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2015 ; 6
(11
): 8722-35
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Identification of a novel synthetic lethality of combined inhibition of hedgehog
and PI3K signaling in rhabdomyosarcoma
#MMPMID25749378
Graab U
; Hahn H
; Fulda S
Oncotarget
2015[Apr]; 6
(11
): 8722-35
PMID25749378
show ga
We previously reported that aberrant HH pathway activation confers a poor
prognosis in rhabdomyosarcoma (RMS). Searching for new treatment strategies we
therefore targeted HH signaling. Here, we identify a novel synthetic lethality of
concomitant inhibition of HH and PI3K/AKT/mTOR pathways in RMS by GLI1/2
inhibitor GANT61 and PI3K/mTOR inhibitor PI103. Synergistic drug interaction is
confirmed by calculation of combination index (CI < 0.2). Similarly, genetic
silencing of GLI1/2 significantly increases PI103-induced apoptosis. GANT61 and
PI103 also synergize to induce apoptosis in cultured primary RMS cells
emphasizing the clinical relevance of this combination. Importantly, GANT61/PI103
cotreatment suppresses clonogenic survival, three-dimensional sphere formation
and tumor growth in an in vivo model of RMS. Mechanistic studies reveal that
GANT61 and PI103 cooperate to trigger caspase-dependent apoptosis via the
mitochondrial pathway, as demonstrated by several lines of evidence. First,
GANT61/PI103 cotreatment increases mRNA and protein expression of NOXA and BMF,
which is required for apoptosis, since knockdown of NOXA or BMF significantly
reduces GANT61/PI103-induced apoptosis. Second, GANT61/PI103 cotreatment triggers
BAK/BAX activation, which contributes to GANT61/PI103-mediated apoptosis, since
knockdown of BAK provides protection. Third, ectopic expression of BCL-2 or
non-degradable phospho-mutant MCL-1 significantly rescue GANT61/PI103-triggered
apoptosis. Fourth, GANT61/PI103 cotreatment initiate activation of the caspase
cascade via apoptosome-mediated cleavage of the initiator caspase-9, as indicated
by changes in the cleavage pattern of caspases (e.g. accumulation of the
caspase-9 p35 cleavage fragment) upon addition of the caspase inhibitor zVAD.fmk.
Thus, combined GLI1/2 and PI3K/mTOR inhibition represents a promising novel
approach for synergistic apoptosis induction and tumor growth reduction with
implications for new treatment strategies in RMS.