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b-catenin Confers Resistance to PI3K and AKT Inhibitors and
 Subverts FOXO3a to Promote Metastasis in Colon Cancer
                Tenbaum et al. Nat Med. 2012



                        Oriol Arqués
                 STEM CELLS and CANCER LABORATORY
                   Vall Hebron Institute of Onocology
                            Barcelona, Spain
b

            INTESTINAL EPITHELIUM                  TUMOR




                         Wnt
                   LRP



                                 Fz

                         Dsh


                     b                               b
                             b                               b
                    b                               b



                                               b
                         b                               b
                   Lef                ON           Lef           ON
                 TCF/LEF genes                 TCF/LEF genes




90% of CRC patients present activating mutations in Wnt pathway
b


                                                     Other          Other
               Vitamin D
    NICHE                                           Ligands        Ligands




                                 LRP
                                  Wnt




                           LRP
                                                      ?              ?
                                             Fz
    CANCER
                                       Dsh
     CELL
                                   b
                                         b
                                  b




          b            b                                    b            b
    LEF          VDR                               FOXO3a            ?
TCF/LEFgenes    VDR genes                         Target Genes ? Target genes ?




                           CELL FATE
What is the role of FOXO3a/b-catenin crosstalk in colon cancer?
b

 a                                                                  b

                                                         b-cat                                                                               b-cat




                                                         FOXO3a                                                                              FOXO3a



b-cat                                                               b-cat
FOXO3a                                                   Merge      FOXO3a                                                                   Merge


 c                       0.08   P = 0.0177
                                                 *                  d
                                                                                       100                             Nuclear
Nuclear FOXO3a & b-cat




                                                                                                                                                     High
                         0.06                                                                                      FOXO3a & b-catenin                Low



                                                                    Patients surviving (%)
    content (r. u. )




                                                                                             80


                         0.04                                                                60


                                                                                             40
                         0.02

                                                                                             20
                                                                                                      n = 113
                                                                                                      P = 0.0003
                           0                                                                 0
                         n=        13        22     135    14                                     0      12   24   36    48   60   72   84    96     108 120
                                ADENOMA      I+II  III+IV LIVER                                                         Time (months)
                                             CARCINOMA METASTASIS
                                                                                                                                   Tenbaum et al. Nat Med. 2012
b
                                            Normal cell           APC -/-



                                                                  ADENOMA

LEVELS of REGULATION
                                                                                APC -/-; K-RasV12
                       APC -/-
- GENETIC               NUCLEAR b-CATENIN                              NUCLEAR b-CATENIN

- NICHE


                                                    NUCLEAR
                                                    FOXO3a
                                                       Stress
                                                         or
                                                     PI3K/AKT
                                                    Inhibitors?




                           Proliferation    APOPTOSIS        METASTASIS          PROLIFERATION




                                                                    HETEROGENEOUS
                                                                      CARCINOMA


                                                                                                    Tenbaum et al. Nat Med. 2012
b

                     WNT                         OXIDATIVE       GROWTH       EGFR/PI3K/AKT
                  INHIBITORS                      ESTRESS        FACTORS        INHIBITORS

                                                                  RTK
                       XAV-939                                          CETUXIMAB


    b
                   Axin

                                                         JNK      RAS

                                     b                                     PI3K BKM-120
                                                             FOXO3a
                                 b       b
                                                                             AKT    API-2




              b                                          b
        LEF                                                  FOXO3a
                          ON                  ON
    PROLIFERATION                                  APOPTOSIS
                                                 CYCLE ARREST
                                                 & METASTASIS



                                             CELL FATE
b

a




E-cadh Phalloidin

b




c                   e   f




                        Tenbaum et al. Nat Med. 2012
b

a     PATIENT             XENOGRAFT       b        PATIENT         XENOGRAFT      c
                                                                                                                           40
T49                     T49                T49                   T49                                                            T49




                                                                                  APOPTOSIS (% Annexin V positive cells)
                                                                                                                           30

                                                                                                                           20

                                                                                                                           10

                                                                                                                            0
                                                                                                                           30
T61                     T61                T61                   T61                                                            T61

                                                                                                                           20


                                                                                                                           10

                                           β-cat
                                                                                      0
                                                                                  XAV-939                                        -   +   -   +   -   +   -   +
                                                                                LY-294002                                        -   -   +   +   -   -   -   -
d                                                                                  BKM120                                        -   -   -   -   +   +   -   -
                                                                                    API-2                                        -   -   -   -   -   -   +   +
                                                             e




          Time (days)            Time (days)


                                                                               Tenbaum et al. Nat Med. 2012
b




    Tenbaum et al. Nat Med. 2012
GENOTYPING   NUCLEAR b-CATENIN   PI3K & AKT   RESPONSE           PI3K & AKT INHIBITORS
                                                          APOPTOSIS
          SEQUENOM         ANALYSIS        INHIBITORS                        + WNT INHIBITORS

                             LOW




  CRC
PATIENT
             APC
           CTNNB1
            AXIN1

            PTEN
            PI3KA                                       RESISTANCE
             AKT                                        METASTASIS

                             HIGH



                                                                      OR
Fundación Olga Torres
b


                                         All-in-one Lentivirus: TetON-Flag-bcatS33Y-IRES-EGFP



                                                             b-cat    IRES   EGFP           rtTA2
                                                    TRE

                                                                                    hPGK1
                                                          FLAG S33Y
                  DOX                                                                                             4OHT



     E-cadh
E-cadh
              b
                             b                                                       b
                  rtTA2                                                                                            ER FOXO3a




                                                                                     b                                    b
                                                b
                  rtTA2                   LEF                                  x                            ER   FOXO3a

                          b-cat   eGFP                  TCF/LEF                           Unknown                                FOXO
                          S33Y
                                                      Target genes                       Target genes                         Target genes
b

