Dual MAPK Inhibition Is an Effective Therapeutic Strategy for a Subset of Class II BRAF Mutant Melanomas

  • Matthew Dankner
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Mathieu Lajoie
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Dan Moldoveanu
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Tan-Trieu Nguyen
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Paul Savage
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Shivshankari Rajkumar
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Xiu Huang
    5KEW Inc., Cambridge, Massachusetts.
  • Maria Lvova
    5KEW Inc., Cambridge, Massachusetts.
  • Alexei Protopopov
    5KEW Inc., Cambridge, Massachusetts.
  • Dana Vuzman
    5KEW Inc., Cambridge, Massachusetts.
  • David Hogg
    8Princess Margaret Cancer Centre, Toronto, Ontario, Canada.
  • Morag Park
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Marie-Christine Guiot
    9Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada.
  • Kevin Petrecca
    9Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada.
  • Catalin Mihalcioiu
    11McGill University Health Centre, McGill University, Montréal, Québec, Canada.
  • Ian R. Watson
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • Peter M. Siegel
    1Goodman Cancer Research Centre, McGill University, Montréal, Québec, Canada.
  • April A.N. Rose
    12Division of Medical Oncology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada.

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<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Purpose:</jats:title> <jats:p>Dual MAPK pathway inhibition (dMAPKi) with BRAF and MEK inhibitors improves survival in BRAF V600E/K mutant melanoma, but the efficacy of dMAPKi in non-V600 BRAF mutant tumors is poorly understood. We sought to characterize the responsiveness of class II (enhanced kinase activity, dimerization dependent) BRAF mutant melanoma to dMAPKi.</jats:p> </jats:sec> <jats:sec> <jats:title>Experimental Design:</jats:title> <jats:p>Tumors from patients with BRAF wild-type (WT), V600E (class I), and L597S (class II) metastatic melanoma were used to generate patient-derived xenografts (PDX). We assembled a panel of melanoma cell lines with class IIa (activation segment) or IIb (p-loop) mutations and compared these with WT or V600E/K BRAF mutant cells. Cell lines and PDXs were treated with BRAFi (vemurafenib, dabrafenib, encorafenib, and LY3009120), MEKi (cobimetinib, trametinib, and binimetinib), or the combination. We identified 2 patients with BRAF L597S metastatic melanoma who were treated with dMAPKi.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>BRAFi impaired MAPK signaling and cell growth in class I and II BRAF mutant cells. dMAPKi was more effective than either single MAPKi at inhibiting cell growth in all class II BRAF mutant cells tested. dMAPKi caused tumor regression in two melanoma PDXs with class II BRAF mutations and prolonged survival of mice with class II BRAF mutant melanoma brain metastases. Two patients with BRAF L597S mutant melanoma clinically responded to dMAPKi.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Class II BRAF mutant melanoma is growth inhibited by dMAPKi. Responses to dMAPKi have been observed in 2 patients with class II BRAF mutant melanoma. These data provide rationale for clinical investigation of dMAPKi in patients with class II BRAF mutant metastatic melanoma.</jats:p> <jats:p>See related commentary by Johnson and Dahlman, p. 6107.</jats:p> </jats:sec>

収録刊行物

  • Clinical Cancer Research

    Clinical Cancer Research 24 (24), 6483-6494, 2018-12-13

    American Association for Cancer Research (AACR)

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