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Llerena S, García-Díaz N, Curiel-Olmo S, Agraz-Doblas A, García-Blanco A, Pisonero H, Varela M, Santibáñez M, Almaraz C, Cereceda L, Martínez N, Arias-Loste MT, Puente Á, Martín-Ramos L, de Lope CR, Castillo-Suescun F, Cagigas-Fernandez C, Isidro P, Lopez-López C, Lopez-Hoyos M, Llorca J, Agüero J, Crespo-Facorro B, Varela I, Piris MÁ, Crespo J, Vaqué JP. Applied diagnostics in liver cancer. Efficient combinations of sorafenib with targeted inhibitors blocking AKT/mTOR. Oncotarget 2018; 9:30869-30882. [PMID: 30112114 PMCID: PMC6089396 DOI: 10.18632/oncotarget.25766] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2018] [Accepted: 06/22/2018] [Indexed: 12/31/2022] Open
Abstract
Hepatocellular carcinoma (HCC) is the third most common cause of cancer-related deaths worldwide. There is increasing interest in developing specific markers to serve as predictors of response to sorafenib and to guide targeted therapy. Using a sequencing platform designed to study somatic mutations in a selection of 112 genes (HepatoExome), we aimed to characterize lesions from HCC patients and cell lines, and to use the data to study the biological and mechanistic effects of case-specific targeted therapies used alone or in combination with sorafenib. We characterized 331 HCC cases in silico and 32 paired samples obtained prospectively from primary tumors of HCC patients. Each case was analyzed in a time compatible with the requirements of the clinic (within 15 days). In 53% of the discovery cohort cases, we detected unique mutational signatures, with up to 34% of them carrying mutated genes with the potential to guide therapy. In a panel of HCC cell lines, each characterized by a specific mutational signature, sorafenib elicited heterogeneous mechanistic and biological responses, whereas targeted therapy provoked the robust inhibition of cell proliferation and DNA synthesis along with the blockage of AKT/mTOR signaling. The combination of sorafenib with targeted therapies exhibited synergistic anti-HCC biological activity concomitantly with highly effective inhibition of MAPK and AKT/mTOR signaling. Thus, somatic mutations may lead to identify case-specific mechanisms of disease in HCC lesions arising from multiple etiologies. Moreover, targeted therapies guided by molecular characterization, used alone or in combination with sorafenib, can effectively block important HCC disease mechanisms.
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Affiliation(s)
- Susana Llerena
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - Nuria García-Díaz
- Translational Hematopathology Group, IDIVAL, Instituto de Investigación Marqués de Valdecilla, Santander, Spain.,Departamento de Biología Molecular, Universidad de Cantabria (UC-IBBTEC), Santander, Spain
| | - Soraya Curiel-Olmo
- Translational Hematopathology Group, IDIVAL, Instituto de Investigación Marqués de Valdecilla, Santander, Spain
| | - Antonio Agraz-Doblas
- Departamento de Biología Molecular, Universidad de Cantabria (UC-IBBTEC), Santander, Spain.,Josep Carreras Leukemia Research Institute and School of Medicine, University of Barcelona, Barcelona, Spain
| | - Agustín García-Blanco
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - Helena Pisonero
- Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain.,Departamento de Biología Molecular, Universidad de Cantabria (UC-IBBTEC), Santander, Spain
| | - María Varela
- Digestive Service, Hepatology Unit, Hospital Universitario Central de Asturias, Oviedo, Spain
| | | | - Carmen Almaraz
- Translational Hematopathology Group, IDIVAL, Instituto de Investigación Marqués de Valdecilla, Santander, Spain
| | - Laura Cereceda
- Translational Hematopathology Group, IDIVAL, Instituto de Investigación Marqués de Valdecilla, Santander, Spain
| | - Nerea Martínez
- Translational Hematopathology Group, IDIVAL, Instituto de Investigación Marqués de Valdecilla, Santander, Spain
| | - María Teresa Arias-Loste
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - Ángela Puente
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - Luis Martín-Ramos
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - Carlos Rodríguez de Lope
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - Federico Castillo-Suescun
- General and Digestive Tract Surgery Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Carmen Cagigas-Fernandez
- General and Digestive Tract Surgery Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Pablo Isidro
- Biobanco-Hospital Universitario Central de Asturias, Oviedo, Spain
| | - Carlos Lopez-López
- Oncology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Marcos Lopez-Hoyos
- Immunology Service, Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Javier Llorca
- Department of Epidemiology and Computational Biology, School of Medicine, University of Cantabria, Santander, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Jesús Agüero
- Microbiology Service, University Hospital Marques de Valdecilla-IDIVAL, Santander, Spain
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, Marqués de Valdecilla University Hospital-IDIVAL, Santander, Spain.,CIBERSAM, Centro de Investigación Biomédica en Red Salud Mental, Madrid, Spain
| | - Ignacio Varela
- Departamento de Biología Molecular, Universidad de Cantabria (UC-IBBTEC), Santander, Spain
| | | | - Javier Crespo
- Gastroenterology and Hepatology Unit, Hospital Universitario Marqués de Valdecilla, Santander, Spain.,Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain
| | - José Pedro Vaqué
- Infection, Immunity and Digestive Pathology Group, IDIVAL, Santander, Spain.,Departamento de Biología Molecular, Universidad de Cantabria (UC-IBBTEC), Santander, Spain
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