Research Papers:

CD44 positive and sorafenib insensitive hepatocellular carcinomas respond to the ATP-competitive mTOR inhibitor INK128

Mohamed Badawi, Jihye Kim, Anees Dauki, Dhruvitkumar Sutaria, Tasneem Motiwala, Ryan Reyes, Nissar Wani, Shamalatha Kolli, Jinmai Jiang, Christopher C. Coss, Samson T. Jacob, Mitch A. Phelps and Thomas D. Schmittgen _

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Oncotarget. 2018; 9:26032-26045. https://doi.org/10.18632/oncotarget.25430

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Mohamed Badawi1,*, Jihye Kim1,*, Anees Dauki1, Dhruvitkumar Sutaria1,3, Tasneem Motiwala2, Ryan Reyes2, Nissar Wani2, Shamalatha Kolli4, Jinmai Jiang3, Christopher C. Coss1,4, Samson T. Jacob2, Mitch A. Phelps1,4 and Thomas D. Schmittgen3

1College of Pharmacy, College of Medicine, The Ohio State University, Columbus, OH, USA

2Department of Molecular and Cellular Biochemistry, College of Medicine, The Ohio State University, Columbus, OH, USA

3College of Pharmacy, University of Florida, Gainesville, FL, USA

4Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA

*These authors contributed equally to this work

Correspondence to:

Thomas D. Schmittgen, email: [email protected]

Keywords: TAK228; MLN0128; sapanisertib; pharmacokinetics

Received: March 26, 2018     Accepted: April 26, 2018     Published: May 25, 2018


The mTOR pathway is activated in about 50% of patients with hepatocellular carcinoma (HCC). In an effort to identify new pathways and compounds to treat advanced HCC, we considered the ATP-competitive mTOR inhibitor INK128. ATP-competitive mTOR inhibitors attenuate both mTORC1 and mTORC2. INK128 was evaluated in sorafenib sensitive and insensitive HCC cell lines, CD44low and CD44high HCC and those cell lines with acquired sorafenib resistance. CD44 was significantly increased in Huh7 cells made resistant to sorafenib. Forced expression of CD44 enhanced cellular proliferation and migration, and rendered the cells more sensitive to the anti-proliferative effects of INK128. INK128 suppressed CD44 expression in HCC cells while allosteric mTOR inhibitors did not. CD44 inhibition correlated with 4EBP1 phosphorylation status. INK128 showed better anti-proliferative and anti-migration effects on the mesenchymal-like HCC cells, CD44high HCC cells compared to the allosteric mTOR inhibitor everolimus. Moreover, a combination of INK128 and sorafenib showed improved anti-proliferative effects in CD44high HCC cells. INK128 was efficacious at reducing tumor growth in CD44high SK-Hep1 xenografts in mice when given as monotherapy or in combination with sorafenib. Since the clinical response to sorafenib is highly variable, our findings suggest that ATP-competitive mTOR inhibitors may be effective in treating advanced, CD44-expressing HCC patients who are insensitive to sorafenib.

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