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      Therapeutic targeting of PLK1 in TERT promoter‐mutant hepatocellular carcinoma

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          Abstract

          Background

          Hotspot mutations in the promoter of telomerase reverse transcriptase ( TERT) gene are the most common genetic variants in hepatocellular carcinoma (HCC) and associated with poor prognosis of the disease. However, no drug was currently approved for treating TERT promoter mutation positive HCC patients. Here, we aim to explore the potential therapeutic strategy for targeting TERT promoter mutation in HCC.

          Methods

          The Liver Cancer Model Repository database was used for screening potential drugs to selectively suppress the growth of TERT promoter mutant HCC cells. RNA‐seq, CRISPR‐Cas9 technology and siRNA transfection were performed for mechanistic studies. Cell counting kit‐8 (CCK8) assay and the xenograft tumour models were used for cell growth detection in vitro and in vivo, respectively. Cell apoptosis and cell cycle arrest were analysed by Annexin V‐FITC staining and/or propidium iodide staining.

          Results

          PLK1 inhibitors were remarkably more sensitive to HCC cells harbouring TERT promoter mutation than wild‐type cells in vitro and in vivo, which were diminished after TERT promoter mutation was edited to the wild‐type nucleotide. Comparing the HCC cells with wild‐type promoter of TERT, PLK1 inhibitors specifically downregulated Smad3 to regulate TERT for inducing apoptosis and G2/M arrest in TERT mutant HCC cells. Moreover, knockout of Smad3 counteracted the effects of PLK1 inhibitors in TERT mutant HCC cells. Finally, a cooperative effect of PLK1 and Smad3 inhibition was observed in TERT mutant cells.

          Conclusions

          PLK1 inhibition selectively suppressed the growth of TERT mutant HCC cells through Smad3, thus contributed to discover a novel therapeutic strategy to treat HCC patients harbouring TERT promoter mutations.

          Key points

          • TERT promoter mutation confers sensitivity to PLK1 inhibitors in HCC.

          • The selective growth inhibition of TERT mutant HCC cells induced by PLK1 inhibitor was mediated by Smad3.

          • Combined inhibition of PLK1 and Smad3 showed a cooperative anti‐tumor effect in TERT mutant HCC cells.

          Abstract

          1. PLK1 inhibitor BI2536 preferred to suppress the growth of HCC cells harboring TERT promoter mutation.

          2. PLK1 inhibition induced cell cycle arrest and apoptosis in TERT mutant HCC cells.

          3. The selective inhibitory effects of PLK1 inhibitor on TERT mutant HCC cells was mediated by Smad3.

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          Most cited references48

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          Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries

          This article provides an update on the global cancer burden using the GLOBOCAN 2020 estimates of cancer incidence and mortality produced by the International Agency for Research on Cancer. Worldwide, an estimated 19.3 million new cancer cases (18.1 million excluding nonmelanoma skin cancer) and almost 10.0 million cancer deaths (9.9 million excluding nonmelanoma skin cancer) occurred in 2020. Female breast cancer has surpassed lung cancer as the most commonly diagnosed cancer, with an estimated 2.3 million new cases (11.7%), followed by lung (11.4%), colorectal (10.0 %), prostate (7.3%), and stomach (5.6%) cancers. Lung cancer remained the leading cause of cancer death, with an estimated 1.8 million deaths (18%), followed by colorectal (9.4%), liver (8.3%), stomach (7.7%), and female breast (6.9%) cancers. Overall incidence was from 2-fold to 3-fold higher in transitioned versus transitioning countries for both sexes, whereas mortality varied <2-fold for men and little for women. Death rates for female breast and cervical cancers, however, were considerably higher in transitioning versus transitioned countries (15.0 vs 12.8 per 100,000 and 12.4 vs 5.2 per 100,000, respectively). The global cancer burden is expected to be 28.4 million cases in 2040, a 47% rise from 2020, with a larger increase in transitioning (64% to 95%) versus transitioned (32% to 56%) countries due to demographic changes, although this may be further exacerbated by increasing risk factors associated with globalization and a growing economy. Efforts to build a sustainable infrastructure for the dissemination of cancer prevention measures and provision of cancer care in transitioning countries is critical for global cancer control.
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            Lenvatinib versus sorafenib in first-line treatment of patients with unresectable hepatocellular carcinoma: a randomised phase 3 non-inferiority trial

