Withdrawn 35th Lorne Cancer Conference 2023

Integrated analyses prioritize therapies for PIK3CA-mutant breast cancer and reveal a pro-survival role for p21 in drug resistance (#267)

Kelvin Yip 1 , Sungyoung Shin 1 , Annabel Chee 1 , Ching-Seng Ang 2 , Lee Wong 1 , Lan Nguyen 1 , Antonella Papa 1
  1. Department of Biochemistry and Molecular Biology, School of Biomedical Sciences, Monash University, Melbourne, VIC, Australia
  2. Bio21 Mass Spectrometry and Proteomics Facility, The University of Melbourne, Parkville, VIC, Australia

Utility of PI3Ka inhibitors like BYL719 is limited by the acquisition of genetic and non-genetic mechanisms of resistance which cause disease recurrence. Several combination therapies based on PI3K inhibition have been proposed, but a way to systematically prioritize them for breast cancer treatment is still missing. By integrating published and in-house studies, we have developed in silico models that quantitatively capture dynamics of PI3K signaling at the network-level under a BYL719-sensitive versus BYL719 resistant-cell state. Computational predictions show that signal rewiring to alternative components of the PI3K pathway promote resistance to BYL719 and identify PDK1 as the most effective co-target with PI3Ka rescuing sensitivity of resistant cells to BYL719. To explore whether PI3K pathway-independent mechanisms further contribute to BYL719 resistance, we performed phosphoproteomics and found that selection of high levels of the cell cycle regulator p21 unexpectedly promoted drug resistance in T47D cells. Functionally, high p21 levels favored repair of BYL719-induced DNA damage and bypass of the associated cellular senescence. Importantly, targeted inhibition of the check-point inhibitor CHK1 with MK-8776 effectively caused death of p21-high T47D cells thus establishing a new vulnerability of BYL719-resistant breast cancer cells. Together, our integrated studies uncover hidden molecular mediators causing resistance to PI3Ka inhibition and provide a framework to prioritize combination therapies for PI3K mutant breast cancer.