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RAF1 amplification drives a subset of bladder tumors and confers sensitivity to MAPK-directed therapeutics
Raie T. Bekele, … , Eliezer M. Van Allen, Kent W. Mouw
Raie T. Bekele, … , Eliezer M. Van Allen, Kent W. Mouw
Published September 23, 2021
Citation Information: J Clin Invest. 2021;131(22):e147849. https://doi.org/10.1172/JCI147849.
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Research Article Oncology

RAF1 amplification drives a subset of bladder tumors and confers sensitivity to MAPK-directed therapeutics

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Abstract

Bladder cancer is a genetically heterogeneous disease, and novel therapeutic strategies are needed to expand treatment options and improve clinical outcomes. Here, we identified a unique subset of urothelial tumors with focal amplification of the RAF1 (CRAF) kinase gene. RAF1-amplified tumors had activation of the RAF/MEK/ERK signaling pathway and exhibited a luminal gene expression pattern. Genetic studies demonstrated that RAF1-amplified tumors were dependent upon RAF1 activity for survival, and RAF1-activated cell lines and patient-derived models were sensitive to available and emerging RAF inhibitors as well as combined RAF plus MEK inhibition. Furthermore, we found that bladder tumors with HRAS- or NRAS-activating mutations were dependent on RAF1-mediated signaling and were sensitive to RAF1-targeted therapy. Together, these data identified RAF1 activation as a dependency in a subset making up nearly 20% of urothelial tumors and suggested that targeting RAF1-mediated signaling represents a rational therapeutic strategy.

Authors

Raie T. Bekele, Amruta S. Samant, Amin H. Nassar, Jonathan So, Elizabeth P. Garcia, Catherine R. Curran, Justin H. Hwang, David L. Mayhew, Anwesha Nag, Aaron R. Thorner, Judit Börcsök, Zsofia Sztupinszki, Chong-Xian Pan, Joaquim Bellmunt, David J. Kwiatkowski, Guru P. Sonpavde, Eliezer M. Van Allen, Kent W. Mouw

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Figure 2

Focal amplification and luminal differentiation in RAF1-amplified bladder tumors.

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Focal amplification and luminal differentiation in RAF1-amplified bladde...
Representative RAF1-amplified (cases 1–3) and RAF1 nonamplified (case 4) bladder tumors from the Dana-Farber Cancer Institute/Brigham and Women’s Cancer Center. (A) For the RAF1-amplified cases, copy number analysis from targeted next-generation sequencing shows focal amplification of the RAF1 locus on chromosome 3 (denoted by red hatched box). (B) FISH analysis using a RAF1-specific probe (red) shows more than 2 RAF1 foci per cell (chromosome 3 centromeric probe [CEP3] shown in green). Tumor H&E and immunohistochemical staining for the luminal marker GATA3 and basal marker CK5 show a staining pattern consistent with luminal differentiation in RAF1-amplified tumors. Original magnification, ×20; insets, ×1 (unmagnified).

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