IGF1R Contributes to Cell Proliferation in ALK-Mutated Neuroblastoma with Preference for Activating the PI3K-AKT Signaling Pathway

SIMPLE SUMMARY: The insulin-like growth factor 1 receptor (IGF1R) is a receptor tyrosine kinase (RTK) widely expressed in many cancers, including the pediatric cancer neuroblastoma. Aberrant activation of the anaplastic lymphoma kinase (ALK) RTK by activating point mutations or amplification is identified in 5–12% of neuroblastomas. Here, we investigated IGF1R in ALK-driven neuroblastoma, with the aim of understanding its contribution and exploring its potential for targeted therapy. Using ALK-driven neuroblastoma cell lines, we show that ALK-mutated cells are more sensitive to IGF1R inhibition than ALK-amplified cells, and a synergistic effect is obtained when combining ALK and IGF1R inhibitors. Mechanistically, in ALK-mutated neuroblastoma cells, both ALK and IGF1R contribute significantly to the activation of the downstream PI3K-AKT and RAS-MAPK signaling pathways. Our results suggest that differential activation of signaling downstream of the ALK and IGF1R pathways is in part due to preferential recruitment of adaptor proteins. ABSTRACT: Aberrant activation of anaplastic lymphoma kinase (ALK) by activating point mutation or amplification drives 5–12% of neuroblastoma (NB). Previous work has identified the involvement of the insulin-like growth factor 1 receptor (IGF1R) receptor tyrosine kinase (RTK) in a wide range of cancers. We show here that many NB cell lines exhibit IGF1R activity, and that IGF1R inhibition led to decreased cell proliferation to varying degrees in ALK-driven NB cells. Furthermore, combined inhibition of ALK and IGF1R resulted in synergistic anti-proliferation effects, in particular in ALK-mutated NB cells. Mechanistically, both ALK and IGF1R contribute significantly to the activation of downstream PI3K-AKT and RAS-MAPK signaling pathways in ALK-mutated NB cells. However, these two RTKs employ a differential repertoire of adaptor proteins to mediate downstream signaling effects. We show here that ALK signaling led to activation of the RAS-MAPK pathway by preferentially phosphorylating the adaptor proteins GAB1, GAB2, and FRS2, while IGF1R signaling preferentially phosphorylated IRS2, promoting activation of the PI3K-AKT pathway. Together, these findings reveal a potentially important role of the IGF1R RTK in ALK-mutated NB and that co-targeting of ALK and IGF1R may be advantageous in clinical treatment of ALK-mutated NB patients.