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Experimental Therapeutics |
Istituto di Endocrinologia ed Oncologia Sperimentale del Consiglio Nazionale delle Ricerche, Dipartimento di Biologia e Patologia Cellulare e Molecolare "Luigi Califano" [F. Ca., D. V., T. G., G. V., A. F., M. S.] and Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica [F. Ci., G. T.], University Federico II, 80131 Naples, Italy; Department of Oncology, Transplants and Advanced Technologies in Medicine, University of Pisa, 56100 Pisa, Italy [G. F.]; and Cancer Discovery, Astra Zeneca Mereside, Macclesfield, Cheshire, SK10 4TG, United Kingdom [A. J. R.]
| ABSTRACT |
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| INTRODUCTION |
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RET/PTC, RET/MEN2A, RET/MEN2B, and RET/FMTC alleles induce transformed foci, anchorage-independent growth and tumorigenicity in nude mice when introduced into NIH3T3 cells (2) . This transforming capacity is linked to their constitutive ligand-independent kinase activity. In RET/PTC, coiled-coil sequences of the fusion partners induce constitutive dimerization of the oncoprotein (10) . Disulfide-bond-mediated dimerization of RET occurs in MEN2A and FMTC cases bearing mutations of the extracellular cysteines (11) . The MEN2B-associated M918T mutation probably modifies the structure of the activation loop of the RET catalytic domain, thereby switching on the enzymatic function and altering its substrate specificity (11 , 12) .
Quinazolines are some of the most promising inhibitors of growth factor receptor tyrosine kinases (13)
. An anilinoquinazoline derivative, ZD1839 (Iressa is a potent and selective inhibitor of the EGFR and is currently in advanced clinical development (14)
. Another anilinoquinazoline, ZD6474, has recently been shown to be a selective inhibitor of the VEGF receptor-2 (flk-1/KDR) tyrosine kinase (15)
. ZD6474 has an IC50 of
0.04 µM against the isolated KDR enzyme and blocks VEGF-stimulated endothelial cell migration and proliferation. In vivo, ZD6474 reverses VEGF-mediated hypotension and produces a dose-dependent increase in hypertrophy of the femoro-tibial epiphyseal growth plate zone, consistently with the inhibition of VEGF signaling and angiogenesis (15)
. ZD6474 inhibits, to a lesser extent, the activity of other tyrosine kinases such as the EGFR (IC50 = 0.5 µM) and the platelet-derived growth factor receptor (IC50 = 1.1 µM). Chronic once-daily oral administration of ZD6474 produced significant broad-spectrum antitumor activity on human tumor xenografts implanted in nude mice. ZD6474 is currently under Phase I evaluation in cancer patients (15)
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Here, we report a hitherto unknown property of ZD6474, i.e., it inhibits the enzymatic and transforming activity of RET oncoproteins and arrests the development of RET/PTC3-induced tumors in nude mice.
| MATERIALS AND METHODS |
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Cell Culture.
Parental NIH3T3 and NIH3T3 cells transfected with EGFR (donated by P. P. Di Fiore; Ref. 16
), EGFR/RET (17)
, RET/PTC3 (4)
, MEN2A-associated RET C634R mutant, MEN2B-associated M918T RET mutant (11)
and v-Ha-Ras (18)
were cultured in DMEM supplemented with calf serum (10% for normal cells and 5% for transformed cells), 2 mM L-glutamine, and 100 units/ml penicillin-streptomycin (Life Technologies, Inc., Paisley, United Kingdom). After overnight starvation, NIH-EGFR and NIH-EGFR/RET were stimulated or not with 100 ng/ml EGF (Upstate Biotechnology Inc., Lake Placid, NY) for 10 min. Human thyroid-carcinoma cell lines [TPC1 (19)
; FB2 (a gift of F. Basolo; Ref. 20
), from papillary carcinomas harboring the RET/PTC1 rearrangement; and ARO (a gift of J. A. Fagin; Ref. 21
), derived from an anaplastic carcinoma negative for RET/PTC rearrangements], were cultured in RPMI with 10% FCS, 2 mM L-glutamine, and 100 units/ml penicillin-streptomycin (Life Technologies, Inc.). HEK293 cells were from American Type Culture Collection (Manassas, VA) and were grown in DMEM supplemented with 10% FCS. Transient transfections were carried out with the LipofectAMINE reagent used according to the manufacturers instructions (Life Technologies, Inc.). Briefly, cells were seeded at a density of 1.5 x 106/dish the day before transfection, then transfected with 5 µg of DNA, and harvested 48 h later.
