Permalink
Switch branches/tags
Nothing to show
Find file
Fetching contributors…
Cannot retrieve contributors at this time
1 lines (1 sloc) 196 KB
<?xml version="1.0" encoding="UTF-8"?><!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Archiving and Interchange DTD v1.1d1 20130915//EN" "JATS-archivearticle1.dtd"><article article-type="research-article" dtd-version="1.1d1" xmlns:xlink="http://www.w3.org/1999/xlink"><front><journal-meta><journal-id journal-id-type="nlm-ta">elife</journal-id><journal-id journal-id-type="hwp">eLife</journal-id><journal-id journal-id-type="publisher-id">eLife</journal-id><journal-title-group><journal-title>eLife</journal-title></journal-title-group><issn publication-format="electronic">2050-084X</issn><publisher><publisher-name>eLife Sciences Publications, Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">00969</article-id><article-id pub-id-type="doi">10.7554/eLife.00969</article-id><article-categories><subj-group subj-group-type="display-channel"><subject>Research article</subject></subj-group><subj-group subj-group-type="heading"><subject>Human biology and medicine</subject></subj-group></article-categories><title-group><article-title>BRAF inhibitors suppress apoptosis through off-target inhibition of JNK signaling</article-title></title-group><contrib-group><contrib contrib-type="author" equal-contrib="yes" id="author-5477"><name><surname>Vin</surname><given-names>Harina</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="equal-contrib">†</xref><xref ref-type="fn" rid="con1"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" equal-contrib="yes" id="author-5478"><name><surname>Ojeda</surname><given-names>Sandra S</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="equal-contrib">†</xref><xref ref-type="fn" rid="con2"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" equal-contrib="yes" id="author-5479"><name><surname>Ching</surname><given-names>Grace</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="equal-contrib">†</xref><xref ref-type="fn" rid="con4"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5480"><name><surname>Leung</surname><given-names>Marco L</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/><xref ref-type="fn" rid="con5"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5481"><name><surname>Chitsazzadeh</surname><given-names>Vida</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/><xref ref-type="fn" rid="con6"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5482"><name><surname>Dwyer</surname><given-names>David W</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="con7"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5483"><name><surname>Adelmann</surname><given-names>Charles H</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="con8"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5484"><name><surname>Restrepo</surname><given-names>Monica</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="con9"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5485"><name><surname>Richards</surname><given-names>Kristen N</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/><xref ref-type="fn" rid="con10"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5486"><name><surname>Stewart</surname><given-names>Larissa R</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff3"/><xref ref-type="fn" rid="con11"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-7586"><name><surname>Du</surname><given-names>Lili</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="fn" rid="con12"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5487"><name><surname>Ferguson</surname><given-names>Scarlett B</given-names></name><xref ref-type="aff" rid="aff4"/><xref ref-type="fn" rid="con13"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5848"><name><surname>Chakravarti</surname><given-names>Deepavali</given-names></name><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff5"/><xref ref-type="fn" rid="con14"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5489"><name><surname>Ehrenreiter</surname><given-names>Karin</given-names></name><xref ref-type="aff" rid="aff6"/><xref ref-type="fn" rid="con16"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5490"><name><surname>Baccarini</surname><given-names>Manuela</given-names></name><xref ref-type="aff" rid="aff6"/><xref ref-type="fn" rid="con17"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5491"><name><surname>Ruggieri</surname><given-names>Rosamaria</given-names></name><xref ref-type="aff" rid="aff7"/><xref ref-type="fn" rid="con18"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5492"><name><surname>Curry</surname><given-names>Jonathan L</given-names></name><xref ref-type="aff" rid="aff8"/><xref ref-type="fn" rid="con19"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5493"><name><surname>Kim</surname><given-names>Kevin B</given-names></name><xref ref-type="aff" rid="aff9"/><xref ref-type="fn" rid="con20"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5494"><name><surname>Ciurea</surname><given-names>Ana M</given-names></name><xref ref-type="aff" rid="aff3"/><xref ref-type="fn" rid="con21"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5495"><name><surname>Duvic</surname><given-names>Madeleine</given-names></name><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff3"/><xref ref-type="fn" rid="con22"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5496"><name><surname>Prieto</surname><given-names>Victor G</given-names></name><xref ref-type="aff" rid="aff8"/><xref ref-type="fn" rid="con23"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5497"><name><surname>Ullrich</surname><given-names>Stephen E</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/><xref ref-type="fn" rid="con15"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-4311"><name><surname>Dalby</surname><given-names>Kevin N</given-names></name><xref ref-type="aff" rid="aff4"/><xref ref-type="other" rid="par-6"/><xref ref-type="other" rid="par-7"/><xref ref-type="fn" rid="con24"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" id="author-5287"><name><surname>Flores</surname><given-names>Elsa R</given-names></name><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff5"/><xref ref-type="fn" rid="con25"/><xref ref-type="fn" rid="conf1"/></contrib><contrib contrib-type="author" corresp="yes" id="author-5286"><name><surname>Tsai</surname><given-names>Kenneth Y</given-names></name><xref ref-type="aff" rid="aff1"/><xref ref-type="aff" rid="aff2"/><xref ref-type="aff" rid="aff3"/><xref ref-type="corresp" rid="cor1">*</xref><xref ref-type="other" rid="par-1"/><xref ref-type="other" rid="par-2"/><xref ref-type="other" rid="par-3"/><xref ref-type="other" rid="par-4"/><xref ref-type="other" rid="par-5"/><xref ref-type="fn" rid="con3"/><xref ref-type="fn" rid="conf1"/></contrib><aff id="aff1"><institution content-type="dept">Department of Immunology</institution>, <institution>University of Texas MD Anderson Cancer Center</institution>, <addr-line><named-content content-type="city">Houston</named-content></addr-line>, <country>United States</country></aff><aff id="aff2"><institution content-type="dept">Graduate School of Biomedical Sciences at Houston</institution>, <institution>University of Texas</institution>, <addr-line><named-content content-type="city">Houston</named-content></addr-line>, <country>United States</country></aff><aff id="aff3"><institution content-type="dept">Department of Dermatology</institution>, <institution>University of Texas MD Anderson Cancer Center</institution>, <addr-line><named-content content-type="city">Houston</named-content></addr-line>, <country>United States</country></aff><aff id="aff4"><institution content-type="dept">Division of Medicinal Chemistry, College of Pharmacy</institution>, <institution>University of Texas</institution>, <addr-line><named-content content-type="city">Austin</named-content></addr-line>, <country>United States</country></aff><aff id="aff5"><institution content-type="dept">Department of Biochemistry and Molecular Biology</institution>, <institution>University of Texas MD Anderson Cancer Center</institution>, <addr-line><named-content content-type="city">Houston</named-content></addr-line>, <country>United States</country></aff><aff id="aff6"><institution>Max F Perutz Laboratories</institution>, <addr-line><named-content content-type="city">Vienna</named-content></addr-line>, <country>Austria</country></aff><aff id="aff7"><institution content-type="dept">Center for Oncology and Cell Biology</institution>, <institution>Feinstein Institute for Medical Research</institution>, <addr-line><named-content content-type="city">Manhasset</named-content></addr-line>, <country>United States</country></aff><aff id="aff8"><institution content-type="dept">Department of Pathology</institution>, <institution>University of Texas MD Anderson Cancer Center</institution>, <addr-line><named-content content-type="city">Houston</named-content></addr-line>, <country>United States</country></aff><aff id="aff9"><institution content-type="dept">Department of Melanoma Medical Oncology</institution>, <institution>University of Texas MD Anderson Cancer Center</institution>, <addr-line><named-content content-type="city">Houston</named-content></addr-line>, <country>United States</country></aff></contrib-group><contrib-group content-type="section"><contrib contrib-type="editor"><name><surname>Davis</surname><given-names>Roger</given-names></name><role>Reviewing editor</role><aff><institution>University of Massachusetts Medical School</institution>, <country>United States</country></aff></contrib></contrib-group><author-notes><corresp id="cor1"><label>*</label>For correspondence: <email>kytsai@mdanderson.org</email></corresp><fn fn-type="con" id="equal-contrib"><label>†</label><p>These authors contributed equally to this work</p></fn></author-notes><pub-date date-type="pub" publication-format="electronic"><day>05</day><month>11</month><year>2013</year></pub-date><pub-date pub-type="collection"><year>2013</year></pub-date><volume>2</volume><elocation-id>e00969</elocation-id><history><date date-type="received"><day>20</day><month>05</month><year>2013</year></date><date date-type="accepted"><day>01</day><month>10</month><year>2013</year></date></history><permissions><copyright-statement>© 2013, Vin et al</copyright-statement><copyright-year>2013</copyright-year><copyright-holder>Vin et al</copyright-holder><license xlink:href="http://creativecommons.org/licenses/by/3.0/"><license-p>This article is distributed under the terms of the <ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by/3.0/">Creative Commons Attribution License</ext-link>, which permits unrestricted use and redistribution provided that the original author and source are credited.</license-p></license></permissions><self-uri content-type="pdf" xlink:href="elife00969.pdf"/><abstract><object-id pub-id-type="doi">10.7554/eLife.00969.001</object-id><p>Vemurafenib and dabrafenib selectively inhibit the v-Raf murine sarcoma viral oncogene homolog B1 (BRAF) kinase, resulting in high response rates and increased survival in melanoma. Approximately 22% of individuals treated with vemurafenib develop cutaneous squamous cell carcinoma (cSCC) during therapy. The prevailing explanation for this is drug-induced paradoxical ERK activation, resulting in hyperproliferation. Here we show an unexpected and novel effect of vemurafenib/PLX4720 in suppressing apoptosis through the inhibition of multiple off-target kinases upstream of c-Jun N-terminal kinase (JNK), principally ZAK. JNK signaling is suppressed in multiple contexts, including in cSCC of vemurafenib-treated patients, as well as in mice. Expression of a mutant ZAK that cannot be inhibited reverses the suppression of JNK activation and apoptosis. Our results implicate suppression of JNK-dependent apoptosis as a significant, independent mechanism that cooperates with paradoxical ERK activation to induce cSCC, suggesting broad implications for understanding toxicities associated with BRAF inhibitors and for their use in combination therapies.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.001">http://dx.doi.org/10.7554/eLife.00969.001</ext-link></p></abstract><abstract abstract-type="executive-summary"><object-id pub-id-type="doi">10.7554/eLife.00969.002</object-id><title>eLife digest</title><p>Over 50% of melanomas, a highly lethal form of skin cancer, carry mutations in a gene called BRAF. The BRAF gene encodes an enzyme that helps to regulate the proliferation of cells, but mutations in this gene lead to the excessive proliferation that is seen in cancer. Clinical trials have shown that a drug called vemurafenib can be used to treat patients who carry the mutated BRAF genes and go on to develop melanoma, but around one fifth of these patients developed another type of skin cancer called cSCC (cutaneous squamous cell carcinoma).</p><p>The cSCC tumors often develop in areas where the sun has damaged the patient’s skin, and it is thought that their growth is then accelerated by vemurafenib activating another enzyme, ERK, which causes the excessive proliferation of skin cells. Vin et al. have now found that vemurafenib might also cause cSCC tumors by blocking another signaling pathway. The experiments were performed in human cells and also in mice, and the results were then verified in human cSCC samples.</p><p>Cells that are exposed to UV radiation usually die, but when treated with vemurafenib, some 70% of the cells that would have died instead survived. The stress from the UV radiation activates the JNK signaling pathway, which causes the irradiated cells to die. However, Vin et al. found that cSCC cells had very low levels of JNK signaling because treatment with vemurafenib had the unintended effect of inhibiting three enzymes that are needed to fully activate the JNK signaling pathway.</p><p>Vin et al. estimate that suppression of JNK signaling and cell death is responsible for about 17.6 to 40% of the effect on cSCC growth seen in melanoma patients, with activation of the ERK pathway accounting for the rest. These unexpected findings suggest that combining vemurafenib treatment with radiation or chemotherapy should be done with caution as these effects could affect their efficacy. It also suggests that future drugs should be designed in a way that avoids these types of effects by making sure they do not inhibit important ‘off-target’ enzymes.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.002">http://dx.doi.org/10.7554/eLife.00969.002</ext-link></p></abstract><kwd-group kwd-group-type="author-keywords"><title>Author keywords</title><kwd>protein kinase</kwd><kwd>cancer</kwd><kwd>apoptosis</kwd><kwd>melanoma</kwd><kwd>squamous cell carcinoma</kwd><kwd>targeted therapy</kwd></kwd-group><kwd-group kwd-group-type="research-organism"><title>Research organism</title><kwd>Human</kwd><kwd>Mouse</kwd></kwd-group><funding-group><award-group id="par-1"><funding-source><institution-wrap><institution>American Skin Association</institution></institution-wrap></funding-source><principal-award-recipient><name><surname>Tsai</surname><given-names>Kenneth Y</given-names></name></principal-award-recipient></award-group><award-group id="par-2"><funding-source><institution-wrap><institution>Elsa U Pardee Foundation</institution></institution-wrap></funding-source><principal-award-recipient><name><surname>Tsai</surname><given-names>Kenneth Y</given-names></name></principal-award-recipient></award-group><award-group id="par-3"><funding-source><institution-wrap><institution>University of Texas MD Anderson IRG Program</institution></institution-wrap></funding-source><principal-award-recipient><name><surname>Tsai</surname><given-names>Kenneth Y</given-names></name></principal-award-recipient></award-group><award-group id="par-4"><funding-source><institution-wrap><institution>DX Biosciences Cancer Research Fund</institution></institution-wrap></funding-source><principal-award-recipient><name><surname>Tsai</surname><given-names>Kenneth Y</given-names></name></principal-award-recipient></award-group><award-group id="par-5"><funding-source><institution-wrap><institution>National Cancer Institute</institution></institution-wrap></funding-source><award-id>CA16672</award-id><principal-award-recipient><name><surname>Tsai</surname><given-names>Kenneth Y</given-names></name></principal-award-recipient></award-group><award-group id="par-6"><funding-source><institution-wrap><institution>National Institutes of Health</institution></institution-wrap></funding-source><award-id>GM059802, CA167505</award-id><principal-award-recipient><name><surname>Dalby</surname><given-names>Kevin N</given-names></name></principal-award-recipient></award-group><award-group id="par-7"><funding-source><institution-wrap><institution>Welch Foundation</institution></institution-wrap></funding-source><award-id>(F-1390)</award-id><principal-award-recipient><name><surname>Dalby</surname><given-names>Kevin N</given-names></name></principal-award-recipient></award-group><funding-statement>The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.</funding-statement></funding-group><custom-meta-group><custom-meta><meta-name>elife-xml-version</meta-name><meta-value>2</meta-value></custom-meta><custom-meta specific-use="meta-only"><meta-name>Author impact statement</meta-name><meta-value>The cancer drug vemurafenib has potent off-target effects on JNK signaling that contribute to the development of squamous cell carcinomas in humans and in mice.</meta-value></custom-meta></custom-meta-group></article-meta></front><body><sec id="s1" sec-type="intro"><title>Introduction</title><p>BRAF inhibitors (BRAFi) have revolutionized the treatment of melanoma (<xref ref-type="bibr" rid="bib22">Flaherty et al., 2010</xref>; <xref ref-type="bibr" rid="bib10">Chapman et al., 2011</xref>; <xref ref-type="bibr" rid="bib54">Sosman et al., 2012</xref>; <xref ref-type="bibr" rid="bib21">Falchook et al., 2012</xref>; <xref ref-type="bibr" rid="bib30">Hauschild et al., 2012</xref>; <xref ref-type="bibr" rid="bib42a">Long et al., 2012</xref>). Their clinical use is associated with the development of keratinocytic tumors including cSCC (<xref ref-type="bibr" rid="bib22">Flaherty et al., 2010</xref>; <xref ref-type="bibr" rid="bib10">Chapman et al., 2011</xref>; <xref ref-type="bibr" rid="bib54">Sosman et al., 2012</xref>; <xref ref-type="bibr" rid="bib30">Hauschild et al., 2012</xref>; <xref ref-type="bibr" rid="bib21">Falchook et al., 2012</xref>; <xref ref-type="bibr" rid="bib42a">Long et al., 2012</xref>). Mechanistic studies of this have centered on paradoxical ERK activation, which is most evident in <italic>BRAF</italic>-wild-type, <italic>RAS</italic>-mutant cells, as the primary mechanism (<xref ref-type="bibr" rid="bib38">Karreth et al., 2009</xref>; <xref ref-type="bibr" rid="bib27">Halaban et al., 2010</xref>; <xref ref-type="bibr" rid="bib29">Hatzivassiliou et al., 2010</xref>; <xref ref-type="bibr" rid="bib31">Heidorn et al., 2010</xref>; <xref ref-type="bibr" rid="bib51">Poulikakos et al., 2010</xref>). This is supported by the findings that <italic>RAS</italic> mutations are significantly enriched in cSCC arising in patients treated with vemurafenib relative to sporadic cSCC (<xref ref-type="bibr" rid="bib47">Oberholzer et al., 2011</xref>; <xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>), and by the low rate of cSCC in patients treated with combined BRAFi and MEK inhibitor (MEKi) (<xref ref-type="bibr" rid="bib22a">Flaherty et al., 2012</xref>). In one model, drug binding relieves the autoinhibition of BRAF whereupon it is recruited to the membrane by activated RAS and dimerizes with CRAF, driving MEK-dependent ERK activation (<xref ref-type="bibr" rid="bib31">Heidorn et al., 2010</xref>). Other studies show ERK hyperactivation resulting from drug-induced CRAF transactivation (<xref ref-type="bibr" rid="bib29">Hatzivassiliou et al., 2010</xref>; <xref ref-type="bibr" rid="bib51">Poulikakos et al., 2010</xref>) and modulation of RAS spatiotemporal dynamics (<xref ref-type="bibr" rid="bib15">Cho et al., 2012</xref>). Inhibitor-induced KSR1-BRAF dimers modulate the activity of ERK (<xref ref-type="bibr" rid="bib43">McKay et al., 2011</xref>) and also affect MEK signaling by activating KSR1 kinase activity (<xref ref-type="bibr" rid="bib5">Brennan et al., 2011</xref>; <xref ref-type="bibr" rid="bib33">Hu et al., 2011</xref>). These models all highlight the importance of CRAF in driving MEK-dependent hyperactivation of ERK.</p><p>Because of the rapid development of these cSCC on BRAFi therapy and the enrichment for <italic>RAS</italic> mutations, pre-existing genetic lesions are likely present prior to therapy, which are then ‘unmasked’ following initiation of BRAFi therapy. The fact that many arise in sun-damaged skin suggests that prior chronic UV exposure is an important predisposing event (<xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>).</p><p>We instead hypothesized that vemurafenib and PLX4720 could also affect the susceptibility of cells to apoptosis and in so doing, contribute to the acceleration of tumor development. We studied the acute ultraviolet radiation (UVR) response because this is the most important environmental risk factor in the development of skin cancer and because many BRAFi-induced cSCC arise in sun-damaged areas (<xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>). PLX4720 and vemurafenib share structural features (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>; <xref ref-type="bibr" rid="bib4">Bollag et al., 2010</xref>) and have similar activities, as is the case in our studies.</p></sec><sec id="s2" sec-type="results"><title>Results</title><sec id="s2-1"><title>BRAFi suppress stress-induced, JNK-dependent apoptosis</title><p>We performed our initial studies using cSCC (SRB1, SRB12, COLO16) and keratinocyte (HaCaT) cell lines. Cells treated with 1 kJ/m<sup>2</sup> of UVB (FS40 lamp) undergo apoptosis within 24 hr (<xref ref-type="fig" rid="fig1">Figure 1A–D</xref>). Surprisingly, this apoptosis was suppressed by at least 70% in cells concomitantly treated with 1 μM PLX4720 (<xref ref-type="fig" rid="fig1">Figure 1A–D</xref>) compared to control DMSO-treated cells as measured by FACS for Annexin V+; TMRE (tetramethylrhodamine)-low cells (<xref ref-type="fig" rid="fig1">Figure 1E</xref>, <xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1A–C</xref>). Similar results were obtained using doxorubicin as the inducer of apoptosis, and similar suppression of apoptosis was obtained using 1 μM PLX4720 in all cells (<xref ref-type="fig" rid="fig1s2">Figure 1—figure supplement 2A,B</xref>). Importantly, these cells have no oncogenic <italic>RAS</italic> or <italic>BRAF</italic> mutations (<xref ref-type="table" rid="tbl1">Table 1</xref>), and PLX4720 conferred no significant proliferative advantage to the tested cells (<xref ref-type="fig" rid="fig1s3">Figure 1—figure supplement 3</xref>) even when used at concentrations that inhibit the proliferation of <italic>BRAF</italic><sup><italic>V600E</italic></sup> melanoma cell lines (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>).<fig-group><fig id="fig1" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.003</object-id><label>Figure 1.</label><caption><title>PLX4720 suppresses UV-induced apoptosis.