Oncogenic RAS pathway activation promotes resistance to anti-VEGF therapy through G-CSF–induced neutrophil recruitment

VT Phan, X Wu, JH Cheng, RX Sheng… - Proceedings of the …, 2013 - National Acad Sciences
VT Phan, X Wu, JH Cheng, RX Sheng, AS Chung, G Zhuang, C Tran, Q Song, M Kowanetz…
Proceedings of the National Academy of Sciences, 2013National Acad Sciences
Granulocyte-colony stimulating factor (G-CSF) promotes mobilization of CD11b+ Gr1+
myeloid cells and has been implicated in resistance to anti-VEGF therapy in mouse models.
High G-CSF production has been associated with a poor prognosis in cancer patients. Here
we show that activation of the RAS/MEK/ERK pathway regulates G-CSF expression through
the Ets transcription factor. Several growth factors induced G-CSF expression by a MEK-
dependent mechanism. Inhibition of G-CSF release with a MEK inhibitor markedly reduced …
Granulocyte-colony stimulating factor (G-CSF) promotes mobilization of CD11b+Gr1+ myeloid cells and has been implicated in resistance to anti-VEGF therapy in mouse models. High G-CSF production has been associated with a poor prognosis in cancer patients. Here we show that activation of the RAS/MEK/ERK pathway regulates G-CSF expression through the Ets transcription factor. Several growth factors induced G-CSF expression by a MEK-dependent mechanism. Inhibition of G-CSF release with a MEK inhibitor markedly reduced G-CSF production in vitro and synergized with anti-VEGF antibodies to reduce CD11b+Ly6G+ neutrophil mobilization and tumor growth and led to increased survival in animal models of cancer, including a genetically engineered mouse model of pancreatic adenocarcinoma. Analysis of biopsies from pancreatic cancer patients revealed increased phospho-MEK, G-CSF, and Ets expression and enhanced neutrophil recruitment compared with normal pancreata. These results provide insights into G-CSF regulation and on the mechanism of action of MEK inhibitors and point to unique anticancer strategies.
National Acad Sciences