Immunoblotting Analysis.
Cells or tumor tissues were lysed in a buffer containing 50 mM HEPES (pH 7.5), 1% (vol/vol) Triton X-100, 50 mM NaCl, 5 mM EGTA, 50 mM NaF, 20 mM sodium PPI, 1 mM sodium vanadate, 2 mM phenylmethylsulphonyl fluoride (PMSF), and 1 µg/ml aprotinin. Lysates were clarified by centrifugation at 10,000 x g for 15 min. Lysates containing comparable amounts of proteins, estimated by a modified Bradford assay (Bio-Rad, Munich, Germany), were immunoprecipitated with the required antibody or subjected to direct Western blot. Immune complexes were detected with the enhanced chemiluminescence kit (Amersham Pharmacia Biotech, Little Chalfont, United Kingdom). Anti-phosphotyrosine (4G10) and anti-EGFR were from Upstate Biotechnology Inc. Anti-MAPK (no. 9101) and anti-phospho-MAPK (no. 9102) were from New England Biolabs (Beverley, MA). Anti-RET is a polyclonal antibody raised against the tyrosine kinase protein fragment of human RET (17)
. Secondary antibodies coupled to horseradish peroxidase were from Santa Cruz Biotechnology (Santa Cruz, CA).
In Vitro Kinase Assays.
Cells were solubilized in lysis buffer with phosphatase and protease inhibitors. NIH-EGFR and NIH-EGFR/RET were stimulated with 100 ng/ml EGF for 10 min before harvesting. Proteins (200 µg) were immunoprecipitated with the required antibodies; immunocomplexes were recovered with protein A Sepharose, washed five times with kinase buffer, and incubated (20 min at room temperature) in kinase buffer containing 200 µM poly-GT (Sigma Chemical Co.), 2.5 µCi [
-32P]ATP and unlabelled ATP to a final concentration of 20 µM in the presence of the inhibitory compound or vehicle. EGFR and EGFR/RET immunocomplexes were incubated with 100 ng/ml EGF. Samples were spotted on Whatman 3MM paper (Springfield Mill, United Kingdom) and 32P incorporation was measured with a ß-counter scintillator (Beckman Coulter, Unterschleissheim-Lohhof, Germany). The GST-RET/TK plasmid was generated by PCR amplification of the intracellular RET domain (residues 718-1072) and fusion to the GST coding sequence into the pEBG vector, kindly provided by S. Meakin (22)
. GST-RET/TK was purified from HEK293 cell lysates using glutathione Sepharose according to standard procedures.
Growth Curve and Cell Cycle Analysis.
For growth curves, NIH3T3 cells (10,000/dish) or human thyroid carcinoma cells (50,000/dish) were seeded on 60-mm dishes in complete medium. The next day (day 1) ZD6474 or vehicle was added to the medium and refreshed every 2 days. Cells were counted every day. For cytofluorimetric [fluorescence-activated cell sorting (FACS)] analysis, cells were grown to subconfluence, serum-starved for 24 h, and then subjected or not to 5.0 µM ZD6474 for an additional 24 h. After harvesting, cells were fixed in cold 70% ethanol in PBS. Propidium iodide (25 µg/ml) was added, and samples were analyzed with a FACScalibur flow cytometer (Becton Dickinson, San Jose, CA) interfaced with a Hewlett Packard computer (Hewlett Packard, Palo Alto, CA).