</title><p>The cSCC and HaCaT cell lines were either unirradiated or irradiated with 1 kJ/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM PLX4720 and isolated for FACS analysis and protein extracts 24 hr later. (<bold>A</bold>) SRB1, (<bold>B</bold>) SRB12, (<bold>C</bold>) COLO16, and (<bold>D</bold>) HaCaT cells show at least 70% suppression of apoptosis in the presence of PLX4720 as measured by FACS for Annexin V+, TMRE-low cells (n = 6 for each cell line, ‘*’ denotes statistical significance at p&lt;0.05). (<bold>E</bold>) A representative FACS plot for COLO16 is shown. Annexin V+, TMRE-low cells are contained in the upper left quadrant (boxed), which was significantly populated in UV-irradiated cells, but not in the absence of UV, or in the presence of PLX4720. (<bold>F</bold>) Western blots probed for the MAP kinases demonstrated strong phospho-JNK and phospho-p38 induction following irradiation and significant suppression by PLX4720. Phospho-ERK was slightly induced following irradiation, and at 24 hr, paradoxical hyperactivation in the presence of PLX4720 was observed, particularly in SRB1 and HaCaT cells. (<bold>G</bold>) Western blots showed that BIM was not upregulated in these <italic>BRAF</italic>-wild-type cells, consistent with intact ERK signaling. MCL1 was downregulated by irradiation and not modulated by PLX4720, whereas NOXA expression was strongly induced in irradiated cells and suppressed by PLX4720. (<bold>H</bold>) Western blots of <italic>BRAF</italic><sup><italic>V600E</italic></sup> melanoma cell lines, A375 and WM35, demonstrated suppression of UV-mediated induction of phospho-JNK and phospho-p38 by PLX4720 at 24 hr. As expected, phospho-ERK is shut down in PLX4720-treated cells.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.003">http://dx.doi.org/10.7554/eLife.00969.003</ext-link></p></caption><graphic xlink:href="elife00969f001"/></fig><fig id="fig1s1" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.004</object-id><label>Figure 1—figure supplement 1.</label><caption><title>PLX4720 potently suppresses apoptosis in cSCC, HaCaT cell lines, and NHEK cells.</title><p>Representative FACS plots of Annexin V vs TMRE in SRB1 (<bold>A</bold>), SRB12 (<bold>B</bold>), HaCaT (<bold>C</bold>), and NHEK (<bold>D</bold>) cells demonstrated low levels of apoptosis (Annexin V+, TMRE-low in quadrant 1) in unirradiated cells in the presence and absence of 1 μM PLX4720. Significant levels of apoptosis were seen in all control-treated irradiated cells, which were significantly suppressed in the presence of PLX4720, by at least 70% in all cells tested.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.004">http://dx.doi.org/10.7554/eLife.00969.004</ext-link></p></caption><graphic xlink:href="elife00969fs001"/></fig><fig id="fig1s2" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.005</object-id><label>Figure 1—figure supplement 2.</label><caption><title>PLX4720 suppresses doxorubicin-induced JNK activation and apoptosis in cSCC and HaCaT cell lines.</title><p>COLO16 and HaCaT cell lines were either treated with doxorubicin or PBS and lysed 24 hr later in the absence (‘o’, 1:2000 DMSO) or presence (“+”) of 1 μM PLX4720. (<bold>A</bold>) COLO16 and (<bold>B</bold>) HaCaT cells showed significant decrease in apoptosis measured by FACS for Annexin V+, TMRE-low cells (n = 3 for each cell line, ‘*’ denotes statistical significance at p&lt;0.05). (<bold>C</bold>) Western blots were probed for phospho-JNK and total JNK, showing a potent activation of JNK by doxorubicin that is significantly suppressed by PLX4720.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.005">http://dx.doi.org/10.7554/eLife.00969.005</ext-link></p></caption><graphic xlink:href="elife00969fs002"/></fig><fig id="fig1s3" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.006</object-id><label>Figure 1—figure supplement 3.</label><caption><title>PLX4720 does not confer a proliferative advantage to cSCC and HaCaT cell lines.</title><p>(<bold>A</bold>) SRB1, (<bold>B</bold>) SRB12, (<bold>C</bold>) COLO16, and (<bold>D</bold>) HaCaT cells were treated with DMSO (1:2000) or the indicated concentrations of PLX4720 for at least 28 days during which cells were serially passaged and counted. Over that time frame there was a slight decrement in the proliferation of SRB12 and HaCaT cells in the presence of 1 μM PLX4720. All cells treated at 5 μM PLX4720 exhibited decreased proliferation.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.006">http://dx.doi.org/10.7554/eLife.00969.006</ext-link></p></caption><graphic xlink:href="elife00969fs003"/></fig></fig-group><table-wrap id="tbl1" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.007</object-id><label>Table 1.</label><caption><p>Lack of <italic>BRAF</italic> and <italic>RAS</italic> mutations in cSCC and HaCaT cell lines</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.007">http://dx.doi.org/10.7554/eLife.00969.007</ext-link></p></caption><table frame="hsides" rules="groups"><tbody><tr><td>ALK_F1174LIV_T3520CAG</td><td>ALK_F1245C_T3734G</td></tr><tr><td>ALK_F1245VI_T3733GA</td><td>BRAF_G464EVA_G1391ATC</td></tr><tr><td>BRAF_G466R_G1396CA</td><td>BRAF_K601E_A1801G</td></tr><tr><td>BRAF_V600EAG_T1799ACG_F</td><td>CTNNB1_S45APT_T133GCA</td></tr><tr><td>CTNNB1_T41APS_A121GCS</td><td>EGFR_Y813C_A2438G</td></tr><tr><td>GNAS_R201SC_C601AT</td><td>KRAS_G12SRC_G34ACT</td></tr><tr><td>KRAS_Q61EKX_C181GAT</td><td>MET_H1112_A3335GT</td></tr><tr><td>MET_Y1248HD_T3742CG</td><td>PIK3CA_A1046V_C3137T</td></tr><tr><td>PIK3CA_C420R_T1258C</td><td>PIK3CA_E110K_G328A</td></tr><tr><td>PIK3CA_E418K_G1252A</td><td>PIK3CA_F909L_C2727G</td></tr><tr><td>PIK3CA_H1047RL_A3140 GT</td><td>PIK3CA_H701P_A2102C</td></tr><tr><td>PIK3CA_N345K_T1035A</td><td>PIK3CA_Q060K_C178A</td></tr><tr><td>PIK3CA_R088Q_G263A</td><td>PIK3CA_S405F_C1214T</td></tr><tr><td>TNK2_R99Q_G296A</td><td>BRAF_G466EVA_G1397ATC</td></tr><tr><td>BRAF_V600LM_G1798 TA</td><td>CTNNB1_S37APT_T109GCA</td></tr><tr><td>CTNNB1_S45CFY_C134GTA</td><td>EGFR_G719_G2155TA</td></tr><tr><td>EGFR_L858R_T2573G</td><td>EGFR_T790M_C2369T</td></tr><tr><td>EPHA3_K761N_G2283</td><td>FGFR2_S252W_C755G</td></tr><tr><td>FOXL2_C134W_C402G</td><td>KIT_K642E_A1924G</td></tr><tr><td>KIT_R634W_C1900T</td><td>KIT_V560D_T1679A</td></tr><tr><td>KIT_V825A_T2474C</td><td>KIT_Y553N_T1657A</td></tr><tr><td>KRAS_G12DAV_G35ACT</td><td>MET_N375S_A1124G</td></tr><tr><td>NRAS_G12SRC_G34ACT</td><td>PIK3CA_E453K_G1357A</td></tr><tr><td>PIK3CA_E545AGV_A1634CGT</td><td>PIK3CA_H1047RL_A3140 GT..1.</td></tr><tr><td>PIK3CA_K111N_G333C</td><td>PIK3CA_M1043V_A3127G</td></tr><tr><td>PIK3CA_P539R_C1616G</td><td>BRAF_E586K_G1756A</td></tr><tr><td>BRAF_G469EVA_G1406ATC</td><td>CTNNB1_S33APT_T97GCA</td></tr><tr><td>CTNNB1_S37CFY_C110GTA</td><td>EGFR_L861_T2582AG</td></tr><tr><td>EGFR_T854I_C2561T</td><td>FGFR2_N549KK_T1647GA</td></tr><tr><td>FRAP_R2505P_G7514C</td><td>FRAP_S2215Y_C6644T</td></tr><tr><td>IDH2_R172MK_G515 TA</td><td>JAK2_V617F_G1849T</td></tr><tr><td>KIT_L576P_T1727C</td><td>KIT_N566D_A1696 G</td></tr><tr><td>KRAS_A146PT_G436CA</td><td>NRAS_G12DAV_G35ACT</td></tr><tr><td>KRAS_Q61HHE_A183CTG</td><td>KRAS_G13SRC_G37ACT</td></tr><tr><td>NRAS_G13DAV_G38ACT</td><td>NRAS_Q61HHQ_A183TCG</td></tr><tr><td>PDGFRA_N659Y_A1975T</td><td>PDGFRA_V561D_T1682A</td></tr><tr><td>PIK3CA_E545KQ_G1633AC</td><td>PIK3CA_H1047Y_C3139T</td></tr><tr><td>PIK3CA_Q546EK_C1636 GA</td><td>PIK3CA_Y1021HN_T3061CA</td></tr><tr><td>RET_M918T_T2753C</td><td>AKT1_G173R_G517C</td></tr><tr><td>AKT2_E17K_G49A</td><td>BRAF_G469R_G1405CA</td></tr><tr><td>BRAF_L597R_T1790G</td><td>BRAF_V600_G1800</td></tr><tr><td>CTNNB1_G34EVA_G101ATC</td><td>EGFR_S720P_T2158C</td></tr><tr><td>GNA11_Q209LP_A626 TC</td><td>IDH1_R132CGS_C394TGA</td></tr><tr><td>IDH2_R140LQ_G419 TA</td><td>IDH2_R140W_C418T</td></tr><tr><td>IDH2_R172S_G516T</td><td>KIT_D816HNY_G2446CAT</td></tr><tr><td>KIT_V559ADG_T1676CAG</td><td>KRAS_G10R_G28A</td></tr><tr><td>KRAS_Q61LPR_A182TCG</td><td>MET_H1112Y_C3334T</td></tr><tr><td>MET_M1268T_T3803C</td><td>MET_T1010I_C3029T</td></tr><tr><td>NRAS_A146T_G436A</td><td>NRAS_Q61EKX_C181GAT</td></tr><tr><td>PDGFRA_D842V_A2525T</td><td>PDGFRA_D842_G2524TA</td></tr><tr><td>PDGFRA_N659K_C1977A</td><td>PIK3CA_E542KQ_G1624AC</td></tr><tr><td>PIK3CA_G1049R_G3145C</td><td>PIK3CA_M1043I_G3129ATC</td></tr><tr><td>PIK3R1_D560Y_G1678T</td><td>PRKAG2_N488I_A1463T</td></tr><tr><td>AKT2_G175R_G523C</td><td>AKT3_G171R_G511A</td></tr><tr><td>ALK_F1174L_C3522AG</td><td>ALK_I1171N_T3512A</td></tr><tr><td>ALK_R1275QL_G3824AT</td><td>BRAF_D594GV_A1781 GT</td></tr><tr><td>CTNNB1_D32HNY_G94CAT</td><td>FBWX7_R465C_C1393T</td></tr><tr><td>FBWX7_R479QL_G1436AT</td><td>FBWX7_R505HLP_G1514ATC</td></tr><tr><td>FGFR3_G370C_G1108T</td><td>GNAQ_Q209H_A627T</td></tr><tr><td>IDH2_R140W_C419T</td><td>IDH2_R172GW_A514 GT</td></tr><tr><td>KIT_N822KNK_T2466GCA</td><td>KRAS_G13DAV_G38ACT</td></tr><tr><td>PDPK1_D527E_C1581G</td><td>PIK3CA_E542VG_A1625TG</td></tr><tr><td>PIK3CA_E545D_G1635CT</td><td>PIK3CA_T1025SA_A3073TG</td></tr><tr><td>PIK3CA_Y1021C_A3062G</td><td>PIK3R1_N564K_C1693AG</td></tr><tr><td>PRKAG1_R70Q_G209A</td><td>AKT1_E17K_G49A</td></tr><tr><td>AKT1_K179M_A536T</td><td>BRAF_V600EAG_T1799ACG_R</td></tr><tr><td>CDK4_R24C_C70T</td><td>CDK4_R24H_G71A</td></tr><tr><td>CTNNB1_D32AGT_A95CGV</td><td>FBWX7_R465HL_G1394AT</td></tr><tr><td>FGFR3_G697C_G2089T</td><td>FGFR3_K650MT_A1949 TC</td></tr><tr><td>FGFR3_R248C_C742T</td><td>FGFR3_S371C_A1111T</td></tr><tr><td>FGFR3_Y373C_A1118G</td><td>GNAS_R201H_G602A</td></tr><tr><td>IDH1_R132HL_G395AT</td><td>KIT_N822YHD_A2464TCG</td></tr><tr><td>MET_R988C_C2962T</td><td>MET_Y1253D_T3757 G</td></tr><tr><td>NRAS_G13SRC_G37ACT</td><td>NRAS_Q61RPL_A182GCT</td></tr><tr><td>PIK3CA_Q546LPR_A1637TCG</td><td>TNK2_E346K_G1036A</td></tr><tr><td>PIK3CA_H1047RL_A3140 GT</td><td>ALK_F1245C_T3734G</td></tr></tbody></table><table-wrap-foot><fn><p>The listed gene mutations were screened by Sequenom INT16/20 panel (Characterized Cell Line Core, MD Anderson Cancer Center) and <italic>HRAS</italic> was sequenced by Sanger sequencing. All examined loci were wild-type in the cSCC cell lines SRB1, SRB12, COLO16, and keratinocyte cell line HaCaT. The PIK3R1_M326I_G978 polymorphism was found in the SRB12 cell line.</p></fn></table-wrap-foot></table-wrap></p><p>Because the p38 and JNK stress-activated MAP kinases are well-established critical mediators of UV-induced apoptosis (<xref ref-type="bibr" rid="bib20">Derijard et al., 1994</xref>; <xref ref-type="bibr" rid="bib11">Chen et al., 1996</xref>; <xref ref-type="bibr" rid="bib61">Tournier et al., 2000</xref>; <xref ref-type="bibr" rid="bib32">Hildesheim et al., 2004</xref>), we explored the status of JNK and p38 activation by assessing phospho-JNK and phospho-p38 levels by Western blot (<xref ref-type="fig" rid="fig1">Figure 1F</xref>). Phospho-JNK levels in particular were highly upregulated upon UV irradiation and were significantly suppressed by treatment post-radiation with 1 μM PLX4720 in cSCC and HaCaT cell lines (<xref ref-type="fig" rid="fig1">Figure 1F</xref>). Similar effects were seen with 1 μM vemurafenib (data not shown) and in cells stressed with doxorubicin (<xref ref-type="fig" rid="fig1s2">Figure 1—figure supplement 2C</xref>). Importantly, ERK signaling remained intact, as evidenced both by the paradoxical activation of ERK (upregulation of phospho-ERK) and by the failure to upregulate BIM levels (<xref ref-type="fig" rid="fig1">Figure 1F,G</xref>). This pro-apoptotic BCL2 family member is upregulated by inhibition of ERK signaling (<xref ref-type="bibr" rid="bib16">Collins et al., 2005</xref>) and in <italic>BRAF</italic><sup><italic>V600E</italic></sup> melanoma cells treated with vemurafenib (<xref ref-type="bibr" rid="bib50">Paraiso et al., 2011</xref>). Since NOXA is a downstream effector of UV-induced apoptosis (<xref ref-type="bibr" rid="bib46">Naik et al., 2007</xref>), we examined its expression and found that NOXA expression is induced by UV irradiation and suppressed by PLX4720 in all cell lines (<xref ref-type="fig" rid="fig1">Figure 1G</xref>), suggesting that inhibition of NOXA expression may be a mechanism of PLX4720-induced suppression of apoptosis. Finally, we examined the expression of the antiapoptotic BCL2 family member MCL1 because it is downregulated by UV exposure (<xref ref-type="fig" rid="fig1">Figure 1G</xref>), but as previously reported (<xref ref-type="bibr" rid="bib50">Paraiso et al., 2011</xref>), unaffected by PLX4720 (<xref ref-type="fig" rid="fig1">Figure 1G</xref>).</p><p>To test the generality of these effects in cells in which ERK activity is suppressed by BRAFi, we extended our analysis to the BRAF<sup>V600E</sup> melanoma cells A375 and WM35. As expected, phospho-ERK expression was strongly suppressed by PLX4720 (<xref ref-type="fig" rid="fig1">Figure 1H</xref>). Phospho-JNK and phospho-p38 were significantly upregulated following UV-irradiation (<xref ref-type="fig" rid="fig1">Figure 1H</xref>), showing that signaling to JNK and p38 is intact in <italic>BRAF</italic><sup><italic>V600E</italic></sup> melanoma cells. Here again, there was significant suppression of both phospho-p38 and phospho-JNK induction by PLX4720 (<xref ref-type="fig" rid="fig1">Figure 1H</xref>), and similar effects were seen with vemurafenib (data not shown).</p><p>We next examined the responses of primary normal human epidermal keratinocytes (NHEKs) to vemurafenib. UV-induced apoptosis was significantly suppressed (approximately 70%) by vemurafenib in these cells (<xref ref-type="fig" rid="fig2">Figure 2A</xref>, <xref ref-type="fig" rid="fig1s1">Figure 1—figure supplement 1D</xref>), and the UV-induced upregulation of phospho-JNK and phospho-p38 was likewise suppressed most significantly at 6 and 24 hr (<xref ref-type="fig" rid="fig2">Figure 2B</xref>). As in the cSCC and HaCaT cell lines, activation of ERK was observed following exposure to vemurafenib (<xref ref-type="fig" rid="fig2">Figure 2B</xref>). The presence of cleaved caspase-3 correlated with high levels of apoptosis in the UV-treated cells and its absence with rescue by vemurafenib at 24 hr post-irradiation (<xref ref-type="fig" rid="fig2">Figure 2C</xref>). In probing members of the BCL2 family, we found similar results to those in the cSCC and HaCaT cell lines. BIM and MCL1 were unaffected by vemurafenib but NOXA induction at 24 hr post-UV irradiation was diminished by vemurafenib (<xref ref-type="fig" rid="fig2">Figure 2C</xref>). The advantage of using primary cells is that <italic>p53</italic> is intact. In NHEKs, p53 is stabilized by 24 hr post-UV irradiation and this is unaffected by vemurafenib (<xref ref-type="fig" rid="fig2">Figure 2C</xref>). However, since BCL2 family members can be modulated by JNK (<xref ref-type="bibr" rid="bib61">Tournier et al., 2000</xref>; <xref ref-type="bibr" rid="bib26">Haeusgen et al., 2011</xref>) and p53 (<xref ref-type="bibr" rid="bib48">Oda et al., 2000</xref>) in apoptosis, the inhibition of NOXA expression by PLX4720 and vemurafenib (<xref ref-type="fig" rid="fig1 fig2">Figures 1G and 2C</xref>) likely reflects <italic>p53</italic>-independent regulation of NOXA given that <italic>p53</italic> is mutant in HaCaT (<xref ref-type="bibr" rid="bib41">Lehman et al., 1993</xref>) cells, p53 is undetectable in SRB12 cells, and p53 levels do not change with radiation in SRB1, COLO16, or HaCaT cells, (<xref ref-type="fig" rid="fig2s1">Figure 2—figure supplement 1</xref>). PUMA, BAX, BCL2, BCL-XL, and BCL2A1 expression were unchanged following irradiation and were unchanged by PLX4720 or vemurafenib exposure (data not shown, <xref ref-type="fig" rid="fig2s2">Figure 2—figure supplement 2</xref>). We conclude from our results that vemurafenib and PLX4720 suppress UV-induced apoptosis by inhibiting JNK signaling and NOXA induction in <italic>BRAF</italic> and <italic>RAS</italic> WT cells.<fig-group><fig id="fig2" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.008</object-id><label>Figure 2.</label><caption><title>Vemurafenib and PLX4720 suppress apoptosis and JNK signaling in primary human keratinocytes and cSCC cells independently of MEK/ERK signaling.</title><p>Normal human epidermal keratinocytes (NHEKs) were irradiated with 1 kJ/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM vemurafenib and isolated for FACS analysis and protein extracts 24 hr later. (<bold>A</bold>) Apoptosis was significantly suppressed (70%) in the presence of vemurafenib as measured by FACS for Annexin V+, TMRE-low cells (n = 6, ‘*’ denotes statistical significance at p&lt;0.05). (<bold>B</bold>) Western blot analysis showed induction of phospho-JNK and phospho-p38 within 1 hr following irradiation, which persisted for at least 24 hr and which was suppressed by vemurafenib at all time points. (<bold>C</bold>) MCL1 and BIM expression was not significantly modulated by vemurafenib; however, NOXA induction, which occurred at 24 hr, was reduced by vemurafenib. In these primary cells, p53 protein was stabilized by 24 hr and vemurafenib did not affect overall levels. Suppression of apoptosis, as measured by cleaved caspase-3 levels, was observed in the presence of vemurafenib-treated irradiated cells, consistent with the FACS results. To test the relevance of MEK signaling, cSCC (SRB1) and NHEK cells were irradiated with 1 kJ/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence of 1 μM PLX4720 singly or in combination with 0.6 μM (NHEK) or 1.2 μM (SRB1) AZD6244 (MEKi) and isolated for FACS analysis and protein extracts 24 hr later. (<bold>D</bold>) SRB1 and (<bold>E</bold>) NHEK cells showed induction of phospho-JNK at 24 hr following irradiation, by Western in the presence (lane 7) and absence (lane 5) of MEKi. The addition of MEKi to PLX4720 did not affect the suppression of JNK activation (compare lanes 6, 8) despite potent suppression of phospho-ERK. (<bold>F</bold>) SRB1 and (<bold>G</bold>) NHEK cells exhibited a strong suppression of UV-induced apoptosis by PLX4720 (Annexin V+, TMRE-low cells; n = 6, ‘*’ denotes statistical significance at p&lt;0.05) that was likewise unaffected by the addition of MEKi. To test whether upstream kinases in the JNK pathway were inhibited, MKK4 and MKK7 activation was probed in cells. (<bold>H</bold>) Both phospho-MKK4 and phospho-MKK7 were induced in HaCaT and NHEK cells following irradiation, and this was suppressed in the presence of 1 μM PLX4720 and vemurafenib, respectively. (<bold>I</bold>) In all cSCC cell lines, SRB1, SRB12, COLO16, phospho-MKK4 and phospho-MKK7 are strongly induced following irradiation, and this is suppressed in all lines by 1 μM PLX4720.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.008">http://dx.doi.org/10.7554/eLife.00969.008</ext-link></p></caption><graphic xlink:href="elife00969f002"/></fig><fig id="fig2s1" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.009</object-id><label>Figure 2—figure supplement 1.</label><caption><title>p53 does not respond to stress in cSCC and HaCaT cell lines.</title><p>cSCC cell lines SRB1, SRB12, and COLO16 were either unirradiated or irradiated with 1 kJ/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM PLX4720 and isolated for protein extracts 24 hr later. (<bold>A</bold>) Western blots of total p53 reveal that none of the cell lines upregulate p53 in response to UV irradiation. SRB12 cells do not express p53. (<bold>B</bold>) HaCaT cells are known to be mutant for <italic>p53</italic> and the presence of p53 in unstressed cells, combined with the failure to upregulate levels following UV radiation, is a hallmark of functionally inactive p53 in cell lines. Loading controls are the same as those in <xref ref-type="fig" rid="fig1">Figure 1F</xref>.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.009">http://dx.doi.org/10.7554/eLife.00969.009</ext-link></p></caption><graphic xlink:href="elife00969fs004"/></fig><fig id="fig2s2" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.010</object-id><label>Figure 2—figure supplement 2.</label><caption><title>BCL2 family members BCL2, BCL-XL, and BCL2A1 are not modulated by acute UV exposure or PLX4720.</title><p>HaCaT cells were either unirradiated or irradiated with 1 kJ/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM PLX4720 and isolated for protein extracts 24 hr later. Western blots for BCL2 (2875P, Cell Signaling) and BCL-XL (2764P/clone 54H6, Cell Signaling) expression show that expression of neither is changed by acute UV exposure and or by PLX4720. c, qRT-PCR for BCL2A1 mRNA expression, referenced to GAPDH (Taqman) shows that BCL2A1 expression is likewise unchanged by acute UV exposure or by PLX4720.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.010">http://dx.doi.org/10.7554/eLife.00969.010</ext-link></p></caption><graphic xlink:href="elife00969fs005"/></fig></fig-group></p></sec><sec id="s2-2"><title>BRAFi suppress JNK activity through off-target inhibition of ZAK, MKK4, MAP4K5</title><p>Although BRAFi-induced JNK inhibition is observed in BRAF-WT as well as BRAF<sup>V600E</sup> cells (<xref ref-type="fig" rid="fig1 fig2">Figure 1F,H, 2B</xref>), with opposite effects on ERK signaling, we sought to further demonstrate that JNK inhibition and paradoxical ERK activation are independent and separable. We treated SRB1 and NHEK cells with the MEK inhibitor (MEKi) AZD6244 and PLX4720 singly and in combination with and without UV irradiation. While MEKi effectively abrogated ERK phosphorylation and activation (<xref ref-type="fig" rid="fig2">Figure 2D,E</xref>), this left PLX4720-mediated suppression of UV-induced JNK activation (<xref ref-type="fig" rid="fig2">Figure 2D,E</xref>) and apoptosis (<xref ref-type="fig" rid="fig2">Figure 2F,G</xref>) unaffected in both SRB1 and NHEK cells.</p><p>Because JNK and p38 isoforms are not significantly inhibited by PLX4720 or vemurafenib directly, (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>; <xref ref-type="bibr" rid="bib4">Bollag et al., 2010</xref>) we probed the phosphorylation status of MKK4 and MKK7 (MAP2K7), the two proximal kinases that synergistically phosphorylate JNK and that are required for JNK activation (<xref ref-type="bibr" rid="bib62">Tournier et al., 2001</xref>; <xref ref-type="bibr" rid="bib26">Haeusgen et al., 2011</xref>). The phosphorylation of both MKK4 and MKK7, corresponding to their activation, was significantly upregulated in control UV-irradiated cells and inhibited by PLX4720 in all cSCC cell lines, HaCaT, and NHEK cells (<xref ref-type="fig" rid="fig2">Figure 2H,I</xref>).</p><p>We then performed a kinome screen of PLX4720 and vemurafenib against a panel of 38 kinases reported to be upstream of JNK (<xref ref-type="bibr" rid="bib39">Keshet and Seger, 2010</xref>; <xref ref-type="bibr" rid="bib26">Haeusgen et al., 2011</xref>) and other kinases previously tested against PLX4720 and vemurafenib (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>; <xref ref-type="bibr" rid="bib4">Bollag et al., 2010</xref>) using a quantitative competitive binding assay (<xref ref-type="bibr" rid="bib19">Davis et al., 2011</xref>) at four concentrations (50 nM, 200 nM, 1 μM, 10 μM). We extended previously reported results obtained on this platform (<xref ref-type="bibr" rid="bib19">Davis et al., 2011</xref>) by testing a wider concentration range and by additionally testing vemurafenib. Reported biochemical IC50s for vemurafenib (<xref ref-type="bibr" rid="bib4">Bollag et al., 2010</xref>) and PLX4720 (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>) against multiple kinases including BRAF<sup>V600E</sup>, MAP4K5, SRMS, and BRK were quantitatively similar to the estimated <italic>K</italic><sub><italic>d</italic></sub>, confirming the validity of this assay (<xref ref-type="table" rid="tbl2 tbl3">Tables 2 and 3</xref>). We confirmed that ZAK and MKK4 (MAP2K4) have high binding affinities comparable to that of the intended target, BRAF (estimated <italic>K</italic><sub><italic>d</italic></sub> below 50 nM) for both PLX4720 (<xref ref-type="bibr" rid="bib19">Davis et al., 2011</xref>) and vemurafenib, and confirmed activity against MAP4K5 (<xref ref-type="bibr" rid="bib4">Bollag et al., 2010</xref>) (<xref ref-type="table" rid="tbl2 tbl3">Tables 2 and 3</xref>). To demonstrate an effect on activity, in vitro kinase assays were performed (<xref ref-type="fig" rid="fig3">Figure 3A–C</xref>) and revealed biochemical IC50s of 187 ± 5 nM, 460 ± 41 nM, and 354 ± 26 nM for ZAK, MKK4, and MAP4K5, respectively. All of these values are within the range of reported correspondences between binding assays and activity-based assays and with reported data (<xref ref-type="bibr" rid="bib2">Anastassiadis et al., 2011</xref>; <xref ref-type="bibr" rid="bib19">Davis et al., 2011</xref>). Importantly, at 1 μM vemurafenib used in our experiments, the residual activity of ZAK, MKK4, and MAP4K5 kinases, was 18.9 ± 0.5%, 29.6 ± 1.1%, and 25.7 ± 0.6%, respectively.