Increased sensitivity to SMAC mimetic LCL161 identified by longitudinal ex vivo pharmacogenomics of recurrent, KRAS mutated rectal cancer liver metastases

Journal of Translational Medicine

Kristoffer Lassen¹  Max Z. Totland²  Kushtrim Kryeziu²  Peter W. Eide²  Ragnhild A. Lothe³  Seyed H. Moosavi³  Christian H. Bergsland³  Anita Sveen³  Marianne G. Guren⁴  Andreas Abildgaard⁵  Arild Nesbakken⁶ 

[1] Department of Hepato-Pancreato-Biliary Surgery, Oslo University Hospital, Oslo, Norway;Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway;Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, P. O. Box 4953, Nydalen, 0424, Oslo, Norway;Department of Molecular Oncology, Institute for Cancer Research, Oslo University Hospital, P. O. Box 4953, Nydalen, 0424, Oslo, Norway;Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;Department of Oncology, Oslo University Hospital, Oslo, Norway;Division of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway;Institute for Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway;Department of Gastrointestinal Surgery, Oslo University Hospital, Oslo, Norway;

关键词: Rectal cancer;    Liver metastasis;    Patient-derived organoid;    LCL161;   

DOI  :  10.1186/s12967-021-03062-3

来源: Springer

【 摘 要 】

Tumor heterogeneity is a primary cause of treatment failure. However, changes in drug sensitivity over time are not well mapped in cancer. Patient-derived organoids (PDOs) may predict clinical drug responses ex vivo and offer an opportunity to evaluate novel treatment strategies in a personalized fashion. Here we have evaluated spatio-temporal functional and molecular dynamics of five PDO models established after hepatic re-resections and neoadjuvant combination chemotherapies in a patient with microsatellite stable and KRAS mutated metastatic rectal cancer. Histopathological differentiation phenotypes of the PDOs corresponded with the liver metastases, and ex vivo drug sensitivities generally reflected clinical responses and selection pressure, assessed in comparison to a reference data set of PDOs from metastatic colorectal cancers. PDOs from the initial versus the two recurrent metastatic settings showed heterogeneous cell morphologies, protein marker expression, and drug sensitivities. Exploratory analyses of a drug screen library of 33 investigational anticancer agents showed the strongest ex vivo sensitivity to the SMAC mimetic LCL161 in PDOs of recurrent disease compared to those of the initial metastasis. Functional analyses confirmed target inhibition and apoptosis induction in the LCL161 sensitive PDOs from the recurrent metastases. Gene expression analyses indicated an association between LCL161 sensitivity and tumor necrosis factor alpha signaling and RIPK1 gene expression. In conclusion, LCL161 was identified as a possible experimental therapy of a metastatic rectal cancer that relapsed after hepatic resection and standard systemic treatment.

【 授权许可】

CC BY