Abstract A121: Constitutive K-Ras activity independent of K-RAS mutational status leads to resistance to anti-EGFR molecular targeting approaches and MEK-dependent reactivation of Akt following PI3K inhibition
Authors: Toulany Mahmoud , Saki Mohammad , Rodemann H. Peter 
Published: May 2016

Abstract
Non-small cell lung cancer (NSCLC) cells expressing K-RAS mutation are resistant to anti-EGFR antibody cetuximab. Oncogenic Ras regulates basal effector PI3K/Akt and MAPK/ERK pathways. In this study, we investigated impact of K-RAS activity independent of its mutational status on targetibility of EGFR as well as the PI3K/Akt and MAPK/ERK pathways. A panel of five NSCLC cells (A549, H460, H661, SK-MES-1, HTB-182) and five head and neck squamous carcinoma (HNSCC) cells (SAS, FaDu, UT-SCC-5, UT-SCC-15, UT-SCC-5R (UT-SCC-5R are UT5 cells acquired resistance to cetuximab) were studied. K-Ras was constitutively activate not only in K-RAS mutated (K-RASmut) A549 and H460 cells, but also in K-RAS wild-type (K-RASwt) SAS and UT-SCC-5R cells. Enhanced K-Ras-GTP either endogenously or following overexpression of K-RAS(V12) was associated with significant shortening of population doubling time and increased clonogenic activity of tu-mor cells from both origin. Constitutive activation of K-Ras independent of K-RAS muta-tional status led to desensitization of both K-RASmut and K-RASwt cells to anti-EGFR an-tibody cetuximab and EGFR-tyrosine kinase inhibitors (TKI) erlotinib and AG1478, tested by standard clonogenic assay. Analyzing EGFR downstream pathways revealed that lack of response to the EGFR-TK inhibitors is through activation of the PI3K/Akt pathway. Thus, inhibition of PI3K was supposed to be an efficient approach to block clonogenic activity. However, PI3K inhibitor completely blocked clonogenic activity only in cells expressing low level of K-RASwt from both origins. In K-RASmut NSCLC cells or in HNSCC cells with overexpression of K-RASwt a partial response to PI-103 was observed. Analyzing pathway activity revealed that PI-103 does not inhibit Akt activity after 24 h pre-treatment while up to 4 h after post-treatment with PI-103, phosphorylation of Akt and Akt substrates (PRAS40 and GSK3αβ) are completely blocked. Lack of effect of PI103 at 24 h post-treatment was shown to be through K-RAS/MEK/ERK dependent reactivation of Akt. In line with this observation, targeting MEK by PD98059 significantly improved the anti-clonogenic activity of PI-103. Although, PD98059 blocked phosphorylation of ERK1/2, no marked effect was observed on clonogenic activity. Thus, EGFR or PI3K, but not MEK are appropriate target to inhibit clonogenic activity of tumor cells expressing low level of K-RASwt. In tumor cells with constitutive K-RAS activity, dual targeting of PI3K and MEK is an efficient approach to inhibit clonogenicity.
Supported by grants from the Deutsche Forschungsgemeinschaft [Ro527/7-1 and SFB-773-TP B02] awarded to HPR, GRK 1302/2 (T11) awarded to MT/HPR.
Citation Format: Mahmoud Toulany, Mohammad Saki, H. Peter Rodemann. Constitutive K-Ras activity independent of K-RAS mutational status leads to resistance to anti-EGFR molecular targeting approaches and MEK-dependent reactivation of Akt following PI3K inhibition. [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2015 Nov 5-9; Boston, MA. Philadelphia (PA): AACR; Mol Cancer Ther 2015;14(12 Suppl 2):Abstract nr A121.