<table-wrap id="tbl2" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.011</object-id><label>Table 2.</label><caption><p>Quantitative competitive binding assays reveal additional kinase targets of PLX4720</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.011">http://dx.doi.org/10.7554/eLife.00969.011</ext-link></p></caption><table frame="hsides" rules="groups"><thead><tr><th>Gene Name</th><th>Entrez gene Symbol</th><th>Percent control (50 nM)</th><th>Percent control (200 nM)</th><th>Percent control (1000 nM)</th><th>Percent control (10 μM)</th><th>Calculated estimate of IC50 (nM)</th><th>Published biochemical IC50 (nM)</th></tr></thead><tbody><tr><td>ASK1</td><td>MAP3K5</td><td align="char" char=".">89</td><td align="char" char=".">98</td><td align="char" char=".">97</td><td align="char" char=".">100</td><td align="char" char=".">14,179.29</td><td/></tr><tr><td>ASK2</td><td>MAP3K6</td><td align="char" char=".">94</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td/><td/></tr><tr><td>BLK</td><td>BLK</td><td align="char" char=".">91</td><td align="char" char=".">78</td><td align="char" char=".">32</td><td align="char" char=".">1</td><td align="char" char=".">446.56</td><td/></tr><tr><td><bold>BRAF(V600E)</bold></td><td><bold>BRAF</bold></td><td align="char" char="."><bold>38</bold></td><td align="char" char="."><bold>19</bold></td><td align="char" char="."><bold>3.9</bold></td><td align="char" char="."><bold>0.1</bold></td><td align="char" char="."><bold>32.04</bold></td><td><bold>13</bold></td></tr><tr><td>BRK</td><td>PTK6</td><td align="char" char=".">47</td><td align="char" char=".">14</td><td align="char" char=".">2.4</td><td align="char" char=".">0.2</td><td align="char" char=".">30.38</td><td>130</td></tr><tr><td>DLK</td><td>MAP3K12</td><td align="char" char=".">95</td><td align="char" char=".">98</td><td align="char" char=".">100</td><td align="char" char=".">92</td><td/><td/></tr><tr><td>FGR</td><td>FGR</td><td align="char" char=".">69</td><td align="char" char=".">38</td><td align="char" char=".">11</td><td align="char" char=".">2.5</td><td align="char" char=".">153.47</td><td/></tr><tr><td>HPK1</td><td>MAP4K1</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">47</td><td/><td/></tr><tr><td>LZK</td><td>MAP3K13</td><td align="char" char=".">94</td><td align="char" char=".">100</td><td align="char" char=".">96</td><td align="char" char=".">75</td><td/><td/></tr><tr><td>MAP3K1</td><td>MAP3K1</td><td align="char" char=".">96</td><td align="char" char=".">100</td><td align="char" char=".">92</td><td align="char" char=".">84</td><td/><td/></tr><tr><td>MAP3K15</td><td>MAP3K15</td><td align="char" char=".">94</td><td align="char" char=".">97</td><td align="char" char=".">91</td><td align="char" char=".">59</td><td/><td/></tr><tr><td>MAP3K2</td><td>MAP3K2</td><td align="char" char=".">100</td><td align="char" char=".">93</td><td align="char" char=".">87</td><td align="char" char=".">41</td><td/><td/></tr><tr><td>MAP3K3</td><td>MAP3K3</td><td align="char" char=".">94</td><td align="char" char=".">97</td><td align="char" char=".">98</td><td align="char" char=".">75</td><td/><td/></tr><tr><td>MAP3K4</td><td>MAP3K4</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">65</td><td/><td/></tr><tr><td>MAP4K2</td><td>MAP4K2</td><td align="char" char=".">98</td><td align="char" char=".">100</td><td align="char" char=".">99</td><td align="char" char=".">67</td><td/><td/></tr><tr><td>MAP4K3</td><td>MAP4K3</td><td align="char" char=".">100</td><td align="char" char=".">95</td><td align="char" char=".">90</td><td align="char" char=".">56</td><td/><td/></tr><tr><td>MAP4K4</td><td>MAP4K4</td><td align="char" char=".">92</td><td align="char" char=".">99</td><td align="char" char=".">100</td><td align="char" char=".">46</td><td/><td/></tr><tr><td><bold>MAP4K5</bold></td><td><bold>MAP4K5</bold></td><td align="char" char="."><bold>96</bold></td><td align="char" char="."><bold>100</bold></td><td align="char" char="."><bold>63</bold></td><td align="char" char="."><bold>8</bold></td><td align="char" char="."><bold>1257.42</bold></td><td/></tr><tr><td>MEK3</td><td>MAP2K3</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">64</td><td/><td/></tr><tr><td><bold>MEK4</bold></td><td><bold>MAP2K4</bold></td><td align="char" char="."><bold>48</bold></td><td align="char" char="."><bold>27</bold></td><td align="char" char="."><bold>2.6</bold></td><td align="char" char="."><bold>0.05</bold></td><td align="char" char="."><bold>37.96</bold></td><td/></tr><tr><td>MEK6</td><td>MAP2K6</td><td align="char" char=".">82</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">47</td><td/><td/></tr><tr><td>MINK</td><td>MINK1</td><td align="char" char=".">89</td><td align="char" char=".">100</td><td align="char" char=".">98</td><td align="char" char=".">55</td><td/><td/></tr><tr><td>MKK7</td><td>MAP2K7</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">84</td><td/><td/></tr><tr><td>MLK1</td><td>MAP3K9</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">&gt;10,000</td><td>&gt;5000</td></tr><tr><td>MLK2</td><td>MAP3K10</td><td align="char" char=".">100</td><td align="char" char=".">82</td><td align="char" char=".">100</td><td align="char" char=".">76</td><td/><td/></tr><tr><td>MLK3</td><td>MAP3K11</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td/><td/></tr><tr><td>MST1</td><td>STK4</td><td align="char" char=".">100</td><td align="char" char=".">93</td><td align="char" char=".">84</td><td align="char" char=".">55</td><td align="char" char=".">6709.79</td><td>&gt;5000</td></tr><tr><td>OSR1</td><td>OXSR1</td><td align="char" char=".">100</td><td align="char" char=".">94</td><td align="char" char=".">95</td><td align="char" char=".">42</td><td/><td/></tr><tr><td>PAK1</td><td>PAK1</td><td align="char" char=".">93</td><td align="char" char=".">97</td><td align="char" char=".">83</td><td align="char" char=".">22</td><td/><td/></tr><tr><td>RIPK1</td><td>RIPK1</td><td align="char" char=".">99</td><td align="char" char=".">87</td><td align="char" char=".">85</td><td align="char" char=".">50</td><td/><td/></tr><tr><td>SRMS</td><td>SRMS</td><td align="char" char=".">1.9</td><td align="char" char=".">0.55</td><td align="char" char=".">0.05</td><td align="char" char=".">0</td><td align="char" char=".">0.64</td><td/></tr><tr><td>STK39</td><td>STK39</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">59</td><td/><td/></tr><tr><td>TAK1</td><td>MAP3K7</td><td align="char" char=".">90</td><td align="char" char=".">88</td><td align="char" char=".">85</td><td align="char" char=".">49</td><td/><td/></tr><tr><td>TAOK1</td><td>TAOK1</td><td align="char" char=".">87</td><td align="char" char=".">94</td><td align="char" char=".">89</td><td align="char" char=".">65</td><td align="char" char=".">7532.57</td><td>&gt;5000</td></tr><tr><td>TAOK2</td><td>TAOK2</td><td align="char" char=".">92</td><td align="char" char=".">100</td><td align="char" char=".">93</td><td align="char" char=".">51</td><td/><td/></tr><tr><td>TAOK3</td><td>TAOK3</td><td align="char" char=".">100</td><td align="char" char=".">98</td><td align="char" char=".">96</td><td align="char" char=".">58</td><td/><td/></tr><tr><td>TNIK</td><td>TNIK</td><td align="char" char=".">97</td><td align="char" char=".">89</td><td align="char" char=".">79</td><td align="char" char=".">24</td><td/><td/></tr><tr><td><bold>ZAK</bold></td><td><bold>ZAK</bold></td><td align="char" char="."><bold>20</bold></td><td align="char" char="."><bold>4</bold></td><td align="char" char="."><bold>0.7</bold></td><td align="char" char="."><bold>0.1</bold></td><td align="char" char="."><bold>9.47</bold></td><td/></tr></tbody></table><table-wrap-foot><fn><p>Quantitative competitive binding assays were performed for a group of kinases previously tested against PLX4720 as well as a group of MAP kinases upstream of JNK. Published biochemical IC50s for PLX4720 are listed (see main text) for comparison and demonstrate good quantitative correspondence between estimated <italic>K</italic><sub><italic>d</italic></sub> from binding assays and biochemical IC50s. ZAK and MKK4 (MAP2K4) were very tightly bound by PLX4720 with estimated <italic>K</italic><sub><italic>d</italic></sub> below 50 nM. Bold text indicates the kinases tested for inhibition by PLX4720 with in-vitro kinase assays.</p></fn></table-wrap-foot></table-wrap><table-wrap id="tbl3" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.012</object-id><label>Table 3.</label><caption><p>Quantitative competitive binding assays reveal additional kinase targets of vemurafenib</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.012">http://dx.doi.org/10.7554/eLife.00969.012</ext-link></p></caption><table frame="hsides" rules="groups"><thead><tr><th/><th/><th>Percent control (50 nM)</th><th>Percent control (200 nM)</th><th>Percent control (1000 nM)</th><th>Percent control (10 μM)</th><th>Calculated estimate of IC50 (nM)</th><th>Published biochemical IC50 (nM)</th></tr></thead><tbody><tr><td>ASK1</td><td>MAP3K5</td><td align="char" char=".">90</td><td align="char" char=".">94</td><td align="char" char=".">97</td><td align="char" char=".">100</td><td align="char" char=".">11,972.22</td><td>&gt;1000</td></tr><tr><td>ASK2</td><td>MAP3K6</td><td align="char" char=".">94</td><td align="char" char=".">98</td><td align="char" char=".">100</td><td align="char" char=".">74</td><td/><td/></tr><tr><td>BLK</td><td>BLK</td><td align="char" char=".">96</td><td align="char" char=".">66</td><td align="char" char=".">30</td><td align="char" char=".">0.55</td><td align="char" char=".">518.03</td><td>547</td></tr><tr><td><bold>BRAF(V600E)</bold></td><td><bold>BRAF</bold></td><td align="char" char="."><bold>63</bold></td><td align="char" char="."><bold>25</bold></td><td align="char" char="."><bold>5.4</bold></td><td align="char" char="."><bold>0.5</bold></td><td align="char" char="."><bold>64.78</bold></td><td><bold>31</bold></td></tr><tr><td>BRK</td><td>PTK6</td><td align="char" char=".">63</td><td align="char" char=".">28</td><td align="char" char=".">6.9</td><td align="char" char=".">0.35</td><td align="char" char=".">68.04</td><td>213</td></tr><tr><td>DLK</td><td>MAP3K12</td><td align="char" char=".">98</td><td align="char" char=".">97</td><td align="char" char=".">66</td><td align="char" char=".">92</td><td/><td/></tr><tr><td>FGR</td><td>FGR</td><td align="char" char=".">65</td><td align="char" char=".">49</td><td align="char" char=".">13</td><td align="char" char=".">1.6</td><td align="char" char=".">149.26</td><td>63</td></tr><tr><td>HPK1</td><td>MAP4K1</td><td align="char" char=".">95</td><td align="char" char=".">88</td><td align="char" char=".">67</td><td align="char" char=".">15</td><td/><td/></tr><tr><td>LZK</td><td>MAP3K13</td><td align="char" char=".">100</td><td align="char" char=".">99</td><td align="char" char=".">93</td><td align="char" char=".">74</td><td/><td/></tr><tr><td>MAP3K1</td><td>MAP3K1</td><td align="char" char=".">98</td><td align="char" char=".">84</td><td align="char" char=".">89</td><td align="char" char=".">81</td><td/><td/></tr><tr><td>MAP3K15</td><td>MAP3K15</td><td align="char" char=".">84</td><td align="char" char=".">100</td><td align="char" char=".">84</td><td align="char" char=".">91</td><td/><td/></tr><tr><td>MAP3K2</td><td>MAP3K2</td><td align="char" char=".">91</td><td align="char" char=".">91</td><td align="char" char=".">89</td><td align="char" char=".">83</td><td/><td/></tr><tr><td>MAP3K3</td><td>MAP3K3</td><td align="char" char=".">87</td><td align="char" char=".">97</td><td align="char" char=".">100</td><td align="char" char=".">94</td><td/><td/></tr><tr><td>MAP3K4</td><td>MAP3K4</td><td align="char" char=".">95</td><td align="char" char=".">92</td><td align="char" char=".">87</td><td align="char" char=".">46</td><td/><td/></tr><tr><td>MAP4K2</td><td>MAP4K2</td><td align="char" char=".">99</td><td align="char" char=".">82</td><td align="char" char=".">95</td><td align="char" char=".">46</td><td/><td/></tr><tr><td>MAP4K3</td><td>MAP4K3</td><td align="char" char=".">80</td><td align="char" char=".">90</td><td align="char" char=".">82</td><td align="char" char=".">24</td><td/><td/></tr><tr><td>MAP4K4</td><td>MAP4K4</td><td align="char" char=".">96</td><td align="char" char=".">92</td><td align="char" char=".">83</td><td align="char" char=".">23</td><td align="char" char=".">2842.34</td><td>&gt;1000</td></tr><tr><td><bold>MAP4K5</bold></td><td><bold>MAP4K5</bold></td><td align="char" char="."><bold>62</bold></td><td align="char" char="."><bold>33</bold></td><td align="char" char="."><bold>4.1</bold></td><td align="char" char="."><bold>0.1</bold></td><td align="char" char="."><bold>58.21</bold></td><td><bold>51</bold></td></tr><tr><td>MEK3</td><td>MAP2K3</td><td align="char" char=".">100</td><td align="char" char=".">96</td><td align="char" char=".">98</td><td align="char" char=".">54</td><td/><td/></tr><tr><td><bold>MEK4</bold></td><td><bold>MAP2K4</bold></td><td align="char" char="."><bold>19</bold></td><td align="char" char="."><bold>4.1</bold></td><td align="char" char="."><bold>0.2</bold></td><td align="char" char="."><bold>0.05</bold></td><td align="char" char="."><bold>6.82</bold></td><td/></tr><tr><td>MEK6</td><td>MAP2K6</td><td align="char" char=".">91</td><td align="char" char=".">97</td><td align="char" char=".">87</td><td align="char" char=".">21</td><td align="char" char=".">4080.69</td><td>&gt;1000</td></tr><tr><td>MINK</td><td>MINK1</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">91</td><td align="char" char=".">66</td><td align="char" char=".">14,761.44</td><td>&gt;1000</td></tr><tr><td>MKK7</td><td>MAP2K7</td><td align="char" char=".">97</td><td align="char" char=".">95</td><td align="char" char=".">94</td><td align="char" char=".">85</td><td/><td/></tr><tr><td>MLK1</td><td>MAP3K9</td><td align="char" char=".">100</td><td align="char" char=".">93</td><td align="char" char=".">97</td><td align="char" char=".">41</td><td align="char" char=".">13,979.88</td><td>&gt;1000</td></tr><tr><td>MLK2</td><td>MAP3K10</td><td align="char" char=".">92</td><td align="char" char=".">96</td><td align="char" char=".">87</td><td align="char" char=".">78</td><td/><td/></tr><tr><td>MLK3</td><td>MAP3K11</td><td align="char" char=".">98</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">77</td><td/><td/></tr><tr><td>MST1</td><td>STK4</td><td align="char" char=".">99</td><td align="char" char=".">83</td><td align="char" char=".">51</td><td align="char" char=".">12</td><td/><td/></tr><tr><td>OSR1</td><td>OXSR1</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">89</td><td align="char" char=".">98</td><td/><td/></tr><tr><td>PAK1</td><td>PAK1</td><td align="char" char=".">99</td><td align="char" char=".">98</td><td align="char" char=".">91</td><td align="char" char=".">46</td><td/><td/></tr><tr><td>RIPK1</td><td>RIPK1</td><td align="char" char=".">92</td><td align="char" char=".">100</td><td align="char" char=".">99</td><td align="char" char=".">73</td><td/><td/></tr><tr><td>SRMS</td><td>SRMS</td><td align="char" char=".">24</td><td align="char" char=".">9.6</td><td align="char" char=".">0.75</td><td align="char" char=".">0</td><td align="char" char=".">11.15</td><td>18</td></tr><tr><td>STK39</td><td>STK39</td><td align="char" char=".">100</td><td align="char" char=".">100</td><td align="char" char=".">97</td><td align="char" char=".">66</td><td/><td/></tr><tr><td>TAK1</td><td>MAP3K7</td><td align="char" char=".">93</td><td align="char" char=".">88</td><td align="char" char=".">86</td><td align="char" char=".">88</td><td/><td/></tr><tr><td>TAOK1</td><td>TAOK1</td><td align="char" char=".">91</td><td align="char" char=".">100</td><td align="char" char=".">97</td><td align="char" char=".">79</td><td/><td/></tr><tr><td>TAOK2</td><td>TAOK2</td><td align="char" char=".">98</td><td align="char" char=".">92</td><td align="char" char=".">95</td><td align="char" char=".">70</td><td align="char" char=".">11,770.83</td><td>&gt;1000</td></tr><tr><td>TAOK3</td><td>TAOK3</td><td align="char" char=".">92</td><td align="char" char=".">98</td><td align="char" char=".">92</td><td align="char" char=".">80</td><td align="char" char=".">15,468.75</td><td>&gt;1000</td></tr><tr><td>TNIK</td><td>TNIK</td><td align="char" char=".">95</td><td align="char" char=".">94</td><td align="char" char=".">66</td><td align="char" char=".">11</td><td/><td/></tr><tr><td><bold>ZAK</bold></td><td><bold>ZAK</bold></td><td align="char" char="."><bold>9</bold></td><td align="char" char="."><bold>1.8</bold></td><td align="char" char="."><bold>0.25</bold></td><td align="char" char="."><bold>0.05</bold></td><td align="char" char="."><bold>4.03</bold></td><td/></tr></tbody></table><table-wrap-foot><fn><p>Quantitative competitive binding assays were performed for a group of kinases previously tested against vemurafenib as well as a group of MAP kinases upstream of JNK. Published biochemical IC50s for vemurafenib are listed (see main text) for comparison and demonstrate good quantitative correspondence between estimated <italic>K</italic><sub><italic>d</italic></sub> from binding assays and biochemical IC50s. ZAK and MKK4 (MAP2K4) were very tightly bound by vemurafenib with estimated <italic>K</italic><sub><italic>d</italic></sub> below 50 nM. Bold text indicates the kinases tested for inhibition by vemurafenib with in-vitro kinase assays.</p></fn></table-wrap-foot></table-wrap><fig-group><fig id="fig3" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.013</object-id><label>Figure 3.</label><caption><title>PLX4720 and vemurafenib suppress apoptosis and JNK signaling through inhibition of off-target kinases.</title><p>(<bold>A–C</bold>) In-vitro kinase assays for ZAK, MKK4, and MAP4K5 were performed across a 10-point concentration range from 0.05 to 1000 nM in triplicate, revealing significant inhibition of kinase activity within the nM range for vemurafenib. (<bold>D</bold>) Lentiviral shRNA knockdown of ZAK singly or in combination with MKK4 and MAP4K5 (triple knockdown, ‘TKD’) was performed revealing potent suppression of apoptosis as measured by FACS for Annexin V+, TMRE-low cells (n = 5, ‘*’ denotes statistical significance at p&lt;0.05, ‘**’ at p&lt;0.01, ‘NS’ is not significant) at 24 hr following single dose UVB irradiation at 720 J/m<sup>2</sup>. ZAK knockdown and triple knockdown cells exhibit 70% and 94% suppression of apoptosis, respectively, relative to PLX4720-treated cells expressing a non-suppressing shRNA control (scramble, ‘SCR’). (<bold>E</bold>) Western blots of lysates obtained at 1 and 6 hr post-UV irradiation show potent induction of phospho-MKK4, phospho-MKK7, and phospho-JNK which are all suppressed with progressively increasing effect in ZAK single knockdown (‘shZAK2’) and triple knockdown (‘TKD’) HaCaT cells. (<bold>F</bold>) Western blots of HaCaT cells electroporated with pcDNA3-wild-type (WT) ZAK and the gatekeeper mutant pcDNA3-(T82Q) ZAK show equivalent expression. (<bold>G</bold>) HaCaT cells overexpressing ZAK (WT) and ZAK (T82Q) were irradiated with a single dose of UVB irradiation at 720 J/m<sup>2</sup> in the absence (‘o’) and presence (‘+’) of 1 μM PLX4720 and apoptosis measured by FACS for Annexin V+, TMRE-low cells (n = 4, ‘**’ at p&lt;0.01, ‘NS’ is not significant) at 24 hr. ZAK (WT) cells are sensitive to PLX4720-mediated suppression of apoptosis (bar 3 vs 4), but drug-treated ZAK (T82Q)-expressing cells undergo significantly more apoptosis than drug-treated ZAK (WT) cells (bar 4 vs 8), with bypass of PLX4720-induced suppression as compared to drug-treated ZAK (WT) cells (paired t-test, p=0.005). (<bold>H</bold>) Western blots of ZAK (WT) and ZAK (T82Q)-expressing HaCaT cells at 1 hr and 6 hr post-irradiation show that phospho-JNK activation is intact in both cell lines in the absence of drug (lanes 3, 7), but that drug-treated ZAK (T82Q)-expressing HaCaT cells have significantly more phospho-JNK activation at both 1 and 6 hr post-irradiation, as compared to drug-treated ZAK (WT)-expressing cells (lane 4 vs 8).</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.013">http://dx.doi.org/10.7554/eLife.00969.013</ext-link></p></caption><graphic xlink:href="elife00969f003"/></fig><fig id="fig3s1" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.014</object-id><label>Figure 3—figure supplement 1.</label><caption><title>Knockdown of ZAK potently inhibits JNK activation and UV-induced apoptosis.</title><p>(<bold>A</bold>) Western blot of HaCaT cells expressing two shRNA clones and HaCaT TKD cells (containing shZAK2) all show significant knockdown of ZAK protein, though shZAK2 produces slightly less knockdown. Approximately 54.6% knockdown (ImageJ) of MAP4K5 is observed in TKD cells. (<bold>B</bold>) HaCaT cells, expressing non-silencing scramble-shRNA (‘SCR’), shZAK1, shZAK2, or TKD, were either unirradiated (black bars) or irradiated (open bars) with 1 kJ/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM PLX4720 and analyzed by FACS for apoptosis (Annexin V+, TMRE-) at 24 hr. UV-induced apoptosis is significantly suppressed by both ZAK shRNA clones in HaCaT cells and in TKD cells. The shZAK2 clone, which results in less knockdown than shZAK1, produces correspondingly less suppression of UV-induced apoptosis (93.7% for shZAK1 vs 67.8% for shZAK2). shZAK1-expressing HaCaT cells, TKD cells, and PLX4720-treated HaCaT scrambled-shRNA-expressing cells show similar degrees of suppression, again consistent with the fact that ZAK can account for the majority of the effect of BRAFi-induced suppression of JNK signaling. (<bold>C</bold>) HaCaT cells, treated as above, were processed for Western blots at 1 and 6 hr following UV exposure to assess JNK activation. Significant suppression of phospho-JNK is observed at 1 hr and 6 hr post-irradiation in all cell lines where ZAK is knocked down, as well as TKD cells and SCR cells treated with PLX4720. In comparing the shZAK1 and shZAK2-expressing HaCaT cells, the degree of phospho-JNK inhibition correlates exactly with the degree of knockdown of ZAK particularly at 1 hr: less phospho-JNK inhibition is observed with less ZAK knockdown.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.014">http://dx.doi.org/10.7554/eLife.00969.014</ext-link></p></caption><graphic xlink:href="elife00969fs006"/></fig><fig id="fig3s2" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.015</object-id><label>Figure 3—figure supplement 2.</label><caption><title>Single knockdown of MKK4 or MAP4K5 partially inhibits JNK activation and UV-induced apoptosis.</title><p>(<bold>A</bold>) Western blot of HaCaT cells expressing two shRNA clones against MKK4 and MAP4K5 show significant knockdown of targets proteins (shMKK4-1: 89.3%, shMKK4-2: 71.9%, shMAP4K5-1: 86.4%, shMAP4K5-2: 84.1%; ImageJ). (<bold>B</bold>) HaCaT cells, expressing non-silencing scramble-shRNA (‘SCR’), shMKK4-1, shMKK4-2, shMAP4K5-1, or shMAP4K5-2 were either unirradiated (black bars) or irradiated (open bars) with 720 J/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM PLX4720 and analyzed by FACS for apoptosis (Annexin V+, TMRE-) at 24 hr. UV-induced apoptosis is suppressed most substantially by MKK4 (up to 27.3%), but not substantially by MAP4K5 (up to 11.6%) in HaCaT cells. These results are consistent with the fact that ZAK can account for the majority of the effect of BRAFi-induced suppression of JNK signaling. Importantly, since MKK4 is important for JNK activation, and ZAK activates MKK4, the partial suppression of phospho-JNK activation and apoptosis is expected. (<bold>C</bold>) HaCaT cells, treated as above, were processed for Western blots at 1 hr following UV exposure to assess JNK activation. Significant activation of phospho-JNK is still observed at 1 hr post-irradiation in all cell lines, as compared to SCR cells treated with PLX4720.