Aryl hydrocarbon receptor nuclear translocator-like (ARNTL/BMAL1) is associated with bevacizumab resistance in colorectal cancer via regulation of vascular endothelial growth factor A

Research output: Contribution to journalResearch articleContributedpeer-review

Contributors

  • Elke Burgermeister - , Heidelberg University  (Author)
  • Francesca Battaglin - , University of Southern California, IRCCS Istituto Oncologico Veneto - Padova (Author)
  • Fagr Eladly - , Heidelberg University  (Author)
  • Wen Wu - , Heidelberg University  (Author)
  • Frank Herweck - , Heidelberg University  (Author)
  • Nadine Schulte - , Heidelberg University  (Author)
  • Johannes Betge - , Heidelberg University  (Author)
  • Nicolai Härtel - , Heidelberg University  (Author)
  • Jakob N. Kather - , University Hospital Aachen (Author)
  • Cleo Aron Weis - , Heidelberg University  (Author)
  • Timo Gaiser - , Heidelberg University  (Author)
  • Alexander Marx - , Heidelberg University  (Author)
  • Christel Weiss - , Heidelberg University  (Author)
  • Ralf Hofheinz - , Heidelberg University  (Author)
  • Ian S. Miller - , Royal College of Surgeons in Ireland (Author)
  • Fotios Loupakis - , IRCCS Istituto Oncologico Veneto - Padova (Author)
  • Heinz Josef Lenz - , University of Southern California (Author)
  • Annette T. Byrne - , Royal College of Surgeons in Ireland, University College Dublin (Author)
  • Matthias P. Ebert - , Heidelberg University  (Author)

Abstract

Background: The identification of new biomarkers and the development of novel, targetable contexts of vulnerability are of urgent clinical need in drug-resistant metastatic colorectal cancer (mCRC). Aryl-Hydrocarbon-Receptor-Nuclear-Translocator-Like (ARNTL/BMAL1) is a circadian clock-regulated transcription factor promoting expression of genes involved in angiogenesis and tumour progression. We hypothesised that BMAL1 increases expression of the vascular endothelial growth factor A VEGFA gene and, thereby, confers resistance to anti-angiogenic therapy with bevacizumab (Beva), a clinically used antibody for neutralization of VEGFA. Methods: PCR and immunohistochemistry were employed to assess BMAL1 expression in mice (C57BL/6 J Apcmin/+; BALB/c nu/nu xenografts) and CRC patients under combination chemotherapy with Beva. BMAL1 single nucleotide gene polymorphisms (SNPs) were analysed by DNA-microarray in clinical samples. BMAL1 functions were studied in human CRC cell lines using colorimetric growth, DNA-binding and reporter assays. Findings: In murine CRCs, high BMAL1 expression correlated with poor preclinical response to Beva treatment. In CRC patients' tumours (n = 74), high BMAL1 expression was associated with clinical non-response to combination chemotherapy with Beva (*p =.0061) and reduced progression-free survival (PFS) [*p =.0223, Hazard Ratio (HR) = 1.69]. BMAL1 SNPs also correlated with shorter PFS (rs7396943, rs7938307, rs2279287) and overall survival (OS) [rs11022780, *p =.014, HR = 1.61]. Mechanistically, Nuclear-Receptor-Subfamily-1-Group-D-Member-1 (NR1D1/REVERBA) bound a − 672 bp Retinoic-Acid-Receptor-Related-Orphan-Receptor-Alpha-responsive-element (RORE) adjacent to a BMAL1 DNA-binding motif (E-box) in the VEGFA gene promoter, resulting in increased VEGFA synthesis and proliferation of human CRC cell lines. Interpretation: BMAL1 was associated with Beva resistance in CRC. Inhibition of REVERBA-BMAL1 signalling may prevent resistance to anti-angiogenic therapy. Fund: This work was in part supported by the European Commission Seventh Framework Programme (Contract No. 278981 [ANGIOPREDICT]).

Details

Original languageEnglish
Pages (from-to)139-154
Number of pages16
JournalEBioMedicine
Volume45
Publication statusPublished - Jul 2019
Peer-reviewedYes
Externally publishedYes

External IDs

PubMed 31300350

Keywords

Sustainable Development Goals

Keywords

  • ARNTL, Bevacizumab, BMAL1, Colorectal cancer, REVERBA, VEGFA