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Updated: Feb 13, 2026

Analysis of Lymph Node Volume by Ultra-High-Frequency Ultrasound Imaging in the Braf/Pten Genetically Engineered Mouse Model of Melanoma
Published on: September 8, 2021
AXL/AKT axis mediated-resistance to BRAF inhibitor depends on PTEN status in melanoma
Qiang Zuo1,2, Jing Liu2, Liping Huang1,2
1Laboratory of Cancer Biology and Genetics, Center for Cancer Research, National Cancer Institutes, National Institutes of Health, Bethesda, MD, 20892-4264, USA.
Abstract:
Multiple genetic mutations within melanoma not only cause lesion-specific responses to targeted therapy but also alter the molecular route of resistance to that therapy. Inactivation of PTEN occurs in up to 30% of melanomas, frequently with a concurrent activating BRAF mutation. PTEN loss regulates both acquired and intrinsic drug resistance. Here we show that AXL/AKT axis mediated-resistance to BRAF inhibitor (BRAFi) depends upon PTEN status in melanoma. Hyperactivation of both ERK and AKT pathways was associated with BRAFi resistance in melanoma with wildtype PTEN. The PTEN-impaired melanoma cells required only the ERK resistance mechanism. Moreover, we identified AXL as a key upstream effector of AKT pathway-associated resistance to BRAFi in melanoma with wildtype PTEN, but not in melanoma with impaired PTEN. Notably, we confirmed that blocking AXL by shRNA and a small molecular inhibitor could rescue the sensitivity of resistant melanoma cells with wildtype PTEN to BRAFi and inhibit their growth in vitro and in vivo. Our study has uncovered a mechanism by which PTEN status contributes to acquired resistance to BRAFi and offers a rational strategy to guide clinical testing in pre-identified subsets of patients who relapse during treatment with BRAFi. The identified protein AXL represents a promising therapeutic target for BRAF mutant melanoma patients with wildtype PTEN.
Insights
PTEN status dictates resistance to BRAF inhibitors (BRAFi) in melanoma. Blocking the AXL/AKT pathway can restore BRAFi sensitivity in wildtype PTEN melanoma, offering a new therapeutic strategy.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Melanoma harbors genetic mutations influencing targeted therapy response and resistance.
- PTEN inactivation, common in melanoma, impacts drug resistance.
- BRAF inhibitors (BRAFi) are a key melanoma therapy, but resistance develops.
Purpose of the Study:
- To investigate the role of PTEN status in mediating resistance to BRAF inhibitors (BRAFi) in melanoma.
- To identify molecular mechanisms driving BRAFi resistance based on PTEN status.
- To explore AXL as a therapeutic target for overcoming BRAFi resistance.
Main Methods:
- Analysis of melanoma cell lines with varying PTEN status.
- Investigating the roles of AXL, AKT, and ERK pathways in BRAFi resistance.
- Utilizing shRNA and small molecule inhibitors to block AXL.
- In vitro and in vivo experiments to assess therapeutic efficacy.
Main Results:
- AXL/AKT axis-mediated resistance to BRAFi is dependent on PTEN status.
- Melanoma with wildtype PTEN exhibits resistance via both ERK and AKT pathways, with AXL being a key effector of AKT-driven resistance.
- PTEN-impaired melanoma cells primarily rely on ERK for resistance.
- Blocking AXL restores BRAFi sensitivity and inhibits tumor growth in wildtype PTEN melanoma.
Conclusions:
- PTEN status is a critical determinant of acquired resistance mechanisms to BRAFi in melanoma.
- The AXL/AKT pathway is a significant contributor to BRAFi resistance in PTEN wildtype melanoma.
- Targeting AXL presents a promising therapeutic strategy for BRAF-mutant melanoma patients with wildtype PTEN who relapse on BRAFi therapy.
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