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在晚期甲状腺癌中,CDK4酸化状态和合理使用用于结合CDK4/6和BRAF/MEK抑制
Jaime M Pita1, Eric Raspé1, Katia Coulonval1
1Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (IRIBHM) and Université Libre de Bruxelles (ULB)-Cancer Research Center (U-CRC), Université Libre de Bruxelles (ULB), Brussels, Belgium.
Frontiers in endocrinology
|November 15, 2023
概括
循环素依赖性激酶4/6抑制剂 (CDK4/6i) 在治疗晚期甲状腺癌方面表现有前途,特别是在与BRAF/MEK抑制剂结合使用时. 检测CDK4酸化可以确定那些对CDK4/6i治疗有反应的患者.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 癌症治疗方法 癌症治疗方法
背景情况:
- CDK4/6抑制剂 (CDK4/6i) 是高级雌激素受体阳性乳腺癌的标准.
- CDK4/6i正在研究其他癌症,通常是组合疗法.
- CDK4的T172-酸化对其活性,视网膜母细胞瘤蛋白 (RB) 失活,细胞循环承诺和对CDK4/6i的敏感性至关重要.
- 差差分化 (PDTC) 和形性 (ATC) 甲状腺癌是致命的恶性瘤,治疗选择有限.
- 分子证据表明CDK4/6i可能对晚期甲状腺癌有效.
研究的目的:
- 研究CDK4酸化在甲状腺癌中的作用.
- 评估甲状腺癌细胞和组织对CDK4/6抑制剂的敏感性.
- 在甲状腺癌模型中评估结合CDK4/6抑制剂与BRAF/MEK抑制剂的疗效.
主要方法:
- 用二维凝电泳分析对98个新鲜冷的甲状腺瘤组织和21个细胞系的CDK4酸化状况进行分析.
- RNA测序和免疫组织化学用于子队列的表征.
- 使用BrdU整合和生命力测定对palbociclib和abemaciclib的敏感性评估.
- 药物组合的评估 (CDK4/6i与dabrafenib/trametinib) 通过西部污染,免疫沉和克隆基因分析.
主要成果:
- 在大多数甲状腺癌中检测到CDK4酸化 (所有分化良好,19/20 PDTC,16/23 ATC) 和细胞系 (18/21).
- 缺乏CDK4酸化与CDK4/6i不敏感性和高p16水平相关.
- 在缺乏CDK4酸化的所有瘤中没有发现RB1缺陷.
- 一个11基因表达特征确定了缺乏CDK4酸化的可能不响应的瘤.
- 帕尔博西基利布与达布拉费尼布/特拉美丁尼布结合,导致细胞系中完全和永久的增殖停止,从而阻止了抵抗机制.
结论:
- CDK4/6i,特别是与抗BRAF/MEK疗法相结合,代表了晚期甲状腺瘤的有前途的治疗策略.
- 结合p16/KI67评估的11基因预测器可以识别CDK4/6i不敏感的患者.
- 这些患者可能是立即化疗的更好的候选人.
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