American Association for Cancer Research
10780432ccr191895-sup-223796_2_supp_6181165_q7pdrs.pptx (383.66 kB)

Supplementary Figure S5 from Metastatic Melanoma Patient–Derived Xenografts Respond to MDM2 Inhibition as a Single Agent or in Combination with BRAF/MEK Inhibition

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posted on 2023-03-31, 20:25 authored by Rebecca L. Shattuck-Brandt, Sheau-Chiann Chen, Emily Murray, Christopher Andrew Johnson, Holly Crandall, Jamye F. O'Neal, Rami Nayef Al-Rohil, Caroline A. Nebhan, Vijaya Bharti, Kimberly B. Dahlman, Gregory D. Ayers, Chi Yan, Mark C. Kelley, Rondi M. Kauffmann, Mary Hooks, Ana Grau, Douglas B. Johnson, Anna E. Vilgelm, Ann Richmond

Supplementary Figure S5: Association Between Mutation Status and t Ratio.




Vanderbilt Mouse Metabolic Phenotyping Center

National Institute of Diabetes and Digestive and Kidney Diseases

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Vanderbilt-Ingram Cancer Center

James C. Bradford Jr. Melanoma Fund




Over 60% of patients with melanoma respond to immune checkpoint inhibitor (ICI) therapy, but many subsequently progress on these therapies. Second-line targeted therapy is based on BRAF mutation status, but no available agents are available for NRAS, NF1, CDKN2A, PTEN, and TP53 mutations. Over 70% of melanoma tumors have activation of the MAPK pathway due to BRAF or NRAS mutations, while loss or mutation of CDKN2A occurs in approximately 40% of melanomas, resulting in unregulated MDM2-mediated ubiquitination and degradation of p53. Here, we investigated the therapeutic efficacy of over-riding MDM2-mediated degradation of p53 in melanoma with an MDM2 inhibitor that interrupts MDM2 ubiquitination of p53, treating tumor-bearing mice with the MDM2 inhibitor alone or combined with MAPK-targeted therapy. To characterize the ability of the MDM2 antagonist, KRT-232, to inhibit tumor growth, we established patient-derived xenografts (PDX) from 15 patients with melanoma. Mice were treated with KRT-232 or a combination with BRAF and/or MEK inhibitors. Tumor growth, gene mutation status, as well as protein and protein–phosphoprotein changes, were analyzed. One-hundred percent of the 15 PDX tumors exhibited significant growth inhibition either in response to KRT-232 alone or in combination with BRAF and/or MEK inhibitors. Only BRAFV600WT tumors responded to KRT-232 treatment alone while BRAFV600E/M PDXs exhibited a synergistic response to the combination of KRT-232 and BRAF/MEK inhibitors. KRT-232 is an effective therapy for the treatment of either BRAFWT or PANWT (BRAFWT, NRASWT) TP53WT melanomas. In combination with BRAF and/or MEK inhibitors, KRT-232 may be an effective treatment strategy for BRAFV600-mutant tumors.