Reports
                Cell Press
                2211-1247
                26 December 2018
                26 December 2018
                26 December 2018
                : 25
                : 13
                : 3545-3553.e2
                Affiliations
                [1 ]Institute of Cancer Research, 237 Fulham Road, London SW3 6JB, UK
                [2 ]Francis Crick Institute, 1 Midland Road, London NW1 1AT, UK
                Author notes
                []Corresponding author julian.downward@ 123456crick.ac.uk
                [3]

                Lead Contact

                Article
                S2211-1247(18)31914-4
                10.1016/j.celrep.2018.12.003
                6315106
                30590030
                508a5667-1b2d-4d76-b38e-701642ea13e4
                © 2018 The Author(s)

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

                History
                : 13 March 2018
                : 11 October 2018
                : 30 November 2018
                Categories
                Article

                Cell biology
                ras,kras,egfr,pi3k,pik3ca,lung cancer,rac1
                Cell biology
                ras, kras, egfr, pi3k, pik3ca, lung cancer, rac1

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