Sustained ERK inhibition maximizes responses of Braf(V600E) thyroid cancers to radioiodine Journal Article


Authors: Nagarajah, J.; Le, M.; Knauf, J. A.; Ferrandino, G.; Montero-Conde, C.; Pillarsetty, N.; Bolaender, A.; Irwin, C.; Krishnamoorthy, G. P.; Saqcena, M.; Larson, S. M.; Ho, A. L.; Seshan, V.; Ishii, N.; Carrasco, N.; Rosen, N.; Weber, W. A.; Fagin, J. A.
Article Title: Sustained ERK inhibition maximizes responses of Braf(V600E) thyroid cancers to radioiodine
Abstract: Radioiodide (RAI) therapy of thyroid cancer exploits the relatively selective ability of thyroid cells to transport and accumulate iodide. Iodide uptake requires expression of critical genes that are involved in various steps of thyroid hormone biosynthesis. ERK signaling, which is markedly increased in thyroid cancer cells driven by oncogenic BRAF, represses the genetic program that enables iodide transport. Here, we determined that a critical threshold for inhibition of MAPK signaling is required to optimally restore expression of thyroid differentiation genes in thyroid cells and in mice with BrafV600E-induced thyroid cancer. Although the MEK inhibitor selumetinib transiently inhibited ERK signaling, which subsequently rebounded, the MEK inhibitor CKI suppressed ERK signaling in a sustained manner by preventing RAF reactivation. A small increase in ERK inhibition markedly increased the expression of thyroid differentiation genes, increased iodide accumulation in cancer cells, and thereby improved responses to RAI therapy. Only a short exposure to the drug was necessary to obtain a maximal response to RAI. These data suggest that potent inhibition of ERK signaling is required to adequately induce iodide uptake and indicate that this is a promising strategy for the treatment of BRAF-mutant thyroid cancer.
Journal Title: Journal of Clinical Investigation
Volume: 126
Issue: 11
ISSN: 0021-9738
Publisher: American Society for Clinical Investigation  
Date Published: 2016-11-01
Start Page: 4119
End Page: 4124
Language: English
DOI: 10.1172/jci89067
PROVIDER: scopus
PMCID: PMC5096947
PUBMED: 27669459
DOI/URL:
Notes: Article -- Export Date: 6 December 2016 -- Source: Scopus
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MSK Authors
  1. James A Fagin
    180 Fagin
  2. Jeffrey A Knauf
    61 Knauf
  3. Steven M Larson
    958 Larson
  4. Christopher P. Irwin
    10 Irwin
  5. Wolfgang Andreas Weber
    173 Weber
  6. Mina Nguyen Le
    1 Le
  7. Mahesh   Saqcena
    11 Saqcena