这种PIK3CA/AKT通路驱动了rhabdomyosarcoma中治疗阻力
Qiqi Yang1,2,3,4, Yueyang Wang1,2,3, Luis A Corchete Sanchez2
1Molecular Pathology Unit, Massachusetts General Hospital, Charlestown, MA, USA.
Nature communications
|December 10, 2025
概括
奥拉巴里布和泰莫索洛米德 (OT) 治疗对狂宫肌肉瘤 (RMS) 有希望,但出现了耐药性. 用alpelisib准PIK3CA/AKT通路可以克服这种抵抗,为难以治疗的RMS提供了一种新策略.
科学领域:
- 在瘤学瘤学.
- 分子生物学分子生物学
- 癌症研究 癌症研究
背景情况:
- 脊髓髓瘤瘤 (RMS) 是一种治疗选择有限的儿科癌症.
- 奥拉巴里布和泰莫索洛米德 (OT) 联合治疗正在为RMS进行临床研究.
- 获得对OT治疗的耐药性是各种癌症的一个重大挑战,包括RMS.
研究的目的:
- 调查RMS中OT电阻的机制.
- 确定潜在的治疗策略,以克服RMS的OT抵抗.
- 评估将OT与PIK3CA/AKT途径抑制剂结合使用的疗效.
主要方法:
- 使用RMS的临床前老鼠异种移植模型.
- 对抗性和敏感的RMS瘤进行了转录组分析.
- 使用alpelisib评估了PIK3CA/AKT通路的药理抑制.
- 进行了涉及OT和alpelisib的组合疗法研究.
主要成果:
- 在临床前模型中,OT有效抑制RMS瘤生长.
- 超过50%的RMS瘤对OT产生了耐药性,特征是没有复发性基因组突变的转录基因组变化.
- 耐药RMS模型经常对PIK3CA/AKT通路进行上调,导致NRF2激活和多药耐药性ABC载体表达.
- 通过抑制ABC输送体表达,阿尔佩利西布通过抑制ABC输送体表达,重新敏感化了抗OT的RMS细胞.
- OT和alpelisib的组合证明了对抗抗化学性RMS的有效性,并在体内抑制了瘤的生长.
结论:
- 在RMS中发现了一种常见的抵抗途径,涉及PIK3CA/AKT激活和随后的ABC载体上调.
- 抑制PIK3CA/AKT通路是一种有前途的临床前策略,可以克服RMS的OT抵抗.
- 与OT和alpelisib的联合治疗有可能治疗耐治疗的RMS.
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