Research Papers:

Combating autophagy is a strategy to increase cytotoxic effects of novel ALK inhibitor entrectinib in neuroblastoma cells

Sanja Aveic _, Marcella Pantile, Anke Seydel, Maria Rosaria Esposito, Carlo Zanon, Gary Li and Gian Paolo Tonini

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Oncotarget. 2016; 7:5646-5663. https://doi.org/10.18632/oncotarget.6778

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Sanja Aveic1, Marcella Pantile1, Anke Seydel1, Maria Rosaria Esposito1, Carlo Zanon1, Gary Li2, Gian Paolo Tonini1

1Neuroblastoma Laboratory, Pediatric Research Institute, Città della Speranza, Padua, Italy

2Ignyta Inc., San Diego, California, USA

Correspondence to:

Sanja Aveic, e-mail: [email protected]

Keywords: neuroblastoma, autophagy, ALK inhibitors; drug combination, entrectinib

Received: July 21, 2015    Accepted: December 22, 2015    Published: December 28, 2015


Neuroblastoma (NB) is a threatening childhood malignancy. Its prognosis is affected by several morphological, and biological characteristics, including the constitutive expression of ALK tyrosine kinase. In this study we examined the therapeutic potential of a novel ALK inhibitor, entrectinib, in obliterating NB tumor cells.

Entrectinib showed the growth-inhibitory effects on NB cells with a 50% inhibitory concentration range of 0.03–5 μM. In the ALK-dependent cells, entrectinib mediated G1-arrest, which was associated with modified expression of multiple cell-cycle regulators. Down-regulation of Ki-67, and attenuated phosphorylation of ERK1/2, and STAT3, correlated with observed antiproliferative capacity of entrectinib. Initial cytostatic activity of entrectinib was followed by concentration-dependent apoptotic cell death, and Caspase-3 activation. However, we delineated a reduced sensitivity of ALK mutated NB cells to entrectinib, and demonstrated strong activation of autophagy in SH-SY5YF1174L NB cell line. Abrogation of autophagy by chloroquine increased significantly the toxicity of entrectinib, as confirmed by enhanced death rate, and PARP protein cleavage in SH-SY5YF1174L cells.

In aggregate, our data show that entrectinib inhibits proliferation, and induces G1-arrest, and apoptosis in NB cells. We propose entrectinib for further consideration in treatment of NB, and recommend pharmacological inhibition of autophagy to be explored for a combined therapeutic approach in NB patients that might develop resistance to entrectinib.

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