MEK mutations conferring resistance to MEK inhibitors
The present invention relates to methods, compositions and kits concerning resistance to treatment with an anti-cancer agent, specifically an inhibitor of MEK. In particular embodiments, the invention concerns mutations in a MEK sequence that confer resistance to a MEK inhibitor. Identification of such mutations in a MEK sequence allows the identification and design of second-generation MEK inhibitors. Methods and kits for detecting the presence of a mutant MEK sequence in a sample are also provided.
1. A method of optimizing treatment of a subject having cancer, comprising:
(a) extracting nucleic acid from cells of the cancer;
(b) assaying a nucleic acid molecule encoding a MEK polypeptide and identifying the nucleotide sequence of a nucleic acid molecule encoding a MEK polypeptide to identify an alteration of an amino acid residue at one or more amino acids of the encoded MEK polypeptide that confers resistance to a MEK inhibitor and identifying the presence of nucleotides that alter the identity of an amino acid residue at one or more amino acids of the encoded MEK polypeptide relative to the amino acid at one or more positions selected from the group consisting of I103N, I111N, L115R, L115P, H119P, P124L, P124S, F129L and V211D of SEQ ID NO:2, the altered identity of the amino acid residue at one or more amino acids of the encoded MEK polypeptide confers resistance to a MEK inhibitor and indicates a need to treat the subject with a MEK inhibitor and a RAF inhibitor; and
(c) administering a MEK inhibitor and a RAF inhibitor to the subiect when the nucleic acid molecule includes nucleotides that alter the identity of an amino acid residue at one or more amino acid of the encoded MEK polypeptide relative to the amino acid at one or more positions selected from the group consisting I103N, I111N, L115R, L115P, H119P, P124L, P124S, F129L and V211D of SEQ ID NO:2, and the altered identity of the amino acid residue at one or more amino acids of the encoded MEK polypeptide confers resistance to a MEK inhibitor.
2. A method of treating a subject having cancer, comprising:
(a) assaying a nucleic acid molecule of the cancer encoding a MEK polypeptide and identifying the nucleotide sequence of a nucleic acid molecule encoding a MEK polypeptide to identify an alteration of an amino acid residue at one or more amino acids of the encoded MEK polypeptide that confers resistance to a MEK inhibitor and identifying the presence of nucleotides that alter the identity of an amino acid residue at one or more amino acids of the encoded MEK polypeptide relative to the amino acid at one or more positions selected from the group consisting of I103N, I111N, L115R, L115P, H119P, P124L, P124S, F129L and V211D of SEQ ID NO:2, the altered identity of the amino acid residue at one or more amino acids of the encoded MEK polypeptide confers resistance to a MEK inhibitor and indicates a need to treat the subject with a MEK inhibitor and a RAF inhibitor;
(b) selecting a subject for treatment with a MEK inhibitor and a RAF inhibitor on the basis of the subject having a nucleic acid molecule encoding a MEK polypeptide having an alteration of an amino acid residue at one or more amino acids of the encoded MEK polypeptide that confers resistance to a MEK inhibitor; and
(c) administering a MEK inhibitor and a RAF inhibitor to the subject when the nucleic acid molecule includes nucleotides that alter the identity of an amino acid residue at one or more amino acid of the encoded MEK polypeptide relative to the amino acid at one or more positions selected from the group consisting of I103N, I111N, L115R, L115P, H119P, P124L, P124S, FLF129L and V211D of SEQ ID NO:2, and the altered identity of the amino acid residue at one or more amino acids of the encoded MEK polypeptide confers resistance to a MEK inhibitor.
3. A method of identifying a subject having cancer as having a high risk of relapse during treatment with a first inhibitor comprising a first-generation MEK inhibitor or as being unresponsive to treatment with a first inhibitor comprising a first-generation MEK inhibitor or who is likely to benefit from treatment with a second inhibitor, comprising:
(a) extracting nucleic acid from cells of the cancer;
(b) assaying a nucleic acid molecule encoding a MEK polypeptide to identify an alteration of an amino acid residue at one or more amino acids of the encoded MEK polypeptide that confers resistance to a MEK inhibitor and identifying the presence of nucleotides that alter the identity of an amino acid residue at one or more amino acids of the encoded MEK polypeptide relative to the amino acid at one or more positions selected from the group consisting of I103N, I111N, L115R, L115P, H119P, P124L, P124S, F129L and V211D of SEQ ID NO:2, the altered identity of the amino acid residue at one or more amino acids of the encoded MEK polypeptide confers resistance to a MEK inhibitor and identifies the subject as having a high risk of relapse during treatment with a first-generation MEK inhibitor or as being unresponsive to treatment with a first-generation MEK inhibitor or who is likely to benefit from treatment with a second inhibitor; and
(c) administering a MEK inhibitor and a RAF inhibitor to the subject when the nucleic acid molecule includes nucleotides that alter the identity of an amino acid residue at one or more amino acid of the encoded MEK polypeptide relative to the amino acid at one or more positions selected from the group consisting I103N, I111N, L115R, L115P, H119P, P124L, P124S, F129L and V211D of SEQ ID NO:2, and the altered identity of the amino acid residue at one or more amino acids of the encoded MEK polypeptide confers resistance to a MEK inhibitor.
4. The method of claim 1 , wherein the MEK inhibitor is selected from the group consisting of CI-1040, AZD6244, PD318088, PD98059, PD334581, RDEA119, 6-Methoxy-7-(3-morpholin-4-yl-propoxy)-4-(4-phenoxy-phenylamino)-quinoline-3-carbonitrile, and 4-[3-Chloro-4-(1-methyl-1H-imidazol-2-ylsulfanyl)-phenylamino]-6-methoxy-7-(3-morpholin-4-yl-propoxy)-quinoline-3-carbonitrile.
5. The method of claim 1 , wherein the RAF inhibitor is selected from the group consisting of PLX4720, PLX4032, BAY 43-9006 (Sorafenib), ZM 336372, RAF 265, AAL-881, LBT-613, and CJS352.
6. The method of claim 1 , wherein the cancer is selected from the group consisting of leukemias, lymphomas, myelomas, carcinomas, metastatic carcinomas, sarcomas, adenomas, nervous system cancers and genitourinary cancers.
7. The method of claim 1 , wherein the cancer is melanoma.
8. The method of claim 2 , wherein the MEK inhibitor is selected from the group consisting of CI-1040, AZD6244, PD318088, PD98059, PD334581, RDEA119, 6-Methoxy-7-(3-morpholin-4-yl-propoxy)-4-(4-phenoxy-phenylamino)-quinoline-3-carbonitrile, and 4-[3-Chloro-4-(1-methyl-1H-imidazol-2-ylsulfanyl)-phenylamino]-6-methoxy-7-(3-morpholin-4-yl-propoxy)-quinoline-3-carbonitrile.
9. The method of claim 2 , wherein the RAF inhibitor is selected from the group consisting of PLX4720, PLX4032, BAY 43-9006 (Sorafenib), ZM 336372, RAF 265, AAL-881, LBT-613, and CJS352.
10. The method of claim 2 , wherein the cancer is selected from the group consisting of leukemias, lymphomas, myelomas, carcinomas, metastatic carcinomas, sarcomas, adenomas, nervous system cancers and genitourinary cancers.
11. The method of claim 2 , wherein the cancer is melanoma.
12. The method of claim 2 , wherein the assay comprises sequencing the nucleic acid or subjecting the sample to PCR.
13. The method of claim 3 , wherein the second inhibitor comprises a RAF inhibitor.