            In a phase 2 trial, lenvatinib, an inhibitor of VEGF receptors 1-3, FGF receptors 1-4, PDGF receptor α, RET, and KIT, showed activity in hepatocellular carcinoma. We aimed to compare overall survival in patients treated with lenvatinib versus sorafenib as a first-line treatment for unresectable hepatocellular carcinoma.
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              Comprehensive and Integrative Genomic Characterization of Hepatocellular Carcinoma

              (2017)
              Liver cancer has the second highest worldwide cancer mortality rate and has limited therapeutic options. We analyzed 363 hepatocellular carcinoma (HCC) cases by whole exome sequencing and DNA copy number analyses, and 196 HCC also by DNA methylation, RNA, miRNA, and proteomic expression. DNA sequencing and mutation analysis identified significantly mutated genes including LZTR1 , EEF1A1 , SF3B1 , and SMARCA4 . Significant alterations by mutation or down-regulation by hypermethylation in genes likely to result in HCC metabolic reprogramming ( ALB , APOB , and CPS1 ) were observed. Integrative molecular HCC subtyping incorporating unsupervised clustering of five data platforms identified three subtypes, one of which was associated with poorer prognosis in three HCC cohorts. Integrated analyses enabled development of a p53 target gene expression signature correlating with poor survival. Potential therapeutic targets for which inhibitors exist include WNT signaling, MDM4, MET, VEGFA, MCL1, IDH1, TERT, and immune checkpoint proteins CTLA-4, PD-1, and PD-L1. Multiplex molecular profiling of human hepatocellular carcinoma patients provides insight into subtype characteristics and points toward key pathways to target therapeutically.
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                Author and article information

                Contributors
                liury9@mail.sysu.edu.cn
                pzhenw@mail.sysu.edu.cn
                Journal
                Clin Transl Med
                Clin Transl Med
                10.1002/(ISSN)2001-1326
                CTM2
                Clinical and Translational Medicine
                John Wiley and Sons Inc. (Hoboken )
                2001-1326
                20 May 2024
                May 2024
                : 14
                : 5 ( doiID: 10.1002/ctm2.v14.5 )
                : e1703
                Affiliations
                [ 1 ] Department of Radiation Oncology The First Affiliated Hospital Sun Yat‐sen University Guangzhou China
                [ 2 ] Institute of Precision Medicine The First Affiliated Hospital Sun Yat‐sen University Guangzhou China
                [ 3 ] Cancer Center The First Affiliated Hospital Sun Yat‐sen University Guangzhou China
                Author notes
                [*] [* ] Correspondence

                Zhenwei Peng, Department of Radiation Oncology, The First Affiliated Hospital, Sun Yat‐sen University, No. 58, Zhongshan Second Road, Guangzhou 510080, China.

                Email: pzhenw@ 123456mail.sysu.edu.cn

                Rengyun Liu, Institute of Precision Medicine, The First Affiliated Hospital, Sun Yat‐sen University, No. 58, Zhongshan Second Road, Guangzhou 510080, China.

                Email: liury9@ 123456mail.sysu.edu.cn

                Author information
                https://orcid.org/0000-0002-1408-2372
                https://orcid.org/0000-0002-0617-3805
                Article
                CTM21703
                10.1002/ctm2.1703
                11106514
                38769666
                f5ba6a86-9839-4f2d-b363-7d31b648ee33
                © 2024 The Authors. Clinical and Translational Medicine published by John Wiley & Sons Australia, Ltd on behalf of Shanghai Institute of Clinical Bioinformatics.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 April 2024
                : 20 January 2024
                : 06 May 2024
                Page count
                Figures: 8, Tables: 0, Pages: 16, Words: 7501
                Funding
                Funded by: National Natural Science Foundation of China , doi 10.13039/501100001809;
                Award ID: 82072029
                Award ID: 82072952
                Award ID: 82373185
                Funded by: Research Talents Program of The First Affiliated Hospital of Sun Yat‐sen University
                Award ID: R04009
                Award ID: Y70310
                Categories
                Research Article
                Research Articles
                Custom metadata
                2.0
                May 2024
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.4.3 mode:remove_FC converted:21.05.2024

                Medicine
                hepatocellular carcinoma,plk1,smad3,tert promoter mutation
                Medicine
                hepatocellular carcinoma, plk1, smad3, tert promoter mutation

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