Impact of combined mTOR and MEK inhibition in uveal melanoma is driven by tumor genotype Journal Article


Authors: Ho, A. L.; Musi, E.; Ambrosini, G.; Nair, J. S.; Deraje Vasudeva, S.; de Stanchina, E.; Schwartz, G. K.
Article Title: Impact of combined mTOR and MEK inhibition in uveal melanoma is driven by tumor genotype
Abstract: Uveal melanomas possess activation of the mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/AKT/mammalian Target of Rapamycin (mTOR) pathways. MAPK activation occurs via somatic mutations in the heterotrimeric G protein subunits GNAQ and GNA11 for over 70% of tumors and less frequently via V600E BRAF mutations. In this report, we describe the impact of dual pathway inhibition upon uveal melanoma cell lines with the MEK inhibitor selumetinib (AZD6244/ARRY-142886) and the ATP-competitive mTOR kinase inhibitor AZD8055. While synergistic reductions in cell viability were observed with AZD8055/selumetinib in both BRAF and GNAQ mutant cell lines, apoptosis was preferentially induced in BRAF mutant cells only. In vitro apoptosis assay results were predictive of in vivo drug efficacy as tumor regressions were observed only in a BRAF mutant xenograft model, but not GNAQ mutant model. We went on to discover that GNAQ promotes relative resistance to AZD8055/selumetinib-induced apoptosis in GNAQ mutant cells. For BRAF mutant cells, both AKT and 4E-BP1 phosphorylation were modulated by the combination; however, decreasing AKT phosphorylation alone was not sufficient and decreasing 4E-BP1 phosphorylation was not required for apoptosis. Instead, cooperative mTOR complex 2 (mTORC2) and MEK inhibition resulting in downregulation of the pro-survival protein MCL-1 was found to be critical for combination-induced apoptosis. These results suggest that the clinical efficacy of combined MEK and mTOR kinase inhibition will be determined by tumor genotype, and that BRAF mutant malignancies will be particularly susceptible to this strategy. © 2012 Ho et al.
Journal Title: PLoS ONE
Volume: 7
Issue: 7
ISSN: 1932-6203
Publisher: Public Library of Science  
Date Published: 2012-01-01
Start Page: e40439
Language: English
DOI: 10.1371/journal.pone.0040439
PROVIDER: scopus
PMCID: PMC3393714
PUBMED: 22808163
DOI/URL:
Notes: --- - "Export Date: 1 August 2012" - "Source: Scopus"
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MSK Authors
  1. Gary Schwartz
    385 Schwartz
  2. Jayasree Nair
    17 Nair
  3. Alan Loh Ho
    237 Ho
  4. Elgilda Musi
    8 Musi