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Published on: January 31, 2025
AMPK promotes tolerance to Ras pathway inhibition by activating autophagy
S Sanduja1, Y Feng1, R A Mathis1,2
1Whitehead Institute for Biomedical Research, Cambridge, MA, USA.
Abstract:
Targeted inhibitors of oncogenic Ras (rat sarcoma viral oncogene)-Raf signaling have shown great promise in the clinic, but resistance remains a major challenge: 30% of tumors with pathway mutations do not respond to targeted inhibitors, and of the 70% that do respond, all eventually develop resistance. Before cancer cells acquire resistance, they respond to initial drug treatment either by undergoing apoptosis ('addiction') or by surviving treatment albeit with reduced growth ('tolerance'). As these drug-tolerant cells serve as a reservoir from which resistant cells eventually emerge, inhibiting the pathways that confer tolerance could potentially delay or even prevent recurrence. Here, we show that melanomas and other cancers acquire tolerance to Ras-Raf pathway inhibitors by activating autophagy, which is mediated by the cellular energy sensor AMP-activated protein kinase (AMPK). Blocking this AMPK-mediated autophagy sensitizes drug-tolerant melanomas to Ras-Raf pathway inhibitors. Conversely, activating AMPK signaling and autophagy enables melanomas that would otherwise be addicted to the Ras-Raf pathway to instead tolerate pathway inhibition. These findings identify a key mechanism of tolerance to Ras-Raf pathway inhibitors and suggest that blocking either AMPK or autophagy in combination with these targeted inhibitors could increase tumor regression and decrease the likelihood of eventual recurrence.
Insights
Cancer cells develop resistance to Ras-Raf inhibitors by activating autophagy via AMP-activated protein kinase (AMPK). Blocking this pathway can sensitize tumors to treatment, potentially preventing recurrence.
Area of Science:
- Oncology
- Molecular Biology
- Cellular Signaling
Background:
- Targeted Ras-Raf pathway inhibitors show promise for cancer treatment but face significant resistance issues.
- Tumor response to inhibitors includes 'addiction' (apoptosis) or 'tolerance' (reduced growth), with tolerant cells serving as a reservoir for resistance.
- Understanding mechanisms of drug tolerance is crucial for overcoming treatment resistance and preventing cancer recurrence.
Purpose of the Study:
- To investigate the role of autophagy and AMP-activated protein kinase (AMPK) in mediating tolerance to Ras-Raf pathway inhibitors.
- To determine if targeting AMPK-mediated autophagy can sensitize drug-tolerant cancer cells to targeted therapies.
- To explore therapeutic strategies combining Ras-Raf inhibitors with AMPK or autophagy blockers.
Main Methods:
- Analysis of melanoma and other cancer cell models treated with Ras-Raf pathway inhibitors.
- Investigating the activation of autophagy and its regulation by AMPK in drug-tolerant cells.
- Experimental manipulation of AMPK signaling and autophagy to assess effects on drug sensitivity.
Main Results:
- Melanomas and other cancers acquire tolerance to Ras-Raf inhibitors through AMPK-mediated activation of autophagy.
- Inhibition of AMPK-mediated autophagy sensitizes drug-tolerant melanomas to Ras-Raf inhibitors.
- Activation of AMPK signaling and autophagy allows some melanomas to tolerate Ras-Raf pathway inhibition.
Conclusions:
- AMPK-mediated autophagy is a key mechanism conferring tolerance to Ras-Raf pathway inhibitors in various cancers.
- Blocking AMPK or autophagy concurrently with Ras-Raf inhibitors may enhance tumor regression.
- Targeting this tolerance pathway offers a potential strategy to decrease cancer recurrence after targeted therapy.
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