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Research ArticleExperimental Studies

ALK Inhibitors Do Not Increase Sensitivity to Radiation in EML4-ALK Non-small Cell Lung Cancer

KATHRIN FLESCHUTZ, LISA WALTER, RUMO LEISTNER and LUCIE HEINZERLING
Anticancer Research September 2020, 40 (9) 4937-4946; DOI: https://doi.org/10.21873/anticanres.14497
KATHRIN FLESCHUTZ
1University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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LISA WALTER
2Central Institute of Medical Engineering (ZiMT), Machine Learning and Data Analytics Lab, Department of Computer Science, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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RUMO LEISTNER
3Department of Pneumology, Hospital Bamberg, Bamberg, Germany
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LUCIE HEINZERLING
4Department of Dermatology, University Hospital Erlangen, Friedrich-Alexander-University Erlangen-Nürnberg (FAU), Erlangen, Germany
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  • For correspondence: Lucie.heinzerling@uk-erlangen.de
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    Figure 1.

    Concentration dependent effect of different ALK-Inhibitors. Cell survival response curve of inhibition of non-small cell lung cancer cell lines by different anaplastic lymphoma kinase (ALK)-inhibitors. Wild-type (CCL WT) and echinoderm microtubule-associated protein-like 4 (EML4)-ALK mutated (CCL mutated) cell lines were treated with increasing concentrations of (A) Alectinib, (B) Ceritinib and (C) Crizotinib. Two days after drug treatment viable cells were measured by using water soluble tetrazolium (WST-1)-assay. Data are presented as mean±SEM of 4 separate experiments performed in duplicate.

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    Figure 2.

    Time-dependent effects of (A) different ALK-Inhibitors and (B) different irradiation doses. Time course of inhibition of lung carcinoma cell lines with (CCL mutated) and without anaplastic lymphoma kinase (ALK)-mutation (CCL WT) by (A) treatment with different ALK-inhibitors and (B) irradiation with 6 Gy and 10 Gy compared to no irradiation. Cell survival responses were assessed by performing water soluble tetrazolium (WST-1)-assay at the indicated time points. Data are presented as mean±SEM of 3 separate experiments performed in duplicate. An unpaired t-test was conducted to examine the effect of (A) drug or (B) irradiation on cell survival. Asterisks indicate statistical significance (p<0.05) of (A) the results of the mutated line compared to the wild-type (WT) line (treated with the same drug and measured on the same time) and of (B) 10 Gy-irradiation compared to no irradiation (same cell line, same indicated time of measurement).

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    Figure 3.

    Treatment with ALK-inhibitors plus irradiation - results of day 2 (A) Effect of combined treatment with different anaplastic lymphoma kinase-inhibitors (Alectinib, Ceritinib, Crizotinib), followed by irradiation of the mutated cell line (CCL mutated) and the wild-type cell line (CCL WT). [Exemplary data for irradiation with 10 Gy compared to 0 Gy and cell viability measured using water soluble tetrazolium (WST-1) 2 days after drug treatment.] (B) Comparison of treatment with vehicle (DMSO) followed by irradiation versus combined treatment with different anaplastic lymphoma kinase-inhibitors (Alectinib, Ceritinib, Crizotinib) followed by irradiation of the mutated cell line (CCL mutated) and the wild-type cell line (CCL WT) [Exemplary data for irradiation with 10 Gy and cell viability measured using water soluble tetrazolium (WST-1) 2 days after drug treatment.] Data are presented as mean±SEM of 3 separate experiments performed in duplicate. An unpaired t test was conducted to examine the effect of drug treatment and irradiation on cell survival. There was no statistically significant (p<0.05) differences of the effects of 10 Gy-irradiation compared to no irradiation (A). Asterisks indicate statistically significant (p<0.05) differences between (B) the results of treatment with ALK-inhibitors followed by irradiation and those of treatment with vehicle (DMSO) followed by irradiation.

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    Figure 4.

    Cell death. Cell death following treatment with different anaplastic lymphoma kinase -inhibitors (Alectinib, Ceritinib, Crizotinib) or vehicle (DMSO) followed by irradiation (0 Gy or 10 Gy) of (A) the wild-type and (B) mutated non-small cell lung cancer cell line was measured by flow cytometry. Early apoptosis indicated by Annexin+ /propidium iodide-singlet events (light grey) and necrosis indicated by propidium iodide+ singlet events (dark grey) are illustrated as percentages of the total cell population. Data are presented as mean ±SEM of 3 separate experiments. A one-way ANOVA was conducted to examine the effect of drug treatment and irradiation on cell death. Asterisks indicate statistically significant (p<0.05) differences between the combined treatment (drug + 10 Gy) and drug treatment only (same cell line), or of the sole irradiation (DMSO + 10 Gy) and control (DMSO+0 Gy), all referring to necrosis.

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    Figure 5.

    Cell-cycle analyses. Cell-cycle analyses after treatment with different anaplastic lymphoma kinase -inhibitors (Alectinib, Ceritinib, Crizotinib) or vehicle (DMSO) followed by irradiation (0 Gy or 10 Gy) of (A) the wild-type and (B) the mutant non-small cell lung cancer cell line. Data are presented as mean ±SEM of 4 separate experiments. An unpaired t-test was conducted to examine the effect of drug treatment and irradiation on the distribution of cells in the cell cycle. Asterisks indicate statistically significant (p<0.05) differences between the combined treatment (drug + irradiation) and the sole drug treatment (same cell line) or of the sole irradiation (DMSO + 10Gy) and the control (DMSO+0Gy), all referring to G2-phase.

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Anticancer Research: 40 (9)
Anticancer Research
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September 2020
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ALK Inhibitors Do Not Increase Sensitivity to Radiation in EML4-ALK Non-small Cell Lung Cancer
KATHRIN FLESCHUTZ, LISA WALTER, RUMO LEISTNER, LUCIE HEINZERLING
Anticancer Research Sep 2020, 40 (9) 4937-4946; DOI: 10.21873/anticanres.14497

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ALK Inhibitors Do Not Increase Sensitivity to Radiation in EML4-ALK Non-small Cell Lung Cancer
KATHRIN FLESCHUTZ, LISA WALTER, RUMO LEISTNER, LUCIE HEINZERLING
Anticancer Research Sep 2020, 40 (9) 4937-4946; DOI: 10.21873/anticanres.14497
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Keywords

  • NSCLC
  • ALK inhibitors
  • Ceritinib
  • Crizotinib
  • Alectinib
  • anaplastic lymphoma kinase
  • Radiation
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