Soft Agar Growth Assay.
Cells were seeded on 60-mm dishes (10,000 cells/dish) in 0.3% agar in complete medium on a base layer of 0.5% agar with or without various concentrations of the inhibitor; the compound solution was added to the top layer every 3 days. Colonies were counted 15 days later.
Tumorigenicity in Nude Mice.
NIH-RET/PTC3 and NIH-RAS cells (50,000/mouse) were inoculated s.c. into the right dorsal portion of 6-week-old male BALB/c nu/nu mice (The Jackson Laboratory, Bar Harbor, ME). ZD6474 (1 or 0.4 mg/mouse/day dissolved in PBS containing 0.5% v/v Tween 80) or vehicle alone was injected i.p. when established tumors (of
510 mm3) appeared. Tumor diameters were measured with calipers every 13 days. Tumor volumes (V) were calculated by the rotational ellipsoid formula: V = A x B2/2 (A = axial diameter; B = rotational diameter). No mouse showed signs of wasting or other signs of toxicity. Animals were maintained at the Dipartimento di Biologia e Patologia Cellulare e Molecolare Animal Facility. All of the manipulations were performed under isoflurane gas anesthesia and conducted in accordance with Italian regulations for experimentation on animals.
Statistical Analysis.
The Students t test was used to evaluate the statistical significance of the results. Analyses were performed with the BMDP New System statistical package version 1.0 for Microsoft Windows (BMDP Statistical Software, Los Angeles, CA).
| RESULTS |
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Inhibition of the Transforming Effects of RET/PTC Oncogenes by ZD6474.
RET/PTC3 induces morphological transformation, serum- and anchorage-independent proliferation and tumorigenicity in nude mice (4)
. We treated NIH-RET/PTC3 cells with 5.0 µM ZD6474 for 24 h and analyzed the morphological changes induced by the drug. As controls, we used parental and v-Ha-Ras-transformed NIH3T3 cells (NIH-RAS). We selected Ras as a control because it acts downstream from most receptors including RET (1)
. As shown in Fig. 3
, ZD6474 caused a complete morphological reversion of NIH-RET/PTC3 cells, whereas neither DMSO nor ZD1839 had any effect. Neither parental nor NIH-RAS cells were affected by ZD6474 (Fig. 3)
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510 mm3, animals (six for each group) were treated i.p. with ZD6474 at either 1 or 0.4 mg/mouse/day (equivalent to 50 or 20 mg/kg/day, respectively) or with vehicle. Fig. 6A
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| DISCUSSION |
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The RET gene is activated by somatic rearrangements in PTCs and by point mutations in sporadic and familial (MEN2) medullary thyroid carcinomas. Thus, RET kinase inhibitors might be beneficial in the treatment of these tumors, especially medullary thyroid carcinoma, which responds poorly to conventional chemotherapeutics (29) .
ZD6474 is a novel inhibitor of KDR with potent antiangiogenetic effects. Chronic oral administration of ZD6474 produces significant, broad-spectrum antitumor activity in different human tumor xenografts. Importantly, ZD6474 is active p.o. and has pharmacokinetics that are compatible with once-daily oral administration. An ongoing Phase I trial of ZD6474 in patients with solid tumors has revealed that the drug is well tolerated at doses of up to 300 mg per day (15) .
