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Overcoming acquired resistance to third-generation EGFR inhibitors by targeting activation of intrinsic apoptotic pathway through Mcl-1 inhibition, Bax activation, or both.

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机构: [1]Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [2]Department of Hematology and Medical Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA, USA. [3]Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [4]Department of Radiation Oncology, Jiangsu Cancer Hospital, Jiangsu Institute of Cancer Research and The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, Jiangsu, China. [5]Department of Radiation Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA, USA. [6]Department of Medicine, University of Pittsburgh and Hillman Cancer Center, Pittsburgh, PA, USA. [7]Ascentage Pharma (Suzhou) Co., Ltd, Suzhou, Jiangsu, China. [8]Department of Hematology and Medical Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA, USA. ssun@emory.edu.
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Treatment of EGFR-mutant non-small cell lung cancer (NSCLC) with mutation-selective third-generation EGFR-tyrosine kinase inhibitors (EGFR-TKIs) such as osimertinib has achieved remarkable success in the clinic. However, the immediate challenge is the emergence of acquired resistance, limiting the long-term remission of patients. This study suggests a novel strategy to overcome acquired resistance to osimertinib and other third-generation EGFR-TKIs through directly targeting the intrinsic apoptotic pathway. We found that osimertinib, when combined with Mcl-1 inhibition or Bax activation, synergistically decreased the survival of different osimertinib-resistant cell lines, enhanced the induction of intrinsic apoptosis, and inhibited the growth of osimertinib-resistant tumor in vivo. Interestingly, the triple-combination of osimertinib with Mcl-1 inhibition and Bax activation exhibited the most potent activity in decreasing the survival and inducing apoptosis of osimertinib-resistant cells and in suppressing the growth of osimertinib-resistant tumors. These effects were associated with increased activation of the intrinsic apoptotic pathway evidenced by augmented mitochondrial cytochrome C and Smac release. Hence, this study convincingly demonstrates a novel strategy for overcoming acquired resistance to osimertinib and other 3rd generation EGFR-TKIs by targeting activation of the intrinsic apoptotic pathway through Mcl-1 inhibition, Bax activation or both, warranting further clinical validation of this strategy.© 2022. The Author(s), under exclusive licence to Springer Nature Limited.

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出版当年[2022]版:
大类 | 1 区 医学
小类 | 1 区 遗传学 1 区 生化与分子生物学 1 区 肿瘤学 2 区 细胞生物学
最新[2023]版:
大类 | 1 区 医学
小类 | 1 区 生化与分子生物学 1 区 遗传学 2 区 细胞生物学 2 区 肿瘤学
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第一作者机构: [1]Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan, China. [2]Department of Hematology and Medical Oncology, Emory University School of Medicine and Winship Cancer Institute, Atlanta, GA, USA.
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