Combined blockade of MEK and PI3KCA as an effective antitumor strategy in HER2 gene amplified human colorectal cancer models

Valentina Belli, Nunzia Matrone, Stefania Napolitano, Giorgia Migliardi, Francesca Cottino, Andrea Bertotti, Livio Trusolino, Erika Martinelli, Floriana Morgillo, Davide Ciardiello, Vincenzo De Falco, Emilio Francesco Giunta, Umberto Bracale, Fortunato Ciardiello, Teresa Troiani

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Targeting the epidermal growth factor receptor (EGFR) either alone or in combination with chemotherapy is an effective treatment for patients with RAS wild-type metastatic colorectal cancer (mCRC). However, only a small percentage of mCRC patients receive clinical benefits from anti-EGFR therapies, due to the development of resistance mechanisms. In this regard, HER2 has emerged as an actionable target in the treatment of mCRC patients with resistance to anti-EGFR therapy.

METHODS: We have used SW48 and LIM1215 human colon cancer cell lines, quadruple wild-type for KRAS, NRAS, BRAF and PI3KCA genes, and their HER2-amplified (LIM1215-HER2 and SW48-HER2) derived cells to perform in vitro and in vivo studies in order to identify novel therapeutic strategies in HER2 gene amplified human colorectal cancer.

RESULTS: LIM1215-HER2 and SW48-HER2 cells showed over-expression and activation of the HER family receptors and concomitant intracellular downstream signaling including the pro-survival PI3KCA/AKT and the mitogenic RAS/RAF/MEK/MAPK pathways. HER2-amplified cells were treated with several agents including anti-EGFR antibodies (cetuximab, SYM004 and MM151); anti-HER2 (trastuzumab, pertuzumab and lapatinib) inhibitors; anti-HER3 (duligotuzumab) inhibitors; and MEK and PI3KCA inhibitors, such as refametinib and pictilisib, as single agents and in combination. Subsequently, different in vivo experiments have been performed. MEK plus PI3KCA inhibitors treatment determined the best antitumor activity. These results were validated in vivo in HER2-amplified patient derived tumor xenografts from three metastatic colorectal cancer patients.

CONCLUSIONS: These results suggest that combined therapy with MEK and PI3KCA inhibitors could represent a novel and effective treatment option for HER2-amplified colorectal cancer.

Original languageEnglish
Pages (from-to)236
JournalJournal of experimental & clinical cancer research : CR
Issue number1
Publication statusPublished - Jun 4 2019


  • Animals
  • Antineoplastic Agents/pharmacology
  • Biomarkers, Tumor
  • Cell Line, Tumor
  • Colorectal Neoplasms/drug therapy
  • Disease Models, Animal
  • Dose-Response Relationship, Drug
  • Drug Resistance, Neoplasm/drug effects
  • Female
  • Gene Amplification
  • Humans
  • MAP Kinase Kinase Kinases/antagonists & inhibitors
  • Mice
  • Nuclear Proteins/antagonists & inhibitors
  • Protein Kinase Inhibitors/pharmacology
  • Receptor, ErbB-2/genetics
  • Transcription Factors/antagonists & inhibitors
  • Xenograft Model Antitumor Assays


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