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Am J Cancer Res. 2015 Mar 15;5(4):1507-18. eCollection 2015.

Melanoma patient derived xenografts acquire distinct Vemurafenib resistance mechanisms.

American journal of cancer research

David J Monsma, David M Cherba, Emily E Eugster, Dawna L Dylewski, Paula T Davidson, Chelsea A Peterson, Andrew S Borgman, Mary E Winn, Karl J Dykema, Craig P Webb, Jeffrey P MacKeigan, Nicholas S Duesbery, Brian J Nickoloff, Noel R Monks

Affiliations

  1. Vivarium and Transgenics Core, Van Andel Research Institute Grand Rapids, Michigan, USA.
  2. Bioinformatics and Biostatistics Core, Van Andel Research Institute Grand Rapids, Michigan, USA.
  3. Pathology and Biorepository Core, Van Andel Research Institute Grand Rapids, Michigan, USA.
  4. Center for Translational Medicine, Van Andel Research Institute Grand Rapids, Michigan, USA.
  5. College of Human Medicine, Michigan State University Grand Rapids, Michigan, USA.
  6. NuMedi Palo Alto, California, USA.
  7. Laboratory of Systems Biology, Van Andel Research Institute Grand Rapids, Michigan, USA.
  8. Laboratory of Cancer and Developmental Cell Biology, Van Andel Research Institute Grand Rapids, Michigan, USA.
  9. Center for Translational Medicine, Van Andel Research Institute Grand Rapids, Michigan, USA ; College of Human Medicine, Michigan State University Grand Rapids, Michigan, USA.
  10. Center for Translational Medicine, Van Andel Research Institute Grand Rapids, Michigan, USA ; Current address: Medimmune, One MedImmune Way Gaithersburg, MD, 20878, USA.

PMID: 26101714 PMCID: PMC4473327

Abstract

Variable clinical responses, tumor heterogeneity, and drug resistance reduce long-term survival outcomes for metastatic melanoma patients. To guide and accelerate drug development, we characterized tumor responses for five melanoma patient derived xenograft models treated with Vemurafenib. Three BRAF(V600E) models showed acquired drug resistance, one BRAF(V600E) model had a complete and durable response, and a BRAF(V600V) model was expectedly unresponsive. In progressing tumors, a variety of resistance mechanisms to BRAF inhibition were uncovered, including mutant BRAF alternative splicing, NRAS mutation, COT (MAP3K8) overexpression, and increased mutant BRAF gene amplification and copy number. The resistance mechanisms among the patient derived xenograft models were similar to the resistance pathways identified in clinical specimens from patients progressing on BRAF inhibitor therapy. In addition, there was both inter- and intra-patient heterogeneity in resistance mechanisms, accompanied by heterogeneous pERK expression immunostaining profiles. MEK monotherapy of Vemurafenib-resistant tumors caused toxicity and acquired drug resistance. However, tumors were eradicated when Vemurafenib was combined the MEK inhibitor. The diversity of drug responses among the xenograft models; the distinct mechanisms of resistance; and the ability to overcome resistance by the addition of a MEK inhibitor provide a scheduling rationale for clinical trials of next-generation drug combinations.

Keywords: BRAF; MEK; Melanoma; Vemurafenib; drug resistance; patient derived xenografts (PDX)

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