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The EMT factor ZEB1 paradoxically inhibits EMT in BRAF-mutant carcinomas
Ester Sánchez-Tilló, Leire Pedrosa, Ingrid Vila, Yongxu Chen, Balázs Győrffy, Lidia Sánchez-Moral, Laura Siles, Juan J. Lozano, Anna Esteve-Codina, Douglas S. Darling, Miriam Cuatrecasas, Antoni Castells, Joan Maurel, Antonio Postigo
Ester Sánchez-Tilló, Leire Pedrosa, Ingrid Vila, Yongxu Chen, Balázs Győrffy, Lidia Sánchez-Moral, Laura Siles, Juan J. Lozano, Anna Esteve-Codina, Douglas S. Darling, Miriam Cuatrecasas, Antoni Castells, Joan Maurel, Antonio Postigo
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Research Article Gastroenterology Oncology

The EMT factor ZEB1 paradoxically inhibits EMT in BRAF-mutant carcinomas

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Abstract

Despite being in the same pathway, mutations of KRAS and BRAF in colorectal carcinomas (CRCs) determine distinct progression courses. ZEB1 induces an epithelial-to-mesenchymal transition (EMT) and is associated with worse progression in most carcinomas. Using samples from patients with CRC, mouse models of KrasG12D and BrafV600E CRC, and a Zeb1-deficient mouse, we show that ZEB1 had opposite functions in KRAS- and BRAF-mutant CRCs. In KrasG12D CRCs, ZEB1 was correlated with a worse prognosis and a higher number of larger and undifferentiated (mesenchymal or EMT-like) tumors. Surprisingly, in BrafV600E CRC, ZEB1 was associated with better prognosis; fewer, smaller, and more differentiated (reduced EMT) primary tumors; and fewer metastases. ZEB1 was positively correlated in KRAS-mutant CRC cells and negatively in BRAF-mutant CRC cells with gene signatures for EMT, cell proliferation and survival, and ERK signaling. On a mechanistic level, ZEB1 knockdown in KRAS-mutant CRC cells increased apoptosis and reduced clonogenicity and anchorage-independent growth; the reverse occurred in BRAFV600E CRC cells. ZEB1 is associated with better prognosis and reduced EMT signature in patients harboring BRAF CRCs. These data suggest that ZEB1 can function as a tumor suppressor in BRAF-mutant CRCs, highlighting the importance of considering the KRAS/BRAF mutational background of CRCs in therapeutic strategies targeting ZEB1/EMT.

Authors

Ester Sánchez-Tilló, Leire Pedrosa, Ingrid Vila, Yongxu Chen, Balázs Győrffy, Lidia Sánchez-Moral, Laura Siles, Juan J. Lozano, Anna Esteve-Codina, Douglas S. Darling, Miriam Cuatrecasas, Antoni Castells, Joan Maurel, Antonio Postigo

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Figure 7

ZEB1 represses EMT and determines better survival in BRAF-mutant mCRC patients.

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ZEB1 represses EMT and determines better survival in BRAF-mutant mCRC pa...
(A) Heatmap of gene signatures in patients with BRAF- (green) and RAS- (blue) mutant (mut) mCRC with high (left) and low (right) ZEB1 levels. (B) Top panel: ZEB1 gene expression in the entire cohort of patients with BRAF- and RAS-mutant mCRC (n = 115); blue indicates high ZEB1 expression, yellow indicates low ZEB1 expression. Bottom panel: Track 1: sex (male: orange; female: purple); track 2: age (<70 years: green; ≥70 years: pink); track 3: ECOG performance status (ECOG 0: green; ECOG 1: blue; ECOG ≥2: pink); track 4: primary tumor site distribution (left side: green; right side: pink); track 5: presence of liver metastases (yes: pink, no: green); track 6: presence of peritoneal metastases (yes: pink; no: green); track 7: number of organs affected (1: blue; ≥1 organ: pink); track 8: LDH level (< upper limit of normal [ULN]: green; > ULN: pink; not determined [n.d.]: white); track 9: genotype (KRAS-mutant: pink; BRAF-mutant: blue; WT: green; n.d.: white); and track 10: microsatellite-instable/microsatellite-stable (MSI/MSS) status (MSI: pink; MSS: green; n.d.: white). (C) Treatment distribution and efficacy in patients with ZEB1 high (left) and ZEB1 low (right) BRAF-mutant mCRC; best overall response according to ZEB1 expression. Percentage of overall response according to each treatment is given in the figure. (D) Progression-free survival and (E) overall survival (OS) in patients with BRAFV600E mCRC with ZEB1 high (black line) or low (red line) according to cutoff. Univariate analysis results of overall survival in patients with BRAF V600E mCRC (P < 0.05) are reported in Supplemental Table S9, and multivariate analysis results are shown in Table 1. Sig, significance. ENCO, encorafenib; BIN, binimetinib; CET, cetuximab.

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