The convergent roles of NF-κB and ER stress in sunitinib-mediated expression of pro-tumorigenic cytokines and refractory phenotype in renal cell carcinoma

Cell Death Dis. 2018 Mar 7;9(3):374. doi: 10.1038/s41419-018-0388-1.

Abstract

Renal cell carcinoma (RCC) is the most common form of kidney cancer. While cure remains exceptionally infrequent in RCC patients with systemic or recurrent disease, current targeted molecular strategies, including multi-targeted tyrosine kinase inhibitors (TKIs), notably changed the treatment paradigm of advanced renal cancer. Yet, complete and durable responses have been noted in only a few cases. Our studies reveal that sunitinib triggers two resistance-promoting signaling pathways in RCC cells, which emanate from the endoplasmic reticulum (ER) stress response: a PERK-driven ER stress response that induces expression of the pro-tumorigenic cytokines IL-6, IL-8, and TNF-α, and a TRAF2-mediated NF-κB survival program that protects tumor cells against cell death. PERK blockade completely prevents sunitinib-induced expression of IL-6, IL-8 and TNF-α, whereas NF-κB inhibition reinstates sensitivity of RCC cells to sunitinib both in vitro and in vivo. Taken together, our findings indicate that ER stress response may contribute to sunitinib resistance in RCC patients.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Carcinoma, Renal Cell / metabolism*
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Cytokines / metabolism*
  • Endoplasmic Reticulum Stress / drug effects*
  • Humans
  • Interleukin-6 / metabolism
  • Interleukin-8 / metabolism
  • Kidney Neoplasms / metabolism*
  • NF-kappa B / metabolism*
  • Signal Transduction / drug effects
  • Sunitinib / pharmacology*
  • TNF Receptor-Associated Factor 2 / metabolism
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Cytokines
  • Interleukin-6
  • Interleukin-8
  • NF-kappa B
  • TNF Receptor-Associated Factor 2
  • Tumor Necrosis Factor-alpha
  • Sunitinib