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.015">http://dx.doi.org/10.7554/eLife.00969.015</ext-link></p></caption><graphic xlink:href="elife00969fs007"/></fig><fig id="fig3s3" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.016</object-id><label>Figure 3—figure supplement 3.</label><caption><title>Knockdown of ZAK potently inhibits JNK activation and UV-induced apoptosis in SRB1 cells.</title><p>(<bold>A</bold>) Western blot of SRB1 cells expressing two shRNA clones (shZAK1, shZAK2) all show significant knockdown of ZAK protein. (<bold>B</bold>) SRB1 cells, expressing non-silencing scramble-shRNA (‘SCR’), shZAK1, or shZAK2, were either unirradiated (black bars) or irradiated (open bars) with 720 J/m<sup>2</sup> of UVB in the absence (‘o’, 1:2000 DMSO) or presence (‘+’) of 1 μM PLX4720 and analyzed by FACS for apoptosis (Annexin V+, TMRE-) at 24 hr. UV-induced apoptosis is significantly suppressed by both ZAK shRNA clones in SRB1 cells. shZAK1/2-expressing SRB1 cells and PLX4720-treated SRB1 scrambled-shRNA-expressing cells show similar degrees of suppression (90%, 92.5% of drug-treated cells), again consistent with the fact that ZAK can account for the majority of the effect of BRAFi-induced suppression of JNK-dependent apoptosis. (<bold>C</bold>) SRB1 cells, treated as above, were processed for Western blots at 1 hr following UV exposure to assess JNK activation. Significant suppression of phospho-JNK is observed at 1 hr post-irradiation in all cell lines where ZAK is knocked down, as well as in SCR cells treated with PLX4720.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.016">http://dx.doi.org/10.7554/eLife.00969.016</ext-link></p></caption><graphic xlink:href="elife00969fs008"/></fig><fig id="fig3s4" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.017</object-id><label>Figure 3—figure supplement 4.</label><caption><title>Vemurafenib and PLX4720 inhibit multiple kinases upstream of JNK and p38.</title><p>The schematic shows MAP kinases upstream of JNK and p38 that are inhibited by these BRAF inhibitors (gray-shaded). Vemurafenib and PLX4720 inhibit ZAK (principally) and MKK4 (MEK4/MAP2K4), resulting in inhibition of MKK7 and MKK4 and, ultimately, JNK. p38 activation was diminished by drug exposure in some contexts , but not to the degree that JNK activation was. Vemurafenib and PLX4720 also inhibit MAP4K5, which has been shown to be upstream of MKK4 and JNK.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.017">http://dx.doi.org/10.7554/eLife.00969.017</ext-link></p></caption><graphic xlink:href="elife00969fs009"/></fig></fig-group></p><p>To examine the requirements for ZAK, MAP4K5, and MKK4 in activating JNK activation and apoptosis more directly, we performed lentiviral shRNA knockdown experiments in HaCaT cells. HaCaT cells with knockdown of ZAK (‘shZAK2’) showed a strong suppression of ZAK protein expression (<xref ref-type="fig" rid="fig3s1">Figure 3—figure supplement 1A</xref>) and of UV-induced apoptosis, showing 70% suppression of apoptosis relative to that achieved by PLX4720 in control (‘SCR’) cells (<xref ref-type="fig" rid="fig3">Figure 3D</xref>, <xref ref-type="fig" rid="fig3s1">Figure 3—figure supplement 1A</xref>). An additional clone of shRNA against ZAK (‘shZAK1’) showed similar results (<xref ref-type="fig" rid="fig3s1">Figure 3—figure supplement 1B,C</xref>), demonstrating that even greater knockdown of ZAK can account for nearly the entire effect of PLX4720 on JNK activation and apoptosis. Western blots show significant suppression of phospho-MKK4/MKK7 in shZAK2 knockdown cells (<xref ref-type="fig" rid="fig3">Figure 3E</xref>). Triple knockdown cells (‘TKD’) with combined shRNA knockdown of ZAK, MKK4, and MAP4K5 kinases, as confirmed by Western (<xref ref-type="fig" rid="fig3">Figure 3E</xref>, <xref ref-type="fig" rid="fig3s1">Figure 3—figure supplement 1A</xref>), showed comparable suppression of apoptosis to that of drug-treated control cells (<xref ref-type="fig" rid="fig3">Figure 3D</xref>, <xref ref-type="fig" rid="fig3s1">Figure 3—figure supplement 1B</xref>) and substantial suppression of phospho-MKK4/MKK7 induction (<xref ref-type="fig" rid="fig3">Figure 3E</xref>). Furthermore, single knockdown of MKK4 and MAP4K5 (<xref ref-type="fig" rid="fig3s2">Figure 3—figure supplement 2A</xref>), only partially suppresses UV-induced apoptosis or phospho-JNK induction in HaCaT cells (<xref ref-type="fig" rid="fig3s2">Figure 3—figure supplement 2B,C</xref>). Knockdown of ZAK alone was able to account for 91.3% of the suppression of UV-induced apoptosis in a distinct cell line, SRB1 (<xref ref-type="fig" rid="fig3s3">Figure 3—figure supplement 3A,B</xref>), with corresponding suppression of phospho-JNK induction (<xref ref-type="fig" rid="fig3s3">Figure 3—figure supplement 3C</xref>). As knockdown of ZAK alone can account for up to 93.7% of the effect of PLX4720 treatment, we conclude that the potent inhibition of JNK activation and resultant apoptosis by PLX4720 and vemurafenib is due to the off-target inhibition of ZAK principally, with smaller additional contributions from inhibition of MKK4 and MAP4K5, which abrogates the activation of the two kinases essential for JNK phosphorylation and activation: MKK4 and MKK7 (<xref ref-type="fig" rid="fig2 fig3">Figures 2H–I,3D–E</xref>, <xref ref-type="fig" rid="fig3s4">Figure 3—figure supplement 4</xref>). Consistent with our findings, ZAK has been shown to be critically important for JNK activation upstream of MKK4 and MKK7 (<xref ref-type="bibr" rid="bib67">Wang et al., 2005</xref>) and doxorubicin-induced apoptosis (<xref ref-type="bibr" rid="bib52">Sauter et al., 2010</xref>; <xref ref-type="bibr" rid="bib71">Wong et al., 2013</xref>).</p></sec><sec id="s2-3"><title>Expression of gatekeeper mutant ZAK reverses BRAFi-mediated apoptosis suppression</title><p>Our biochemical and shRNA data showed that knockdown of ZAK suppressed phospho-JNK activation and apoptosis (<xref ref-type="fig" rid="fig3">Figure 3D–E</xref>, <xref ref-type="fig" rid="fig3s1 fig3s3">Figure 3—figure supplements 1,3</xref>) and that the degree of knockdown correlated with the degree of JNK and apoptosis suppression. To show that PLX4720 suppresses apoptosis primarily through direct action on ZAK in cells, we employed a chemical-genetic approach by engineering a gatekeeper mutant ZAK (T82Q). Gatekeeper mutant kinases, in which the threonine (T) is replaced by a larger amino acid, in our case glutamine (Q), are often rendered insensitive to small molecule inhibitors and are an important mechanism of drug resistance (<xref ref-type="bibr" rid="bib18">Daub et al., 2004</xref>; <xref ref-type="bibr" rid="bib70">Whittaker et al., 2010</xref>). We overexpressed equivalent amounts of ZAK (T82Q) wild-type ZAK (WT) in HaCaT cells (<xref ref-type="fig" rid="fig3">Figure 3F</xref>), and compared their UV responses.</p><p>Whereas ZAK (WT) cells were sensitive to PLX4720-mediated suppression of apoptosis (<xref ref-type="fig" rid="fig1 fig3">Figures 1D and 3G</xref>), drug-treated ZAK (T82Q)-expressing cells underwent 2.13-fold more apoptosis than drug-treated ZAK (WT) cells (bar 4 vs 8; p=0.005), corresponding to 76.9% of the levels of apoptosis in untreated cells (bars 3, 7 vs 8; p=0.08) (<xref ref-type="fig" rid="fig3">Figure 3G</xref>). The effects on apoptosis corresponded to higher levels of phospho-JNK, even in drug-treated cells expressing the ZAK (T82Q) mutant as compared to drug-treated ZAK (WT)-expressing cells at both 1 hr and 6 hr post-irradiation (lane 4 vs 8; <xref ref-type="fig" rid="fig3">Figure 3H</xref>). Sustained activation of JNK is necessary for apoptosis (<xref ref-type="bibr" rid="bib59">Tobiume et al., 2001</xref>; <xref ref-type="bibr" rid="bib37">Kamata et al., 2005</xref>; <xref ref-type="bibr" rid="bib66">Ventura et al., 2006</xref>), and our results show that PLX4720-treated ZAK (T82Q)-expressing cells retain higher activation across 1–6 hr as compared to PLX4720-treated ZAK (WT) cells.</p></sec><sec id="s2-4"><title>Vemurafenib suppresses JNK activity and apoptosis in cSCC arising in treated patients</title><p>We then explored whether vemurafenib or PLX4720-mediated suppression of JNK and apoptosis is relevant in vivo. We first examined cSCC arising in patients treated with vemurafenib and compared them to sporadic cSCC that were histologically similar, arising in individuals never treated with vemurafenib (<xref ref-type="fig" rid="fig4">Figure 4A–E</xref>). Phospho-JNK and cleaved caspase-3 expression were assessed by immunohistochemistry and then quantified following normalization by unit area (mm<sup>2</sup>) of tumor tissue (malignant keratinocytes) only (<xref ref-type="fig" rid="fig4">Figure 4A–D</xref>, <xref ref-type="fig" rid="fig4s1">Figure 4—figure supplement 1</xref>). Sporadic cSCC arising in patients never treated with vemurafenib (n = 15) contained substantially greater expression of phospho-JNK (p=0.013; <xref ref-type="fig" rid="fig4">Figure 4A,E</xref>) and cleaved caspase-3 (p=0.042; <xref ref-type="fig" rid="fig4">Figure 4C,E</xref>) as compared to lesions arising in vemurafenib-treated patients (n = 16; <xref ref-type="fig" rid="fig4">Figure 4B,D,E</xref>). Therefore, we found significant reductions in phospho-JNK and cleaved caspase-3 expression in human cSCC suggesting that suppression of JNK activity and apoptosis occur in vivo in patients treated with vemurafenib.<fig-group><fig id="fig4" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.018</object-id><label>Figure 4.</label><caption><title>Vemurafenib and PLX4720 suppress apoptosis and JNK signaling in vivo.</title><p>(<bold>A–D</bold>) cSCC samples from vemurafenib-treated patients and non-treated patients were analyzed by immunohistochemistry for phospho-JNK and cleaved caspase-3 expression. cSCC arising in vemurafenib-treated patients show decreased expression of phospho-JNK (<bold>B</bold>) and cleaved caspase-3 (<bold>D</bold>) as compared to sporadic cSCC in patient never treated with vemurafenib (<bold>A</bold> and <bold>C</bold>). Scale bar is 100 μm. (<bold>E</bold>) Comparisons of stained cells normalized to mm<sup>2</sup> of tumor area revealed significant suppression of both phospho-JNK and cleaved caspase 3 expression in vemurafenib-treated cSCC (‘*’, p&lt;0.05). (<bold>F</bold> and <bold>G</bold>) Hematoxylin-stained cryosections of skin harvested at 24 hr post-irradiation showed extensive apoptosis (arrowheads) with vacuolated blebbed cells and clumped pyknotic nuclei in control-treated mice (<bold>F</bold>) and significantly fewer apoptotic cells in PLX4720-treated mice (<bold>G</bold>). Scale bar is 50 μm. (<bold>H–I</bold>) Vehicle-treated (‘o’) and PLX4720-treated (‘+’) mice were unirradiated or irradiated once, and epidermis was harvested at 1 hr, 6 hr, and 24 hr post-irradiation. (<bold>H</bold>) Significant UV-induced upregulation of both phospho-JNK and phospho-p38 were observed within 1 hr, with significant suppression of phospho-JNK in PLX4720-treated mice by 6 hr and minimal suppression of phospho-p38. Phospho-ERK levels remained constant. The upstream regulators of JNK, MKK4 and MKK7, were both significantly activated within 1 hr of irradiation, and potently suppressed in PLX4720-treated mice. Cleaved caspase-3 levels increased within 6 hr and were suppressed in PLX4720-treated mice. (<bold>I</bold>) Noxa was induced most significantly at 6 hr and was potently suppressed by PLX4720 at all time points (‘***’, p&lt;0.001).</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.018">http://dx.doi.org/10.7554/eLife.00969.018</ext-link></p></caption><graphic xlink:href="elife00969f004"/></fig><fig id="fig4s1" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.019</object-id><label>Figure 4—figure supplement 1.</label><caption><title>Double staining of sporadic cSCC confirms phospho-JNK and cleaved caspase-3 expression within keratinocytes of tumors.</title><p>Sections were processed for standard immunohistochemistry and stained with primary antibodies against phospho-JNK, cleaved caspase-3 (Cell Signaling; peroxidase–DAB) as before, together with antibodies against cytokeratins 5/6 (clone D5/16 B4—Thermo; peroxidase–AEC). Results of the double staining show that in all cases, phospho-JNK staining and cleaved caspase 3 staining was observed exclusively in keratinocytes within tumors. Keratinocytes (CK5/6 +) are significantly larger and have more cytoplasm than macrophages or lymphocytes. Scale bar is 50 μM.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.019">http://dx.doi.org/10.7554/eLife.00969.019</ext-link></p></caption><graphic xlink:href="elife00969fs010"/></fig></fig-group></p></sec><sec id="s2-5"><title>BRAFi suppress acute UVR-induced epidermal apoptosis in vivo</title><p>We then probed the acute, in vivo, short-term UV response in skin by pre-treating C57BL/6 mice with PLX4720 administered by oral gavage 40–80 mg/kg twice a day for 2–4 days (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>). Following depilation, mice were irradiated once using a solar simulator (Oriel) with 10 kJ/m<sup>2</sup> UVB. The skin was harvested at 1 hr, 6 hr, and 24 hr post-irradiation. Consistent with our other results, we found significant apoptosis of epidermal keratinocytes in irradiated mouse skin that was suppressed by PLX4720 treatment (12.7 ± 0.4 apoptotic cells/mm vs 4.9 ± 0.3 apoptotic cells/mm skin, [n = 3 pairs], p&lt;10<sup>−5</sup>; <xref ref-type="fig" rid="fig4">Figure 4F,G</xref>), a finding corroborated by cleaved caspase-3 levels, which were induced within 6 hr of irradiation and suppressed in PLX4720-treated mice (<xref ref-type="fig" rid="fig4">Figure 4H</xref>). As expected, phospho-JNK and phospho-p38 were significantly upregulated following UV irradiation and phospho-JNK was significantly suppressed by PLX4720 (<xref ref-type="fig" rid="fig4">Figure 4H</xref>). The upstream kinases MKK4 and MKK7 were likewise activated by UV radiation and suppressed by PLX4720 at 1 and 6 hr post-irradiation, confirming the importance of this mechanism of PLX4720-induced JNK signaling suppression in vivo. Finally, Noxa mRNA expression, as measured by qPCR, was strongly induced by UV exposure, a response significantly dampened by PLX4720 treatment (<xref ref-type="fig" rid="fig4">Figure 4I</xref>).</p></sec><sec id="s2-6"><title>BRAFi accelerates UVR-driven cSCC development in Hairless mice</title><p>We also used the Hairless mouse model of squamous cell carcinoma to assess whether PLX4720 would affect UV-driven tumor development. This is particularly relevant since it appears that UV exposure is an important initiating event in BRAFi-accelerated cSCC (<xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>). Unlike the DMBA/TPA model, in which lesions almost universally harbor <italic>Hras</italic> mutations (<xref ref-type="bibr" rid="bib6">Brown et al., 1990</xref>), the Hairless model has a very low frequency of <italic>Ras</italic> mutation in papillomas and carcinomas (<xref ref-type="bibr" rid="bib64">van Kranen et al., 1995</xref>), more similar to sporadic human cSCC. The cohorts (n = 5 each) were identically irradiated thrice weekly (12.5 kJ/m<sup>2</sup> per week UVB) for 72 days before starting on PLX4720 treatment vs vehicle control. Within 20 days of administration of drug, hyperkeratotic papules were visible on the backs of PLX4720-treated animals (<xref ref-type="fig" rid="fig5">Figure 5A,B</xref>), which steadily grew into cSCC over the following several weeks (<xref ref-type="fig" rid="fig5">Figure 5C,D</xref>). Within this period of 150 days (78 days of drug treatment), control-treated mice had not yet developed any visible lesions (<xref ref-type="fig" rid="fig5">Figure 5E</xref>). When we quantified the effects of each of these drug treatments, we found significant decreases in both phospho-JNK expression (p=0.046; <xref ref-type="fig" rid="fig5">Figure 5F,G,J</xref>) and cleaved caspase 3 expression (p=0.019; <xref ref-type="fig" rid="fig5">Figure 5H–J</xref>) in PLX4720-treated mice as compared to control-treated mice. Importantly, we sequenced the entire coding regions for <italic>Ras</italic> (<italic>Hras</italic>, <italic>Kras</italic>, <italic>Nras</italic>) and found no mutations in any of the tumors in PLX4720-treated mice, as compared to one of 14 papillomas and carcinomas in a cohort of control-treated chronically-irradiated Hairless mice (<xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1</xref>).<fig-group><fig id="fig5" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.020</object-id><label>Figure 5.</label><caption><title>PLX4720 and JNK inhibition dramatically accelerate cSCC development in the UV-driven Hairless mouse model.</title><p>(<bold>A–E)</bold> Chronically-irradiated Hairless mice were treated with PLX4720 (n = 5), or vehicle (n = 5) starting at day 72 (arrow, <bold>E</bold>). Tumors were induced within 20 days of PLX-4720 treatment (<bold>B</bold>), whereas only erythema was seen in control animals (<bold>A</bold>). The tumors in PLX4720-treated mice progressed to well-differentiated cSCC (<bold>C</bold>, scale bar 75 μm), steadily increasing in size and number (<bold>D</bold>, day 132). <bold>(E)</bold> Even at 150 days (78 days of drug treatment), only PLX4720-treated mice had tumors and the differences in tumor number persisted throughout (‘**’, p=0.0026). <bold>(F–J)</bold> cSCC from mice were harvested and assessed for phospho-JNK and cleaved caspase 3 expression by immunohistochemistry. Tumors from PLX4720-treated animals showed significantly lower levels of phospho-JNK (<bold>G</bold>) and cleaved caspase 3 (<bold>I</bold>) as compared to control-treated animals (<bold>F</bold> and <bold>H</bold>). Differences in these parameters were significant across all comparisons (<bold>J</bold>, ‘*’, p&lt;0.05).</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.020">http://dx.doi.org/10.7554/eLife.00969.020</ext-link></p></caption><graphic xlink:href="elife00969f005"/></fig><fig id="fig5s1" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.021</object-id><label>Figure 5—figure supplement 1.</label><caption><title>cSCC and papillomas arising in Hairless mice treated with PLX4720 do not have <italic>Ras</italic> mutations.</title><p>(<bold>A</bold> and <bold>B</bold>) cDNA was reverse-transcribed from total RNA, PCR-amplified with the above primers (<bold>B</bold>) and analyzed by Sanger sequencing for mutations in both directions. No mutations in <italic>Hras</italic>, <italic>Kras</italic>, or <italic>Nras</italic> were detected in any of the papillomas (n = 5) or carcinomas (n = 3) isolated from PLX4720-treated mice. One of the papillomas from untreated mice had a heterozygous point mutation (<bold>A</bold>) in <italic>Hras</italic> (G35A, G12E) among 14 samples (12 papillomas, 2 cSCC).</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.021">http://dx.doi.org/10.7554/eLife.00969.021</ext-link></p></caption><graphic xlink:href="elife00969fs011"/></fig></fig-group></p></sec><sec id="s2-7"><title>Paradoxical ERK activation and off-target JNK inhibition cooperate to accelerate tumor growth</title><p>While the effects of these BRAFi on JNK-dependent apoptosis is clear and independent of ERK activity, the relative contribution of paradoxical ERK activation vs JNK pathway inhibition to tumorigenesis has not been precisely addressed (<xref ref-type="fig" rid="fig6">Figure 6A</xref>). To accomplish this, we took advantage of the fact that paradoxical ERK activation requires intact <italic>CRAF</italic> (<xref ref-type="bibr" rid="bib29">Hatzivassiliou et al., 2010</xref>; <xref ref-type="bibr" rid="bib31">Heidorn et al., 2010</xref>; <xref ref-type="bibr" rid="bib51">Poulikakos et al., 2010</xref>) (<xref ref-type="fig" rid="fig6">Figure 6A</xref>). We used isogenic, matched WT and <italic>Craf</italic>-deficient (<italic>Craf</italic>−/−) mouse embryonic fibroblasts (MEFs) and transformed them with adenovirus E1A and human <italic>HRAS</italic><sup><italic>G12V</italic></sup> to enable anchorage-independent growth (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1</xref>). These <italic>Craf</italic>−/− cells do not exhibit strong paradoxical MEK or ERK activation, consistent with previous reports (<xref ref-type="bibr" rid="bib51">Poulikakos et al., 2010</xref>) (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1A</xref>). Wild-type and matched <italic>Craf</italic>-deficient MEFs were plated in soft agar assays (<xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>) and treated with PLX4720. Both WT and <italic>Craf</italic>-deficient MEFs exhibited a significant colony formation advantage in the presence of drug (<xref ref-type="fig" rid="fig6">Figure 6B–D</xref>). Based upon this analysis, we estimated that the effect of paradoxical ERK activation to be 60% and other effects, including inhibition of JNK activity, to account for the rest (40%) of the total colony growth advantage (<xref ref-type="fig" rid="fig6">Figure 6D</xref>). To assess the role of JNK signaling directly, we used <italic>HRAS</italic><sup><italic>G12V</italic></sup>-transformed HaCaT cells with (‘TKD’) and without (‘SCR’) triple lentiviral knockdown of ZAK, MAP4K5, and MKK4 (<xref ref-type="fig" rid="fig3">Figure 3D,E</xref>), to perform similar colony formation assays to assess responses to PLX4720 treatment (<xref ref-type="fig" rid="fig6">Figure 6E</xref>). Drug treatment conferred a significant colony formation advantage in both sets of cells, which exhibit equivalent paradoxical ERK activation (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1B</xref>). Yet, untreated TKD HaCaT cells produced more colonies than SCR HaCaT cells suggesting that JNK pathway suppression results in an advantage in the absence of drug and paradoxical ERK activation (<xref ref-type="fig" rid="fig6">Figure 6E</xref>). Drug-treated SCR and TKD HaCaT cells, had elevated colony counts to similar levels, as expected, because both lines would experience similar degrees of both paradoxical ERK activation and JNK inhibition, and TKD cells (knocked down for ZAK, MAP4K5, MKK4) are unlikely to experience any further suppression of JNK signaling (<xref ref-type="fig" rid="fig3">Figure 3D</xref>). Based on this, we estimated the effect of JNK pathway inhibition to be 17.6% (<xref ref-type="fig" rid="fig6">Figure 6E</xref>). When combined with the MEF experiment, we estimate that the effect of JNK inhibition contributes approximately 17.6–40% of the total effect of PLX4720-accelerated colony formation (<xref ref-type="fig" rid="fig6">Figure 6D,E</xref>). Importantly, although we can quantify these individual contributions, it is clear in many contexts in cancer that hyperproliferation and inhibition of apoptosis are highly cooperative (<xref ref-type="bibr" rid="bib28">Hanahan and Weinberg, 2011</xref>), and our data do not preclude the possibility that one or both are individually required.<fig-group><fig id="fig6" position="float"><object-id pub-id-type="doi">10.7554/eLife.00969.022</object-id><label>Figure 6.</label><caption><title>Paradoxical ERK activation and JNK pathway inhibition make significant and separable contributions to BRAFi-induced growth.