Co-inhibition of SMAD and MAPK signaling enhances (124)I uptake in BRAF-mutant thyroid cancers Journal Article


Authors: Luckett, K. A.; Cracchiolo, J. R.; Krishnamoorthy, G. P.; Leandro-Garcia, L. J.; Nagarajah, J.; Saqcena, M.; Lester, R.; Im, S. Y.; Zhao, Z.; Lowe, S. W.; de Stanchina, E.; Sherman, E. J.; Ho, A. L.; Leach, S. D.; Knauf, J. A.; Fagin, J. A.
Article Title: Co-inhibition of SMAD and MAPK signaling enhances (124)I uptake in BRAF-mutant thyroid cancers
Abstract: Constitutive MAPK activation silences genes required for iodide uptake and thyroid hormone biosynthesis in thyroid follicular cells. Accordingly, most BRAFV600E papillary thyroid cancers (PTC) are refractory to radioiodide (RAI) therapy. MAPK pathway inhibitors rescue thyroid-differentiated properties and RAI responsiveness in mice and patient subsets with BRAFV600E-mutant PTC. TGFB1 also impairs thyroid differentiation and has been proposed to mediate the effects of mutant BRAF. We generate d a mouse model of BRAFV600E-PTC with thyroid-specific knockout of the Tgfbr1 gene to investigate the role of TGFB1 on thyroid-differentiated gene expression and RAI uptake in vivo. Despite appropriate loss of Tgfbr1, pSMAD levels remained high, indicating that ligands other than TGFB1 were engaging in this pathway. The activin ligand subunits Inhba and Inhbb were found to be overexpressed in BRAFV600E-mutant thyroid cancers. Treatment with follistatin, a potent inhibitor of activin, or vactosertib, which inhibits both TGFBR1 and the activin type I receptor ALK4, induced a profound inhibition of pSMAD in BRAFV600E-PTCs. Blocking SMAD signaling alone was insufficient to enhance iodide uptake in the setting of constitutive MAPK activation. However, combination treatment with either follistatin or vactosertib and the MEK inhibitor CKI increased 124I uptake compared to CKI alone. In summary, activin family ligands converge to induce pSMAD in Braf-mutant PTCs. Dedifferentiation of BRAFV600E-PTCs cannot be ascribed primarily to activation of SMAD. However, targeting TGFβ/activin-induced pSMAD augmented MAPK inhibitor effects on iodine incorporation into BRAF tumor cells, indicating that these two pathways exert interdependent effects on the differentiation state of thyroid cancer cells. © 2021 The authors.
Keywords: thyroid; braf; tgf beta; iodide uptake
Journal Title: Endocrine-Related Cancer
Volume: 28
Issue: 6
ISSN: 1351-0088
Publisher: Bioscientifica Ltd  
Date Published: 2021-06-01
Start Page: 391
End Page: 402
Language: English
DOI: 10.1530/erc-21-0017
PUBMED: 33890869
PROVIDER: scopus
PMCID: PMC8183640
DOI/URL:
Notes: Article -- Export Date: 1 July 2021 -- Source: Scopus
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MSK Authors
  1. James A Fagin
    180 Fagin
  2. Jeffrey A Knauf
    61 Knauf
  3. Eric J Sherman
    339 Sherman
  4. Alan Loh Ho
    237 Ho
  5. Scott W Lowe
    249 Lowe
  6. Zhen Zhao
    15 Zhao
  7. Steven Leach
    37 Leach
  8. Mahesh   Saqcena
    11 Saqcena
  9. Rona I Lester
    2 Lester
  10. Soo Yeon Im
    1 Im