This study shows that ZD6474 is a potent (IC50 of 100 nM) inhibitor of RET oncoproteins. In our experience, RET enzymatic activity, with the agents tried until now, is refractory to the effects of many kinase inhibitors. In a previous screening of compounds of different chemical classes, we found that only the pyrazolo-pyrimidine PP1 and two related compounds were efficient inhibitors of RET (23) . We also found that potent kinase inhibitors such as several tyrphostins (23) and ZD1839 (this report) do not affect RET. ZD6474-mediated block of RET enzymatic activity resulted in the inhibition of the signaling and transforming capacity of RET oncoproteins. Furthermore, ZD6474 exerted a powerful growth-inhibitory effect on thyroid carcinoma cell lines that spontaneously harbor RET/PTC rearrangements. Because, these thyroid carcinoma cells do not express detectable levels of KDR (not shown), we think that ZD6474 effects are mediated by RET inhibition and that the possibility that they are also mediated by KDR inhibition can be excluded. ZD6474 prevented the growth of NIH-RET/PTC3 xenografts. It also had inhibitory effects, albeit less strong, on NIH-RAS tumors. These last effects are likely attributable to the antiangiogenic properties of ZD6474.
Treating both cancer and endothelial cells in a tumor has the potential to be more effective than treating cancer cells alone. Tumor cells often are selected to bypass the effects of antineoplastic agents, and the occurrence of therapy-resistant clones is frequently the reason for treatment failure. A possible advantage of ZD6474 in RET-associated tumors is that it has the potential to act as both an antiangiogenetic and an antineoplastic drug. The simultaneous assault on both neoplastic and endothelial cells may offer a mechanism to circumvent the development of resistance. We have recently shown that PP1 is a powerful inhibitor of RET-derived oncoproteins with an IC50 (80 nM) similar to that for ZD6474. Nevertheless, ZD6474 has several possible advantages in the treatment of RET-related tumors, including antiangiogenetic effects, low toxicity, and the possibility of oral administration. On the other hand, PP1 and ZD6474 may be used alternately to treat RET-associated cancers. Such a strategy may further help to prevent the development of treatment resistance.
| ACKNOWLEDGMENTS |
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| FOOTNOTES |
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1 Supported by the Associazione Italiana per la Ricerca sul Cancro (AIRC), by the Ministero per lIstruzione, Università e Ricerca Scientifica (MIUR), and by the Ministero della Salute. ![]()
2 To whom requests for reprints should be addressed, at Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Facoltà di Medicina e Chirurgia, via. S. Pansini 5, 80131 Naples, Italy. Phone: 0039-081-7463056; Fax: 0039-081-7463037; E-mail: masantor{at}unina.it ![]()
3 The abbreviations used are: PTC, papillary thyroid carcinoma; MEN2, multiple endocrine neoplasia type 2 (syndrome); EGF, epidermal growth factor; EGFR, EGF receptor; VEGF, vascular endothelial growth factor; MAPK, mitogen-activated protein kinase; GST, glutathione-S-transferase; poly-GT, poly(L-glutamic acid-L-tyrosine); ERK, extracellular signal-regulated kinase. ![]()
Received 5/23/02. Accepted 10/10/02.
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X.-F. Zhu, B.-F. Xie, J.-M. Zhou, G.-K. Feng, Z.-C. Liu, X.-Y. Wei, F.-X. Zhang, M.-F. Liu, and Y.-X. Zeng Blockade of Vascular Endothelial Growth Factor Receptor Signal Pathway and Antitumor Activity of ON-III (2',4'-Dihydroxy-6'-methoxy-3',5'-dimethylchalcone), a Component from Chinese Herbal Medicine Mol. Pharmacol., May 1, 2005; 67(5): 1444 - 1450. [Abstract] [Full Text] [PDF] |