</title><p>(<bold>A</bold>) We envision two separable, parallel mechanisms by which PLX4720 and vemurafenib contribute to cSCC development. Drug-induced paradoxical ERK activation and inhibition of JNK signaling occur in parallel, but the former depends on intact <italic>CRAF</italic>. (<bold>B</bold> and <bold>C</bold>) Representative soft agar colonies of E1A and <italic>HRAS</italic><sup><italic>G12V</italic></sup>-transformed wild-type (WT) (<bold>B</bold>) and <italic>Craf</italic>−/− (<bold>C</bold>) MEFs, following exposure to 0.2 μM and 1.0 μM PLX4720 over 4–6 weeks show significant colony-forming advantages conferred by BRAFi. (<bold>D</bold>) The fold-change in colony counts of transformed wild-type (WT) (n = 22 replicates) and <italic>Craf</italic>−/− (n = 14 replicates) MEFs demonstrate a dose-dependent increase in colonies, particularly for WT MEFs. The difference between colony formation advantages conferred by 1.0 μM PLX4720 in WT vs <italic>Craf</italic>−/− MEFs was interpreted to reflect the contribution of paradoxical ERK signaling (red arrow), which depends upon <italic>Craf</italic>, and is 60% of the total effect (black arrow), with the remainder composed of other effects including JNK inhibition (blue arrow). All differences between each MEF population were significant (‘***’, p&lt;0.001) (<bold>E</bold>) The fold-change in colony counts of transformed HaCaT cells with (‘TKD’) and without (‘SCR’) triple lentiviral shRNA knockdown of ZAK, MAP4K5, and MAP2K4, show significant differences between 1.0 μM PLX4720-treated and control-treated conditions (‘****’, p&lt;10<sup>−10</sup>). Importantly, untreated TKD cells had a significant advantage over untreated SCR HaCaT cells (‘**’, p&lt;0.01), which we interpreted to be the contribution of JNK signaling inhibition, of 17.6% (blue arrow). Drug-treated SCR and TKD cells both had a similar degree of total colony formation advantage (averaged as black arrow), as expected, since the TKD cells are not expected to have any additional suppression of JNK signaling in the presence of drug (‘NS’, p=0.17, <xref ref-type="fig" rid="fig3">Figure 3D</xref>). Therefore, the colony counts for these two distinct systems (<bold>D</bold> and <bold>E</bold>), when taken together, show that JNK pathway inhibition accounts for approximately 17.6–40% and paradoxical ERK activation accounts for approximately 60–82.4% of the total effects of PLX4720 on tumor growth.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.022">http://dx.doi.org/10.7554/eLife.00969.022</ext-link></p></caption><graphic xlink:href="elife00969f006"/></fig><fig id="fig6s1" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.023</object-id><label>Figure 6—figure supplement 1.</label><caption><title>Paradoxical MEK and ERK activation require intact <italic>Craf</italic>.</title><p>Wild-type (WT) and isogenic <italic>Craf</italic>−/− MEFs were retrovirally transduced with <italic>HRAS</italic><sup><italic>G12V</italic></sup> and adenovirus E1A thereby enabling anchorage-independent growth for soft agar assays. (<bold>A</bold>) WT MEFs exhibit paradoxical MEK and ERK activation, effects that are significantly reduced in <italic>Craf</italic>−<italic>/</italic>− MEFs, particularly for MEK activation. (<bold>B</bold>) <italic>HRAS</italic><sup><italic>G12V</italic></sup>–transformed HaCaT cells with (‘TKD’) and without (‘SCR’) triple knockdown of ZAK, MAP4K5, and MAP2K4 show equivalent paradoxical ERK activation. (<bold>C</bold>) Transformed WT and <italic>Craf</italic>−/− MEFs show equivalent expression of E1A (sc-25, Santa Cruz) and RAS (sc-32, Santa Cruz). (<bold>D</bold>) Transformed HaCaT cells show equivalent expression of RAS.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.023">http://dx.doi.org/10.7554/eLife.00969.023</ext-link></p></caption><graphic xlink:href="elife00969fs012"/></fig><fig id="fig6s2" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.024</object-id><label>Figure 6—figure supplement 2.</label><caption><title>Dabrafenib fails to suppress apoptosis and phospho-JNK upregulation following UV irradiation at bioequivalent doses as compared to PLX4720.</title><p>Based upon human pharmacokinetic data and in vitro experiments, dabrafenib and PLX4720 were compared in multiple settings at bioequivalent doses (0.05 μM and 1.0 μM, respectively). (<bold>A</bold>) Both BRAFi suppress the growth of A375 and WM35 <italic>BRAF</italic><sup><italic>V600E</italic></sup> melanoma cell lines to the same degree at these doses. (<bold>B</bold> and <bold>C)</bold> At these doses, dabrafenib fails to suppress UV-induced apoptosis significantly in HaCaT and SRB1 cells. (<bold>D</bold> and <bold>E)</bold> Likewise, dabrafenib fails to suppress phospho-JNK induction, whereas PLX4720 potently suppresses phospho-JNK induction as shown earlier. (<bold>F</bold>) Dabrafenib inhibits ZAK kinase with an estimated IC50 of 28.92 ± 2.23 nM, with no significant inhibition of MAP4K5 or MKK4 up to 1 μM. At 0.01 μM of dabrafenib, the retained activity of ZAK kinase is over 64%.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.024">http://dx.doi.org/10.7554/eLife.00969.024</ext-link></p></caption><graphic xlink:href="elife00969fs013"/></fig><fig id="fig6s3" position="float" specific-use="child-fig"><object-id pub-id-type="doi">10.7554/eLife.00969.025</object-id><label>Figure 6—figure supplement 3.</label><caption><title>Dabrafenib produces a colony formation advantage only in WT MEFs.</title><p>At 0.05 μM, dabrafenib produce a significant growth advantage in E1A-<italic>HRAS</italic><sup><italic>G12V</italic></sup>- transformed WT MEFs. In E1A-<italic>HRAS</italic><sup><italic>G12V</italic></sup>-transformed <italic>Craf</italic>−/− MEFs, dabrafenib fails to confer a significant growth advantage, suggesting that in the absence of significant paradoxical ERK activation, dabrafenib does not have a relevant off-target effect that results in a growth advantage.</p><p><bold>DOI:</bold> <ext-link ext-link-type="doi" xlink:href="10.7554/eLife.00969.025">http://dx.doi.org/10.7554/eLife.00969.025</ext-link></p></caption><graphic xlink:href="elife00969fs014"/></fig></fig-group></p></sec><sec id="s2-8"><title>Dabrafenib and vemurafenib differ significantly in their off-target effects and risk of cSCC</title><p>The recently updated combination trial of the BRAFi dabrafenib and MEKi trametinib shows a low 7% cSCC rate in 54 patients, (<xref ref-type="bibr" rid="bib22a">Flaherty et al., 2012</xref>) suggesting that combined MEK inhibition can reduce, but not eliminate cSCC formation, nevertheless reinforcing a role for paradoxical ERK activation (<xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>). However, clinical trial data on dabrafenib alone at 150 mg PO BID, shows an overall aggregated cSCC rate of 6.1% (<xref ref-type="bibr" rid="bib21">Falchook et al., 2012</xref>; <xref ref-type="bibr" rid="bib30">Hauschild et al., 2012</xref>; <xref ref-type="bibr" rid="bib42a">Long et al., 2012</xref>) vs 22% for vemurafenib at 960 mg PO BID in several hundred patients (<xref ref-type="bibr" rid="bib22">Flaherty et al., 2010</xref>; <xref ref-type="bibr" rid="bib10">Chapman et al., 2011</xref>; <xref ref-type="bibr" rid="bib54">Sosman et al., 2012</xref>; <xref ref-type="bibr" rid="bib44">Menzies et al., 2013</xref>). We interpreted this as being reflective of differences between vemurafenib and dabrafenib, as opposed to unequivocal proof that paradoxical ERK activation is the only mechanism involved. To explore this further, we used similar assays to assess the effects of dabrafenib on apoptosis, JNK signaling, and colony formation. In stark contrast to vemurafenib, dabrafenib has little effect on apoptosis and JNK signaling at doses that are biologically equivalent based upon growth inhibition of <italic>BRAF</italic><sup><italic>V600E</italic></sup> melanoma cells and human pharmacokinetic data (<xref ref-type="bibr" rid="bib21">Falchook et al., 2012</xref>; <xref ref-type="bibr" rid="bib23">Gowrishankar et al., 2012</xref>) (<xref ref-type="fig" rid="fig6s2">Figure 6—figure supplement 2A</xref>). Peak serum concentrations of dabrafenib at 150 mg PO BID in humans (<xref ref-type="bibr" rid="bib21">Falchook et al., 2012</xref>) are over 50-fold lower (1.55 μM) than mean sustained serum levels of vemurafenib (86 μM) at 960 mg PO BID (<xref ref-type="bibr" rid="bib22">Flaherty et al., 2010</xref>), and the GI<sub>50</sub> for the A375 melanoma cell line is less than 0.01 μM for dabrafenib (<xref ref-type="bibr" rid="bib24">Greger et al., 2012</xref>) vs 0.50 μM for PLX4720 (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>). Even at 0.05 μM, dabrafenib did not significantly impact UV-induced phospho-JNK upregulation or apoptosis in HaCaT and SRB1 cells (<xref ref-type="fig" rid="fig6s2">Figure 6—figure supplement 2B–E</xref>). We profiled dabrafenib activity against ZAK, MKK4, and MAP4K5, and found that ZAK is a significant off-target kinase for dabrafenib as well, but at 0.01 μM, over 64% of activity is retained (<xref ref-type="fig" rid="fig6s2">Figure 6—figure supplement 2F</xref>). Neither MKK4 nor MAP4K5 is substantially inhibited by dabrafenib up to 1 μM (<xref ref-type="fig" rid="fig6s2">Figure 6—figure supplement 2F</xref>).</p><p>Using transformed WT and <italic>Craf</italic>-deficient MEFs in soft agar assays, we also showed that dabrafenib enhanced colony formation in WT MEFs, but not in <italic>Craf</italic>-deficient MEFs (<xref ref-type="fig" rid="fig6s3">Figure 6—figure supplement 3</xref>). Our results suggest that while both dabrafenib and vemurafenib cause equivalent paradoxical ERK activation in <italic>BRAF</italic>-wild-type cells (<xref ref-type="fig" rid="fig6s1">Figure 6—figure supplement 1A–B</xref>), only vemurafenib confers a significant colony formation advantage in <italic>Craf</italic>-deficient cells that have no significant paradoxical MEK/ERK activation, implicating off-target effects as a key difference between the two drugs with respect to cSCC development (<xref ref-type="bibr" rid="bib44">Menzies et al., 2013</xref>).</p></sec></sec><sec id="s3" sec-type="discussion"><title>Discussion</title><p>We have discovered an unexpected and novel effect of the BRAFi PLX4720 and vemurafenib in inhibiting apoptosis in vitro and in vivo through the ERK-independent suppression of JNK signaling (<xref ref-type="bibr" rid="bib61">Tournier et al., 2000</xref>). Our studies implicate the off-target binding and inhibition of these compounds to ZAK primarily (<xref ref-type="fig" rid="fig3s1 fig3s2 fig3s3">Figure 3—figure supplements 1–3</xref>), with additional contributions of MKK4 (MAP2K4) and MAP4K5 inhibition, thus implicating inhibition of JNK signaling at all three upstream tiers of MAP kinase signaling (<xref ref-type="fig" rid="fig3s4">Figure 3—figure supplement 4</xref>). Although MKK4 knockdown alone could suppress UV-induced apoptosis and phospho-JNK induction by up to 27.3% (<xref ref-type="fig" rid="fig3s2">Figure 3—figure supplement 2</xref>), this is expected, given that ZAK signals through MKK4 and MKK7 (<xref ref-type="bibr" rid="bib25">Gross et al., 2002</xref>) (<xref ref-type="fig" rid="fig2 fig3 fig4">Figure 2H,I,3E,4H</xref>) and MKK4 is important (with MKK7) for full JNK activation (<xref ref-type="bibr" rid="bib62">Tournier et al., 2001</xref>; <xref ref-type="bibr" rid="bib26">Haeusgen et al., 2011</xref>). Additionally, UV-mediated induction of NOXA is suppressed in cell lines, primary NHEKs, and in vivo, indicating that this BCL2 family member may be a critical effector of apoptosis in this context (<xref ref-type="fig" rid="fig1 fig4">Figures 1G and 4I</xref>). In chronically-irradiated Hairless mice, development of well-differentiated papillomas and cSCC is substantially accelerated by PLX4720 treatment without the need for <italic>Ras</italic> mutation and with a dramatic reduction in latency by at least 10 weeks (<xref ref-type="fig" rid="fig5">Figure 5E</xref>, <xref ref-type="fig" rid="fig5s1">Figure 5—figure supplement 1</xref>).</p><p>While there is enrichment for <italic>RAS</italic> mutations in human cSCC arising in vemurafenib-treated patients vs controls (<xref ref-type="bibr" rid="bib47">Oberholzer et al., 2011</xref>; <xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>), up to 30–40% of these lesions do not have <italic>RAS</italic> mutations. Our novel mechanism of BRAFi-mediated apoptosis suppression is the off-target inhibition of several kinases in the JNK pathway, which is independent from, and compatible with, paradoxical ERK–dependent mechanisms (<xref ref-type="bibr" rid="bib57">Su et al., 2012</xref>) (<xref ref-type="fig" rid="fig6">Figure 6A</xref>). Importantly, our approach (<xref ref-type="fig" rid="fig6">Figure 6B–E</xref>) has not only allowed us to quantify the contribution of the effect on apoptosis (17.6–40%) vs paradoxical ERK activation (60–82.4%), but also shows that the growth advantage conferred by BRAFi in <italic>BRAF</italic>-WT cells is not accounted for entirely by paradoxical ERK activation. Our results have also shown that there are significant differences between the BRAFi vemurafenib and dabrafenib (<xref ref-type="fig" rid="fig6s2 fig6s3">Figure 6—figure supplements 2,3</xref>) with respect to these off-target effects in cells (even though their relative selectivities for BRAF over ZAK are similar) and this may, in part, explain why they differ in rates of cSCC (<xref ref-type="bibr" rid="bib22">Flaherty et al., 2010</xref>; <xref ref-type="bibr" rid="bib10">Chapman et al., 2011</xref>; <xref ref-type="bibr" rid="bib21">Falchook et al., 2012</xref>; <xref ref-type="bibr" rid="bib30">Hauschild et al., 2012</xref>; <xref ref-type="bibr" rid="bib42a">Long et al., 2012</xref>; <xref ref-type="bibr" rid="bib54">Sosman et al., 2012</xref>). At present it is unclear why ZAK appears to be a common off-target kinase and whether structural similarities with other kinases may explain this (<xref ref-type="bibr" rid="bib52">Sauter et al., 2010</xref>; <xref ref-type="bibr" rid="bib71">Wong et al., 2013</xref>).</p><p>ZAK has been previously studied in the context of bacterial toxin and doxorubicin-mediated cytokine signaling (<xref ref-type="bibr" rid="bib36">Jandhyala et al., 2008</xref>; <xref ref-type="bibr" rid="bib52">Sauter et al., 2010</xref>; <xref ref-type="bibr" rid="bib55">Stone et al., 2012</xref>; <xref ref-type="bibr" rid="bib71">Wong et al., 2013</xref>), cardiac (<xref ref-type="bibr" rid="bib34">Huang et al., 2004</xref>) and ischemic stress responses (<xref ref-type="bibr" rid="bib58">Su et al., 2012</xref>), and in cellular responses to ionizing radiation (<xref ref-type="bibr" rid="bib25">Gross et al., 2002</xref>; <xref ref-type="bibr" rid="bib60">Tosti et al., 2004</xref>; <xref ref-type="bibr" rid="bib65">Vanan et al., 2012</xref>). It is widely expressed across tissues including epidermis, but most prominently in heart, liver, and muscle (<xref ref-type="bibr" rid="bib1">Abe et al., 1995</xref>; <xref ref-type="bibr" rid="bib45">Miyata et al., 1999</xref>; <xref ref-type="bibr" rid="bib42">Liu et al., 2000</xref>; <xref ref-type="bibr" rid="bib3">Bloem et al., 2001</xref>; <xref ref-type="bibr" rid="bib25">Gross et al., 2002</xref>; <xref ref-type="bibr" rid="bib56">Su et al., 2004</xref>), and has purported tumor suppressive roles in lung cancer (<xref ref-type="bibr" rid="bib72">Yang et al., 2010</xref>) and tumor promoting ones in partially transformed mouse skin epidermal cells (<xref ref-type="bibr" rid="bib14">Cho et al., 2004</xref>). ZAK is a MAP3K that is upstream of both JNK and p38 signaling (<xref ref-type="bibr" rid="bib25">Gross et al., 2002</xref>; <xref ref-type="bibr" rid="bib60">Tosti et al., 2004</xref>; <xref ref-type="bibr" rid="bib36">Jandhyala et al., 2008</xref>; <xref ref-type="bibr" rid="bib13">Cheng et al., 2009</xref>; <xref ref-type="bibr" rid="bib55">Stone et al., 2012</xref>; <xref ref-type="bibr" rid="bib71">Wong et al., 2013</xref>) and signals to JNK through MKK4 and MKK7 (<xref ref-type="bibr" rid="bib25">Gross et al., 2002</xref>) (<xref ref-type="fig" rid="fig2 fig3 fig4">Figures 2H,I,3E,4H</xref>). Accordingly, macrophages derived from ZAK-deficient mice have profound defects in activation of both JNK and p38 signaling following doxorubicin exposure (<xref ref-type="bibr" rid="bib71">Wong et al., 2013</xref>). In the setting of UV-induced apoptosis as we have examined here, JNK activity is the major driver of apoptosis (<xref ref-type="bibr" rid="bib20">Derijard et al., 1994</xref>; <xref ref-type="bibr" rid="bib11">Chen et al., 1996</xref>; <xref ref-type="bibr" rid="bib61">Tournier et al., 2000</xref>), also by virtue of the fact that phospho-p38 induction by UV is inconstant (<xref ref-type="fig" rid="fig1 fig2 fig4">Figures 1F,H,2B,4H</xref>); although where it is induced, PLX4720/vemurafenib treatment suppresses it (<xref ref-type="fig" rid="fig1">Figure 1F</xref> (SRB1, HaCaT cells), <xref ref-type="fig" rid="fig1 fig2">Figures 1H,2B</xref>). These results are consistent with the model (<xref ref-type="fig" rid="fig3s4">Figure 3—figure supplement 4</xref>) that ZAK signals to both JNK and p38, but is principally necessary for activating JNK in stress-induced apoptosis.</p><p>Because off-target kinases in the JNK pathway are affected by vemurafenib/PLX4720, one expects that these kinases would be affected in all cells regardless of <italic>BRAF</italic> status. Indeed, melanoma cells expressing BRAF<sup>V600E</sup> also exhibit suppression of JNK activity following irradiation (<xref ref-type="fig" rid="fig1">Figure 1H</xref>). However, in <italic>BRAF</italic><sup><italic>V600E</italic></sup>-expressing melanoma cells, the effect of blocking BRAF activity alone clearly dominates, because these cells are exquisitely dependent upon BRAF activity (<xref ref-type="bibr" rid="bib63">Tsai et al., 2008</xref>). Therefore, although off-target kinases are inhibited, the cellular context of dependence on particular kinases is still highly relevant and likely dictates the outcome.</p><p>Our findings suggest a tumor suppressive role for JNK signaling in the context of drug-induced cSCC, though the role of JNK in cancer is highly context-dependent and is partly related to differing functions of the individual isoforms and partial redundancy (<xref ref-type="bibr" rid="bib61">Tournier et al., 2000</xref>). Nonetheless, there is ample in vivo evidence showing that JNK can function in a tumor suppressive role. Genetically-engineered mice lacking <italic>Jnk1</italic> and <italic>Jnk2</italic> have increased (<xref ref-type="bibr" rid="bib53">She et al., 2002</xref>) and decreased (<xref ref-type="bibr" rid="bib12">Chen et al., 2001</xref>) susceptibility, respectively, to chemical carcinogenesis in skin, though these mice also have opposite defects in epidermal differentiation (<xref ref-type="bibr" rid="bib69">Weston et al., 2004</xref>). In mouse models, lack of <italic>Jnk1/2</italic> activity suppresses <italic>Ras</italic>-driven tumorigenesis in lung (<xref ref-type="bibr" rid="bib8">Cellurale et al., 2011</xref>) and promotes it in <italic>Ras</italic>-driven and <italic>Trp53</italic>-deficient breast cancer models (<xref ref-type="bibr" rid="bib7">Cellurale et al., 2010</xref>, <xref ref-type="bibr" rid="bib9">2012</xref>). In the context of <italic>Pten</italic>-deficiency, loss of <italic>Jnk1/2</italic> or <italic>Mkk4</italic>/<italic>Mkk7</italic> promotes aggressive prostate adenocarcinoma (<xref ref-type="bibr" rid="bib35">Hubner et al., 2012</xref>). Importantly, the effects of JNK on cancer are not always tumor cell autonomous, as JNK activity supports a pro-tumorigenic inflammatory microenvironment in hepatocellular carcinoma (<xref ref-type="bibr" rid="bib17">Das et al., 2011</xref>).</p><p>Our results have important clinical implications and suggest careful consideration of combining certain BRAFi with therapeutic modalities that induce apoptosis such as radiation or chemotherapy, particularly with respect to off-target tissues (keratinocytes in skin). We have shown that off-target inhibition of kinases, even at higher IC50s, can contribute biologically significant effects, particularly if they are in the same pathway. Finally, our results show that kinase inhibitors must be considered in terms of their entire spectrum of activity, which can dramatically affect pathways distinct from those affected by inhibition of the intended target.</p></sec><sec id="s4" sec-type="materials|methods"><title>Materials and methods</title><sec id="s4-1"><title>Ethics statement</title><p>All studies were conducted under institutionally-approved IRB (LAB08-0750) and ACUF (06-09-06332) protocols for the protection of human and animal subjects, respectively.</p></sec><sec id="s4-2"><title>Cell lines</title><p>Cutaneous SCC cell lines (SRB1, SRB12, COLO16) were obtained from Jeffrey N Myers (MD Anderson), HaCaT cells from Norbert Fusenig (German Cancer Research Center), and WM35 and A375 melanoma cell lines from Michael Davies (MD Anderson). The cell lines were validated by STR DNA fingerprinting using the AmpFℓSTR Identifiler kit according to manufacturer instructions (Applied Biosystems, Grand Island, NY). The STR profiles were compared to known ATCC fingerprints (<ext-link ext-link-type="uri" xlink:href="http://ATCC.org">ATCC.org</ext-link>), to the Cell Line Integrated Molecular Authentication database (CLIMA) version 0.1.200808 (<ext-link ext-link-type="uri" xlink:href="http://bioinformatics.istge.it/clima/">http://bioinformatics.istge.it/clima/</ext-link>) and to the MD Anderson fingerprint database. The STR profiles matched known DNA fingerprints (HaCaT) or were unique (SRB1, SRB12, COLO16). The cells were cultured in DMEM/Ham’s F12 50/50 (Cellgro) supplemented with 10% Fetal Bovine Serum (FBS) (Sigma), glutamine, and Primocin (Invivogen). NHEKs (Lonza) were cultured in media according to manufacturer’s instructions. Irradiation was performed using an FS40 sunlamp dosed by an IL1700 radiometer. Following irradiation, cells were treated with PLX4720 (Plexxikon), vemurafenib (Selleck Chemicals) or DMSO (1:2000).</p></sec><sec id="s4-3"><title>Antibodies</title><p>Primary antibodies (Cell Signaling) used for Western blot analysis included p53 (2527P, clone 7F5), phospho-/total p44/42 MAPK (4370S, cloneD13.14.4E/9102S), phospho-/total p38 MAPK (4511S, clone D3F9/9212S), phospho-/total JNK (4668S, clone 81E11/9252S), BIM (2933, clone C34C5), MCL1 (5453P, clone D35A5), cleaved caspase-3 (9661L, clone D175), phospho-/total MKK7 (4171S/4172S), phospho-/total MKK4 (9156S/9152S), phospho-/total MEK (9121S/9122), MAP4K5 (ab56848; Abcam) and NOXA (mA1-41000; Thermo Scientific). GAPDH (21,182, clone 14C10; Cell Signaling) and beta-actin (A5060; Sigma) were probed to ensure even loading of protein samples. Immunohistochemistry was performed for phospho-JNK (V7931; Promega) and cleaved caspase-3 (Cell Signaling as above). Antibody against ZAK was generously provided by R Ruggieri (Feinstein Institute for Medical Research).</p></sec><sec id="s4-4"><title>Flow Cytometry</title><p>TMRE (Invitrogen) was used as a measure of mitochondrial membrane potential, Annexin V-FITC or Annexin V-APC (Invitrogen) as a probe for apoptosis, and Sytox Blue (Invitrogen) as an indicator for dead cells. At 24 hr post-irradiation, floating and adherent cells were collected and stained with TMRE, Annexin V and Sytox Blue. Data was collected and analyzed using a flow cytometer (Fortessa, Becton Dickinson) and FlowJo Software (Tree Star). Data were calculated and charts were plotted using GraphPad Prism 5 software.</p></sec><sec id="s4-5"><title>Western blot analysis</title><p>Cell were lysed in standard buffers with protease inhibitors (Roche) and phosphatase inhibitors (Santa Cruz) with extracts run on SDS/polyacrylamide gels and transferred to Immobilon-P transfer membrane (Millipore). Blots were blocked in TBST (10 mM Tris-HCL pH8, 150 mM NaCl, 0.5% Tween) with milk or BSA, probed with primary antibodies, corresponding HRP-conjugated secondary antibodies, and signals detected using ECL kit (Amersham).