articleCancer DiscoveryNov 21, 2013BRONZE OA

Acquired Resistance and Clonal Evolution in Melanoma during BRAF Inhibitor Therapy

The University of Sydney · University of California, Los Angeles · +4 more institutions

PubMed
Indexed incrossrefpubmed

Abstract

Abstract BRAF inhibitors elicit rapid antitumor responses in the majority of patients with BRAFV600-mutant melanoma, but acquired drug resistance is almost universal. We sought to identify the core resistance pathways and the extent of tumor heterogeneity during disease progression. We show that mitogen-activated protein kinase reactivation mechanisms were detected among 70% of disease-progressive tissues, with RAS mutations, mutant BRAF amplification, and alternative splicing being most common. We also detected PI3K–PTEN–AKT–upregulating genetic alterations among 22% of progressive melanomas. Distinct molecular lesions in both core drug escape pathways were commonly detected concurrently in the same tumor or…

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