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Updated: Aug 9, 2025

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
Dual kinase inhibitor for EGFR mutants and ErbB2 limit breast cancer
Peeyush N Goel1, Hongtao Zhang2, Ramachandran Murali3
1Department of Pathology and Lab Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104-6082, USA; Children's Hospital of Philadelphia, Philadelphia, PA, 19104-6082, USA.
Abstract:
Mutations in the epidermal growth factor receptor (EGFR) have been found in more than 10% of non-small cell lung cancer (NSCLC) patients in North America. The vast majority of these differences are L858R point mutations in Exon 21. Currently, monoclonal antibodies directed against the extracellular domain of EGFR or small molecule/tyrosine kinase inhibitors (TKI) are the stalwarts of NSCLC therapy. Resistance, however, gradually develops because of the T790 mutation towards first and second generation TKIs. The third generation TKI AZD9291 (Osimertinib) has a high affinity for both activating and the acquired resistant mutation (T790 M) in EGFR, with a low affinity towards wild-type EGFR. Recent research, however, suggests that the EGFR (C797S) mutation in the tyrosine kinase domain is a likely cause of resistance to AZD9291. Another significant transformation mechanism associated with this resistance is erbB2 amplification. Our laboratory has developed a small kinase inhibitor, ER121 (MW: ∼500), that inhibits the erbB2/HER2 tyrosine kinases in addition to the EGFR C797S mutations. We have identified a TKI, ER121 targeting the mutant EGFR(T790 M). Using in vitro and in vivo models, examined the efficacy of ER121 on mutant EGFR cell lines. This has enabled us to establish that ER121 is well tolerated when administered orally and produces significant inhibitory activity against human cancers generated by mutant EGFR and amplified ErbB2.
Insights
A new drug, ER121, effectively targets epidermal growth factor receptor (EGFR) mutations, including C797S, and erbB2 amplification in non-small cell lung cancer (NSCLC). This orally administered tyrosine kinase inhibitor shows promise for overcoming resistance to current NSCLC therapies.
Area of Science:
- Oncology
- Molecular Biology
- Drug Discovery
Background:
- Epidermal growth factor receptor (EGFR) mutations are prevalent in non-small cell lung cancer (NSCLC).
- Acquired resistance to tyrosine kinase inhibitors (TKIs) develops due to mutations like T790M and C797S, and erbB2 amplification.
- Current therapies face challenges in overcoming resistance mechanisms in NSCLC.
Purpose of the Study:
- To evaluate the efficacy of a novel small kinase inhibitor, ER121, against EGFR mutations and erbB2 amplification in NSCLC.
- To investigate ER121's potential to overcome resistance to existing EGFR-targeted therapies.
- To assess the in vitro and in vivo activity of ER121.
Main Methods:
- Development of a small kinase inhibitor, ER121, targeting EGFR C797S mutations and erbB2/HER2 tyrosine kinases.
- In vitro and in vivo studies using mutant EGFR cell lines.
- Assessment of ER121's tolerability, oral administration, and inhibitory activity.
Main Results:
- ER121 demonstrates significant inhibitory activity against human cancers driven by mutant EGFR and amplified ErbB2.
- The drug targets both EGFR T790M mutations and EGFR C797S mutations.
- ER121 is well tolerated and can be administered orally.
Conclusions:
- ER121 is a promising therapeutic agent for NSCLC patients with specific EGFR mutations and erbB2 amplification.
- ER121 offers a potential strategy to overcome resistance to current EGFR-targeted TKIs.
- Further clinical investigation of ER121 is warranted for NSCLC treatment.
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