</p></sec><sec id="s4-6"><title>Immunohistochemistry and histology</title><p>Cutaneous squamous cell carcinomas biopsied from patients treated with or without BRAF-inhibitor were obtained either under clinical trials (Roche) or separate IRB approval (LAB08-0750). Staining levels were quantified by counting positively labeled cells and dividing by the total area of the tumor tissue within each sample. To measure tumor areas, all samples were photographed, tumor cells outlined, and total pixel numbers calculated using included image analysis tools in Adobe Photoshop and standardized to a hemacytometer to convert to mm<sup>2</sup>. To measure apoptosis in irradiated skin, pyknotic or dyskeratotic epidermal keratinocytes were counted and normalized to length (mm) of epidermis.</p></sec><sec id="s4-7"><title>Kinase activity profiling</title><p>PLX4720 and vemurafenib were prepared in DMSO and tested in duplicate at four concentrations (50 nM, 200 nM, 1000 nM, 10 μM) against a panel of 38 kinases using a quantitative competitive binding assay (KINOMEscan, San Diego, CA). Average percent inhibition was reported. Estimated <italic>K</italic><sub><italic>d</italic></sub> values were derived by averaging pointwise estimates calculated using a transformed Hill equation at each concentration of drug. In vitro kinase assays were performed using human full-length ZAK (MBP substrate, ATP 2.5 μM), amino acids 33-end MKK4 (JNK1 substrate, ATP 0.1 μM), and full length MAP4K5 (MBP substrate, ATP 10 μM) (Reaction Biology). Assays for BRAF<sup>V600E</sup> and ASK1 against vemurafenib were run in parallel revealing IC50s of 31.6 ± 2.9 nM for BRAF<sup>V600E</sup> and no significant inhibition of ASK1, as previously reported (<xref ref-type="bibr" rid="bib4">Bollag et al., 2010</xref>).</p></sec><sec id="s4-8"><title>Lentiviral knockdown experiments</title><p>Lentiviral shRNA knockdown was accomplished using standard lentiviral methods using 293T cells and psPAX2/pVSV.G packaging plasmids. shRNA clones against ZAK (clones V2LHS_239842, V3LHS_336769), MKK4 (clones V3LHS_646205, V3LHS_386825A), and MAP4K5 (clones 196277A, 334084), as well as a non-silencing shRNA were obtained from Open Biosystems in the GIPZ vector. Following transduction, cells were puromycin-selected and FACS sorted to obtain cells with high-level suppression. Degree of mRNA suppression was quantified by qPCR using Taqman probes using internally controlled (2-color, same well) GAPDH probes to ensure proper normalization.</p></sec><sec id="s4-9"><title>ZAK overexpression</title><p>ZAK (T82Q) mutant was generated in the pcDNA3 mammalian expression vector. HaCaT cells were electroporated using the Neon transfection system 24 hr prior to irradiation. Transfection efficiencies were estimated to be 70–80% by GFP fluorescence.</p></sec><sec id="s4-10"><title>Mouse experiments</title><p>Wild-type C57BL/6 mice, 5–8 weeks old, were pretreated with PLX4720 in 5% DMSO in 1% methylcellulose for 2–4 days at 40–80 mg/kg twice a day or control 5% DMSO in 1% methylcellulose by oral gavage. The mice were shaved and depilated (Nair) 24 hr prior to irradiation with a solar simulator (Oriel) dosed at 10 kJ/m<sup>2</sup> of UVB. Epidermis was harvested and protein extracts run on Western blots and probed as above. For chronically-irradiated Hairless mice, 3–4 week old males were irradiated thrice weekly for a total weekly dose of 12.5 kJ/m<sup>2</sup> UVB (solar simulator, Oriel). At 72 days, PLX4720 treatment was started using drug-impregnated chow (Plexxikon) with vehicle chow in the control cohort.</p></sec><sec id="s4-11"><title>Soft agar assays</title><p>Following plating of bottom agar (0.6% Bacto Agar) with media and appropriate amounts of drug, 2500 to 10,000 cells per well (transformed WT, <italic>Craf</italic>−/− MEFs; transformed HaCaT SCR and TKD cells) were embedded in top agar (0.3%) and plated in 24-well plates. Control or drug-treated media was replaced every 48 hr for 4–6 weeks. The plates were stained with 1% crystal violet and colonies counted by bright-field microscopy.</p></sec><sec id="s4-12"><title>Statistical analysis</title><p>All data are represented as means ± SEM. All experiments were performed in triplicate at least. Student’s t-test was used for comparison between two groups. p≤0.05 was considered significant.</p></sec></sec></body><back><ack id="ack"><title>Acknowledgements</title><p>The authors acknowledge the assistance of Trellis Thompson in initial cell culture experiments, Sherie Mudd, Humaira Khan, Hafsa Ahmed, and Patricia Sheffield for histology, Nasser Kazimi and Omid Tavana for assistance in UV radiation experiments, Haiching Ma, Sean Deacon, Gideon Bollag, Chao Zhang, Zhiqiang Wang, and R Eric Davis for experimental advice and reagents, and the South Campus Vivarium for mouse maintenance. KYT acknowledges Ronald P Rapini for departmental support as well as Tyler Jacks, Gordon B Mills, Patrick Hwu, and Jeffrey N Myers for critical discussions and mentorship. KYT acknowledges the funding support of DX Biosciences Cancer Research Fund, MD Anderson Cancer IRG Program, American Skin Association, Elsa U Pardee Foundation, institutional funds, and NCI CA16672 (FACS, Characterized Cell Line, and DNA Analysis Facility Cores). This paper is dedicated to the memories of Lee ‘Sarge’ Englet and Thomas C R Huang.</p></ack><sec sec-type="additional-information"><title>Additional information</title><fn-group content-type="competing-interest"><title>Competing interests</title><fn fn-type="conflict" id="conf1"><p>The authors declare that no competing interests exist.</p></fn></fn-group><fn-group content-type="author-contribution"><title>Author contributions</title><fn fn-type="con" id="con1"><p>HV, Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting or revising the article</p></fn><fn fn-type="con" id="con2"><p>SSO, Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting or revising the article</p></fn><fn fn-type="con" id="con3"><p>KYT, Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting or revising the article</p></fn><fn fn-type="con" id="con4"><p>GC, Acquisition of data, Analysis and interpretation of data, Drafting or revising the article</p></fn><fn fn-type="con" id="con5"><p>MLL, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con6"><p>VC, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con7"><p>DWD, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con8"><p>CHA, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con9"><p>MR, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con10"><p>KNR, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con11"><p>LRS, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con12"><p>LD, Acquisition of data, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con13"><p>SBF, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con14"><p>DC, Conception and design, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con15"><p>SEU, Conception and design, Analysis and interpretation of data</p></fn><fn fn-type="con" id="con16"><p>KE, Provided critical advice and input on use of Craf−/− cells, Conception and design, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con17"><p>MB, Provided critical advice and input on use of Craf−/− cells, Conception and design, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con18"><p>RR, Provided critical advice and input on use of anti-ZAK antibody, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con19"><p>JLC, Acquisition of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con20"><p>KBK, Identification of appropriate patient samples, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con21"><p>AMC, Identification of appropriate patient samples, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con22"><p>MD, Identification of appropriate patient samples, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con23"><p>VGP, Identification of appropriate patient samples, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con24"><p>KND, Conception and design, Analysis and interpretation of data, Contributed unpublished essential data or reagents</p></fn><fn fn-type="con" id="con25"><p>ERF, Conception and design, Analysis and interpretation of data, Drafting or revising the article</p></fn></fn-group><fn-group content-type="ethics-information"><title>Ethics</title><fn fn-type="other"><p>Human subjects: All human samples were archived tissue specimens made available for study through University of Texas MD Anderson Cancer Center IRB approved protocol LAB08-0750 (KYT). Informed consent specifically for these samples was not necessary due to the fact that they were de-identified, archived FFPE specimens.</p><p>Animal experimentation: This study was performed in strict accordance with the recommendations in the Guide for the Care and Use of Laboratory Animals of the National Institutes of Health. All of the animals were handled according to approved institutional animal care and use committee (IACUC) protocols (#06-09-06332) of the University of Texas MD Anderson Cancer Center. Every effort was made to minimize suffering.</p></fn></fn-group></sec><ref-list><title>References</title><ref id="bib1"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Abe</surname><given-names>S</given-names></name><name><surname>Yagi</surname><given-names>T</given-names></name><name><surname>Ishiyama</surname><given-names>S</given-names></name><name><surname>Hiroe</surname><given-names>M</given-names></name><name><surname>Marumo</surname><given-names>F</given-names></name><name><surname>Ikawa</surname><given-names>Y</given-names></name></person-group><year>1995</year><article-title>Molecular cloning of a novel serine/threonine kinase, MRK, possibly involved in cardiac development</article-title><source>Oncogene</source><volume>11</volume><fpage>2187</fpage><lpage>95</lpage></element-citation></ref><ref id="bib2"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Anastassiadis</surname><given-names>T</given-names></name><name><surname>Deacon</surname><given-names>SW</given-names></name><name><surname>Devarajan</surname><given-names>K</given-names></name><name><surname>Ma</surname><given-names>H</given-names></name><name><surname>Peterson</surname><given-names>JR</given-names></name></person-group><year>2011</year><article-title>Comprehensive assay of kinase catalytic activity reveals features of kinase inhibitor selectivity</article-title><source>Nat Biotechnol</source><volume>29</volume><fpage>1039</fpage><lpage>45</lpage><pub-id pub-id-type="doi">10.1038/nbt.2017</pub-id></element-citation></ref><ref id="bib3"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bloem</surname><given-names>LJ</given-names></name><name><surname>Pickard</surname><given-names>TR</given-names></name><name><surname>Acton</surname><given-names>S</given-names></name><name><surname>Donoghue</surname><given-names>M</given-names></name><name><surname>Beavis</surname><given-names>RC</given-names></name><name><surname>Knierman</surname><given-names>MD</given-names></name><etal/></person-group><year>2001</year><article-title>Tissue distribution and functional expression of a cDNA encoding a novel mixed lineage kinase</article-title><source>J Mol Cell Cardiol</source><volume>33</volume><fpage>1739</fpage><lpage>50</lpage><pub-id pub-id-type="doi">10.1006/jmcc.2001.1437</pub-id></element-citation></ref><ref id="bib4"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Bollag</surname><given-names>G</given-names></name><name><surname>Hirth</surname><given-names>P</given-names></name><name><surname>Tsai</surname><given-names>J</given-names></name><name><surname>Zhang</surname><given-names>J</given-names></name><name><surname>Ibrahim</surname><given-names>PN</given-names></name><name><surname>Cho</surname><given-names>H</given-names></name><etal/></person-group><year>2010</year><article-title>Clinical efficacy of a RAF inhibitor needs broad target blockade in BRAF-mutant melanoma</article-title><source>Nature</source><volume>467</volume><fpage>596</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1038/nature09454</pub-id></element-citation></ref><ref id="bib5"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brennan</surname><given-names>DF</given-names></name><name><surname>Dar</surname><given-names>AC</given-names></name><name><surname>Hertz</surname><given-names>NT</given-names></name><name><surname>Chao</surname><given-names>WC</given-names></name><name><surname>Burlingame</surname><given-names>AL</given-names></name><name><surname>Shokat</surname><given-names>KM</given-names></name><etal/></person-group><year>2011</year><article-title>A Raf-induced allosteric transition of KSR stimulates phosphorylation of MEK</article-title><source>Nature</source><volume>472</volume><fpage>366</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1038/nature09860</pub-id></element-citation></ref><ref id="bib6"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Brown</surname><given-names>K</given-names></name><name><surname>Buchmann</surname><given-names>A</given-names></name><name><surname>Balmain</surname><given-names>A</given-names></name></person-group><year>1990</year><article-title>Carcinogen-induced mutations in the mouse c-Ha-ras gene provide evidence of multiple pathways for tumor progression</article-title><source>Proc Natl Acad Sci USA</source><volume>87</volume><fpage>538</fpage><lpage>42</lpage><pub-id pub-id-type="doi">10.1073/pnas.87.2.538</pub-id></element-citation></ref><ref id="bib7"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cellurale</surname><given-names>C</given-names></name><name><surname>Weston</surname><given-names>CR</given-names></name><name><surname>Reilly</surname><given-names>J</given-names></name><name><surname>Garlick</surname><given-names>DS</given-names></name><name><surname>Jerry</surname><given-names>DJ</given-names></name><name><surname>Sluss</surname><given-names>HK</given-names></name><etal/></person-group><year>2010</year><article-title>Role of JNK in a Trp53-dependent mouse model of breast cancer</article-title><source>PLOS ONE</source><volume>5</volume><fpage>e12469</fpage><pub-id pub-id-type="doi">10.1371/journal.pone.0012469</pub-id></element-citation></ref><ref id="bib8"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cellurale</surname><given-names>C</given-names></name><name><surname>Sabio</surname><given-names>G</given-names></name><name><surname>Kennedy</surname><given-names>NJ</given-names></name><name><surname>Das</surname><given-names>M</given-names></name><name><surname>Barlow</surname><given-names>M</given-names></name><name><surname>Sandy</surname><given-names>P</given-names></name><etal/></person-group><year>2011</year><article-title>Requirement of c-Jun NH(2)-terminal kinase for Ras-initiated tumor formation</article-title><source>Mol Cell Biol</source><volume>31</volume><fpage>1565</fpage><lpage>76</lpage><pub-id pub-id-type="doi">10.1128/MCB.01122-10</pub-id></element-citation></ref><ref id="bib9"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cellurale</surname><given-names>C</given-names></name><name><surname>Girnius</surname><given-names>N</given-names></name><name><surname>Jiang</surname><given-names>F</given-names></name><name><surname>Cavanagh-Kyros</surname><given-names>J</given-names></name><name><surname>Lu</surname><given-names>S</given-names></name><name><surname>Garlick</surname><given-names>DS</given-names></name><etal/></person-group><year>2012</year><article-title>Role of JNK in mammary gland development and breast cancer</article-title><source>Cancer Res</source><volume>72</volume><fpage>472</fpage><lpage>81</lpage><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-11-1628</pub-id></element-citation></ref><ref id="bib10"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chapman</surname><given-names>PB</given-names></name><name><surname>Hauschild</surname><given-names>A</given-names></name><name><surname>Robert</surname><given-names>C</given-names></name><name><surname>Haanen</surname><given-names>JB</given-names></name><name><surname>Ascierto</surname><given-names>P</given-names></name><name><surname>Larkin</surname><given-names>J</given-names></name><etal/></person-group><year>2011</year><article-title>Improved survival with vemurafenib in melanoma with BRAF V600E mutation</article-title><source>N Engl J Med</source><volume>364</volume><fpage>2507</fpage><lpage>16</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1103782</pub-id></element-citation></ref><ref id="bib11"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>YR</given-names></name><name><surname>Wang</surname><given-names>X</given-names></name><name><surname>Templeton</surname><given-names>D</given-names></name><name><surname>Davis</surname><given-names>RJ</given-names></name><name><surname>Tan</surname><given-names>TH</given-names></name></person-group><year>1996</year><article-title>The role of c-Jun N-terminal kinase (JNK) in apoptosis induced by ultraviolet C and gamma radiation. Duration of JNK activation may determine cell death and proliferation</article-title><source>J Biol Chem</source><volume>271</volume><fpage>31929</fpage><lpage>36</lpage><pub-id pub-id-type="doi">10.1074/jbc.271.50.31929</pub-id></element-citation></ref><ref id="bib12"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Chen</surname><given-names>N</given-names></name><name><surname>Nomura</surname><given-names>M</given-names></name><name><surname>She</surname><given-names>QB</given-names></name><name><surname>Ma</surname><given-names>WY</given-names></name><name><surname>Bode</surname><given-names>AM</given-names></name><name><surname>Wang</surname><given-names>L</given-names></name><etal/></person-group><year>2001</year><article-title>Suppression of skin tumorigenesis in c-Jun NH(2)-terminal kinase-2-deficient mice</article-title><source>Cancer Res</source><volume>61</volume><fpage>3908</fpage><lpage>12</lpage></element-citation></ref><ref id="bib13"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cheng</surname><given-names>YC</given-names></name><name><surname>Kuo</surname><given-names>WW</given-names></name><name><surname>Wu</surname><given-names>HC</given-names></name><name><surname>Lai</surname><given-names>TY</given-names></name><name><surname>Wu</surname><given-names>CH</given-names></name><name><surname>Hwang</surname><given-names>JM</given-names></name><etal/></person-group><year>2009</year><article-title>ZAK induces MMP-2 activity via JNK/p38 signals and reduces MMP-9 activity by increasing TIMP-1/2 expression in H9c2 cardiomyoblast cells</article-title><source>Mol Cell Biochem</source><volume>325</volume><fpage>69</fpage><lpage>77</lpage><pub-id pub-id-type="doi">10.1007/s11010-008-0021-1</pub-id></element-citation></ref><ref id="bib14"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cho</surname><given-names>YY</given-names></name><name><surname>Bode</surname><given-names>AM</given-names></name><name><surname>Mizuno</surname><given-names>H</given-names></name><name><surname>Choi</surname><given-names>BY</given-names></name><name><surname>Choi</surname><given-names>HS</given-names></name><name><surname>Dong</surname><given-names>Z</given-names></name></person-group><year>2004</year><article-title>A novel role for mixed-lineage kinase-like mitogen-activated protein triple kinase alpha in neoplastic cell transformation and tumor development</article-title><source>Cancer Res</source><volume>64</volume><fpage>3855</fpage><lpage>64</lpage><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-04-0201</pub-id></element-citation></ref><ref id="bib15"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Cho</surname><given-names>KJ</given-names></name><name><surname>Kasai</surname><given-names>RS</given-names></name><name><surname>Park</surname><given-names>JH</given-names></name><name><surname>Chigurupati</surname><given-names>S</given-names></name><name><surname>Heidorn</surname><given-names>SJ</given-names></name><name><surname>van der Hoeven</surname><given-names>D</given-names></name><etal/></person-group><year>2012</year><article-title>Raf inhibitors target ras spatiotemporal dynamics</article-title><source>Curr Biol</source><volume>22</volume><fpage>945</fpage><lpage>55</lpage><pub-id pub-id-type="doi">10.1016/j.cub.2012.03.067</pub-id></element-citation></ref><ref id="bib16"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Collins</surname><given-names>NL</given-names></name><name><surname>Reginato</surname><given-names>MJ</given-names></name><name><surname>Paulus</surname><given-names>JK</given-names></name><name><surname>Sgroi</surname><given-names>DC</given-names></name><name><surname>Labaer</surname><given-names>J</given-names></name><name><surname>Brugge</surname><given-names>JS</given-names></name></person-group><year>2005</year><article-title>G1/S cell cycle arrest provides anoikis resistance through Erk-mediated Bim suppression</article-title><source>Mol Cell Biol</source><volume>25</volume><fpage>5282</fpage><lpage>91</lpage><pub-id pub-id-type="doi">10.1128/MCB.25.12.5282-5291.2005</pub-id></element-citation></ref><ref id="bib17"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Das</surname><given-names>M</given-names></name><name><surname>Garlick</surname><given-names>DS</given-names></name><name><surname>Greiner</surname><given-names>DL</given-names></name><name><surname>Davis</surname><given-names>RJ</given-names></name></person-group><year>2011</year><article-title>The role of JNK in the development of hepatocellular carcinoma</article-title><source>Genes Dev</source><volume>25</volume><fpage>634</fpage><lpage>45</lpage><pub-id pub-id-type="doi">10.1101/gad.1989311</pub-id></element-citation></ref><ref id="bib18"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Daub</surname><given-names>H</given-names></name><name><surname>Specht</surname><given-names>K</given-names></name><name><surname>Ullrich</surname><given-names>A</given-names></name></person-group><year>2004</year><article-title>Strategies to overcome resistance to targeted protein kinase inhibitors</article-title><source>Nat Rev Drug Discov</source><volume>3</volume><fpage>1001</fpage><lpage>10</lpage><pub-id pub-id-type="doi">10.1038/nrd1579</pub-id></element-citation></ref><ref id="bib19"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Davis</surname><given-names>MI</given-names></name><name><surname>Hunt</surname><given-names>JP</given-names></name><name><surname>Herrgard</surname><given-names>S</given-names></name><name><surname>Ciceri</surname><given-names>P</given-names></name><name><surname>Wodicka</surname><given-names>LM</given-names></name><name><surname>Pallares</surname><given-names>G</given-names></name><etal/></person-group><year>2011</year><article-title>Comprehensive analysis of kinase inhibitor selectivity</article-title><source>Nat Biotechnol</source><volume>29</volume><fpage>1046</fpage><lpage>51</lpage><pub-id pub-id-type="doi">10.1038/nbt.1990</pub-id></element-citation></ref><ref id="bib20"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Derijard</surname><given-names>B</given-names></name><name><surname>Hibi</surname><given-names>M</given-names></name><name><surname>Wu</surname><given-names>IH</given-names></name><name><surname>Barrett</surname><given-names>T</given-names></name><name><surname>Su</surname><given-names>B</given-names></name><name><surname>Deng</surname><given-names>T</given-names></name><etal/></person-group><year>1994</year><article-title>JNK1: a protein kinase stimulated by UV light and Ha-Ras that binds and phosphorylates the c-Jun activation domain</article-title><source>Cell</source><volume>76</volume><fpage>1025</fpage><lpage>37</lpage><pub-id pub-id-type="doi">10.1016/0092-8674(94)90380-8</pub-id></element-citation></ref><ref id="bib21"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Falchook</surname><given-names>GS</given-names></name><name><surname>Long</surname><given-names>GV</given-names></name><name><surname>Kurzrock</surname><given-names>R</given-names></name><name><surname>Kim</surname><given-names>KB</given-names></name><name><surname>Arkenau</surname><given-names>TH</given-names></name><name><surname>Brown</surname><given-names>MP</given-names></name><etal/></person-group><year>2012</year><article-title>Dabrafenib