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Overcoming Therapeutic Resistance in HER2-Positive Breast Cancers with CDK4/6 Inhibitors

机译:用CDK4 / 6抑制剂克服HER2阳性乳腺癌的治疗耐药性。

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摘要

Using transgenic mouse models, cell line-based functional studies, and clinical specimens, we show that cyclin D1/CDK4 mediate resistance to targeted therapy for HER2-positive breast cancer. This is overcome using CDK4/6 inhibitors. Inhibition of CDK4/6 not only suppresses Rb phosphorylation, but also reduces TSC2 phosphorylation and thus partially attenuates mTORC1 activity. This relieves feedback inhibition of upstream EGFR family kinases, resensitizing tumors to EGFR/HER2 blockade. Consequently, dual inhibition of EGFR/HER2 and CDK4/6 invokes a more potent suppression of TSC2 phosphorylation and hence mTORC1/S6K/ S6RP activity. The suppression of both Rb and S6RP enhances G1 arrest and a phenotype resembling cellular senescence. In vivo, CDK4/6 inhibitors sensitize patient-derived xenograft tumors to HER2-targeted therapies and delay tumor recurrence in a transgenic model of HER2-positive breast cancer.
机译:使用转基因小鼠模型,基于细胞系的功能研究和临床标本,我们显示出细胞周期蛋白D1 / CDK4介导对HER2阳性乳腺癌靶向治疗的耐药性。使用CDK4 / 6抑制剂可以克服这一问题。抑制CDK4 / 6不仅抑制Rb磷酸化,而且降低TSC2磷酸化,从而部分减弱mTORC1活性。这减轻了上游EGFR家族激酶的反馈抑制,使肿瘤对EGFR / HER2阻断重新敏感。因此,对EGFR / HER2和CDK4 / 6的双重抑制会更有效地抑制TSC2磷酸化,从而抑制mTORC1 / S6K / S6RP活性。 Rb和S6RP的抑制作用增强了G1阻滞和类似于细胞衰老的表型。在体内,在HER2阳性乳腺癌的转基因模型中,CDK4 / 6抑制剂可使患者衍生的异种移植肿瘤对靶向HER2的疗法敏感,并延迟肿瘤的复发。

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