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In vivo RNAi screening identifies a mechanism of sorafenib resistance in liver cancer


In solid tumors, resistance to therapy inevitably develops upon treatment with cytotoxic drugs or molecularly targeted therapies. Here, we describe a system that enables pooled shRNA screening directly in mouse hepatocellular carcinomas (HCC) in vivo to identify genes likely to be involved in therapy resistance. Using a focused shRNA library targeting genes located within focal genomic amplifications of human HCC, we screened for genes whose inhibition increased the therapeutic efficacy of the multikinase inhibitor sorafenib. Both shRNA-mediated and pharmacological silencing of Mapk14 (p38α) were found to sensitize mouse HCC to sorafenib therapy and prolong survival by abrogating Mapk14-dependent activation of Mek-Erk and Atf2 signaling. Elevated Mapk14-Atf2 signaling predicted poor response to sorafenib therapy in human HCC, and sorafenib resistance of p-Mapk14-expressing HCC cells could be reverted by silencing Mapk14. Our results suggest that a combination of sorafenib and Mapk14 blockade is a promising approach to overcoming therapy resistance of human HCC.

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Figure 1: A transposon-based mouse model of liver cancer shows therapy resistance resembling that of human HCC.
Figure 2: Outline and results of an in vivo RNAi screen to identify sorafenib treatment response modifiers.
Figure 3: Functional genetic validation of Mapk14 as a sorafenib sensitizer gene.
Figure 4: Pharmacological inhibition of Mapk14 sensitizes to sorafenib therapy.
Figure 5: Second-generation Mapk14 inhibitors (skepinone-L and PH-797804) are effective for HCC treatment in combination with sorafenib and exert no adverse effects.
Figure 6: Cross-talk of Mapk14 and Mek-Erk signaling in HCC and its role in sorafenib resistance.


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We thank A. Rinkel, N. Struever, C. Hermann, V. Geissler, U. Koppenhoefer, H. Riedesel, M. Jarek, M. Scharfe and the HZI Genome Analytics Group team for technical assistance. We thank the tissue bank of the National Center for Tumor Diseases Heidelberg for providing human HCC tissues. This work was supported by the German Research Foundation, DFG (Emmy Noether Programme ZE 545/2-1 to L.Z., the “Rebirth” Cluster of Excellence, project “Liver regeneration”, SFB/TRR77 and SFB685), the Helmholtz Association of German Research Centers (VH-NG-424 to L.Z.), the European Commission (project 'Heptromic') and the Wilhelm Sander Stiftung.

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The study was designed by L.Z. Research was conducted by R.R., D.D., T.L., K.M., T.W., T.-W.K., A.H., M.P., J.L., A.v.T., P.S., J.Z., K.-H.W., S.P., N.P.M., M.E., B.S., S.W.L., R.G., S.L. and L.Z. The manuscript was written by L.Z., R.R. and D.D.

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Correspondence to Lars Zender.

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The authors declare no competing financial interests.

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Supplementary Table 1

Results from in vivo RNAi screen. (XLS 169 kb)

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Rudalska, R., Dauch, D., Longerich, T. et al. In vivo RNAi screening identifies a mechanism of sorafenib resistance in liver cancer. Nat Med 20, 1138–1146 (2014).

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