in patients with melanoma, untreated brain metastases, and other solid tumours: a phase 1 dose-escalation trial</article-title><source>Lancet</source><volume>379</volume><fpage>1893</fpage><lpage>901</lpage><pub-id pub-id-type="doi">10.1016/S0140-6736(12)60398-5</pub-id></element-citation></ref><ref id="bib22"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Flaherty</surname><given-names>KT</given-names></name><name><surname>Puzanov</surname><given-names>I</given-names></name><name><surname>Kim</surname><given-names>KB</given-names></name><name><surname>Ribas</surname><given-names>A</given-names></name><name><surname>McArthur</surname><given-names>GA</given-names></name><name><surname>Sosman</surname><given-names>JA</given-names></name><etal/></person-group><year>2010</year><article-title>Inhibition of mutated, activated BRAF in metastatic melanoma</article-title><source>N Engl J Med</source><volume>363</volume><fpage>809</fpage><lpage>19</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1002011</pub-id></element-citation></ref><ref id="bib22a"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Flaherty</surname><given-names>KT</given-names></name><name><surname>Infante</surname><given-names>JR</given-names></name><name><surname>Daud</surname><given-names>A</given-names></name><name><surname>Gonzalez</surname><given-names>R</given-names></name><name><surname>Kefford</surname><given-names>RF</given-names></name><name><surname>Sosman</surname><given-names>J</given-names></name><etal/></person-group><year>2012</year><article-title>Combined BRAF and MEK Inhibition in Melanoma with BRAF V600 Mutations</article-title><source>N Engl J Med</source><volume>367</volume><fpage>1694</fpage><lpage>703</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1210093</pub-id></element-citation></ref><ref id="bib23"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gowrishankar</surname><given-names>K</given-names></name><name><surname>Snoyman</surname><given-names>S</given-names></name><name><surname>Pupo</surname><given-names>GM</given-names></name><name><surname>Becker</surname><given-names>TM</given-names></name><name><surname>Kefford</surname><given-names>RF</given-names></name><name><surname>Rizos</surname><given-names>H</given-names></name></person-group><year>2012</year><article-title>Acquired resistance to BRAF inhibition can confer cross-resistance to combined BRAF/MEK inhibition</article-title><source>J Invest Dermatol</source><volume>132</volume><fpage>1850</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1038/jid.2012.63</pub-id></element-citation></ref><ref id="bib24"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Greger</surname><given-names>JG</given-names></name><name><surname>Eastman</surname><given-names>SD</given-names></name><name><surname>Zhang</surname><given-names>V</given-names></name><name><surname>Bleam</surname><given-names>MR</given-names></name><name><surname>Hughes</surname><given-names>AM</given-names></name><name><surname>Smitheman</surname><given-names>KN</given-names></name><etal/></person-group><year>2012</year><article-title>Combinations of BRAF, MEK, and PI3K/mTOR inhibitors overcome acquired resistance to the BRAF inhibitor GSK2118436 dabrafenib, mediated by NRAS or MEK mutations</article-title><source>Mol Cancer Ther</source><volume>11</volume><fpage>909</fpage><lpage>20</lpage><pub-id pub-id-type="doi">10.1158/1535-7163.MCT-11-0989</pub-id></element-citation></ref><ref id="bib25"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Gross</surname><given-names>EA</given-names></name><name><surname>Callow</surname><given-names>MG</given-names></name><name><surname>Waldbaum</surname><given-names>L</given-names></name><name><surname>Thomas</surname><given-names>S</given-names></name><name><surname>Ruggieri</surname><given-names>R</given-names></name></person-group><year>2002</year><article-title>MRK a mixed lineage kinase-related molecule that plays a role in gamma-radiation-induced cell cycle arrest</article-title><source>J Biol Chem</source><volume>277</volume><fpage>13873</fpage><lpage>82</lpage><pub-id pub-id-type="doi">10.1074/jbc.M111994200</pub-id></element-citation></ref><ref id="bib26"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Haeusgen</surname><given-names>W</given-names></name><name><surname>Herdegen</surname><given-names>T</given-names></name><name><surname>Waetzig</surname><given-names>V</given-names></name></person-group><year>2011</year><article-title>The bottleneck of JNK signaling: molecular and functional characteristics of MKK4 and MKK7</article-title><source>Eur J Cell Biol</source><volume>90</volume><fpage>536</fpage><lpage>44</lpage><pub-id pub-id-type="doi">10.1016/j.ejcb.2010.11.008</pub-id></element-citation></ref><ref id="bib27"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Halaban</surname><given-names>R</given-names></name><name><surname>Zhang</surname><given-names>W</given-names></name><name><surname>Bacchiocchi</surname><given-names>A</given-names></name><name><surname>Cheng</surname><given-names>E</given-names></name><name><surname>Parisi</surname><given-names>F</given-names></name><name><surname>Ariyan</surname><given-names>S</given-names></name><etal/></person-group><year>2010</year><article-title>PLX4032, a selective BRAF(V600E) kinase inhibitor, activates the ERK pathway and enhances cell migration and proliferation of BRAF melanoma cells</article-title><source>Pigment Cell Melanoma Res</source><volume>23</volume><fpage>190</fpage><lpage>200</lpage><pub-id pub-id-type="doi">10.1111/j.1755-148X.2010.00685.x</pub-id></element-citation></ref><ref id="bib28"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hanahan</surname><given-names>D</given-names></name><name><surname>Weinberg</surname><given-names>RA</given-names></name></person-group><year>2011</year><article-title>Hallmarks of cancer: the next generation</article-title><source>Cell</source><volume>144</volume><fpage>646</fpage><lpage>74</lpage><pub-id pub-id-type="doi">10.1016/j.cell.2011.02.013</pub-id></element-citation></ref><ref id="bib29"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hatzivassiliou</surname><given-names>G</given-names></name><name><surname>Song</surname><given-names>K</given-names></name><name><surname>Yen</surname><given-names>I</given-names></name><name><surname>Brandhuber</surname><given-names>BJ</given-names></name><name><surname>Anderson</surname><given-names>DJ</given-names></name><name><surname>Alvarado</surname><given-names>R</given-names></name><etal/></person-group><year>2010</year><article-title>RAF inhibitors prime wild-type RAF to activate the MAPK pathway and enhance growth</article-title><source>Nature</source><volume>464</volume><fpage>431</fpage><lpage>5</lpage><pub-id pub-id-type="doi">10.1038/nature08833</pub-id></element-citation></ref><ref id="bib30"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hauschild</surname><given-names>A</given-names></name><name><surname>Grob</surname><given-names>JJ</given-names></name><name><surname>Demidov</surname><given-names>LV</given-names></name><name><surname>Jouary</surname><given-names>T</given-names></name><name><surname>Gutzmer</surname><given-names>R</given-names></name><name><surname>Millward</surname><given-names>M</given-names></name><etal/></person-group><year>2012</year><article-title>Dabrafenib in BRAF-mutated metastatic melanoma: a multicentre, open-label, phase 3 randomised controlled trial</article-title><source>Lancet</source><volume>380</volume><fpage>358</fpage><lpage>65</lpage><pub-id pub-id-type="doi">10.1016/S0140-6736(12)60868-X</pub-id></element-citation></ref><ref id="bib31"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Heidorn</surname><given-names>SJ</given-names></name><name><surname>Milagre</surname><given-names>C</given-names></name><name><surname>Whittaker</surname><given-names>S</given-names></name><name><surname>Nourry</surname><given-names>A</given-names></name><name><surname>Niculescu-Duvas</surname><given-names>I</given-names></name><name><surname>Dhomen</surname><given-names>N</given-names></name><etal/></person-group><year>2010</year><article-title>Kinase-dead BRAF and oncogenic RAS cooperate to drive tumor progression through CRAF</article-title><source>Cell</source><volume>140</volume><fpage>209</fpage><lpage>21</lpage><pub-id pub-id-type="doi">10.1016/j.cell.2009.12.040</pub-id></element-citation></ref><ref id="bib32"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hildesheim</surname><given-names>J</given-names></name><name><surname>Awwad</surname><given-names>RT</given-names></name><name><surname>Fornace</surname><given-names>AJ</given-names><suffix>Jnr</suffix></name></person-group><year>2004</year><article-title>p38 Mitogen-activated protein kinase inhibitor protects the epidermis against the acute damaging effects of ultraviolet irradiation by blocking apoptosis and inflammatory responses</article-title><source>J Invest Dermatol</source><volume>122</volume><fpage>497</fpage><lpage>502</lpage><pub-id pub-id-type="doi">10.1111/j.1523-1747.2004.22229.x</pub-id></element-citation></ref><ref id="bib33"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hu</surname><given-names>J</given-names></name><name><surname>Yu</surname><given-names>H</given-names></name><name><surname>Kornev</surname><given-names>AP</given-names></name><name><surname>Zhao</surname><given-names>J</given-names></name><name><surname>Filbert</surname><given-names>EL</given-names></name><name><surname>Taylor</surname><given-names>SS</given-names></name><etal/></person-group><year>2011</year><article-title>Mutation that blocks ATP binding creates a pseudokinase stabilizing the scaffolding function of kinase suppressor of Ras, CRAF and BRAF</article-title><source>Proc Natl Acad Sci USA</source><volume>108</volume><fpage>6067</fpage><lpage>72</lpage><pub-id pub-id-type="doi">10.1073/pnas.1102554108</pub-id></element-citation></ref><ref id="bib34"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Huang</surname><given-names>CY</given-names></name><name><surname>Chueh</surname><given-names>PJ</given-names></name><name><surname>Tseng</surname><given-names>CT</given-names></name><name><surname>Liu</surname><given-names>KY</given-names></name><name><surname>Tsai</surname><given-names>HY</given-names></name><name><surname>Kuo</surname><given-names>WW</given-names></name><etal/></person-group><year>2004</year><article-title>ZAK re-programs atrial natriuretic factor expression and induces hypertrophic growth in H9c2 cardiomyoblast cells</article-title><source>Biochem Biophys Res Commun</source><volume>324</volume><fpage>973</fpage><lpage>80</lpage><pub-id pub-id-type="doi">10.1016/j.bbrc.2004.09.156</pub-id></element-citation></ref><ref id="bib35"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Hubner</surname><given-names>A</given-names></name><name><surname>Mulholland</surname><given-names>DJ</given-names></name><name><surname>Standen</surname><given-names>CL</given-names></name><name><surname>Karasarides</surname><given-names>M</given-names></name><name><surname>Cavanagh-Kyros</surname><given-names>J</given-names></name><name><surname>Barrett</surname><given-names>T</given-names></name><etal/></person-group><year>2012</year><article-title>JNK and PTEN cooperatively control the development of invasive adenocarcinoma of the prostate</article-title><source>Proc Natl Acad Sci USA</source><volume>109</volume><fpage>12046</fpage><lpage>51</lpage><pub-id pub-id-type="doi">10.1073/pnas.1209660109</pub-id></element-citation></ref><ref id="bib36"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Jandhyala</surname><given-names>DM</given-names></name><name><surname>Ahluwalia</surname><given-names>A</given-names></name><name><surname>Obrig</surname><given-names>T</given-names></name><name><surname>Thorpe</surname><given-names>CM</given-names></name></person-group><year>2008</year><article-title>ZAK: a MAP3Kinase that transduces Shiga toxin- and ricin-induced proinflammatory cytokine expression</article-title><source>Cell Microbiol</source><volume>10</volume><fpage>1468</fpage><lpage>77</lpage><pub-id pub-id-type="doi">10.1111/j.1462-5822.2008.01139.x</pub-id></element-citation></ref><ref id="bib37"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Kamata</surname><given-names>H</given-names></name><name><surname>Honda</surname><given-names>S</given-names></name><name><surname>Maeda</surname><given-names>S</given-names></name><name><surname>Chang</surname><given-names>L</given-names></name><name><surname>Hirata</surname><given-names>H</given-names></name><name><surname>Karin</surname><given-names>M</given-names></name></person-group><year>2005</year><article-title>Reactive oxygen species promote TNFalpha-induced death and sustained JNK activation by inhibiting MAP kinase phosphatases</article-title><source>Cell</source><volume>120</volume><fpage>649</fpage><lpage>61</lpage><pub-id pub-id-type="doi">10.1016/j.cell.2004.12.041</pub-id></element-citation></ref><ref id="bib38"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Karreth</surname><given-names>FA</given-names></name><name><surname>DeNicola</surname><given-names>GM</given-names></name><name><surname>Winter</surname><given-names>SP</given-names></name><name><surname>Tuveson</surname><given-names>DA</given-names></name></person-group><year>2009</year><article-title>C-Raf inhibits MAPK activation and transformation by B-Raf(V600E)</article-title><source>Mol Cell</source><volume>36</volume><fpage>477</fpage><lpage>86</lpage><pub-id pub-id-type="doi">10.1016/j.molcel.2009.10.017</pub-id></element-citation></ref><ref id="bib39"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Keshet</surname><given-names>Y</given-names></name><name><surname>Seger</surname><given-names>R</given-names></name></person-group><year>2010</year><article-title>The MAP kinase signaling cascades: a system of hundreds of components regulates a diverse array of physiological functions</article-title><source>Methods Mol Biol</source><volume>661</volume><fpage>3</fpage><lpage>38</lpage><pub-id pub-id-type="doi">10.1007/978-1-60761-795-2_1</pub-id></element-citation></ref><ref id="bib41"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Lehman</surname><given-names>TA</given-names></name><name><surname>Modali</surname><given-names>R</given-names></name><name><surname>Boukamp</surname><given-names>P</given-names></name><name><surname>Stanek</surname><given-names>J</given-names></name><name><surname>Bennett</surname><given-names>WP</given-names></name><name><surname>Welsh</surname><given-names>JA</given-names></name><etal/></person-group><year>1993</year><article-title>p53 mutations in human immortalized epithelial cell lines</article-title><source>Carcinogenesis</source><volume>14</volume><fpage>833</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1093/carcin/14.5.833</pub-id></element-citation></ref><ref id="bib42"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Liu</surname><given-names>TC</given-names></name><name><surname>Huang</surname><given-names>CJ</given-names></name><name><surname>Chu</surname><given-names>YC</given-names></name><name><surname>Wei</surname><given-names>CC</given-names></name><name><surname>Chou</surname><given-names>CC</given-names></name><name><surname>Chou</surname><given-names>MY</given-names></name><etal/></person-group><year>2000</year><article-title>Cloning and expression of ZAK, a mixed lineage kinase-like protein containing a leucine-zipper and a sterile-alpha motif</article-title><source>Biochem Biophys Res Commun</source><volume>274</volume><fpage>811</fpage><lpage>6</lpage><pub-id pub-id-type="doi">10.1006/bbrc.2000.3236</pub-id></element-citation></ref><ref id="bib42a"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Long</surname><given-names>GV</given-names></name><name><surname>Trefzer</surname><given-names>U</given-names></name><name><surname>Davies</surname><given-names>MA</given-names></name><name><surname>Kefford</surname><given-names>RF</given-names></name><name><surname>Ascierto</surname><given-names>PA</given-names></name><name><surname>Chapman</surname><given-names>PB</given-names></name><etal/></person-group><year>2012</year><article-title>Dabrafenib in patients with Val600Glu or Val600Lys BRAF-mutant melanoma metastatic to the brain (BREAK-MB): a multicentre, open-label, phase 2 trial</article-title><source>Lancet Oncol</source><volume>13</volume><fpage>1087</fpage><lpage>95</lpage><pub-id pub-id-type="doi">10.1016/S1470-2045(12)70431-X</pub-id></element-citation></ref><ref id="bib43"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>McKay</surname><given-names>MM</given-names></name><name><surname>Ritt</surname><given-names>DA</given-names></name><name><surname>Morrison</surname><given-names>DK</given-names></name></person-group><year>2011</year><article-title>RAF inhibitor-induced KSR1/B-RAF binding and its effects on ERK cascade signaling</article-title><source>Curr Biol</source><volume>21</volume><fpage>563</fpage><lpage>8</lpage><pub-id pub-id-type="doi">10.1016/j.cub.2011.02.033</pub-id></element-citation></ref><ref id="bib44"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Menzies</surname><given-names>AM</given-names></name><name><surname>Kefford</surname><given-names>RF</given-names></name><name><surname>Long</surname><given-names>GV</given-names></name></person-group><year>2013</year><article-title>Paradoxical oncogenesis: are all BRAF inhibitors equal?</article-title><source>Pigment Cell Melanoma Res</source><volume>26</volume><fpage>611</fpage><lpage>5</lpage><pub-id pub-id-type="doi">10.1111/pcmr.12132</pub-id></element-citation></ref><ref id="bib45"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Miyata</surname><given-names>Y</given-names></name><name><surname>Akashi</surname><given-names>M</given-names></name><name><surname>Nishida</surname><given-names>E</given-names></name></person-group><year>1999</year><article-title>Molecular cloning and characterization of a novel member of the MAP kinase superfamily</article-title><source>Genes Cells</source><volume>4</volume><fpage>299</fpage><lpage>309</lpage><pub-id pub-id-type="doi">10.1046/j.1365-2443.1999.00261.x</pub-id></element-citation></ref><ref id="bib46"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Naik</surname><given-names>E</given-names></name><name><surname>Michalak</surname><given-names>EM</given-names></name><name><surname>Villunger</surname><given-names>A</given-names></name><name><surname>Adams</surname><given-names>JM</given-names></name><name><surname>Strasser</surname><given-names>A</given-names></name></person-group><year>2007</year><article-title>Ultraviolet radiation triggers apoptosis of fibroblasts and skin keratinocytes mainly via the BH3-only protein Noxa</article-title><source>J Cell Biol</source><volume>176</volume><fpage>415</fpage><lpage>24</lpage><pub-id pub-id-type="doi">10.1083/jcb.200608070</pub-id></element-citation></ref><ref id="bib47"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Oberholzer</surname><given-names>PA</given-names></name><name><surname>Kee</surname><given-names>D</given-names></name><name><surname>Dziunycz</surname><given-names>P</given-names></name><name><surname>Sucker</surname><given-names>A</given-names></name><name><surname>Kamsukom</surname><given-names>N</given-names></name><name><surname>Jones</surname><given-names>R</given-names></name><etal/></person-group><year>2011</year><article-title>RAS mutations are associated with the development of cutaneous squamous cell tumors in patients treated with RAF inhibitors</article-title><source>J Clin Oncol</source><volume>30</volume><fpage>316</fpage><lpage>21</lpage><pub-id pub-id-type="doi">10.1200/JCO.2011.36.7680</pub-id></element-citation></ref><ref id="bib48"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Oda</surname><given-names>E</given-names></name><name><surname>Ohki</surname><given-names>R</given-names></name><name><surname>Murasawa</surname><given-names>H</given-names></name><name><surname>Nemoto</surname><given-names>J</given-names></name><name><surname>Shibue</surname><given-names>T</given-names></name><name><surname>Yamashita</surname><given-names>T</given-names></name><etal/></person-group><year>2000</year><article-title>Noxa, a BH3-only member of the Bcl-2 family and candidate mediator of p53-induced apoptosis</article-title><source>Science</source><volume>288</volume><fpage>1053</fpage><lpage>8</lpage><pub-id pub-id-type="doi">10.1126/science.288.5468.1053</pub-id></element-citation></ref><ref id="bib50"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Paraiso</surname><given-names>KH</given-names></name><name><surname>Xiang</surname><given-names>Y</given-names></name><name><surname>Rebecca</surname><given-names>VW</given-names></name><name><surname>Abel</surname><given-names>EV</given-names></name><name><surname>Chen</surname><given-names>A</given-names></name><name><surname>Munko</surname><given-names>AC</given-names></name><etal/></person-group><year>2011</year><article-title>PTEN loss confers BRAF inhibitor resistance to melanoma cells through the suppression of BIM expression</article-title><source>Cancer Res</source><volume>71</volume><fpage>2750</fpage><lpage>60</lpage><pub-id pub-id-type="doi">10.1158/0008-5472.CAN-10-2954</pub-id></element-citation></ref><ref id="bib51"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Poulikakos</surname><given-names>PI</given-names></name><name><surname>Zhang</surname><given-names>C</given-names></name><name><surname>Bollag</surname><given-names>G</given-names></name><name><surname>Shokat</surname><given-names>KM</given-names></name><name><surname>Rosen</surname><given-names>N</given-names></name></person-group><year>2010</year><article-title>RAF inhibitors transactivate RAF dimers and ERK signalling in cells with wild-type BRAF</article-title><source>Nature</source><volume>464</volume><fpage>427</fpage><lpage>30</lpage><pub-id pub-id-type="doi">10.1038/nature08902</pub-id></element-citation></ref><ref id="bib52"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sauter</surname><given-names>KA</given-names></name><name><surname>Magun</surname><given-names>EA</given-names></name><name><surname>Iordanov</surname><given-names>MS</given-names></name><name><surname>Magun</surname><given-names>BE</given-names></name></person-group><year>2010</year><article-title>ZAK is required for doxorubicin, a novel ribotoxic stressor, to induce SAPK activation and apoptosis in HaCaT cells</article-title><source>Cancer Biol Ther</source><volume>10</volume><fpage>258</fpage><lpage>66</lpage><pub-id pub-id-type="doi">10.4161/cbt.10.3.12367</pub-id></element-citation></ref><ref id="bib53"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>She</surname><given-names>QB</given-names></name><name><surname>Chen</surname><given-names>N</given-names></name><name><surname>Bode</surname><given-names>AM</given-names></name><name><surname>Flavell</surname><given-names>RA</given-names></name><name><surname>Dong</surname><given-names>Z</given-names></name></person-group><year>2002</year><article-title>Deficiency of c-Jun-NH(2)-terminal kinase-1 in mice enhances skin tumor development by 12-O-tetradecanoylphorbol-13-acetate</article-title><source>Cancer Res</source><volume>62</volume><fpage>1343</fpage><lpage>8</lpage></element-citation></ref><ref id="bib54"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Sosman</surname><given-names>JA</given-names></name><name><surname>Kim</surname><given-names>KB</given-names></name><name><surname>Schuchter</surname><given-names>L</given-names></name><name><surname>Gonzalez</surname><given-names>R</given-names></name><name><surname>Pavlick</surname><given-names>AC</given-names></name><name><surname>Weber</surname><given-names>JS</given-names></name><etal/></person-group><year>2012</year><article-title>Survival