Melanoma Therapeutic Strategies that Select against Resistance by Exploiting MYC-Driven Evolutionary Convergence.

Journal Article (Journal Article)

Diverse pathways drive resistance to BRAF/MEK inhibitors in BRAF-mutant melanoma, suggesting that durable control of resistance will be a challenge. By combining statistical modeling of genomic data from matched pre-treatment and post-relapse patient tumors with functional interrogation of >20 in vitro and in vivo resistance models, we discovered that major pathways of resistance converge to activate the transcription factor, c-MYC (MYC). MYC expression and pathway gene signatures were suppressed following drug treatment, and then rebounded during progression. Critically, MYC activation was necessary and sufficient for resistance, and suppression of MYC activity using genetic approaches or BET bromodomain inhibition was sufficient to resensitize cells and delay BRAFi resistance. Finally, MYC-driven, BRAFi-resistant cells are hypersensitive to the inhibition of MYC synthetic lethal partners, including SRC family and c-KIT tyrosine kinases, as well as glucose, glutamine, and serine metabolic pathways. These insights enable the design of combination therapies that select against resistance evolution.

Full Text

Duke Authors

Cited Authors

  • Singleton, KR; Crawford, L; Tsui, E; Manchester, HE; Maertens, O; Liu, X; Liberti, MV; Magpusao, AN; Stein, EM; Tingley, JP; Frederick, DT; Boland, GM; Flaherty, KT; McCall, SJ; Krepler, C; Sproesser, K; Herlyn, M; Adams, DJ; Locasale, JW; Cichowski, K; Mukherjee, S; Wood, KC

Published Date

  • December 5, 2017

Published In

Volume / Issue

  • 21 / 10

Start / End Page

  • 2796 - 2812

PubMed ID

  • 29212027

Pubmed Central ID

  • PMC5728698

Electronic International Standard Serial Number (EISSN)

  • 2211-1247

Digital Object Identifier (DOI)

  • 10.1016/j.celrep.2017.11.022


  • eng

Conference Location

  • United States