Molecular and Cellular Pathobiology Mutationally Activated PIK3CA Cooperates with BRAF to Promote Lung Cancer Progression

Adenocarcinoma of the lung, a leading cause of cancer death, frequently displays mutational activation of the KRAS proto-oncogene but, unlike lung cancers expressing mutated EGFR, ROS1, or ALK, there is no pathway-targeted therapy for patients with KRAS-mutated lung cancer. In preclinical models, expression of oncogenic KRAS in the lung epithelium of adult mice initiates development of lung adenocarcinoma through activation of downstream signaling pathways. In contrast, mutationally activated BRAF, a KRAS effector, fails to initiate lung carcinogenesis despite highly efficient induction of benign lung tumorigenesis. To test if phosphoinositide 3-kinase (PI3K)-a (PIK3CA), another KRAS effector, might cooperate with oncogenic BRAF to promote lung cancer progression, we used mice carrying a conditional allele of Pik3ca that allows conversion of the wild-type catalytic subunit of PIK3CA to mutationally activated PIK3CA. Although expression of PIK3CA in the lung epithelium, either alone or in combination with PTEN silencing, was without phenotype, concomitant expression of BRAF and PIK3CA led to dramatically decreased tumor latency and increased tumor burden compared with BRAF alone. Most notably, coexpression of BRAF and PIK3CA elicited lung adenocarcinomas in a manner reminiscent of the effects of KRAS. These data emphasize a role for PI3K signaling, not in lung tumor initiation per se, but in both the rate of tumor growth and the propensity of benign lung tumors to progress to a malignant phenotype. Finally, biologic and biochemical analysis of BRAF/PIK3CA-expressing mouse lung cancer cells revealed mechanistic clues about cooperative regulation of the cell-division cycle and apoptosis by these oncogenes. Cancer Res; 73(21); 6448–61. 2013 AACR.