Responses to targeted therapy

Thomas McFall, Jolene K. Diedrich, Meron Mengistu, Stacy L. Littlechild, Kendra V. Paskvan, Laura Sisk-Hackworth, James J. Moresco, Andrey S. Shaw, Edward C. Stites

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Cancer treatment decisions are increasingly guided by which specific genes are mutated within each patient's tumor. For example, agents inhibiting the epidermal growth factor receptor (EGFR) benefit many colorectal cancer (CRC) patients, with the general exception of those whose tumor includes a KRAS mutation. However, among the various KRAS mutations, that which encodes the G13D mutant protein (KRASG13D) behaves differently; for unknown reasons, KRASG13D CRC patients benefit from the EGFR-blocking antibody cetuximab. Controversy surrounds this observation, because it contradicts the well-established mechanisms of EGFR signaling with regard to RAS mutations. Here, we identified a systems-level, mechanistic explanation for why KRASG13D cancers respond to EGFR inhibition. A computational model of RAS signaling revealed that the biophysical differences between the three most common KRAS mutants were sufficient to generate different sensitivities to EGFR inhibition. Integrated computation with experimentation then revealed a nonintuitive, mutant-specific dependency of wild-type RAS activation by EGFR that is determined by the interaction strength between KRAS and the tumor suppressor neurofibromin (NF1). KRAS mutants that strongly interacted with and competitively inhibited NF1 drove wild-type RAS activation in an EGFR-independent manner, whereas KRASG13D weakly interacted with and could not competitively inhibit NF1 and, thus, KRASG13D cells remained dependent on EGFR for wild-type RAS activity. Overall, our work demonstrates how systems approaches enable mechanism-based inference in genomic medicine and can help identify patients for selective therapeutic strategies.

Original languageEnglish (US)
Article numbereaaw8288
JournalScience Signaling
Volume12
Issue number600
DOIs
StatePublished - Sep 24 2019
Externally publishedYes

Fingerprint

Epidermal Growth Factor Receptor
Tumors
Therapeutics
Neoplasms
Mutation
Colorectal Neoplasms
Neurofibromin 1
Chemical activation
Blocking Antibodies
Oncology
Mutant Proteins
Medicine
Genes

ASJC Scopus subject areas

  • Biochemistry
  • Molecular Biology
  • Cell Biology

Cite this

McFall, T., Diedrich, J. K., Mengistu, M., Littlechild, S. L., Paskvan, K. V., Sisk-Hackworth, L., ... Stites, E. C. (2019). Responses to targeted therapy. Science Signaling, 12(600), [eaaw8288]. https://doi.org/10.1126/scisignal.aaw8288

Responses to targeted therapy. / McFall, Thomas; Diedrich, Jolene K.; Mengistu, Meron; Littlechild, Stacy L.; Paskvan, Kendra V.; Sisk-Hackworth, Laura; Moresco, James J.; Shaw, Andrey S.; Stites, Edward C.

In: Science Signaling, Vol. 12, No. 600, eaaw8288, 24.09.2019.

Research output: Contribution to journalArticle

McFall, T, Diedrich, JK, Mengistu, M, Littlechild, SL, Paskvan, KV, Sisk-Hackworth, L, Moresco, JJ, Shaw, AS & Stites, EC 2019, 'Responses to targeted therapy', Science Signaling, vol. 12, no. 600, eaaw8288. https://doi.org/10.1126/scisignal.aaw8288
McFall T, Diedrich JK, Mengistu M, Littlechild SL, Paskvan KV, Sisk-Hackworth L et al. Responses to targeted therapy. Science Signaling. 2019 Sep 24;12(600). eaaw8288. https://doi.org/10.1126/scisignal.aaw8288
McFall, Thomas ; Diedrich, Jolene K. ; Mengistu, Meron ; Littlechild, Stacy L. ; Paskvan, Kendra V. ; Sisk-Hackworth, Laura ; Moresco, James J. ; Shaw, Andrey S. ; Stites, Edward C. / Responses to targeted therapy. In: Science Signaling. 2019 ; Vol. 12, No. 600.
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