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.

Abstract

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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