BTK inhibitors synergise with 5-FU to treat drug-resistant TP53-null colon cancers

J Pathol. 2020 Feb;250(2):134-147. doi: 10.1002/path.5347. Epub 2019 Dec 2.

Abstract

Colorectal cancer (CRC) is the fourth cause of death from cancer worldwide mainly due to the high incidence of drug-resistance. During a screen for new actionable targets in drug-resistant tumours we recently identified p65BTK - a novel oncogenic isoform of Bruton's tyrosine kinase. Studying three different cohorts of patients here we show that p65BTK expression correlates with histotype and cancer progression. Using drug-resistant TP53-null colon cancer cells as a model we demonstrated that p65BTK silencing or chemical inhibition overcame the 5-fluorouracil resistance of CRC cell lines and patient-derived organoids and significantly reduced the growth of xenografted tumours. Mechanistically, we show that blocking p65BTK in drug-resistant cells abolished a 5-FU-elicited TGFB1 protective response and triggered E2F-dependent apoptosis. Taken together, our data demonstrated that targeting p65BTK restores the apoptotic response to chemotherapy of drug-resistant CRCs and gives a proof-of-concept for suggesting the use of BTK inhibitors in combination with 5-FU as a novel therapeutic approach in CRC patients. © 2019 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

Keywords: BTK inhibitors; TP53; colon cancer; drug-resistance; p65BTK.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Agammaglobulinaemia Tyrosine Kinase / antagonists & inhibitors
  • Agammaglobulinaemia Tyrosine Kinase / metabolism
  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Apoptosis / drug effects
  • Colonic Neoplasms / drug therapy*
  • Colonic Neoplasms / genetics
  • Colonic Neoplasms / pathology
  • Disease Progression
  • Drug Resistance, Neoplasm / drug effects
  • Drug Synergism
  • E2F Transcription Factors / metabolism
  • Fluorouracil / administration & dosage
  • Fluorouracil / pharmacology
  • Genes, p53
  • Humans
  • Mice, Nude
  • Molecular Targeted Therapy / methods
  • Neoplasm Staging
  • Organoids / drug effects
  • Protein Isoforms / antagonists & inhibitors
  • Protein Isoforms / metabolism
  • Protein Kinase Inhibitors / administration & dosage*
  • Protein Kinase Inhibitors / pharmacology
  • Transforming Growth Factor beta1 / metabolism
  • Tumor Cells, Cultured
  • Xenograft Model Antitumor Assays / methods

Substances

  • E2F Transcription Factors
  • Protein Isoforms
  • Protein Kinase Inhibitors
  • TGFB1 protein, human
  • Transforming Growth Factor beta1
  • Agammaglobulinaemia Tyrosine Kinase
  • BTK protein, human
  • Fluorouracil