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Updated: Mar 13, 2026

Integration of Bioinformatics Approaches and Experimental Validations to Understand the Role of Notch Signaling in Ovarian Cancer
Published on: January 12, 2020
Blocking NOTCH pathway can enhance the effect of EGFR inhibitor through targeting CD133+ endometrial cancer cells
Chao Shang1, Bin Lang2, Li-Rong Meng2
1a Department of Neurobiology , China Medical University , Shenyang , P. R. China.
Abstract:
Although the molecular therapeutics targeting key biomarkers such as epithelial growth factor receptor (EGFR), PI3K/AKT/mTOR, and vascular endothelial growth factor (VEGF) shows some success in clinical trials, some internally existing challenges in endothelial cancer biology hinder the drug effects. One of the major challenges stems from cancer stem cell-derived drug resistance. CD133 positive cells are well believed as cancer stem cells (CSC) in endometrial cancers and NOTCH pathway plays a critical role in retaining CD133+ cells by promoting CSC self-renewal and chemoresistance. Here, we initiated a therapeutic strategy to improve effects of EGFR inhibition by targeting NOTCH pathway of CD133+ cells in endometrial cancers. We first detected and purified the CD133+ cell fraction in endometrial cancer cell line Ishikawa (IK), and validated activation of NOTCH pathway in the CD133+ cells that have higher proliferation rate and lower apoptosis rate, comparing to CD133- cells. Results of nude mouse xenograft experiments further demonstrated CD133+ cells retain higher tumorigenesis capacity than CD133- cells, indicating their tumor-initiating property. Last, we applied both NOTCH inhibitor DAPT and EGFR inhibitor AG1478 treatment on endometrial cancer lines IK and HEC-1A and the results suggested improvement effects of the combination therapy compared to the treatments of DAPT or AG1478 alone. These findings indicated targeting NOTCH pathway in CD133+ cells, combining with EGFR inhibition, which provides a novel therapeutic strategy for endometrial cancer diseases.
Insights
Targeting NOTCH pathway in CD133+ cancer stem cells enhances EGFR inhibition efficacy for endometrial cancer treatment. This combination therapy overcomes drug resistance, offering a novel strategy for this disease.
Area of Science:
- Gynecologic Oncology
- Cancer Stem Cell Biology
- Molecular Therapeutics
Background:
- Endometrial cancer drug resistance is a major challenge, often linked to cancer stem cells (CSCs).
- CD133-positive cells are identified as CSCs in endometrial cancer, with the NOTCH pathway crucial for their self-renewal and chemoresistance.
- Existing therapies targeting biomarkers like EGFR show promise but are limited by CSC-mediated resistance.
Purpose of the Study:
- To develop a therapeutic strategy combining NOTCH pathway inhibition with EGFR inhibition to overcome drug resistance in endometrial cancer.
- To investigate the role of CD133+ cells and NOTCH pathway activation in endometrial cancer stemness and chemoresistance.
Main Methods:
- Isolation and characterization of CD133+ and CD133- cells from Ishikawa endometrial cancer cell line.
- Assessment of NOTCH pathway activation, proliferation, and apoptosis rates in CD133+ versus CD133- cells.
- Nude mouse xenograft experiments to evaluate tumor-initiating capacity.
- In vitro combination therapy studies using NOTCH inhibitor (DAPT) and EGFR inhibitor (AG1478) on endometrial cancer cell lines.
Main Results:
- CD133+ cells exhibited higher proliferation and lower apoptosis rates, confirming their CSC properties.
- CD133+ cells demonstrated superior tumor-initiating capacity in vivo.
- Combination therapy with DAPT and AG1478 showed improved efficacy compared to monotherapies in endometrial cancer cell lines.
Conclusions:
- NOTCH pathway activation is critical for maintaining CD133+ cancer stem cells in endometrial cancer.
- Targeting the NOTCH pathway in CD133+ cells, in conjunction with EGFR inhibition, represents a promising therapeutic strategy.
- This combined approach offers a novel avenue for overcoming drug resistance and improving treatment outcomes in endometrial cancer.
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