Impact of combined mTOR and MEK inhibition in uveal melanoma is driven by tumor genotype

Uveal melanomas possess activation of the mitogen-activated protein kinase (MAPK) and phosphoinositide 3-kinase (PI3K)/AKT/mammalian Target of Rapamycin (mTOR) pathways. MAPK activation occurs via somatic mutations in the heterotrimeric G protein subunits GNAQ and GNA11 for over 70% of tumors and less frequently via V600E BRAF mutations. In this report, we describe the impact of dual pathway inhibition upon uveal melanoma cell lines with the MEK inhibitor selumetinib (AZD6244/ARRY-142886) and the ATP-competitive mTOR kinase inhibitor AZD8055. While synergistic reductions in cell viability were observed with AZD8055/selumetinib in both BRAF and GNAQ mutant cell lines, apoptosis was preferentially induced in BRAF mutant cells only. In vitro apoptosis assay results were predictive of in vivo drug efficacy as tumor regressions were observed only in a BRAF mutant xenograft model, but not GNAQ mutant model. We went on to discover that GNAQ promotes relative resistance to AZD8055/selumetinib-induced apoptosis in GNAQ mutant cells. For BRAF mutant cells, both AKT and 4E-BP1 phosphorylation were modulated by the combination; however, decreasing AKT phosphorylation alone was not sufficient and decreasing 4E-BP1 phosphorylation was not required for apoptosis. Instead, cooperative mTOR complex 2 (mTORC2) and MEK inhibition resulting in downregulation of the pro-survival protein MCL-1 was found to be critical for combination-induced apoptosis. These results suggest that the clinical efficacy of combined MEK and mTOR kinase inhibition will be determined by tumor genotype, and that BRAF mutant malignancies will be particularly susceptible to this strategy.     

Liposome Damage and Modeling of Fragments of Human Islet Amyloid Polypeptide (IAPP) Support a Two-Step Model of Membrane Destruction

A key factor in the development of Type II diabetes is the loss of insulin-producing beta-cells. Human islet amyloid polypeptide (hIAPP) is believed to play a crucial role in this process by forming small aggregates that disrupt the cellular membrane. During Type II diabetes mellitus, human IAPP (hIAPP) fibrillizes to form amyloid deposits. However, the role of various regions of the 37 amino acid peptide in the process of membrane disruption has yet to be fully elucidated. Therefore, several fragments (10–19, 20–29, 10–29, 1–19) of hIAPP were synthesized and compared to full length hIAPP for their effects on model PC/PS bilayers. These fragments were also modeled using density functional methods and analyzed by circular dichroism, to determine possible correlations between activity and available conformations and charge distribution. Results from dye leakage and Thioflavin T fluorescence assays confirmed that the hIAPP fragments disrupt the lipid bilayer to varying extents, despite their inability to form amyloid fibrils. The longer and more positively charged fragments were most active in the assay (1–19 > 10–29 > 10–19 > 20–29), though none rivaled the activity of the native full length peptide. This may reflect their relative abilities to interact with the negatively charged membrane. Data support a two-step model for membrane disruption: insertion by the N-terminus followed by fibrillization mediated by the middle to C-terminal region.