ERK mutations confer resistance to mitogen-activated protein kinase pathway inhibitors

EM Goetz, M Ghandi, DJ Treacy, N Wagle… - Cancer research, 2014 - AACR
EM Goetz, M Ghandi, DJ Treacy, N Wagle, LA Garraway
Cancer research, 2014AACR
The use of targeted therapeutics directed against BRAFV600-mutant metastatic melanoma
improves progression-free survival in many patients; however, acquired drug resistance
remains a major medical challenge. By far, the most common clinical resistance mechanism
involves reactivation of the MAPK (RAF/MEK/ERK) pathway by a variety of mechanisms.
Thus, targeting ERK itself has emerged as an attractive therapeutic concept, and several
ERK inhibitors have entered clinical trials. We sought to preemptively determine mutations in …
Abstract
The use of targeted therapeutics directed against BRAFV600-mutant metastatic melanoma improves progression-free survival in many patients; however, acquired drug resistance remains a major medical challenge. By far, the most common clinical resistance mechanism involves reactivation of the MAPK (RAF/MEK/ERK) pathway by a variety of mechanisms. Thus, targeting ERK itself has emerged as an attractive therapeutic concept, and several ERK inhibitors have entered clinical trials. We sought to preemptively determine mutations in ERK1/2 that confer resistance to either ERK inhibitors or combined RAF/MEK inhibition in BRAFV600-mutant melanoma. Using a random mutagenesis screen, we identified multiple point mutations in ERK1 (MAPK3) and ERK2 (MAPK1) that could confer resistance to ERK or RAF/MEK inhibitors. ERK inhibitor–resistant alleles were sensitive to RAF/MEK inhibitors and vice versa, suggesting that the future development of alternating RAF/MEK and ERK inhibitor regimens might help circumvent resistance to these agents. Cancer Res; 74(23); 7079–89. ©2014 AACR.
AACR