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FOXA2 plays a critical role in hepatocellular carcinoma progression and lenvatinib-associated drug resistance

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机构: [1]Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China [2]Department of Hepatobiliary Pancreatic Surgery, Chengdu Second People's Hospital, Chengdu, China [3]Institute of Clinical Pathology, West China Hospital, Sichuan University, Chengdu, Sichuan, China [4]Laboratory of Liver Transplantation, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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关键词: hepatocellular carcinoma FOXA2 lenvatinib AMPK-mTOR pathway drug resistance

摘要:
Hepatic forkhead box protein A2 (FOXA2) is a crucial transcription factor for liver development and metabolic homeostasis. However, its role in hepatocellular carcinoma (HCC) progression and lenvatinib-related drug resistance remains unknown. In this study, the level of FOXA2 expression was found to be lower in HCC tissues than in paired adjacent tumor tissues. A low level of FOXA2 expression was associated with aggressive tumor characteristics (vascular invasion and poor differentiation). A low level of FOXA2 expression was found to be an independent risk factor for tumor recurrence (hazard ratio (HR): 1.899, P < 0.001) and long-term survival (HR: 2.011, P = 0.003) in HCC patients after hepatectomy. In xenograft animal models, FOXA2 overexpression significantly inhibited tumor growth. Moreover, FOXA2 overexpression was found to enhance the inhibitory effect of lenvatinib on HCC cells by upregulating the adenosine monophosphate-activated protein kinase-mechanistic target of rapamycin (AMPK-mTOR) pathway. Conversely, inhibition of adenosine monophosphate-activated protein kinase (AMPK) or stimulation of mechanistic target of rapamycin (mTOR) attenuated the sensitization of cells overexpressing FOXA2 to lenvatinib. Similarly, FOXA2 overexpression augmented the antitumor effect of lenvatinib in animal models with xenograft tumors. FOXA2 overexpression increased autophagy in HCC cells treated with lenvatinib. Lenvatinib treatment activated the platelet-derived growth factor receptor-extracellular regulated protein kinase (PDGFR-ERK) pathway in HCC. FOXA2 overexpression further downregulated the PDGFR-ERK pathway through the activation of the AMPK-mTOR axis. In conclusion, FOXA2 was identified as an independent risk factor for HCC after hepatectomy. FOXA2 was found to be closely associated with the biological progression of HCC. By modulating the AMPK-mTOR-autophagy signaling pathway, FOX2 significantly augmented antitumor effect of lenvatinib in HCC.

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出版当年[2023]版:
大类 | 4 区 生物学
小类 | 4 区 生物学
最新[2023]版:
大类 | 4 区 生物学
小类 | 4 区 生物学
第一作者:
第一作者机构: [1]Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China [2]Department of Hepatobiliary Pancreatic Surgery, Chengdu Second People's Hospital, Chengdu, China
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通讯机构: [1]Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China [*1]Department of Liver Surgery, West China Hospital, Sichuan University, Chengdu 610041, China.
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