Kim Eun Ju, Jeong Jae-Hoon, Bae Sangwoo, Kang Seongman, Kim Cheol Hyeon, Lim Young-Bin
Division of Radiation Effects, Korea Institute of Radiological and Medical Sciences, Seoul 139-706, Republic of Korea.
J Cell Biochem. 2013 Jun;114(6):1248-56. doi: 10.1002/jcb.24465.
Clinical resistance to gefitinib, an epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI), in patients with lung cancer has been linked to acquisition of the T790M resistance mutation in activated EGFR or amplification of MET. Phosphatase and tensin homolog (PTEN) loss has been recently reported as a gefitinib resistance mechanism in lung cancer. The aim of this study was to evaluate the efficacy of radiotherapy in non-small-cell lung cancer (NSCLC) with acquired gefitinib resistance caused by PTEN deficiency to suggest radiotherapy as an alternative to EGFR TKIs. PTEN deficient-mediated gefitinib resistance was generated in HCC827 cells, an EGFR TKI sensitive NSCLC cell line, by PTEN knockdown with a lentiviral vector expressing short hairpin RNA-targeting PTEN. The impact of PTEN knockdown on sensitivity to radiation in the presence or absence of PTEN downstream signaling inhibitors was investigated. PTEN knockdown conferred acquired resistance not only to gefitinib but also to radiation on HCC827 cells. mTOR inhibitors alone failed to reduce HCC827 cell viability, regardless of PTEN expression, but ameliorated PTEN knockdown-induced radioresistance. PTEN knockdown-mediated radioresistance was accompanied by repression of radiation-induced cytotoxic autophagy, and treatment with mTOR inhibitors released the repression of cytotoxic autophagy to overcome PTEN knockdown-induced radioresistance in HCC827 cells. These results suggest that inhibiting mTOR signaling could be an effective strategy to radiosensitize NSCLC harboring the EGFR activating mutation that acquires resistance to both TKIs and radiotherapy due to PTEN loss or inactivation mutations.
肺癌患者对表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)吉非替尼的临床耐药性与活化型EGFR中T790M耐药突变的获得或MET扩增有关。最近有报道称,磷酸酶和张力蛋白同源物(PTEN)缺失是肺癌中吉非替尼的耐药机制。本研究的目的是评估放疗对因PTEN缺乏而获得吉非替尼耐药性的非小细胞肺癌(NSCLC)的疗效,以表明放疗可作为EGFR TKIs的替代方案。通过用表达靶向PTEN的短发夹RNA的慢病毒载体敲低PTEN,在EGFR TKI敏感的NSCLC细胞系HCC827细胞中产生PTEN缺陷介导的吉非替尼耐药性。研究了在存在或不存在PTEN下游信号抑制剂的情况下,PTEN敲低对辐射敏感性的影响。PTEN敲低不仅使HCC827细胞对吉非替尼产生获得性耐药,而且对辐射也产生耐药。无论PTEN表达如何,单独使用mTOR抑制剂均不能降低HCC827细胞的活力,但可改善PTEN敲低诱导的放射抗性。PTEN敲低介导的放射抗性伴随着辐射诱导的细胞毒性自噬的抑制,而mTOR抑制剂治疗可解除对细胞毒性自噬的抑制,从而克服HCC827细胞中PTEN敲低诱导的放射抗性。这些结果表明,抑制mTOR信号传导可能是一种有效的策略,可使携带EGFR激活突变的NSCLC对放疗增敏,该突变由于PTEN缺失或失活突变而对TKIs和放疗均产生耐药。