[HTML][HTML] Mixed lineage kinases activate MEK independently of RAF to mediate resistance to RAF inhibitors

AA Marusiak, ZC Edwards, W Hugo, EW Trotter… - Nature …, 2014 - nature.com
AA Marusiak, ZC Edwards, W Hugo, EW Trotter, MR Girotti, NL Stephenson, X Kong…
Nature communications, 2014nature.com
RAF inhibitor therapy yields significant reductions in tumour burden in the majority of V600E-
positive melanoma patients; however, resistance occurs within 2–18 months. Here we
demonstrate that the mixed lineage kinases (MLK1–4) are MEK kinases that reactivate the
MEK/ERK pathway in the presence of RAF inhibitors. Expression of MLK1–4 mediates
resistance to RAF inhibitors and promotes survival in V600E-positive melanoma cell lines.
Furthermore, we observe upregulation of the MLKs in 9 of 21 melanoma patients with …
Abstract
RAF inhibitor therapy yields significant reductions in tumour burden in the majority of V600E-positive melanoma patients; however, resistance occurs within 2–18 months. Here we demonstrate that the mixed lineage kinases (MLK1–4) are MEK kinases that reactivate the MEK/ERK pathway in the presence of RAF inhibitors. Expression of MLK1–4 mediates resistance to RAF inhibitors and promotes survival in V600E-positive melanoma cell lines. Furthermore, we observe upregulation of the MLKs in 9 of 21 melanoma patients with acquired drug resistance. Consistent with this observation, MLKs promote resistance to RAF inhibitors in mouse models and contribute to acquired resistance in a cell line model. Lastly, we observe that a majority of MLK1 mutations identified in patients are gain-of-function mutations. In summary, our data demonstrate a role for MLKs as direct activators of the MEK/ERK pathway with implications for melanomagenesis and resistance to RAF inhibitors.
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