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Malignant pleural mesothelioma co-opts BCL-XL and autophagy to escape apoptosis
Authors:Duo Xu,Shun-Qing Liang,Zhang Yang,Haitang Yang,Ré  my Bruggmann,Simone Oberhaensli,Sabina Berezowska,Thomas M. Marti,Sean R. R. Hall,Patrick Dorn,Gregor J. Kocher,Ralph A. Schmid,Ren-Wang Peng
Affiliation:1.Division of General Thoracic Surgery, Inselspital, Bern University Hospital, Bern, Switzerland ;2.Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland ;3.Interfaculty Bioinformatics Unit and Swiss Institute of Bioinformatics, University of Bern, Bern, Switzerland ;4.Institute of Pathology, University of Bern, Bern, Switzerland
Abstract:Escape from programmed cell death is a hallmark of cancer. In this study, we investigated the anti-apoptotic mechanisms and explored the therapeutic potential of BCL-2 homology domain-3 (BH3) mimetics in malignant pleural mesothelioma (MPM), a lethal thoracic malignancy with an extreme dearth of treatment options. By implementing integrated analysis of functional genomic data of MPM cells and quantitative proteomics of patients’ tumors, we identified BCL-XL as an anti-apoptotic driver that is overexpressed and confers an oncogenic dependency in MPM. MPM cells harboring genetic alterations that inactivate the NF2/LATS1/2 signaling are associated with increased sensitivity to A-1155463, a BCL-XL-selective BH3 mimetic. Importantly, BCL-XL inhibition elicits protective autophagy, and concomitant blockade of BCL-XL and autophagic machinery with A-1155463 and hydroxychloroquine (HCQ), the US Food and Drug Administration (FDA)-approved autophagy inhibitor, synergistically enhances anti-MPM effects in vitro and in vivo. Together, our work delineates the molecular basis underlying resistance to apoptosis and uncovers an evasive mechanism that limits response to BH3 mimetics in MPM, suggesting a novel strategy to target this aggressive disease.Subject terms: Apoptosis, Target identification, Mesothelioma
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