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IGFBP2 modulates the chemoresistant phenotype in esophageal adenocarcinoma
Amy L Myers1, Lin Lin1, Derek J Nancarrow1
1Department of Surgery, University of Michigan, Ann Arbor, MI, USA.
Abstract:
Esophageal adenocarcinoma (EAC) patients commonly present with advanced stage disease and demonstrate resistance to therapy, with response rates below 40%. Understanding the molecular mechanisms of resistance is crucial for improvement of clinical outcomes. IGFBP2 is a member of the IGFBP family of proteins that has been reported to modulate both IGF and integrin signaling and is a mediator of cell growth, invasion and resistance in other tumor types. In this study, high IGFBP2 expression was observed in a subset of primary EACs and was found to be significantly higher in patients with shorter disease-free intervals as well as in treatment-resistant EACs as compared to chemonaive EACs. Modulation of IGFBP2 expression in EAC cell lines promoted cell proliferation, migration and invasion, implicating a role in the metastatic potential of these cells. Additionally, knockdown of IGFBP2 sensitized EAC cells to cisplatin in a serum-dependent manner. Further in vitro exploration into this chemosensitization implicated both the AKT and ERK pathways. Silencing of IGFBP2 enhanced IGF1-induced immediate activation of AKT and reduced cisplatin-induced ERK activation. Addition of MEK1/2 (selumetinib or trametinib) or AKT (AKT Inhibitor VIII) inhibitors enhanced siIGFBP2-induced sensitization of EAC cells to cisplatin. These results suggest that targeted inhibition of IGFBP2 alone or together with either the MAPK or PI3K/AKT signaling pathway in IGFBP2-overexpressing EAC tumors may be an effective approach for sensitizing resistant EACs to standard neoadjuvant chemotherapy.
Insights
High IGFBP2 expression correlates with treatment resistance in esophageal adenocarcinoma (EAC). Targeting IGFBP2 and related pathways may sensitize resistant EAC tumors to chemotherapy.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Esophageal adenocarcinoma (EAC) often presents at advanced stages with poor therapeutic response rates (<40%).
- Understanding molecular resistance mechanisms is critical for improving EAC patient outcomes.
- Insulin-like growth factor-binding protein 2 (IGFBP2) influences cell signaling, growth, invasion, and resistance in various cancers.
Purpose of the Study:
- To investigate the role of IGFBP2 in esophageal adenocarcinoma (EAC) resistance to therapy.
- To explore IGFBP2's impact on EAC cell proliferation, migration, and invasion.
- To determine if targeting IGFBP2 can sensitize EAC cells to chemotherapy.
Main Methods:
- Assessed IGFBP2 expression in primary EAC tissues and correlated it with clinical outcomes.
- Modulated IGFBP2 expression in EAC cell lines to study its effects on cellular behavior.
- Investigated the effects of IGFBP2 knockdown on chemosensitivity to cisplatin in vitro.
- Examined the involvement of AKT and ERK signaling pathways in IGFBP2-mediated chemosensitization.
- Tested the efficacy of combining IGFBP2 inhibition with MAPK or PI3K/AKT pathway inhibitors.
Main Results:
- High IGFBP2 expression was found in a subset of EACs and associated with shorter disease-free intervals and treatment resistance.
- Increased IGFBP2 expression promoted EAC cell proliferation, migration, and invasion.
- IGFBP2 knockdown sensitized EAC cells to cisplatin, particularly in a serum-dependent manner.
- Silencing IGFBP2 altered AKT and ERK pathway activation in response to IGF1 and cisplatin.
- Inhibitors of MEK1/2 (MAPK pathway) or AKT enhanced cisplatin sensitization in IGFBP2-silenced EAC cells.
Conclusions:
- IGFBP2 plays a significant role in EAC progression and chemoresistance.
- Targeting IGFBP2, alone or in combination with MAPK or PI3K/AKT pathway inhibitors, may offer a strategy to overcome neoadjuvant chemotherapy resistance in EAC.
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