title: Phosphoprotein pathway mapping: Akt/mammalian target of rapamycin activation is negatively associated with childhood rhabdomyosarcoma survival.
abstract: Mapping of protein signaling networks within tumors can identify new targets for therapy and provide a means to stratify patients for individualized therapy. Despite advances in combination chemotherapy, the overall survival for childhood rhabdomyosarcoma remains approximately 60%. A critical goal is to identify functionally important protein signaling defects associated with treatment failure for the 40% nonresponder cohort. Here, we show, by phosphoproteomic network analysis of microdissected tumor cells, that interlinked components of the Akt/mammalian target of rapamycin (mTOR) pathway exhibited increased levels of phosphorylation for tumors of patients with short-term survival. Specimens (n = 59) were obtained from the Children's Oncology Group Intergroup Rhabdomyosarcoma Study (IRS) IV, D9502 and D9803, with 12-year follow-up. High phosphorylation levels were associated with poor overall and poor disease-free survival: Akt Ser(473) (overall survival P < 0.001, recurrence-free survival P < 0.0009), 4EBP1 Thr(37/46) (overall survival P < 0.0110, recurrence-free survival P < 0.0106), eIF4G Ser(1108) (overall survival P < 0.0017, recurrence-free survival P < 0.0072), and p70S6 Thr(389) (overall survival P < 0.0085, recurrence-free survival P < 0.0296). Moreover, the findings support an altered interrelationship between the insulin receptor substrate (IRS-1) and Akt/mTOR pathway proteins (P < 0.0027) for tumors from patients with poor survival. The functional significance of this pathway was tested using CCI-779 in a mouse xenograft model. CCI-779 suppressed phosphorylation of mTOR downstream proteins and greatly reduced the growth of two different rhabdomyosarcoma (RD embryonal P = 0.00008; Rh30 alveolar P = 0.0002) cell lines compared with controls. These results suggest that phosphoprotein mapping of the Akt/mTOR pathway should be studied further as a means to select patients to receive mTOR/IRS pathway inhibitors before administration of chemotherapy.
authors.affiliation: Food and Drug Administration, Center for Biologics Evaluation and Research, Office of Cellular and Gene Therapy, National Cancer Institute, NIH, Bethesda, Maryland, USA.
authors.forename: Emanuel F
authors.initials: EF
authors.lastname: Petricoin
authors.forename: Virginia
authors.initials: V
authors.lastname: Espina
authors.forename: Robyn P
authors.initials: RP
authors.lastname: Araujo
authors.forename: Brieanne
authors.initials: B
authors.lastname: Midura
authors.forename: Choh
authors.initials: C
authors.lastname: Yeung
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Wan
authors.forename: Gabriel S
authors.initials: GS
authors.lastname: Eichler
authors.forename: Donald J
authors.initials: DJ
authors.lastname: Johann
authors.forename: Stephen
authors.initials: S
authors.lastname: Qualman
authors.forename: Maria
authors.initials: M
authors.lastname: Tsokos
authors.forename: Kartik
authors.initials: K
authors.lastname: Krishnan
authors.forename: Lee J
authors.initials: LJ
authors.lastname: Helman
authors.forename: Lance A
authors.initials: LA
authors.lastname: Liotta
mesh_terms: D000818:Animals; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007223:Infant; D055504:Insulin Receptor Substrate Proteins; D008297:Male; D051379:Mice; D016513:Mice, SCID; D010750:Phosphoproteins / Q000378:metabolism; D010766:Phosphorylation; D011494:Protein Kinases / Q000378:metabolism*; D051057:Proto-Oncogene Proteins c-akt / Q000378:metabolism*; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000378:metabolism*; D015398:Signal Transduction; D015996:Survival Rate; D058570:TOR Serine-Threonine Kinases; D023041:Xenograft Model Antitumor Assays
chemical_list: C526292:IRS1 protein, human; D055504:Insulin Receptor Substrate Proteins; C526295:Irs1 protein, mouse; D010750:Phosphoproteins; D011494:Protein Kinases; C546842:MTOR protein, human; C546843:mTOR protein, mouse; D051057:Proto-Oncogene Proteins c-akt; D058570:TOR Serine-Threonine Kinases