CDK6 protects epithelial ovarian cancer from platinum-induced death via FOXO3 regulation

EMBO Mol Med. 2017 Oct;9(10):1415-1433. doi: 10.15252/emmm.201607012.

Abstract

Epithelial ovarian cancer (EOC) is an infrequent but highly lethal disease, almost invariably treated with platinum-based therapies. Improving the response to platinum represents a great challenge, since it could significantly impact on patient survival. Here, we report that silencing or pharmacological inhibition of CDK6 increases EOC cell sensitivity to platinum. We observed that, upon platinum treatment, CDK6 phosphorylated and stabilized the transcription factor FOXO3, eventually inducing ATR transcription. Blockage of this pathway resulted in EOC cell death, due to altered DNA damage response accompanied by increased apoptosis. These observations were recapitulated in EOC cell lines in vitro, in xenografts in vivo, and in primary tumor cells derived from platinum-treated patients. Consistently, high CDK6 and FOXO3 expression levels in primary EOC predict poor patient survival. Our data suggest that CDK6 represents an actionable target that can be exploited to improve platinum efficacy in EOC patients. As CDK4/6 inhibitors are successfully used in cancer patients, our findings can be immediately transferred to the clinic to improve the outcome of EOC patients.

Keywords: ATR; CDK6; FOXO3; ovarian cancer; platinum sensitivity.

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Ataxia Telangiectasia Mutated Proteins / genetics
  • Ataxia Telangiectasia Mutated Proteins / metabolism
  • Carcinoma, Ovarian Epithelial
  • Cell Death
  • Cell Line, Tumor
  • Cyclin-Dependent Kinase 6 / genetics
  • Cyclin-Dependent Kinase 6 / metabolism*
  • DNA Damage
  • Female
  • Forkhead Box Protein O3 / genetics
  • Forkhead Box Protein O3 / metabolism*
  • Humans
  • Mice
  • Mice, Nude
  • Neoplasms, Glandular and Epithelial / drug therapy*
  • Neoplasms, Glandular and Epithelial / enzymology
  • Ovarian Neoplasms / drug therapy*
  • Ovarian Neoplasms / enzymology
  • Piperazines / pharmacology
  • Piperazines / therapeutic use
  • Platinum / pharmacology*
  • Platinum / therapeutic use
  • Primary Cell Culture
  • Protein Kinase Inhibitors / pharmacology
  • Protein Kinase Inhibitors / therapeutic use
  • Pyridines / pharmacology
  • Pyridines / therapeutic use
  • Survival Analysis
  • Xenograft Model Antitumor Assays

Substances

  • Antineoplastic Agents
  • FOXO3 protein, human
  • Forkhead Box Protein O3
  • Piperazines
  • Protein Kinase Inhibitors
  • Pyridines
  • Platinum
  • ATR protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • CDK6 protein, human
  • Cyclin-Dependent Kinase 6
  • palbociclib