Yun Xiao

Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKI), including crizotinib, are effective treatments in preclinical models and in cancer patients with ALK-translocated cancers. However, their efficacy will ultimately be limited by the development of acquired drug resistance. Here we report two mechanisms of ALK TKI resistance identified from a crizotinib-treated non-small cell lung cancer (NSCLC) patient and in a cell line generated from the resistant tumor (DFCI076) as well as from studying a resistant version of the ALK TKI (TAE684)-sensitive H3122 cell line. The crizotinib-resistant DFCI076 cell line harbored a unique L1152R ALK secondary mutation and was also resistant to the structurally unrelated ALK TKI TAE684. Although the DFCI076 cell line was still partially dependent on ALK for survival, it also contained concurrent coactivation of epidermal growth factor receptor (EGFR) signaling. In contrast, the TAE684-resistant (TR3) H3122 cell line did not contain an ALK secondary mutation but instead harbored coactivation of EGFR signaling. Dual inhibition of both ALK and EGFR was the most effective therapeutic strategy for the DFCI076 and H3122 TR3 cell lines. We further identified a subset (3/50; 6%) of treatment naive NSCLC patients with ALK rearrangements that also had concurrent EGFR activating mutations. Our studies identify resistance mechanisms to ALK TKIs mediated by both ALK and by a bypass signaling pathway mediated by EGFR. These mechanisms can occur independently, or in the same cancer, suggesting that the combination of both ALK and EGFR inhibitors may represent an effective therapy for these subsets of NSCLC patients.

• Phospholipase D (PLD) hydrolyzes phospholipids to produce phosphatidic acid (PA) and a head group, and is involved in the response to various environmental stresses, including salinity. Here, we determined the roles of PLDα and PA in the mediation of salt (NaCl)-stress signaling through the regulation of mitogen-activated protein kinase (MAPK or MPK) in Arabidopsis thaliana. • NaCl-induced changes in the content and composition of PA were quantitatively profiled by electrospray ionization-tandem mass spectrometry (ESI-MS/MS). A specific PA species (a MAPK 16:0-18:2 PA), which was increased in abundance by exposure to NaCl, bound to a MPK6, according to filter binding and ELISA. The effect of PA on MPK6 activity was tested using in-gel analysis. • 16:0-18:2 PA stimulated the activity of MPK6 immunoprecipitated from Arabidopsis leaf extracts. Treatment with NaCl induced a transient activation of MPK6 in wild-type plant, but the activation was abolished in the pldα1 plant mutant. A plasma membrane Na(+)/H(+) antiporter (SOS1) was identified as a downstream target of MPK6. MPK6 phosphorylated the C-terminal fragment of SOS1. The MPK6 phosphorylation of SOS1 was stimulated by treatment with NaCl, as well as directly by PA. • These results suggest that PA plays a critical role in coupling MAPK cascades in response to salt stress.

About 10% of patients with non-small cell lung carcinoma (NSCLC) respond to epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitors (TKIs). More than 75% of "responders" have activating mutations in EGFR. However, mutation analysis is not widely available, and proposed alternatives (in situ hybridization and immunohistochemical analysis) have shown inconsistent associations with outcome. Fluorescence in situ hybridization (FISH), chromogenic in situ hybridization (CISH), immunohistochemical analysis, and DNA sequencing were compared in this study of 40 NSCLC samples from TKI-treated patients. Response rates were 12 of 19 in EGFR-mutant vs 1 of 20 EGFR wild-type tumors (P = .0001), 7 of 19 FISH+ vs 4 of 17 FISH- tumors (not significant [NS]), 5 of 16 CISH+ vs 6 of 21 CISH- tumors (NS), and 3 of 9 immunohistochemically positive vs 7 of 22 immunohistochemically negative tumors (NS). EGFR mutation was associated with improved progression-free survival (P = .0004). Increased copy number (FISH or CISH) and protein expression (immunohistochemical) did not independently predict outcome. Thus, EGFR sequence analysis was the only method useful for predicting response and progression-free survival following TKI therapy in NSCLC.