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Insulin induces drug resistance in melanoma through activation of the PI3K/Akt pathway

Authors Chi M, Ye Y, Zhang XD, Chen J

Received 26 August 2013

Accepted for publication 5 November 2013

Published 17 February 2014 Volume 2014:8 Pages 255—262

DOI https://dx.doi.org/10.2147/DDDT.S53568

Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Mengna Chi,1 Yan Ye,1 Xu Dong Zhang,1 Jiezhong Chen2,3

1School of Medicine and Public Health, The University of Newcastle, Newcastle, NSW, Australia; 2School of Biomedical Sciences, The University of Queensland, Brisbane, QLD, Australia; 3Faculty of Science, Medicine and Health, The University of Wollongong, Wollongong, NSW, Australia

Introduction: There is currently no curative treatment for melanoma once the disease spreads beyond the original site. Although activation of the PI3K/Akt pathway resulting from genetic mutations and epigenetic deregulation of its major regulators is known to cause resistance of melanoma to therapeutic agents, including the conventional chemotherapeutic drug dacarbazine and the Food and Drug Administration-approved mutant BRAF inhibitors vemurafenib and dabrafenib, the role of extracellular stimuli of the pathway, such as insulin, in drug resistance of melanoma remains less understood.
Objective: To investigate the effect of insulin on the response of melanoma cells to dacarbazine, and in particular, the effect of insulin on the response of melanoma cells carrying the BRAFV600E mutation to mutant BRAF inhibitors. An additional aim was to define the role of the PI3K/Akt pathway in the insulin-triggered drug resistance.
Methods: The effect of insulin on cytotoxicity induced by dacarbazine or the mutant BRAF inhibitor PLX4720 was tested by pre-incubation of melanoma cells with insulin. Cytotoxicity was determined by the MTS assay. The role of the PI3K/Akt pathway in the insulin-triggered drug resistance was examined using the PI3K inhibitor LY294002 and the PI3K and mammalian target of rapamycin dual inhibitor BEZ-235. Activation of the PI3K/Akt pathway was monitored by Western blot analysis of phosphorylated levels of Akt.
Results: Recombinant insulin attenuated dacarbazine-induced cytotoxicity in both wild-type BRAF and BRAFV600E melanoma cells, whereas it also reduced killing of BRAFV600E melanoma cells by PLX4720. Nevertheless, the protective effect of insulin was abolished by the PI3K and mTOR dual inhibitor BEZ-235 or the PI3K inhibitor LY294002.
Conclusion: Insulin attenuates the therapeutic efficacy of dacarbazine and PLX4720 in melanoma cells, which is mediated by activation of the PI3K/Akt pathway and can be overcome by PI3K inhibitors.

Keywords: insulin, PI3K/Akt, melanoma, drug resistance, DTIC, BRAF inhibitors

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