Noncanonical hedgehog pathway activation through SRF-MKL1 promotes drug resistance in basal cell carcinomas

Nat Med. 2018 Mar;24(3):271-281. doi: 10.1038/nm.4476. Epub 2018 Feb 5.

Abstract

Hedgehog pathway-dependent cancers can escape Smoothened (SMO) inhibition through mutations in genes encoding canonical hedgehog pathway components; however, around 50% of drug-resistant basal cell carcinomas (BCCs) lack additional variants of these genes. Here we use multidimensional genomics analysis of human and mouse drug-resistant BCCs to identify a noncanonical hedgehog activation pathway driven by the transcription factor serum response factor (SRF). Active SRF along with its coactivator megakaryoblastic leukemia 1 (MKL1) binds DNA near hedgehog target genes and forms a previously unknown protein complex with the hedgehog transcription factor glioma-associated oncogene family zinc finger-1 (GLI1), causing amplification of GLI1 transcriptional activity. We show that cytoskeletal activation through Rho and the formin family member Diaphanous (mDia) is required for SRF-MKL-driven GLI1 activation and for tumor cell viability. Remarkably, nuclear MKL1 staining served as a biomarker in tumors from mice and human subjects to predict tumor responsiveness to MKL inhibitors, highlighting the therapeutic potential of targeting this pathway. Thus, our study illuminates, for the first time, cytoskeletal-activation-driven transcription as a personalized therapeutic target for combatting drug-resistant malignancies.

Publication types

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

MeSH terms

  • Animals
  • Carcinoma, Basal Cell / drug therapy*
  • Carcinoma, Basal Cell / genetics
  • Carcinoma, Basal Cell / pathology
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Cell Survival / drug effects
  • Drug Resistance, Neoplasm / genetics*
  • Gene Expression Regulation, Neoplastic / genetics
  • Hedgehog Proteins
  • Humans
  • Mice
  • Multiprotein Complexes / genetics
  • Serum Response Factor / genetics*
  • Signal Transduction
  • Trans-Activators / genetics*
  • Transcriptional Activation
  • Zinc Finger Protein GLI1 / genetics*

Substances

  • GLI1 protein, human
  • Hedgehog Proteins
  • MRTFA protein, human
  • Multiprotein Complexes
  • SRF protein, human
  • Serum Response Factor
  • Trans-Activators
  • Zinc Finger Protein GLI1