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Establishing Dual Resistance to EGFR-TKI and MET-TKI in Lung Adenocarcinoma Cells In Vitro with a 2-step Dose-escalation Procedure
Published on: August 11, 2017
Non-small-cell lung cancer cells combat epidermal growth factor receptor tyrosine kinase inhibition through immediate
Hsian-Yu Wang1, Min-Kung Hsu2, Kai-Hsuan Wang3
1Institute of Biotechnology and Pharmaceutical Research, National Health Research Institutes (NHRI), Zhunan, Miaoli County, Republic of China; Institute of Molecular Medicine and Bioengineering, National Chiao Tung University (NCTU), Hsinchu, Taiwan, Republic of China.
Background:
Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs), such as gefitinib, erlotinib, and afatinib, have greatly improved treatment efficacy in non-small cell lung cancer (NSCLC) patients with drug-sensitive EGFR mutations. However, in some TKI responders, the benefits of such targeted therapies are limited by the rapid development of resistance, and strategies to overcome this resistance are urgently needed. Studies of drug resistance in cancer cells typically involve long term in vitro induction to obtain stably acquired drug-resistant cells followed by elucidation of resistance mechanisms, but the immediate responses of cancer cells upon drug treatment have been ignored. The aim of this study was to investigate the immediate responses of NSCLC cells upon treatment with EGFR TKIs.
Results:
Both NSCLC cells, ie, PC9 and H1975, showed immediate enhanced adhesion-related responses as an apoptosis-countering mechanism upon first-time TKI treatment. By gene expression and pathway analysis, adhesion-related pathways were enriched in gefitinib-treated PC9 cells. Pathway inhibition by small-hairpin RNAs or small-molecule drugs revealed that within hours of EGFR TKI treatment, NSCLC cells used adhesion-related responses to combat the drugs. Importantly, we show here that the Src family inhibitor, dasatinib, dramatically inhibits cell adhesion-related response and greatly enhances the cell-killing effects of EGFR TKI (gefitinib for the PC9 cells; afatinib for the H1975 cells) in NSCLC cells, which would otherwise escape the TKI-induced apoptosis.
Conclusion:
Results from this study indicate that NSCLC cells can employ the adhesion response as a survival pathway to survive under EGFR-targeted therapy. Simultaneous targeting of EGFR signaling and adhesion pathways would further boost the efficacy of EGFR-targeted therapy in NSCLC.
Insights
Non-small cell lung cancer cells use immediate adhesion responses to resist EGFR TKIs. Combining EGFR inhibitors with Src family inhibitors like dasatinib enhances cancer cell killing by blocking this survival pathway.
Area of Science:
- Oncology
- Molecular Biology
- Cancer Therapeutics
Background:
- Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are effective against non-small cell lung cancer (NSCLC) with sensitive mutations.
- Drug resistance limits TKI efficacy, necessitating new therapeutic strategies.
- Immediate cellular responses to TKIs, rather than long-term adaptation, are often overlooked in resistance studies.
Purpose of the Study:
- To investigate the immediate cellular responses of NSCLC cells upon treatment with EGFR TKIs.
- To identify mechanisms by which NSCLC cells counteract EGFR-targeted therapy in the short term.
Main Methods:
- Gene expression and pathway analysis of EGFR TKI-treated NSCLC cells (PC9 and H1975).
- Functional validation using small-hairpin RNAs and small-molecule inhibitors targeting identified pathways.
- Combination therapy studies involving EGFR TKIs and Src family inhibitors (dasatinib).
Main Results:
- NSCLC cells exhibit enhanced adhesion-related responses as an immediate, apoptosis-countering mechanism upon EGFR TKI exposure.
- Adhesion pathways are significantly enriched in gefitinib-treated PC9 cells.
- Dasatinib, a Src family inhibitor, effectively inhibits cell adhesion and potentiates the cytotoxic effects of EGFR TKIs, preventing TKI-induced apoptosis escape.
Conclusions:
- NSCLC cells utilize adhesion responses as an immediate survival pathway to resist EGFR-targeted therapy.
- Simultaneous targeting of EGFR signaling and adhesion pathways holds promise for enhancing TKI efficacy in NSCLC treatment.
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