in BRAF V600-mutant advanced melanoma treated with vemurafenib</article-title><source>N Engl J Med</source><volume>366</volume><fpage>707</fpage><lpage>14</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1112302</pub-id></element-citation></ref><ref id="bib55"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Stone</surname><given-names>SM</given-names></name><name><surname>Thorpe</surname><given-names>CM</given-names></name><name><surname>Ahluwalia</surname><given-names>A</given-names></name><name><surname>Rogers</surname><given-names>AB</given-names></name><name><surname>Obata</surname><given-names>F</given-names></name><name><surname>Vozenilek</surname><given-names>A</given-names></name><etal/></person-group><year>2012</year><article-title>Shiga toxin 2-induced intestinal pathology in infant rabbits is A-subunit dependent and responsive to the tyrosine kinase and potential ZAK inhibitor imatinib</article-title><source>Front Cell Infect Microbiol</source><volume>2</volume><fpage>135</fpage><pub-id pub-id-type="doi">10.3389/fcimb.2012.00135</pub-id></element-citation></ref><ref id="bib56"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Su</surname><given-names>AI</given-names></name><name><surname>Wiltshire</surname><given-names>T</given-names></name><name><surname>Batalov</surname><given-names>S</given-names></name><name><surname>Lapp</surname><given-names>H</given-names></name><name><surname>Ching</surname><given-names>KA</given-names></name><name><surname>Block</surname><given-names>D</given-names></name><etal/></person-group><year>2004</year><article-title>A gene atlas of the mouse and human protein-encoding transcriptomes</article-title><source>Proc Natl Acad Sci USA</source><volume>101</volume><fpage>6062</fpage><lpage>7</lpage><pub-id pub-id-type="doi">10.1073/pnas.0400782101</pub-id></element-citation></ref><ref id="bib57"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Su</surname><given-names>F</given-names></name><name><surname>Viros</surname><given-names>A</given-names></name><name><surname>Milagre</surname><given-names>C</given-names></name><name><surname>Trunzer</surname><given-names>K</given-names></name><name><surname>Bollag</surname><given-names>G</given-names></name><name><surname>Spleiss</surname><given-names>O</given-names></name><etal/></person-group><year>2012</year><article-title>RAS mutations in cutaneous squamous-cell carcinomas in patients treated with BRAF inhibitors</article-title><source>N Engl J Med</source><volume>366</volume><fpage>207</fpage><lpage>15</lpage><pub-id pub-id-type="doi">10.1056/NEJMoa1105358</pub-id></element-citation></ref><ref id="bib58"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Su</surname><given-names>X</given-names></name><name><surname>Zhu</surname><given-names>CL</given-names></name><name><surname>Shi</surname><given-names>W</given-names></name><name><surname>Ni</surname><given-names>LC</given-names></name><name><surname>Shen</surname><given-names>JH</given-names></name><name><surname>Chen</surname><given-names>J</given-names></name></person-group><year>2012</year><article-title>Transient global cerebral ischemia induces up-regulation of MLTKalpha in hippocampal CA1 neurons</article-title><source>J Molecular Histol</source><volume>43</volume><fpage>187</fpage><lpage>93</lpage><pub-id pub-id-type="doi">10.1007/s10735-011-9381-z</pub-id></element-citation></ref><ref id="bib59"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tobiume</surname><given-names>K</given-names></name><name><surname>Matsuzawa</surname><given-names>A</given-names></name><name><surname>Takahashi</surname><given-names>T</given-names></name><name><surname>Nishitoh</surname><given-names>H</given-names></name><name><surname>Morita</surname><given-names>K</given-names></name><name><surname>Takeda</surname><given-names>K</given-names></name><etal/></person-group><year>2001</year><article-title>ASK1 is required for sustained activations of JNK/p38 MAP kinases and apoptosis</article-title><source>EMBO Rep</source><volume>2</volume><fpage>222</fpage><lpage>8</lpage><pub-id pub-id-type="doi">10.1093/embo-reports/kve046</pub-id></element-citation></ref><ref id="bib60"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tosti</surname><given-names>E</given-names></name><name><surname>Waldbaum</surname><given-names>L</given-names></name><name><surname>Warshaw</surname><given-names>G</given-names></name><name><surname>Gross</surname><given-names>EA</given-names></name><name><surname>Ruggieri</surname><given-names>R</given-names></name></person-group><year>2004</year><article-title>The stress kinase MRK contributes to regulation of DNA damage checkpoints through a p38gamma-independent pathway</article-title><source>J Biol Chem</source><volume>279</volume><fpage>47652</fpage><lpage>60</lpage><pub-id pub-id-type="doi">10.1074/jbc.M409961200</pub-id></element-citation></ref><ref id="bib61"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tournier</surname><given-names>C</given-names></name><name><surname>Hess</surname><given-names>P</given-names></name><name><surname>Yang</surname><given-names>DD</given-names></name><name><surname>Xu</surname><given-names>J</given-names></name><name><surname>Turner</surname><given-names>TK</given-names></name><name><surname>Nimnual</surname><given-names>A</given-names></name><etal/></person-group><year>2000</year><article-title>Requirement of JNK for stress-induced activation of the cytochrome c-mediated death pathway</article-title><source>Science</source><volume>288</volume><fpage>870</fpage><lpage>4</lpage><pub-id pub-id-type="doi">10.1126/science.288.5467.870</pub-id></element-citation></ref><ref id="bib62"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tournier</surname><given-names>C</given-names></name><name><surname>Dong</surname><given-names>C</given-names></name><name><surname>Turner</surname><given-names>TK</given-names></name><name><surname>Jones</surname><given-names>SN</given-names></name><name><surname>Flavell</surname><given-names>RA</given-names></name><name><surname>Davis</surname><given-names>RJ</given-names></name></person-group><year>2001</year><article-title>MKK7 is an essential component of the JNK signal transduction pathway activated by proinflammatory cytokines</article-title><source>Genes Dev</source><volume>15</volume><fpage>1419</fpage><lpage>26</lpage><pub-id pub-id-type="doi">10.1101/gad.888501</pub-id></element-citation></ref><ref id="bib63"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Tsai</surname><given-names>J</given-names></name><name><surname>Lee</surname><given-names>JT</given-names></name><name><surname>Wang</surname><given-names>W</given-names></name><name><surname>Zhang</surname><given-names>J</given-names></name><name><surname>Cho</surname><given-names>H</given-names></name><name><surname>Mamo</surname><given-names>S</given-names></name><etal/></person-group><year>2008</year><article-title>Discovery of a selective inhibitor of oncogenic B-Raf kinase with potent antimelanoma activity</article-title><source>Proc Natl Acad Sci USA</source><volume>105</volume><fpage>3041</fpage><lpage>6</lpage><pub-id pub-id-type="doi">10.1073/pnas.0711741105</pub-id></element-citation></ref><ref id="bib64"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>van Kranen</surname><given-names>HJ</given-names></name><name><surname>de Gruijl</surname><given-names>FR</given-names></name><name><surname>de Vries</surname><given-names>A</given-names></name><name><surname>Sontag</surname><given-names>Y</given-names></name><name><surname>Wester</surname><given-names>PW</given-names></name><name><surname>Senden</surname><given-names>HC</given-names></name><etal/></person-group><year>1995</year><article-title>Frequent p53 alterations but low incidence of ras mutations in UV-B-induced skin tumors of hairless mice</article-title><source>Carcinogenesis</source><volume>16</volume><fpage>1141</fpage><lpage>7</lpage><pub-id pub-id-type="doi">10.1093/carcin/16.5.1141</pub-id></element-citation></ref><ref id="bib65"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Vanan</surname><given-names>I</given-names></name><name><surname>Dong</surname><given-names>Z</given-names></name><name><surname>Tosti</surname><given-names>E</given-names></name><name><surname>Warshaw</surname><given-names>G</given-names></name><name><surname>Symons</surname><given-names>M</given-names></name><name><surname>Ruggieri</surname><given-names>R</given-names></name></person-group><year>2012</year><article-title>Role of a DNA damage checkpoint pathway in ionizing radiation-induced glioblastoma cell migration and invasion</article-title><source>Cell Mol Neurobiol</source><volume>32</volume><fpage>1199</fpage><lpage>208</lpage><pub-id pub-id-type="doi">10.1007/s10571-012-9846-y</pub-id></element-citation></ref><ref id="bib66"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Ventura</surname><given-names>JJ</given-names></name><name><surname>Hubner</surname><given-names>A</given-names></name><name><surname>Zhang</surname><given-names>C</given-names></name><name><surname>Flavell</surname><given-names>RA</given-names></name><name><surname>Shokat</surname><given-names>KM</given-names></name><name><surname>Davis</surname><given-names>RJ</given-names></name></person-group><year>2006</year><article-title>Chemical genetic analysis of the time course of signal transduction by JNK</article-title><source>Mol Cell</source><volume>21</volume><fpage>701</fpage><lpage>10</lpage><pub-id pub-id-type="doi">10.1016/j.molcel.2006.01.018</pub-id></element-citation></ref><ref id="bib67"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wang</surname><given-names>X</given-names></name><name><surname>Mader</surname><given-names>MM</given-names></name><name><surname>Toth</surname><given-names>JE</given-names></name><name><surname>Yu</surname><given-names>X</given-names></name><name><surname>Jin</surname><given-names>N</given-names></name><name><surname>Campbell</surname><given-names>RM</given-names></name><etal/></person-group><year>2005</year><article-title>Complete inhibition of anisomycin and UV radiation but not cytokine induced JNK and p38 activation by an aryl-substituted dihydropyrrolopyrazole quinoline and mixed lineage kinase 7 small interfering RNA</article-title><source>J Biol Chem</source><volume>280</volume><fpage>19298</fpage><lpage>305</lpage><pub-id pub-id-type="doi">10.1074/jbc.M413059200</pub-id></element-citation></ref><ref id="bib69"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Weston</surname><given-names>CR</given-names></name><name><surname>Wong</surname><given-names>A</given-names></name><name><surname>Hall</surname><given-names>JP</given-names></name><name><surname>Goad</surname><given-names>ME</given-names></name><name><surname>Flavell</surname><given-names>RA</given-names></name><name><surname>Davis</surname><given-names>RJ</given-names></name></person-group><year>2004</year><article-title>The c-Jun NH2-terminal kinase is essential for epidermal growth factor expression during epidermal morphogenesis</article-title><source>Proc Natl Acad Sci USA</source><volume>101</volume><fpage>14114</fpage><lpage>9</lpage><pub-id pub-id-type="doi">10.1073/pnas.0406061101</pub-id></element-citation></ref><ref id="bib70"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Whittaker</surname><given-names>S</given-names></name><name><surname>Kirk</surname><given-names>R</given-names></name><name><surname>Hayward</surname><given-names>R</given-names></name><name><surname>Zambon</surname><given-names>A</given-names></name><name><surname>Viros</surname><given-names>A</given-names></name><name><surname>Cantarino</surname><given-names>N</given-names></name><etal/></person-group><year>2010</year><article-title>Gatekeeper mutations mediate resistance to BRAF-targeted therapies</article-title><source>Sci Transl Med</source><volume>2</volume><fpage>35ra41</fpage><pub-id pub-id-type="doi">10.1126/scitranslmed.3000758</pub-id></element-citation></ref><ref id="bib71"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Wong</surname><given-names>J</given-names></name><name><surname>Smith</surname><given-names>LB</given-names></name><name><surname>Magun</surname><given-names>EA</given-names></name><name><surname>Engstrom</surname><given-names>T</given-names></name><name><surname>Kelley-Howard</surname><given-names>K</given-names></name><name><surname>Jandhyala</surname><given-names>DM</given-names></name><etal/></person-group><year>2013</year><article-title>Small molecule kinase inhibitors block the ZAK-dependent inflammatory effects of doxorubicin</article-title><source>Cancer Biol Ther</source><volume>14</volume><fpage>56</fpage><lpage>63</lpage><pub-id pub-id-type="doi">10.4161/cbt.22628</pub-id></element-citation></ref><ref id="bib72"><element-citation publication-type="journal"><person-group person-group-type="author"><name><surname>Yang</surname><given-names>JJ</given-names></name><name><surname>Lee</surname><given-names>YJ</given-names></name><name><surname>Hung</surname><given-names>HH</given-names></name><name><surname>Tseng</surname><given-names>WP</given-names></name><name><surname>Tu</surname><given-names>CC</given-names></name><name><surname>Lee</surname><given-names>H</given-names></name><etal/></person-group><year>2010</year><article-title>ZAK inhibits human lung cancer cell growth via ERK and JNK activation in an AP-1-dependent manner</article-title><source>Cancer Sci</source><volume>101</volume><fpage>1374</fpage><lpage>81</lpage><pub-id pub-id-type="doi">10.1111/j.1349-7006.2010.01537.x</pub-id></element-citation></ref></ref-list></back><sub-article article-type="article-commentary" id="SA1"><front-stub><article-id pub-id-type="doi">10.7554/eLife.00969.026</article-id><title-group><article-title>Decision letter</article-title></title-group><contrib-group content-type="section"><contrib contrib-type="editor"><name><surname>Davis</surname><given-names>Roger</given-names></name><role>Reviewing editor</role><aff><institution>University of Massachusetts Medical School</institution>, <country>United States</country></aff></contrib></contrib-group></front-stub><body><boxed-text><p>eLife posts the editorial decision letter and author response on a selection of the published articles (subject to the approval of the authors). An edited version of the letter sent to the authors after peer review is shown, indicating the substantive concerns or comments; minor concerns are not usually shown. Reviewers have the opportunity to discuss the decision before the letter is sent (see <ext-link ext-link-type="uri" xlink:href="http://elife.elifesciences.org/review-process">review process</ext-link>). Similarly, the author response typically shows only responses to the major concerns raised by the reviewers.</p></boxed-text><p>Thank you for sending your work entitled “BRAF inhibitors suppress apoptosis through off-target inhibition of JNK signaling” for consideration at <italic>eLife</italic>. Your article has been favorably evaluated by a Senior editor and 2 reviewers, one of whom is a member of our Board of Reviewing Editors.</p><p>The Reviewing editor and the other reviewer discussed their comments before we reached this decision, and the Reviewing editor has assembled the following comments to help you prepare a revised submission.</p><p>The authors investigate the contribution of non-ERK driven squamous cell cancers in melanoma patients treated with BRAF inhibitors. The clinical observation is that the incidence of SCC increases in patients treated with vemurafenib, which has been attributed to paradoxical increased RAF signaling due to the unrestrained activity of CRAF. Here they show that vemurafenib also inhibits a number of other serine threonine kinases including ZAK, which regulates JNK signaling. Expression of a ZAK mutant that cannot be inhibited by vemurafenib blocks this effect. The authors also demonstrate that dabrafenib has a different spectrum of kinase inhibition, suggesting that SCC may be less prevalent in patients treated with this inhibitor.</p><p>1) Overall the experiments in this manuscript are clearly presented and support the authors’ conclusions. They have used cell lines from human cancers and genetically engineered mice to great advantage. The use of many different cell lines in different parts of the manuscript is helpful but does lead to some question of whether all of the observations can be observed in at least 1 or 2 of the cell lines.</p><p>2) It has previously been reported (Davis et al. Nat. Biotech. (2011) 29, 1046) that ZAK, MKK4, BRK, SRMS etc bind to Raf inhibitors, including PLX-4720. The competitive binding assay presented for PLX-4720 appears to duplicate the previously published report. The authors should make it clear in the text what is new and what has been published previously.</p><p>3) Conclusions regarding the relative importance of ZAK, MKK4, and MAP4K5 are unclear. Moreover, the shRNA studies are poorly described. There are a number of questions concerning these studies:</p><p>a) The shRNA sequences are not described.</p><p>b) The ZAK and MAP4K5 antibody used for the shRNA analysis is not described.</p><p>c) The ZAK knockdown in <xref ref-type="fig" rid="fig3s1">Figure 3–figure supplement 1</xref> appears clear, but the knockdown of MAP4K5 is unclear – this needs to be quantitated. Also, the extent of the MKK4 knockdown should be presented.</p><p>d) shRNA studies are described for ZAK and a triple KD of ZAK, MKK4, and MAP4K5. The effect of single knockdown of MKK4 or MAP4K5 using two different shRNA (each) should be shown. Without these data, conclusions concerning the relative roles of ZAK, MKK4, and MAP4K5 cannot be made.</p><p>4) ZAK is a poorly studied protein kinase. It would be helpful to the reader if information concerning ZAK tissue expression was presented.</p><p>5) SP600125 is an inhibitor of a large fraction of the kinome, including JNK. It is difficult to interpret any findings using this drug (see Phil Cohen’s publication in BJ).</p></body></sub-article><sub-article article-type="reply" id="SA2"><front-stub><article-id pub-id-type="doi">10.7554/eLife.00969.027</article-id><title-group><article-title>Author response</article-title></title-group></front-stub><body><p><italic>1) Overall the experiments in this manuscript are clearly presented and support the authors’ conclusions. They have used cell lines from human cancers and genetically engineered mice to great advantage. The use of many different cell lines in different parts of the manuscript is helpful but does lead to some question of whether all of the observations can be observed in at least 1 or 2 of the cell lines</italic>.</p><p>We chose to replicate our results using ZAK knockdown in a different cell line (SRB1) by introducing two ZAK shRNA clones into these cells and demonstrating a similar diminution of JNK activity and apoptosis following UV exposure. These are now placed in <xref ref-type="fig" rid="fig3s3">Figure 3–figure supplement 3</xref> and cited in the text in the Results section (“BRAFi suppress JNK activity through off-target inhibition of ZAK, MKK4, MAP4K5”).</p><p><italic>2) It has previously been reported (Davis et al. Nat. Biotech. (2011) 29, 1046) that ZAK, MKK4, BRK, SRMS etc bind to Raf inhibitors, including PLX-4720. The competitive binding assay presented for PLX-4720 appears to duplicate the previously published report. The authors should make it clear in the text what is new and what has been published previously</italic>.</p><p>The binding assay used is the identical platform to that described in Davis et al. (2011), though their presented results were restricted to an estimate of <italic>K</italic><sub><italic>d</italic></sub> based upon one screening drug concentration of 10 micromolar. In our paper, we extended the panel of kinases (listed in <xref ref-type="table" rid="tbl2">Table 2</xref>), replicated some of the assays described in Davis et al., but included lower concentrations of drug to get a better estimated <italic>K</italic><sub><italic>d</italic></sub>, and included vemurafenib, to verify that both drugs had similar effects on the kinases of interest. The other kinases we profiled were selected on the basis of literature supporting a role in signaling to JNK and ones that had been shown to bind or be inhibited by PLX4720/vemurafenib previously as controls. This is now more completely described in the main text in the Results section (“BRAFi suppress JNK activity through off-target inhibition of ZAK, MKK4, MAP4K5”).</p><p><italic>3) Conclusions regarding the relative importance of ZAK, MKK4, and MAP4K5 are unclear. Moreover, the shRNA studies are poorly described. There are a number of questions concerning these studies</italic>:</p><p><italic>a) The shRNA sequences are not described</italic>.</p><p>This is now clearly described in the Materials and methods section.</p><p><italic>b) The ZAK and MAP4K5 antibody used for the shRNA analysis is not described</italic>.</p><p>This is now clearly described in the Materials and methods section.</p><p><italic>c) The ZAK knockdown in</italic> <xref ref-type="fig" rid="fig3s1"><italic>Figure 3–figure supplement 1</italic></xref> <italic>appears clear, but the knockdown of MAP4K5 is unclear – this needs to be quantitated. Also, the extent of the MKK4 knockdown should be presented</italic>.</p><p>This is now done using Image J densitometry controlled against the GAPDH loading control. The degree of knockdown is described in detail in <xref ref-type="fig" rid="fig3s1">Figure 3–figure supplement 1</xref>. In TKD cells, MKK4 is knocked down by 72.9% (lanes 1 vs. 3, <xref ref-type="fig" rid="fig3">Figure 3E</xref>) and MAP4K5 by 54.6% (<xref ref-type="fig" rid="fig3s1">Figure 3–figure supplement 1A</xref>).</p><p><italic>d) shRNA studies are described for ZAK and a triple KD of ZAK, MKK4, and MAP4K5. The effect of single knockdown of MKK4 or MAP4K5 using two different shRNA (each) should be shown. Without these data, conclusions concerning the relative roles of ZAK, MKK4, and MAP4K5 cannot be made</italic>.</p><p>This is now shown in <xref ref-type="fig" rid="fig3s2">Figure 3–figure supplement 2</xref>. In short, single KD of either MAP4K5 or MKK4 only partially suppresses apoptosis and phospho-JNK induction. At least 71.9% knockdown was achieved for two MKK4 and MAP4K5 shRNA clones (Image J densitometry). The effect on apoptosis and phospho-JNK suppression is greater with MKK4 knockdown (up to 27.3%). This is however, completely expected, since MKK4 is important for full activation of JNK activity and ZAK has been shown to be upstream of MKK4 (<xref ref-type="fig" rid="fig2 fig3">Figures 2H, I, 3E</xref>), thus implying that the effect of ZAK induction proceeds, at least in part, through MKK4. Consistent with this, we have also shown that ZAK knockdown and drug treatment suppresses phospho-MKK4 induction following irradiation (<xref ref-type="fig" rid="fig2 fig3">Figures 2H, I, 3E</xref>). This is now discussed in the main text in the Discussion section.</p><p><italic>4) ZAK is a poorly studied protein kinase. It would be helpful to the reader if information concerning ZAK tissue expression was presented</italic>.</p><p>This is now included in the main text in the Discussion section.</p><p><italic>5) SP600125 is an inhibitor of a large fraction of the kinome, including JNK. It is difficult to interpret any findings using this drug (see Phil Cohen’s publication in BJ)</italic>.</p><p>We agree that SP600125 lacks the degree of specificity for JNK that would be desirable. We have therefore elected to remove these data from the paper given this problem. Parenthetically, we tried multiple JNK inhibitors in-vivo and were unable to consistently obtain pharmacodynamic evidence for specificity and in-vivo action.</p></body></sub-article></article>