Co-targeting BET and MEK as salvage therapy for MAPK and checkpoint inhibitor-resistant melanoma

Ileabett M. Echevarría-Vargas, Patricia I. Reyes-Uribe, Adam N. Guterres, Xiangfan Yin, Andrew V. Kossenkov, Qin Liu, Gao Zhang, Clemens Krepler, Chaoran Cheng, Zhi Wei, Rajasekharan Somasundaram, Giorgos Karakousis, Wei Xu, Jennifer J.D. Morrissette, Yiling Lu, Gordon B. Mills, Ryan J. Sullivan, Miao Benchun, Dennie T. Frederick, Genevieve BolandKeith T. Flaherty, Ashani T. Weeraratna, Meenhard Herlyn, Ravi Amaravadi, Lynn M. Schuchter, Christin E. Burd, Andrew E. Aplin, Xiaowei Xu, Jessie Villanueva

Research output: Contribution to journalArticlepeer-review

66 Scopus citations


Despite novel therapies for melanoma, drug resistance remains a significant hurdle to achieving optimal responses. NRAS-mutant melanoma is an archetype of therapeutic challenges in the field, which we used to test drug combinations to avert drug resistance. We show that BET proteins are overexpressed in NRAS-mutant melanoma and that high levels of the BET family member BRD4 are associated with poor patient survival. Combining BET and MEK inhibitors synergistically curbed the growth of NRAS-mutant melanoma and prolonged the survival of mice bearing tumors refractory to MAPK inhibitors and immunotherapy. Transcriptomic and proteomic analysis revealed that combining BET and MEK inhibitors mitigates a MAPK and checkpoint inhibitor resistance transcriptional signature, downregulates the transcription factor TCF19, and induces apoptosis. Our studies demonstrate that co-targeting MEK and BET can offset therapy resistance, offering a salvage strategy for melanomas with no other therapeutic options, and possibly other treatment-resistant tumor types.

Original languageEnglish (US)
Article numbere8446
JournalEMBO Molecular Medicine
Issue number5
StatePublished - May 2018

All Science Journal Classification (ASJC) codes

  • Molecular Medicine


  • BET
  • combination therapy
  • drug resistance
  • melanoma
  • mutant NRAS


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