The V600E mutation in the
kinase BRAF is frequently detected in
melanomas and results in constitutive activation of BRAF, which then promotes cell proliferation by the
mitogen-activated protein kinase signaling pathway. Although the BRAFV600E
kinase inhibitor
vemurafenib has remarkable antitumor activity in patients with BRAFV600E-mutated
melanoma, its effects are limited by the onset of drug resistance. We found that exposure of
melanoma cell lines with the BRAFV600E mutation to
vemurafenib decreased the abundance of antiapoptotic
proteins and induced intrinsic mitochondrial apoptosis.
Vemurafenib-treated
melanoma cells showed increased cytosolic concentration of
calcium, a potential trigger for endoplasmic reticulum (ER) stress, which can lead to apoptosis. Consistent with an ER stress-induced response,
vemurafenib decreased the abundance of the ER chaperone
protein glucose-regulated
protein 78, increased the abundance of the spliced
isoform of the
transcription factor X-box binding protein 1 (XBP1) (which transcriptionally activates genes involved in ER stress responses), increased the phosphorylation of the translation
initiation factor eIF2α (which would be expected to inhibit
protein synthesis), and induced the expression of ER stress-related genes. Knockdown of the ER stress response
protein activating transcription factor 4 (ATF4) significantly reduced
vemurafenib-induced apoptosis. Moreover, the ER stress inducer
thapsigargin prevented invasive growth of
tumors formed from
vemurafenib-sensitive
melanoma cells in vivo. In
melanoma cells with low sensitivity or resistance to
vemurafenib, combination treatment with
thapsigargin augmented or induced apoptosis. Thus,
thapsigargin or other inducers of ER stress may be useful in combination
therapies to overcome
vemurafenib resistance.