Research Papers:

Activation of MAPK signalling results in resistance to saracatinib (AZD0530) in ovarian cancer

Niamh McGivern, Aya El-Helali, Paul Mullan, Iain A. McNeish, D. Paul Harkin, Richard D. Kennedy _ and Nuala McCabe

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Oncotarget. 2018; 9:4722-4736. https://doi.org/10.18632/oncotarget.23524

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Niamh McGivern1, Aya El-Helali1, Paul Mullan1, Iain A. McNeish2, D. Paul Harkin1,3, Richard D. Kennedy1,3 and Nuala McCabe1,3

1Centre for Cancer Research and Cell Biology, Queen’s University Belfast, Northern Ireland, UK

2Institute of Cancer Sciences, University of Glasgow, Scotland, UK

3Almac Diagnostics, 19 Seagoe Industrial Estate, Craigavon, Northern Ireland, UK

Correspondence to:

Richard D. Kennedy, email: [email protected]

Nuala McCabe, email: [email protected]

Keywords: ovarian cancer; SRC; MAPK; resistance; drug combination

Received: August 01, 2017     Accepted: December 01, 2017     Published: December 20, 2017


SRC tyrosine kinase is frequently overexpressed and activated in late-stage, poor prognosis ovarian tumours, and preclinical studies have supported the use of targeted SRC inhibitors in the treatment of this disease. The SAPPROC trial investigated the addition of the SRC inhibitor saracatinib (AZD0530) to weekly paclitaxel for the treatment of platinum resistant ovarian cancer; however, this drug combination did not provide any benefit to progression free survival (PFS) of women with platinum resistant disease. In this study we aimed to identify mechanisms of resistance to SRC inhibitors in ovarian cancer cells. Using two complementary strategies; a targeted tumour suppressor gene siRNA screen, and a phospho-receptor tyrosine kinase array, we demonstrate that activation of MAPK signalling, via a reduction in NF1 (neurofibromin) expression or overexpression of HER2 and the insulin receptor, can drive resistance to AZD0530. Knockdown of NF1 in two ovarian cancer cell lines resulted in resistance to AZD0530, and was accompanied with activated MEK and ERK signalling. We also show that silencing of HER2 and the insulin receptor can partially resensitize AZD0530 resistant cells, which was associated with decreased phosphorylation of MEK and ERK. Furthermore, we demonstrate a synergistic effect of combining SRC and MEK inhibitors in both AZD0530 sensitive and resistant cells, and that MEK inhibition is sufficient to completely resensitize AZD0530 resistant cells. This work provides a preclinical rationale for the combination of SRC and MEK inhibitors in the treatment of ovarian cancer, and also highlights the need for biomarker driven patient selection for clinical trials.

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