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M. Santoro, R. M. Melillo, F. Carlomagno, G. Vecchio, and A. Fusco Minireview: RET: Normal and Abnormal Functions Endocrinology, December 1, 2004; 145(12): 5448 - 5451. [Abstract] [Full Text] [PDF] |
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J A Fagin How thyroid tumors start and why it matters: kinase mutants as targets for solid cancer pharmacotherapy J. Endocrinol., November 1, 2004; 183(2): 249 - 256. [Abstract] [Full Text] [PDF] |
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J. A. Fagin Challenging Dogma in Thyroid Cancer Molecular Genetics--Role of RET/PTC and BRAF in Tumor Initiation J. Clin. Endocrinol. Metab., September 1, 2004; 89(9): 4264 - 4266. [Full Text] [PDF] |
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R. M. Melillo, A. M. Cirafici, V. De Falco, M. Bellantoni, G. Chiappetta, A. Fusco, F. Carlomagno, A. Picascia, D. Tramontano, G. Tallini, et al. The Oncogenic Activity of RET Point Mutants for Follicular Thyroid Cells May Account for the Occurrence of Papillary Thyroid Carcinoma in Patients Affected by Familial Medullary Thyroid Carcinoma Am. J. Pathol., August 1, 2004; 165(2): 511 - 521. [Abstract] [Full Text] [PDF] |
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S. A. Wells and J. R. Nevins Evolving Strategies for Targeted Cancer Therapy--Past, Present, and Future J Natl Cancer Inst, July 7, 2004; 96(13): 980 - 981. [Full Text] [PDF] |
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G. Cuccuru, C. Lanzi, G. Cassinelli, G. Pratesi, M. Tortoreto, G. Petrangolini, E. Seregni, A. Martinetti, D. Laccabue, C. Zanchi, et al. Cellular Effects and Antitumor Activity of RET Inhibitor RPI-1 on MEN2A-Associated Medullary Thyroid Carcinoma J Natl Cancer Inst, July 7, 2004; 96(13): 1006 - 1014. [Abstract] [Full Text] [PDF] |
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G. A. Kaltsas, G. M. Besser, and A. B. Grossman The Diagnosis and Medical Management of Advanced Neuroendocrine Tumors Endocr. Rev., June 1, 2004; 25(3): 458 - 511. [Abstract] [Full Text] [PDF] |
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M. Braga-Basaria, E. Hardy, R. Gottfried, K. D. Burman, M. Saji, and M. D. Ringel 17-Allylamino-17-Demethoxygeldanamycin Activity against Thyroid Cancer Cell Lines Correlates with Heat Shock Protein 90 Levels J. Clin. Endocrinol. Metab., June 1, 2004; 89(6): 2982 - 2988. [Abstract] [Full Text] [PDF] |
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D. Vitagliano, F. Carlomagno, M. L. Motti, G. Viglietto, Y. E. Nikiforov, M. N. Nikiforova, J. M. Hershman, A. J. Ryan, A. Fusco, R. M. Melillo, et al. Regulation of p27Kip1 Protein Levels Contributes to Mitogenic Effects of the RET/PTC Kinase in Thyroid Carcinoma Cells Cancer Res., June 1, 2004; 64(11): 3823 - 3829. [Abstract] [Full Text] [PDF] |
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H. Namba, M. Nakashima, T. Hayashi, N. Hayashida, S. Maeda, T. I. Rogounovitch, A. Ohtsuru, V. A. Saenko, T. Kanematsu, and S. Yamashita Clinical Implication of Hot Spot BRAF Mutation, V599E, in Papillary Thyroid Cancers J. Clin. Endocrinol. Metab., September 1, 2003; 88(9): 4393 - 4397. [Abstract] [Full Text] [PDF] |
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C. J. Strock, J.-I. Park, M. Rosen, C. Dionne, B. Ruggeri, S. Jones-Bolin, S. R. Denmeade, D. W. Ball, and B. D. Nelkin CEP-701 and CEP-751 Inhibit Constitutively Activated RET Tyrosine Kinase Activity and Block Medullary Thyroid Carcinoma Cell Growth Cancer Res., September 1, 2003; 63(17): 5559 - 5563. [Abstract] [Full Text] [PDF] |
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M. Braga-Basaria and M. D. Ringel Beyond Radioiodine: A Review of Potential New Therapeutic Approaches for Thyroid Cancer J. Clin. Endocrinol. Metab., May 1, 2003; 88(5): 1947 - 1960. [Abstract] [Full Text] [PDF] |
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