Induction of thyroid iodide-handling gene expression in human cancers
Dual suppression of the MAP kinase and PI3K/Akt pathways showed synergistic or greatly enhanced anti-melanoma cell effects, compared to suppression of a single pathway, including the inhibition of cell proliferation, transformation and invasion, induction of G 0 /G 1 cell cycle arrest and, importantly, cell apoptosis. Remarkably, suppression of either pathway induces the expression of thyroid iodide-handling genes and dual suppression of the two pathways synergistically and robustly induces expression of these genes, accompanied by uptake of radioiodine in the cells. These genes include sodium/iodide symporter, thyroid-stimulating hormone receptor, thyroglobulin, thyroperoxidase, pendrin gene, thyroid transcription factors (e.g., TTF-1, TTF-2, PAX8) and other thyroid genes. Targeting major signaling pathways, such as the MAP kinase and PI3K/Akt pathways, for potent cell death, optionally coupled with induction of thyroid gene expression for adjunct radioiodine ablation therapy may be used for many human cancers, both thyroid and non-thyroid.
1. A method of treating a human cancer in a patient comprising: administering an inhibitor of a PI3K/Akt pathway protein or its expression to the patient; and administering an inhibitor of a MAP kinase pathway protein or its expression to the patient, wherein the inhibitors are administered in sufficient amounts to induce expression of one or more iodide-handling genes in the human cancer.
2. The method of claim 1 further comprising: administering radioiodine to the patient.
3. A method of treating a human cancer in a patient comprising: administering an inhibitor of a PI3K/Akt pathway protein or its expression or an inhibitor of a MAP kinase pathway protein or its expression to the patient in sufficient amounts to induce expression of one or more iodide-handling genes in the human cancer; and administering radioiodine to the patient.
4. The method of claim 3 wherein the radioiodine is administered subsequent to the administering of the inhibitors.
5. The method of claim 3 wherein the human cancer is a thyroid tumor.
6. The method of claim 3 wherein the human cancer is a melanoma.
7. The method of claim 3 wherein the human cancer is a non-thyroid tumor.
8. The method of claim 3 , wherein the cancer has an activating mutation in the PI3K/Akt pathway.
9. The method of claim 8 wherein the mutation is selected from the group consisting of PIK3CA mutation, PIK3D mutation, PIK3B mutation, Ras mutation, PTEN mutation, and PI3KCA amplification.
10. The method of claim 8 wherein the mutation is in a receptor tyrosine kinase gene.
11. The method of claim 1 wherein the cancer has an activating mutation in the MAP kinase pathway.
12. The method of claim 11 wherein the cancer has an activating mutation selected from the group consisting of: BRAF mutation, RET/PTC rearrangement, Ras mutation, MEK mutation, and ERK mutation.
13. The method of claim 3 , wherein the cancer has an activating mutation in PI3K.
14. The method of claim 1 wherein the cancer has an activating mutation in MAP kinase.
15. The method of claim 1 wherein the cancer has activating mutations in both PI3K/Akt and MAP kinase pathways.
16. The method of claim 3 wherein the cancer is a poorly differentiated or undifferentiated thyroid tumor.
17. The method of claim 3 wherein prior to administration of the inhibitors, the cancer is non-responsive to radioiodine treatment.
18. The method of claim 3 wherein a thyroid stimulating hormone is administered to the patient in an amount sufficient to induce expression of one or more iodide-handling genes in the cancer.
19. The method of claim 3 , wherein a PI3K/Akt pathway protein inhibitor is administered which is selected from the group consisting of perifosine, triciribine, temsirolimus, everolimus, motesanib, axitinib, sunitinib, Wortmanin, LYS 294002, and AktiIV.
20. The method of claim 1 wherein a MAP kinase pathway protein inhibitor is administered which is selected from the group consisting of CI-1040, PD325901, PD184352, AZD6344, ARRY-142886, RDEA119, RDEA436, RDEA119, PLX4720, BAY43-9006 (sorafenib) and U0126.
21. The method of claim 3 , wherein a PI3K/Akt pathway expression inhibitor is administered which is siRNA.
22. The method of claim 1 wherein a MAP kinase pathway expression inhibitor is administered which is siRNA.
23. The method of claim 3 , wherein the cancer is selected from the group consisting of salivary, lacrimal, stomach, colon, liver, and breast cancer.
24. The method of claim 1 wherein a MAP kinase pathway expression inhibitor is administered which is selected from the group of siRNA consisting of Ras, RAF, MEK1, MEK2, ERK1, and ERK2 siRNA.
25. The method of claim 3 wherein the one or more iodide-handling genes are selected from the group consisting of the sodium/iodide symporter, thyroid stimulating hormone receptor, thyroglobulin, thyroperoxidase, pendrin, and thyroid transcription factors TTF-1, TTF-2, and PAX8.
26. A method of treating a melanoma or thyroid cancer in a human comprising: administering an inhibitor of a PI3K/Akt pathway protein or its expression and an inhibitor of a MAP kinase pathway protein or its expression to the patient in sufficient amounts to induce expression of one or more iodide-handling genes in the melanoma or thyroid cancer; and administering radioiodine to the human.