Li C, Iida M, Dunn E F, Ghia A J, Wheeler D L
Department of Human Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Oncogene. 2009 Oct 29;28(43):3801-13. doi: 10.1038/onc.2009.234. Epub 2009 Aug 17.
Epidermal growth factor receptor (EGFR) is a ubiquitously expressed receptor tyrosine kinase involved in the etiology of several human cancers. Cetuximab is an EGFR-blocking antibody that has been approved for the treatment of patients with head and neck squamous cell carcinoma and metastatic colorectal cancer. Previous reports have shown that EGFR translocation to the nucleus is associated with cell proliferation. Here we investigated mechanisms of acquired resistance to cetuximab using a model derived from the non-small cell lung cancer line H226. We demonstrated that cetuximab-resistant cells overexpress HER family ligands including epidermal growth factor (EGF), amphiregulin, heparin-binding EGF and beta-cellulin. Overexpression of these ligands is associated with the nuclear translocation of the EGFR and this process was mediated by the Src family kinases (SFK). Treatment of cetuximab-resistant cells with the SFK inhibitor, dasatinib, resulted in loss of nuclear EGFR, increased membrane expression of the EGFR and resensitization to cetuximab. In addition, expression of a nuclear localization sequence-tagged EGFR in cetuximab-sensitive cells increased resistance to cetuximab both in vitro and in mouse xenografts. Collectively, these data suggest that nuclear expression of EGFR may be an important molecular determinant of resistance to cetuximab therapy and provides a rationale for investigating nuclear EGFR as a biomarker for cetuximab response. Further, these data suggest a rationale for the design of clinical trials that examine the value of treating patients with cetuximab-resistant tumors with inhibitors of SFKs in combination with cetuximab.
表皮生长因子受体(EGFR)是一种广泛表达的受体酪氨酸激酶,参与多种人类癌症的发病机制。西妥昔单抗是一种EGFR阻断抗体,已被批准用于治疗头颈部鳞状细胞癌和转移性结直肠癌患者。先前的报道表明,EGFR易位至细胞核与细胞增殖有关。在此,我们使用源自非小细胞肺癌细胞系H226的模型研究了对西妥昔单抗获得性耐药的机制。我们证明,西妥昔单抗耐药细胞过表达HER家族配体,包括表皮生长因子(EGF)、双调蛋白、肝素结合EGF和β-细胞素。这些配体的过表达与EGFR的核转位有关,这一过程由Src家族激酶(SFK)介导。用SFK抑制剂达沙替尼处理西妥昔单抗耐药细胞,导致核内EGFR丢失,EGFR膜表达增加,并重新对西妥昔单抗敏感。此外,在西妥昔单抗敏感细胞中表达带有核定位序列标签的EGFR,在体外和小鼠异种移植中均增加了对西妥昔单抗的耐药性。总体而言,这些数据表明EGFR的核表达可能是西妥昔单抗治疗耐药的重要分子决定因素,并为将核EGFR作为西妥昔单抗反应的生物标志物进行研究提供了理论依据。此外,这些数据为设计临床试验提供了理论依据,该试验旨在研究用SFK抑制剂联合西妥昔单抗治疗西妥昔单抗耐药肿瘤患者的价值。