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The CRTC1-MAML2 fusion is the major oncogenic driver in mucoepidermoid carcinoma
Zirong Chen, … , Frederic J. Kaye, Lizi Wu
Zirong Chen, … , Frederic J. Kaye, Lizi Wu
Published April 8, 2021
Citation Information: JCI Insight. 2021;6(7):e139497. https://doi.org/10.1172/jci.insight.139497.
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Research Article Oncology

The CRTC1-MAML2 fusion is the major oncogenic driver in mucoepidermoid carcinoma

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Abstract

No effective systemic treatment is available for patients with unresectable, recurrent, or metastatic mucoepidermoid carcinoma (MEC), the most common salivary gland malignancy. MEC is frequently associated with a t(11;19)(q14-21;p12-13) translocation that creates a CRTC1-MAML2 fusion gene. The CRTC1-MAML2 fusion exhibited transforming activity in vitro; however, whether it serves as an oncogenic driver for MEC establishment and maintenance in vivo remains unknown. Here, we show that doxycycline-induced CRTC1-MAML2 knockdown blocked the growth of established MEC xenografts, validating CRTC1-MAML2 as a therapeutic target. We further generated a conditional transgenic mouse model and observed that Cre-induced CRTC1-MAML2 expression caused 100% penetrant formation of salivary gland tumors resembling histological and molecular characteristics of human MEC. Molecular analysis of MEC tumors revealed altered p16-CDK4/6-RB pathway activity as a potential cooperating event in promoting CRTC1-MAML2–induced tumorigenesis. Cotargeting of aberrant p16-CDK4/6-RB signaling and CRTC1-MAML2 fusion–activated AREG/EGFR signaling with the respective CDK4/6 inhibitor Palbociclib and EGFR inhibitor Erlotinib produced enhanced antitumor responses in vitro and in vivo. Collectively, this study provides direct evidence for CRTC1-MAML2 as a key driver for MEC development and maintenance and identifies a potentially novel combination therapy with FDA-approved EGFR and CDK4/6 inhibitors as a potential viable strategy for patients with MEC.

Authors

Zirong Chen, Wei Ni, Jian-Liang Li, Shuibin Lin, Xin Zhou, Yuping Sun, Jennifer W. Li, Marino E. Leon, Maria D. Hurtado, Sergei Zolotukhin, Chen Liu, Jianrong Lu, James D. Griffin, Frederic J. Kaye, Lizi Wu

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Figure 5

Combination of CDK4/6 inhibitor and EGFR inhibitor led to enhanced inhibition of human MEC cell growth and clonal expansion in vitro.

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Combination of CDK4/6 inhibitor and EGFR inhibitor led to enhanced inhib...
(A) Human MEC H3118 cells were treated with Palbociclib (1 μM) and Erlotinib (1 μM) individually or in combination for 24 hours. Cell lysates were harvested for Western blotting analysis. (B and C) H3118 cells were treated with Palbociclib (200 nM) and Erlotinib (200 nM), individually or in combination. Cell cycle analysis was performed 48 hours after treatment, and cells in G1 were quantified (B). Annexin V/PI staining was performed at 72 hours after treatment, and apoptotic cells were quantified (C). (D–I) Human MEC cells, H3118, H292, and HMC-3B, were treated with 9-point dose concentrations of Palbociclib (1:4 dilutions starting from 10 μM) and 4 doses of static Erlotinib concentrations plus vehicle control (0, 9.8 nM, 39 nM, 156 nM, 625 nM) (D, F, and H) or 9-point dose concentrations of Erlotinib (1:4 dilutions starting from 10 μM) and 4 doses of static Palbociclib concentrations plus control (0, 39 nM, 156 nM, 625 nM, 2.5 μM) (E,G, and I) for 72 hours. Synergistic analysis was conducted using SynergyFinder2.0 with the Loewe’s reference model. Loewe’s synergy scores and color scale bars indicate strength of interaction with synergistic effect shown in red in heatmaps. (J–L) Human MEC cells were seeded at 500 cells per well in 12-well plates and treated with vehicle control, Palbociclib, Erlotinib, or a combination of Palbociclib and Erlotinib the next day (n = 3 for each group). After 2-week culture, the colonies were stained with crystal violet and counted by using ImageJ software. The percentage of colony formation was represented as the ratio of the colony number in drug-treated groups to DMSO vehicle control. Data are mean ± SD. One-way ANOVA for multiple comparisons was used to calculate the P values (*P < 0.05, **P < 0.01, ***P < 0.001).

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