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拉帕替尼,一种表皮生长因子受体(EGFR)和人表皮生长因子受体 2(HER2)的双重抑制剂,与氟尿嘧啶(5-fluorouracil)联用对食管癌具有协同作用。

Lapatinib, a dual inhibitor of EGFR and HER2, has synergistic effects with 5-fluorouracil on esophageal carcinoma.

机构信息

Xinxiang Medical University, The First Affiliated Hospital of Xingiang Medical University, Henan Province, PR China.

出版信息

Oncol Rep. 2012 May;27(5):1639-45. doi: 10.3892/or.2012.1659. Epub 2012 Jan 26.

Abstract

Epidermal growth factor receptor (EGFR) and human epidermal growth factor receptor 2 (HER2) amplification occurs in over 30% of esophageal carcinomas. Combination therapies with EGFR and HER2-targeting agents and cytotoxic agents are considered a potential therapeutic option for esophageal cancer. We evaluated the antitumor effects of lapatinib, a dual tyrosine kinase inhibitor which simultaneously inhibits EGFR and HER2, 5-fluorouracil (5-Fu) alone and in combination on esophageal cancer cells. The antiproliferative activity of lapatinib, 5-Fu and lapatinib plus 5-Fu was measured by MTT assay and the combination index (CI) values were calculated. Additionally, cell cycle distribution of lapatinib alone and the combination with 5-Fu were detected by flow cytometry analysis. Annexin V-FITC and propidium iodide stain were used for analyzing the apoptotic cells after cells were treated with either agent alone or in combination. The EGFR and HER2 activated signaling pathways were monitored by western blotting. The combination of lapatinib and 5-Fu synergistically inhibited cell proliferation and exhibited an enhanced proapoptotic effect on esophageal cancer cells. The potentiation effect of combined treatment was associated with downregulation of EGFR and HER2 signaling pathways because data from western blot analysis showed that lapatinib in combination with 5-Fu markedly reduced the phosphorylation of EGFR and HER2, and inhibited the activation of downstream signaling molecules, such as AKT and ERK. A significant G1 arrest was also observed in cell cycle analysis after exposing cells to lapatinib, however, combination with 5-Fu did not enhance G1 arrest. These results indicate that the combination of the lapatinib and 5-Fu is a promising treatment option for esophageal carcinoma with HER2 amplification.

摘要

表皮生长因子受体(EGFR)和人表皮生长因子受体 2(HER2)扩增发生在超过 30%的食管癌中。针对 EGFR 和 HER2 的靶向药物联合细胞毒性药物的联合治疗被认为是食管癌潜在的治疗选择。我们评估了拉帕替尼(一种同时抑制 EGFR 和 HER2 的双重酪氨酸激酶抑制剂)、5-氟尿嘧啶(5-Fu)单独和联合对食管癌细胞的抗肿瘤作用。通过 MTT 测定法测量拉帕替尼、5-Fu 和拉帕替尼加 5-Fu 的增殖活性,并计算组合指数(CI)值。此外,通过流式细胞术分析检测拉帕替尼单独和与 5-Fu 联合的细胞周期分布。用 Annexin V-FITC 和碘化丙啶染色法分析单独用药物或联合用药物处理后的凋亡细胞。用 Western blot 监测 EGFR 和 HER2 激活的信号通路。拉帕替尼和 5-Fu 的联合协同抑制细胞增殖,并对食管癌细胞表现出增强的促凋亡作用。联合治疗的增效作用与下调 EGFR 和 HER2 信号通路有关,因为 Western blot 分析数据表明,拉帕替尼与 5-Fu 联合使用显著降低了 EGFR 和 HER2 的磷酸化,并抑制了下游信号分子(如 AKT 和 ERK)的激活。细胞周期分析还显示,细胞暴露于拉帕替尼后出现明显的 G1 期阻滞,但与 5-Fu 联合使用并未增强 G1 期阻滞。这些结果表明,拉帕替尼和 5-Fu 的联合治疗是一种很有前途的治疗 HER2 扩增型食管癌的选择。

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