Kinase Inhibition in Kidney Cancer

摘要 肾细胞癌（renal cell carcinoma，RCC）的发病率呈上升趋势。美国每年有65，000例新病例 States.血管内皮生长因子受体（VEGFR）和哺乳动物雷帕霉素靶蛋白（mTOR） 抑制剂是FDA批准的，并且是晚期RCC的常用治疗方法， 总生存期仅数月。此时，基因组中最易被药物化的部分仍然是激酶组。 通过无偏倚的高通量筛选，我们已经确定并验证了一种新的 酪氨酸激酶2（TYK 2：Janus激酶家族的成员），并证明它在肾细胞癌中起作用。 在mTOR抑制剂抗性中的作用。我们已经表征了一个信号网络，其中TYK 2阳性 调节SRC家族激酶（SFK），并证明mTOR和SRC的双重抑制与 依维莫司和达沙替尼在体内诱导肿瘤消退。基于这些结果，我们假设， TYK 2/SRC轴的抑制是RCC亚组中的一种易处理的治疗策略，我们可以定义 TYK 2/SRC抑制剂反应的预测标志物，以及定义RCC及其 对mTOR抑制的应答将导致进一步的组合靶点。

ABSTRACT The incidence of renal cell carcinoma (RCC) is on the rise. 65,000 new cases occur annually in the United States. Vascular endothelial growth factor receptor (VEGFR) and mammalian target of rapamycin (mTOR) inhibitors are FDA approved and commonly used treatments for advanced RCC but result in increases in overall survival by only months. At this time, the most druggable portion of the genome remains the kinome. Through unbiased, high-throughput screening we have identified and validated the therapeutic value of a novel kinase in RCC, tyrosine kinase 2 (TYK2: a member of the Janus Kinase family) and demonstrate that it plays a role in mTOR inhibitor resistance. We have characterized a signaling network in which TYK2 positively regulates the SRC family kinases (SFKs) and demonstrate that dual inhibition of mTOR and SRC with everolimus and dasatinib induces tumor regression in vivo. Based on these results we hypothesize that inhibition of the TYK2/SRC axis is a tractable therapeutic strategy in a subset of RCC, that we can define predictive markers of TYK2/SRC inhibitor response, and that defining the kinomic landscape of RCC and its response to mTOR inhibition will lead to further combinatorial targets.