Cited by 210Pancreatic and Hepatic Oncology ResearchAdvanced Breast Cancer TherapiesCancer-related Molecular Pathways

CDK4/6 inhibitors have potent activity in combination with pathway selective therapeutic agents in models of pancreatic cancer

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Franco, Jorge, Witkiewicz, Agnieszka K., Knudsen, Erik S.·2014·Oncotarget

Abstract

// Jorge Franco 1 , Agnieszka K. Witkiewicz 1,2 and Erik S. Knudsen 1,2 1 Department of Pathology , UT Southwestern, Dallas TX 2 Simmons Cancer Center, UT Southwestern, Dallas TX Correspondence: Erik S. Knudsen, email: // Agnieszka K. Witkiewicz, email: // Keywords : RB, CDK4/6, palbocicllb, pancreatic cancer, E2F Received : July 10, 2014 Accepted : July 26, 2014 Published : July 26, 2014 Abstract Pancreatic ductal adenocarcinoma (PDA) has a poor prognosis, in part, due to the therapy-recalcitrant nature of the disease. Loss of the CDK4/6 inhibitor CDKN2A is a signature genetic event in PDA. Therefore, PDA may be amenable to treatment with pharmaceutical CDK4/6 inhibitors. Surprisingly, response to CDK4/6 inhibition was highly variable in PDA models, and was associated with differential suppression of RB-regulated gene expression. Mitotic genes were repressed and FOXM1 was uniformly attenuated; however, genes involved in DNA replication were uniquely suppressed in sensitive models. Aberrant induction of Cyclin E1 was associated with resistance, and knockdown demonstrated synergistic suppression of the cell cycle with CDK4/6 inhibition. Combination therapies are likely required for the effective treatment of disease, and drug screening demonstrated additive/antagonistic interactions with CDK4/6 inhibitors. Agents dependent on mitotic progression (taxanes/PLK1 inhibitors) were antagonized by CDK4/6 inhibition, while the response to 5-FU and gemcitabine exhibited drug specific interactions. PI3K/MTOR and MEK inhibitors potently cooperated with CDK4/6 inhibition. These agents were synergistic with CDK4/6 inhibition, blocked the aberrant upregulation of Cyclin E1, and yielded potent inhibition of tumor cell growth. Together, these data identify novel mechanisms of resistance to CDK4/6 inhibitions and provide a roadmap for combination therapies in the treatment of PDA.

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Crossref · 10.18632/oncotarget.2270

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  • Preclinical studies show synergistic effects of CDK4/6 inhibition and MAP kinase inhibition in melanoma and pancreatic cancer models.

    “preclinical synergistic effects of CDK4/6 inhibition and MAP kinase inhibition in melanoma and pancreatic cancer models has stimulated substantial interest in the development of these combinations (106-108)”

    From Targeting CDK4 and CDK6: From Discovery to Therapy (2016) · cites this paper as [108]

  • Combined CDK4 and MEK inhibition increased apoptosis and/or reduced viability in colony formation assays in human melanoma and pancreatic cancer cell lines.

    “combined CDK4 and MEK inhibition has led to increased apoptosis and/or reduced viability in colony formation assays in human melanoma and pancreatic cancer cell lines.”

    From Targeting CDK4 and CDK6: From Discovery to Therapy (2016) · cites this paper as [108]

  • Alterations in expression of cyclin E, p27Kip1, and D-type cyclins have been demonstrated in adaptation to CDK4/6 inhibition, potentially contributing to acquired resistance.

    “alterations in expression of such cell cycle regulators, including cyclin E and p27Kip1, as well as D-type cyclins themselves, have been demonstrated in adaptation to CDK4/6 inhibition, potentially contributing to acquired resistance (108, 134-136).”

    From Targeting CDK4 and CDK6: From Discovery to Therapy (2016) · cites this paper as [108]

  • p16INK4A-deficient pancreatic cancer cell lines may be inherently resistant to CDK4/6 inhibitors; synergistic compromise of proliferation and viability has been shown with PI3K inhibitors and IGF1R inhibitors in vitro and in vivo.

    “p16INK4A-deficient pancreatic cancer cell lines may be inherently resistant to CDK4/6 inhibitors; synergistic compromise of cell proliferation and viability have been demonstrated with PI3K inhibitors (108), as well as with inhibitors of IGF1R both in vitro and in vivo (120).”

    From Targeting CDK4 and CDK6: From Discovery to Therapy (2016) · cites this paper as [108]

  • Some adaptations to CDK4/6 inhibition are reversible after drug removal, suggesting potential value of intermittent dosing schedules for maintaining cell cycle arrest.

    “some of these adaptations are reversible after drug removal suggesting, perhaps counter-intuitively, the potential value of intermittent dosing schedules for maintenance of cell cycle arrest.”

    From Targeting CDK4 and CDK6: From Discovery to Therapy (2016) · cites this paper as [108]

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Authors
Franco, J., Witkiewicz, A. K., & Knudsen, E. S.
Affiliations
  • The University of Texas Southwestern Medical Center (US)
  • Harold C. Simmons Comprehensive Cancer Center (US)
Venue
Oncotarget
Published
2014-07-26
Volume
5
Issue
15
Pages
6512-6525
ISSN
1949-2553 (ISSN-L)
OpenAlex
W2118874870
Cited by
207
References
61
Citations by year
2026: 4 · 2025: 7 · 2024: 9 · 2023: 19 · 2022: 23 · 2021: 17 · 2020: 21 · 2019: 25 · 2018: 31 · 2017: 20 · 2016: 15 · 2015: 15 · 2014: 1
FWCI
8.21
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Oncotarget (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Oncology › Pancreatic and Hepatic Oncology Research
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Advanced Breast Cancer Therapies
  • Health Sciences › Medicine › Oncology › Cancer-related Molecular Pathways
Keywords
CDK4/6 inhibitors, pancreatic ductal adenocarcinoma, palbociclib, retinoblastoma protein, CDKN2A loss, E2F transcription factors, cyclin E1, drug resistance, combination therapy, PI3K/mTOR inhibitors, MEK inhibitors, taxanes, PLK1 inhibitors, 5-fluorouracil, gemcitabine, drug synergy, DNA replication
MeSH terms
Humans, Pancreatic Neoplasms, Piperazines, Prognosis, Pyridines, Transfection, Gene Expression, Cyclin-Dependent Kinase Inhibitor p16, Gene Expression Profiling, Carcinoma, Pancreatic Ductal, Cell Line, Tumor, Protein Kinase Inhibitors, Cyclin-Dependent Kinase 4, Cyclin-Dependent Kinase 6

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