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Signalling pathways passing Src in pancreatic endocrine tumours: relevance for possible combined targeted therapies
Gabriele Capurso1, Alessia Di Florio, Claudio Sette
1Digestive and Liver Disease Unit, II Medical School, University of Rome La Sapienza, Rome, Italy.
Abstract:
The most frequent molecular abnormalities in pancreatic endocrine tumours (PETs) are mutations of the MEN1 gene, deregulation of the PI3K/AKT/mTOR signalling pathway and overactivation of growth factors and their receptors, such as the VEGF. On this basis, everolimus (Afinitor®; Novartis) and sunitinib (Sutent®; Pfizer) have both been approved by the FDA for the treatment of progressive, unresectable, locally advanced or metastatic PETs. However, molecular or surrogate markers able to predict the response of PET patients to treatment with these drugs are not available, and cancer cells treated with targeted therapies might develop escape pathways that evoke pro-survival feedback responses. The existence of cross-talk between different molecular pathways in PETs has been poorly investigated. In the present review, we present data supporting an important role for Src family kinases (SFKs) in PETs, together with the recent observation of a novel role for SFK in modulating the mTOR pathway activity. Of note, while treatment with everolimus triggered the activation of a survival response dependent on PI3K/AKT signalling in vitro, the simultaneous inhibition of SFKs blocked the activation of this unwanted escape signal. These studies might set the ground for the investigation of combined treatment of PETs with SFK and mTOR inhibitors.
Insights
Src family kinases (SFKs) play a key role in pancreatic endocrine tumors (PETs). Inhibiting SFKs alongside mTOR inhibitors may overcome treatment resistance in PET patients.
Area of Science:
- Oncology
- Molecular Biology
- Endocrinology
Background:
- Pancreatic endocrine tumors (PETs) frequently exhibit MEN1 gene mutations, PI3K/AKT/mTOR pathway deregulation, and growth factor overactivation.
- Everolimus and sunitinib are FDA-approved for advanced PETs, but predictive markers for treatment response are lacking.
- Cancer cells can develop resistance to targeted therapies via pro-survival feedback pathways, with limited understanding of pathway cross-talk in PETs.
Purpose of the Study:
- To investigate the role of Src family kinases (SFKs) in pancreatic endocrine tumors (PETs).
- To explore the novel function of SFKs in modulating mTOR pathway activity.
- To evaluate the potential of combined SFK and mTOR inhibition as a therapeutic strategy for PETs.
Main Methods:
- Review of existing data on molecular abnormalities in PETs.
- Investigation of SFK's role in PET pathogenesis.
- In vitro studies examining the effect of everolimus on PI3K/AKT signaling and the impact of simultaneous SFK inhibition.
Main Results:
- Src family kinases (SFKs) are implicated in the development of PETs.
- SFKs were found to modulate the activity of the mTOR pathway.
- In vitro, everolimus treatment activated PI3K/AKT survival signaling, but co-inhibition of SFKs blocked this escape mechanism.
Conclusions:
- SFKs play a significant role in PETs and can influence mTOR pathway activity.
- Combined inhibition of SFKs and mTOR may represent a promising therapeutic approach to overcome treatment resistance in PETs.
- Further investigation into combined SFK and mTOR inhibition is warranted for clinical application in PET treatment.
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