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E Puxeddu
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J A Knauf
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M A Sartor
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N Mitsutake
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E P Smith
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M Medvedovic
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C R Tomlinson
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S Moretti
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J A Fagin
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RET/PTC rearrangements represent key genetic events involved in papillary thyroid carcinoma (PTC) initiation. The aim of the present study was to identify the early changes in gene expression induced by RET/PTC in thyroid cells. For this purpose, microarray analysis was conducted on PCCL3 cells conditionally expressing the RET/PTC3 oncogene. Gene expression profiling 48 h after activation of RET/PTC3 identified a statistically significant modification of expression of 270 genes. Quantitative PCR confirmation of 20 of these demonstrated 90% accuracy of the microarray. Functional clustering of genes with greater than or less than 1.75-fold expression change (86 genes) revealed RET/PTC3-induced regulation of genes with key functions in apoptosis (Ripk3, Tdga), cell–cell signaling (Cdh6, Fn1), cell cycle (Il24), immune and inflammation response (Cxcl10, Scya2, Il6, Gbp2, Oas1, Tap1, RT1Aw2, C2ta, Irf1, Lmp2, Psme2, Prkr), metabolism (Aldob, Ptges, Nd2, Gss, Gstt1), signal transduction (Socs3, Nf1, Jak2, Cpg21, Dusp6, Socs1, Stat1, Stat3, Cish) and transcription (Nr4a1, Junb, Hfh1, Runx1, Foxe1). Genes coding for proteins involved in the immune response and in intracellular signal transduction pathways activated by cytokines and chemokines were strongly represented, indicating a critical role of RET/PTC3 in the early modulation of the immune response.

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Donata Vitagliano
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Valentina De Falco
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Anna Tamburrino
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Sabrina Coluzzi
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Giancarlo Troncone Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto Nazionale dei Tumori di Napoli, Division of Medical Oncology, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Department of Medicine and Human Oncology and Pathogenesis Program, Cancer Discovery, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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Gennaro Chiappetta Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto Nazionale dei Tumori di Napoli, Division of Medical Oncology, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Department of Medicine and Human Oncology and Pathogenesis Program, Cancer Discovery, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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Fortunato Ciardiello Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto Nazionale dei Tumori di Napoli, Division of Medical Oncology, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Department of Medicine and Human Oncology and Pathogenesis Program, Cancer Discovery, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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Giampaolo Tortora Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto Nazionale dei Tumori di Napoli, Division of Medical Oncology, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Department of Medicine and Human Oncology and Pathogenesis Program, Cancer Discovery, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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James A Fagin Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto Nazionale dei Tumori di Napoli, Division of Medical Oncology, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Department of Medicine and Human Oncology and Pathogenesis Program, Cancer Discovery, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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Anderson J Ryan Dipartimento di Biologia e Patologia Cellulare e Molecolare, Dipartimento di Scienze Biomorfologiche e Funzionali, Istituto Nazionale dei Tumori di Napoli, Division of Medical Oncology, Dipartimento di Endocrinologia e Oncologia Molecolare e Clinica, Department of Medicine and Human Oncology and Pathogenesis Program, Cancer Discovery, Istituto di Endocrinologia ed Oncologia Sperimentale del CNR, Università Federico II, Via S. Pansini 5, 80131 Napoli, Italy

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Francesca Carlomagno
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Massimo Santoro
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Oncogenic conversion of the RET tyrosine kinase is a frequent feature of medullary thyroid carcinoma (MTC). ZD6474 (vandetanib) is an ATP-competitive inhibitor of RET, epidermal growth factor receptor (EGFR), and vascular endothelial growth factor receptors kinases. In this study, we have studied ZD6474 mechanism of action in TT and MZ-CRC-1 human MTC cell lines, carrying cysteine 634 to tryptophan (C634W) and methionine 918 to threonine (M918T) RET mutation respectively. ZD6474 blunted MTC cell proliferation and RET, Shc and p44/p42 mitogen-activated protein kinase (MAPK) phosphorylation. Single receptor knockdown by RNA interference showed that MTC cells depended on RET for proliferation. Adoptive expression of the ZD6474-resistant V804M RET mutant rescued proliferation of TT cells under ZD6474 treatment, showing that RET is a key ZD6474 target in these MTC cells. Upon RET inhibition, adoptive stimulation of EGFR partially rescued TT cell proliferation, MAPK signaling, and expression of cell-cycle-related genes. This suggests that simultaneous inhibition of RET and EGFR by ZD6474 may overcome the risk of MTC cells to escape from RET blockade through compensatory over-activation of EGFR.

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Kathleen A Luckett Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Jennifer R Cracchiolo Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Gnana P Krishnamoorthy Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Luis Javier Leandro-Garcia Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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James Nagarajah Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Mahesh Saqcena Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Rona Lester Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Soo Y Im Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Zhen Zhao Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Scott W Lowe Cancer Biology and Genetics Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Elisa de Stanchina Antitumor Assessment Core Facility, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Eric J Sherman Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill-Cornell Medical College, New York, New York, USA

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Alan L Ho Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill-Cornell Medical College, New York, New York, USA

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Steven D Leach Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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Jeffrey A Knauf Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA

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James A Fagin Human Oncology and Pathogenesis Program, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York, USA
Weill-Cornell Medical College, New York, New York, USA

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Constitutive MAPK activation silences genes required for iodide uptake and thyroid hormone biosynthesis in thyroid follicular cells. Accordingly, most BRAFV600E papillary thyroid cancers (PTC) are refractory to radioiodide (RAI) therapy. MAPK pathway inhibitors rescue thyroid-differentiated properties and RAI responsiveness in mice and patient subsets with BRAFV600E-mutant PTC. TGFB1 also impairs thyroid differentiation and has been proposed to mediate the effects of mutant BRAF. We generated a mouse model of BRAFV600E-PTC with thyroid-specific knockout of the Tgfbr1 gene to investigate the role of TGFB1 on thyroid-differentiated gene expression and RAI uptake in vivo. Despite appropriate loss of Tgfbr1, pSMAD levels remained high, indicating that ligands other than TGFB1 were engaging in this pathway. The activin ligand subunits Inhba and Inhbb were found to be overexpressed in BRAFV600E-mutant thyroid cancers. Treatment with follistatin, a potent inhibitor of activin, or vactosertib, which inhibits both TGFBR1 and the activin type I receptor ALK4, induced a profound inhibition of pSMAD in BRAFV600E-PTCs. Blocking SMAD signaling alone was insufficient to enhance iodide uptake in the setting of constitutive MAPK activation. However, combination treatment with either follistatin or vactosertib and the MEK inhibitor CKI increased 124I uptake compared to CKI alone. In summary, activin family ligands converge to induce pSMAD in Braf-mutant PTCs. Dedifferentiation of BRAFV600E-PTCs cannot be ascribed primarily to activation of SMAD. However, targeting TGFβ/activin-induced pSMAD augmented MAPK inhibitor effects on iodine incorporation into BRAF tumor cells, indicating that these two pathways exert interdependent effects on the differentiation state of thyroid cancer cells.

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