Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.

V-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) mutated lung cancer is relatively aggressive and is resistant to currently available therapies. In a recent phase II study for patients with BRAF-V600E non-small cell lung cancer (NSCLC), BRAF V600E inhibitor demonstrated evidence of activity, but...

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Main Authors: Monika Joshi, Shawn J Rice, Xin Liu, Bruce Miller, Chandra P Belani
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2015-01-01
Series:PLoS ONE
Online Access:https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0118210&type=printable
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author Monika Joshi
Shawn J Rice
Xin Liu
Bruce Miller
Chandra P Belani
author_facet Monika Joshi
Shawn J Rice
Xin Liu
Bruce Miller
Chandra P Belani
author_sort Monika Joshi
collection DOAJ
description V-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) mutated lung cancer is relatively aggressive and is resistant to currently available therapies. In a recent phase II study for patients with BRAF-V600E non-small cell lung cancer (NSCLC), BRAF V600E inhibitor demonstrated evidence of activity, but 30% of this selected group progressed while on treatment, suggesting a need for developing alternative strategies. We tested two different options to enhance the efficacy of vemurafenib (BRAF V600E inhibitor) in BRAF mutated NSCLC. The first option was the addition of erlotinib to vemurafenib to see whether the combination provided synergy. The second was to induce MEK inhibition (downstream of RAF) with trametinib (MEK inhibitor). We found that the combination of vemurafenib and erlotinib was not synergistic to the inhibition of p-ERK signaling in BRAF-V600E cells. Vemurafenib caused significant apoptosis, G1 arrest and upregulation of BIM in BRAF-V600 cells. Trametinib was effective as a single agent in BRAF mutated cells, either V600E or non-V600E. Finally, the combination of vemurafenib and trametinib caused a small but significant increase in apoptosis as well as a significant upregulation of BIM when compared to either single agent. Thus, hinting at the possibility of utilizing a combinational approach for the management of this group of patients. Importantly, trametinib alone caused upregulation of p-AKT in BRAF non-V600 mutated cells, while this effect was nullified with the combination. This finding suggests that, the combination of a MEK inhibitor with a BRAF inhibitor will be more efficacious in the clinical setting for patients with BRAF mutated NSCLC.
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spelling doaj-art-afdc1f6d364a4a11836d9ae9ebf03bf82025-08-20T03:01:31ZengPublic Library of Science (PLoS)PLoS ONE1932-62032015-01-01102e011821010.1371/journal.pone.0118210Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.Monika JoshiShawn J RiceXin LiuBruce MillerChandra P BelaniV-Raf Murine Sarcoma Viral Oncogene Homolog B (BRAF) mutated lung cancer is relatively aggressive and is resistant to currently available therapies. In a recent phase II study for patients with BRAF-V600E non-small cell lung cancer (NSCLC), BRAF V600E inhibitor demonstrated evidence of activity, but 30% of this selected group progressed while on treatment, suggesting a need for developing alternative strategies. We tested two different options to enhance the efficacy of vemurafenib (BRAF V600E inhibitor) in BRAF mutated NSCLC. The first option was the addition of erlotinib to vemurafenib to see whether the combination provided synergy. The second was to induce MEK inhibition (downstream of RAF) with trametinib (MEK inhibitor). We found that the combination of vemurafenib and erlotinib was not synergistic to the inhibition of p-ERK signaling in BRAF-V600E cells. Vemurafenib caused significant apoptosis, G1 arrest and upregulation of BIM in BRAF-V600 cells. Trametinib was effective as a single agent in BRAF mutated cells, either V600E or non-V600E. Finally, the combination of vemurafenib and trametinib caused a small but significant increase in apoptosis as well as a significant upregulation of BIM when compared to either single agent. Thus, hinting at the possibility of utilizing a combinational approach for the management of this group of patients. Importantly, trametinib alone caused upregulation of p-AKT in BRAF non-V600 mutated cells, while this effect was nullified with the combination. This finding suggests that, the combination of a MEK inhibitor with a BRAF inhibitor will be more efficacious in the clinical setting for patients with BRAF mutated NSCLC.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0118210&type=printable
spellingShingle Monika Joshi
Shawn J Rice
Xin Liu
Bruce Miller
Chandra P Belani
Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.
PLoS ONE
title Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.
title_full Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.
title_fullStr Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.
title_full_unstemmed Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.
title_short Trametinib with or without vemurafenib in BRAF mutated non-small cell lung cancer.
title_sort trametinib with or without vemurafenib in braf mutated non small cell lung cancer
url https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0118210&type=printable
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AT xinliu trametinibwithorwithoutvemurafenibinbrafmutatednonsmallcelllungcancer
AT brucemiller trametinibwithorwithoutvemurafenibinbrafmutatednonsmallcelllungcancer
AT chandrapbelani trametinibwithorwithoutvemurafenibinbrafmutatednonsmallcelllungcancer