DLD-1Fb-C7
         VEHICLE               4OHT   DOX                 4OHT + DOX




b




             PROLIFERATION                     APOPTOSIS
             FOXO3a dominant                   b-catenin dominant




    DLD1 -1Fb-C7          XENOGRAFT    DLD1 -1Fb-C7            XENOGRAFT
                                                      Tenbaum et al. Nat Med. 2012
b


    E-cadherin relocation             Increased cell motility      Increased cell adhesion
                                                                VEHICLE            4OHT


                                          A

                                              B        B
                                                       A        DOX                4OHT+DOX

                         E-cadherin
                         Phalloidin




  4OHT       -   +   -   +
   DOX       -   -   +   +
 E-cadh                      - 120
(Clone 36)

 E-cadh                      - 120
 (HECD1)

  Snail1                     - 28

Tubulin                      - 50


                                                                          Tenbaum et al. Nat Med. 2012

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The Wnt–β-catenin and PI3K-AKT-FOXO3a pathways have a central role in cancer

  • 1. b-catenin Confers Resistance to PI3K and AKT Inhibitors and Subverts FOXO3a to Promote Metastasis in Colon Cancer Tenbaum et al. Nat Med. 2012 Oriol Arqués STEM CELLS and CANCER LABORATORY Vall Hebron Institute of Onocology Barcelona, Spain
  • 2. b INTESTINAL EPITHELIUM TUMOR Wnt LRP Fz Dsh b b b b b b b b b Lef ON Lef ON TCF/LEF genes TCF/LEF genes 90% of CRC patients present activating mutations in Wnt pathway
  • 3. b Other Other Vitamin D NICHE Ligands Ligands LRP Wnt LRP ? ? Fz CANCER Dsh CELL b b b b b b b LEF VDR FOXO3a ? TCF/LEFgenes VDR genes Target Genes ? Target genes ? CELL FATE
  • 4. What is the role of FOXO3a/b-catenin crosstalk in colon cancer?
  • 5. b a b b-cat b-cat FOXO3a FOXO3a b-cat b-cat FOXO3a Merge FOXO3a Merge c 0.08 P = 0.0177 * d 100 Nuclear Nuclear FOXO3a & b-cat High 0.06 FOXO3a & b-catenin Low Patients surviving (%) content (r. u. ) 80 0.04 60 40 0.02 20 n = 113 P = 0.0003 0 0 n= 13 22 135 14 0 12 24 36 48 60 72 84 96 108 120 ADENOMA I+II III+IV LIVER Time (months) CARCINOMA METASTASIS Tenbaum et al. Nat Med. 2012
  • 6. b Normal cell APC -/- ADENOMA LEVELS of REGULATION APC -/-; K-RasV12 APC -/- - GENETIC NUCLEAR b-CATENIN NUCLEAR b-CATENIN - NICHE NUCLEAR FOXO3a Stress or PI3K/AKT Inhibitors? Proliferation APOPTOSIS METASTASIS PROLIFERATION HETEROGENEOUS CARCINOMA Tenbaum et al. Nat Med. 2012
  • 7. b WNT OXIDATIVE GROWTH EGFR/PI3K/AKT INHIBITORS ESTRESS FACTORS INHIBITORS RTK XAV-939 CETUXIMAB b Axin JNK RAS b PI3K BKM-120 FOXO3a b b AKT API-2 b b LEF FOXO3a ON ON PROLIFERATION APOPTOSIS CYCLE ARREST & METASTASIS CELL FATE
  • 8. b a E-cadh Phalloidin b c e f Tenbaum et al. Nat Med. 2012
  • 9. b a PATIENT XENOGRAFT b PATIENT XENOGRAFT c 40 T49 T49 T49 T49 T49 APOPTOSIS (% Annexin V positive cells) 30 20 10 0 30 T61 T61 T61 T61 T61 20 10 β-cat 0 XAV-939 - + - + - + - + LY-294002 - - + + - - - - d BKM120 - - - - + + - - API-2 - - - - - - + + e Time (days) Time (days) Tenbaum et al. Nat Med. 2012
  • 10. b Tenbaum et al. Nat Med. 2012
  • 11. GENOTYPING NUCLEAR b-CATENIN PI3K & AKT RESPONSE PI3K & AKT INHIBITORS APOPTOSIS SEQUENOM ANALYSIS INHIBITORS + WNT INHIBITORS LOW CRC PATIENT APC CTNNB1 AXIN1 PTEN PI3KA RESISTANCE AKT METASTASIS HIGH OR
  • 13.
  • 14. b All-in-one Lentivirus: TetON-Flag-bcatS33Y-IRES-EGFP b-cat IRES EGFP rtTA2 TRE hPGK1 FLAG S33Y DOX 4OHT E-cadh E-cadh b b b rtTA2 ER FOXO3a b b b rtTA2 LEF x ER FOXO3a b-cat eGFP TCF/LEF Unknown FOXO S33Y Target genes Target genes Target genes
  • 15. b DLD-1Fb-C7 VEHICLE 4OHT DOX 4OHT + DOX b PROLIFERATION APOPTOSIS FOXO3a dominant b-catenin dominant DLD1 -1Fb-C7 XENOGRAFT DLD1 -1Fb-C7 XENOGRAFT Tenbaum et al. Nat Med. 2012
  • 16. b E-cadherin relocation Increased cell motility Increased cell adhesion VEHICLE 4OHT A B B A DOX 4OHT+DOX E-cadherin Phalloidin 4OHT - + - + DOX - - + + E-cadh - 120 (Clone 36) E-cadh - 120 (HECD1) Snail1 - 28 Tubulin - 50 Tenbaum et al. Nat Med. 2012