The Mitogen-Activated Protein Kinase Pathway Facilitates Resistance to the Src Inhibitor Dasatinib in Thyroid Cancer

Thomas C Beadnell1, Katie M Mishall1, Qiong Zhou1

  • 1Division of Endocrinology, Metabolism, and Diabetes, Department of Medicine, University of Colorado School of Medicine, Aurora, Colorado.

Insights

Src inhibitors show limited efficacy in advanced thyroid cancer. Resistance mechanisms involve SRC mutations and MAPK pathway activation, suggesting combination therapies with MEK inhibitors could improve treatment outcomes.

Area of Science:

  • Oncology
  • Molecular Biology
  • Drug Discovery

Background:

  • Advanced thyroid cancer, including papillary and anaplastic types, is aggressive with limited therapeutic options.
  • c-SRC is a key mediator of thyroid cancer growth, invasion, and metastasis, making it a promising therapeutic target.
  • Clinical efficacy of Src inhibitors is often limited, necessitating research into resistance mechanisms and combination therapies.

Purpose of the Study:

  • To investigate resistance mechanisms to the Src inhibitor dasatinib in thyroid cancer.
  • To explore the role of MAPK pathway activation in dasatinib resistance.
  • To evaluate the efficacy of combination therapies involving dasatinib and MEK/ERK inhibitors.

Main Methods:

  • Generated four thyroid cancer cell lines with acquired resistance to dasatinib.
  • Analyzed for c-SRC gatekeeper mutations (T341M) in RAS-mutant lines and BRAF-mutant lines.
  • Assessed MAPK pathway activation and response to MEK1/2 inhibition.
  • Evaluated in vivo efficacy of MEK1/2 inhibition in a resistant cell line model.
  • Tested upfront combination therapy with dasatinib and MEK/ERK inhibitors.

Main Results:

  • RAS-mutant resistant cell lines acquired the c-SRC gatekeeper mutation (T341M), rendering Src signaling refractory to dasatinib.
  • BRAF-mutant resistant cell lines did not acquire the gatekeeper mutation.
  • MAPK pathway activation increased in all resistant cell lines, potentially via B-Raf and c-Raf dimerization.
  • MEK1/2 inhibition restored sensitivity to dasatinib in all resistant cell lines and overcame resistance in vivo.
  • Combined dasatinib and MEK1/2 or ERK1/2 inhibition demonstrated synergistic effects on growth inhibition and apoptosis induction.

Conclusions:

  • Acquisition of the c-SRC gatekeeper mutation and MAPK pathway signaling are key mechanisms of dasatinib resistance in thyroid cancer.
  • Combined inhibition strategies targeting Src and MAPK pathways offer a promising approach to overcome resistance and improve therapeutic outcomes in advanced thyroid cancer.

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