TAMPA, Fla. — Targeted therapy with BRAF-MEK inhibitors is an effective treatment for patients with advanced melanoma that cannot be surgically removed or has spread to other areas of the body. However, many patients become resistant to the therapy, and this can often lead to further metastasis. Moffitt Cancer Center researchers who helped develop this type of combination therapy are now working to better understand what leads to this resistance in hopes of developing ways to overcome it.

In a new article published in the Journal of Investigative Dermatology, Moffitt researchers identify erythropoietin-producing hepatocellular receptor A2 (EphA2) as a driver of metastasis and BRAF-MEK inhibitor resistance in melanoma.

EphA2 is a tyrosine kinase receptor that helps maintain a stable environment in normal cells. However, EphA2 is often overexpressed in many cancers and plays a critical role in its growth. Its exact function depends upon the signaling pathway: canonical and noncanonical. The canonical pathway inhibits cancer cell proliferation and acts as a tumor suppressor. The noncanonical pathway has the opposite effect, promoting tumor survival and metastasis.  

The Moffitt team, in collaboration with scientists at Sanford Burnham Prebys Medical Discovery Institute, focused on the noncanonical pathway of EphA2. Using comprehensive mass spectrometry-based phosphoproteomics, the researchers mapped the signaling network driven by noncanonical EphA2 and found that it induces an amoeboid phenotype that enhances metastatic potential.

“This is important because an amoeboid phenotype enhances metastatic potential by helping to protect melanoma cells that have entered the blood stream from shear stress and allowing the cells to adhere to endothelial cells in other areas of the body,” said Inna Smalley, Ph.D., study author and assistant member in the Cancer Physiology Department at Moffitt.

The research team further confirmed the findings by developing a mouse model using melanoma cells transduced with EphA2-S897E, the noncanonical pathway, and found a significantly higher number of metastases to the lungs. 

“We hope that having a better understanding on what drives resistance to BRAF and BRAF-MEK inhibitor therapy and further metastasis will allow us to better understand the process of therapy escape and develop new treatment strategies for melanoma patients,” said Keiran Smalley, Ph.D., lead study author and director of the Donald A. Adam Melanoma and Skin Cancer Center of Excellence at Moffitt.

This study was supported by the National Cancer Institute (K99 CA226679, R01 GM131374, P30 CA076292) and a Bankhead-Coley grant from the State of Florida (8BC03).

About Moffitt Cancer Center
Moffitt is dedicated to one lifesaving mission: to contribute to the prevention and cure of cancer. The Tampa-based facility is one of only 51 National Cancer Institute-designated Comprehensive Cancer Centers, a distinction that recognizes Moffitt’s scientific excellence, multidisciplinary research, and robust training and education. Moffitt is the No. 11 cancer hospital and has been nationally ranked by U.S. News & World Report since 1999. Moffitt’s expert nursing staff is recognized by the American Nurses Credentialing Center with Magnet® status, its highest distinction. With more than 7,000 team members, Moffitt has an economic impact in the state of $2.4 billion. For more information, call 1-888-MOFFITT (1-888-663-3488), visit MOFFITT.org, and follow the momentum on Facebook, Twitter, Instagram and YouTube