Treatment-Induced Tumor Dormancy through YAP-Mediated Transcriptional Reprogramming of the Apoptotic Pathway
Kari J Kurppa1, Yao Liu2, Ciric To1
1Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School, Boston, MA 02215, USA.
Abstract:
Eradicating tumor dormancy that develops following epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment of EGFR-mutant non-small cell lung cancer, is an attractive therapeutic strategy but the mechanisms governing this process are poorly understood. Blockade of ERK1/2 reactivation following EGFR TKI treatment by combined EGFR/MEK inhibition uncovers cells that survive by entering a senescence-like dormant state characterized by high YAP/TEAD activity. YAP/TEAD engage the epithelial-to-mesenchymal transition transcription factor SLUG to directly repress pro-apoptotic BMF, limiting drug-induced apoptosis. Pharmacological co-inhibition of YAP and TEAD, or genetic deletion of YAP1, all deplete dormant cells by enhancing EGFR/MEK inhibition-induced apoptosis. Enhancing the initial efficacy of targeted therapies could ultimately lead to prolonged treatment responses in cancer patients.
Insights
Targeting dormant cancer cells after EGFR TKI treatment is key. Combining EGFR/MEK inhibition with YAP/TEAD blockade overcomes dormancy by promoting apoptosis in non-small cell lung cancer.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- Tumor dormancy following epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) treatment in EGFR-mutant non-small cell lung cancer (NSCLC) presents a significant therapeutic challenge.
- Understanding the mechanisms that drive this dormancy is crucial for developing effective eradication strategies.
Purpose of the Study:
- To investigate the mechanisms underlying tumor cell dormancy after EGFR TKI treatment.
- To identify novel therapeutic targets for eradicating dormant cells and overcoming treatment resistance in NSCLC.
Main Methods:
- Utilized combined EGFR/MEK inhibition to block ERK1/2 reactivation and uncover dormant cells.
- Characterized the senescence-like dormant state, focusing on YAP/TEAD activity and its interaction with SLUG.
- Assessed the impact of pharmacological YAP/TEAD co-inhibition and genetic YAP1 deletion on dormant cell depletion.
Main Results:
- Combined EGFR/MEK inhibition induced a senescence-like dormant state characterized by high YAP/TEAD activity.
- YAP/TEAD, via SLUG, represses the pro-apoptotic protein BMF, thereby limiting drug-induced apoptosis.
- Pharmacological co-inhibition of YAP/TEAD or genetic YAP1 deletion effectively depleted dormant cells by enhancing apoptosis.
Conclusions:
- Targeting the YAP/TEAD pathway in conjunction with EGFR/MEK inhibition offers a promising strategy to eradicate dormant non-small cell lung cancer cells.
- Enhancing the initial efficacy of targeted therapies by overcoming dormancy could lead to improved and prolonged treatment responses in cancer patients.
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