Aberrant activation of AXL may drive progression of squamous cell carcinoma in CLL patients: a mechanistic study with clinical implications

Br J Cancer. 2024 Aug;131(3):589-600. doi: 10.1038/s41416-024-02752-1. Epub 2024 Jun 17.

Abstract

Background: Occurrence of squamous cell carcinoma (SCC) even in early-stage, untreated chronic lymphocytic leukemia (CLL) patients can be a significant morbidity issue with occasional transformation into metastatic skin lesions.

Methods: CLL cells and extracellular vesicles (EVs) from CLL patients' blood/plasma were purified and used. Expression/activation of AXL and its functions in normal keratinocytes (HEKa) were assessed in vitro co-culture system and in SCC tissues.

Results: We detected aberrant activation of AXL, AKT and ERK-1/2 in SCC cell lines compared to HEKa. We also detected increased expression of AXL in primary SCC tissues obtained from CLL patients. Increased activation of AXL, AKT, ERK-1/2 and Src was discernible in HEKa upon co-culturing with CLL cells. Further analysis suggests that Gas6, a ligand of AXL, regulates AXL activation in co-cultured HEKa. Interestingly, exposure of HEKa cells to CLL plasma-derived EVs induced expression of AXL, P-AKT, and EMT-associated markers leading to migration of the cells. Finally, pharmacologic inhibition of AXL induced cell death in SCC lines in a dose dependent manner.

Conclusions: Our findings that CLL cells likely are involved in driving SCC progression, at least in part, via activation of the AXL signaling axis, indicating that AXL inhibition may be beneficial for our CLL patients with SCC.

MeSH terms

  • Axl Receptor Tyrosine Kinase*
  • Carcinoma, Squamous Cell* / metabolism
  • Carcinoma, Squamous Cell* / pathology
  • Cell Line, Tumor
  • Coculture Techniques
  • Disease Progression*
  • Extracellular Vesicles* / metabolism
  • Humans
  • Intercellular Signaling Peptides and Proteins / metabolism
  • Keratinocytes / metabolism
  • Keratinocytes / pathology
  • Leukemia, Lymphocytic, Chronic, B-Cell* / metabolism
  • Leukemia, Lymphocytic, Chronic, B-Cell* / pathology
  • Male
  • Proto-Oncogene Proteins c-akt / metabolism
  • Proto-Oncogene Proteins* / metabolism
  • Receptor Protein-Tyrosine Kinases* / metabolism
  • Skin Neoplasms / genetics
  • Skin Neoplasms / metabolism
  • Skin Neoplasms / pathology

Substances

  • Axl Receptor Tyrosine Kinase
  • Receptor Protein-Tyrosine Kinases
  • Proto-Oncogene Proteins
  • AXL protein, human
  • growth arrest-specific protein 6
  • Proto-Oncogene Proteins c-akt
  • Intercellular Signaling Peptides and Proteins