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P-Rex1 Promotes Resistance to VEGF/VEGFR-Targeted Therapy in Prostate Cancer
Hira Lal Goel1, Bryan Pursell1, Leonard D Shultz2
1Department of Molecular, Cell and Cancer Biology, University of Massachusetts Medical School, Worcester, MA 01605, USA.
Abstract:
Autocrine VEGF signaling is critical for sustaining prostate and other cancer stem cells (CSCs), and it is a potential therapeutic target, but we observed that CSCs isolated from prostate tumors are resistant to anti-VEGF (bevacizumab) and anti-VEGFR (sunitinib) therapy. Intriguingly, resistance is mediated by VEGF/neuropilin signaling, which is not inhibited by bevacizumab and sunitinib, and it involves the induction of P-Rex1, a Rac GEF, and consequent Rac1-mediated ERK activation. This induction of P-Rex1 is dependent on Myc. CSCs isolated from the PTEN(pc-/-) transgenic model of prostate cancer exhibit Rac1-dependent resistance to bevacizumab. Rac1 inhibition or P-Rex1 downregulation increases the sensitivity of prostate tumors to bevacizumab. These data reveal that prostate tumors harbor cells with stem cell properties that are resistant to inhibitors of VEGF/VEGFR signaling. Combining the use of available VEGF/VEGFR-targeted therapies with P-Rex1 or Rac1 inhibition should improve the efficacy of these therapies significantly.
Insights
Prostate cancer stem cells resist anti-VEGF therapies via VEGF/neuropilin signaling and P-Rex1 induction. Inhibiting Rac1 or P-Rex1 enhances treatment efficacy.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Research
Background:
- Autocrine vascular endothelial growth factor (VEGF) signaling supports cancer stem cells (CSCs) in prostate and other cancers.
- VEGF signaling is a validated therapeutic target for various cancers.
Purpose of the Study:
- To investigate the mechanisms of resistance to anti-VEGF (bevacizumab) and anti-VEGFR (sunitinib) therapies in prostate cancer stem cells (CSCs).
- To identify novel therapeutic strategies to overcome resistance and improve treatment efficacy.
Main Methods:
- Isolation and characterization of CSCs from prostate tumors and a PTEN(pc-/-) transgenic model.
- Assessment of resistance mechanisms involving VEGF/neuropilin signaling, P-Rex1, Rac1, and ERK activation.
- Evaluation of the effects of Rac1 inhibition and P-Rex1 downregulation on therapeutic sensitivity.
Main Results:
- Prostate CSCs exhibit resistance to bevacizumab and sunitinib, mediated by VEGF/neuropilin signaling.
- This resistance involves the induction of P-Rex1 (a Rac GEF) and subsequent Rac1-mediated ERK activation, dependent on Myc.
- Rac1 inhibition or P-Rex1 downregulation sensitized prostate tumors to bevacizumab.
Conclusions:
- Prostate tumors contain stem cell populations resistant to current VEGF/VEGFR-targeted therapies.
- Combining VEGF/VEGFR inhibitors with P-Rex1 or Rac1 inhibitors could significantly improve therapeutic outcomes.
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