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Therapeutic Targeting of TFE3/IRS-1/PI3K/mTOR Axis in Translocation Renal Cell Carcinoma
Nur P Damayanti1, Justin A Budka2, Heba W Z Khella3
1Genitourinary Program, Division of Hematology & Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, Indiana.
Purpose:
Translocation renal cell carcinoma (tRCC) represents a rare subtype of kidney cancer associated with various TFE3, TFEB, or MITF gene fusions that are not responsive to standard treatments for RCC. Therefore, the identification of new therapeutic targets represents an unmet need for this disease.
Experimental Design:
We have established and characterized a tRCC patient-derived xenograft, RP-R07, as a novel preclinical model for drug development by using next-generation sequencing and bioinformatics analysis. We then assessed the therapeutic potential of inhibiting the identified pathway using in vitro and in vivo models.
Results:
The presence of a SFPQ-TFE3 fusion [t(X;1) (p11.2; p34)] with chromosomal break-points was identified by RNA-seq and validated by RT-PCR. TFE3 chromatin immunoprecipitation followed by deep sequencing analysis indicated a strong enrichment for the PI3K/AKT/mTOR pathway. Consistently, miRNA microarray analysis also identified PI3K/AKT/mTOR as a highly enriched pathway in RP-R07. Upregulation of PI3/AKT/mTOR pathway in additional TFE3-tRCC models was confirmed by significantly higher expression of phospho-S6 (P < 0.0001) and phospho-4EBP1 (P < 0.0001) in established tRCC cell lines compared with clear cell RCC cells. Simultaneous vertical targeting of both PI3K/AKT and mTOR axis provided a greater antiproliferative effect both in vitro (P < 0.0001) and in vivo (P < 0.01) compared with single-node inhibition. Knockdown of TFE3 in RP-R07 resulted in decreased expression of IRS-1 and inhibited cell proliferation.
Conclusions:
These results identify TFE3/IRS-1/PI3K/AKT/mTOR as a potential dysregulated pathway in TFE3-tRCC, and suggest a therapeutic potential of vertical inhibition of this axis by using a dual PI3K/mTOR inhibitor for patients with TFE3-tRCC.
Insights
Translocation renal cell carcinoma (tRCC) is resistant to standard treatments. Targeting the TFE3/IRS-1/PI3K/AKT/mTOR pathway with dual inhibitors shows promise for tRCC drug development.
Area of Science:
- Oncology
- Molecular Biology
- Genetics
Background:
- Translocation renal cell carcinoma (tRCC) is a rare subtype of kidney cancer.
- tRCC is characterized by gene fusions (TFE3, TFEB, MITF) and is unresponsive to conventional treatments.
- Novel therapeutic targets are urgently needed for tRCC.
Purpose of the Study:
- To establish and characterize a patient-derived xenograft (PDX) model for tRCC drug development.
- To identify and validate therapeutic targets within tRCC.
- To assess the efficacy of targeting identified pathways in preclinical tRCC models.
Main Methods:
- Next-generation sequencing and bioinformatics analysis of a tRCC PDX model (RP-R07).
- RNA-sequencing (RNA-seq) and RT-PCR to identify gene fusions.
- Chromatin immunoprecipitation followed by deep sequencing (ChIP-seq) and miRNA microarray analysis to identify enriched pathways.
- In vitro and in vivo studies to assess therapeutic interventions.
- Gene knockdown experiments.
Main Results:
- A SFPQ-TFE3 fusion was identified in the RP-R07 model.
- The PI3K/AKT/mTOR pathway was significantly enriched in tRCC models.
- Dual inhibition of PI3K/AKT and mTOR demonstrated superior antiproliferative effects compared to single-agent inhibition.
- TFE3 knockdown reduced IRS-1 expression and inhibited cell proliferation.
Conclusions:
- The TFE3/IRS-1/PI3K/AKT/mTOR axis is a potential dysregulated pathway in TFE3-tRCC.
- Vertical inhibition of this axis using dual PI3K/mTOR inhibitors represents a promising therapeutic strategy for tRCC.
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