Cancer Center, Daping Hospital and Research Institute of Surgery, Third Military Medical University, Chongqing, 400042, China.
Cell Death Dis. 2018 Oct 31;9(11):1111. doi: 10.1038/s41419-018-1162-0.
Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have become the standard first-line treatment for advanced lung adenocarcinoma (LUAD) cancer patients with activating EGFR mutations. However, most patients show acquired resistance to EGFR-TKIs, thereby resulting in a modest overall survival benefit. Here, we found that expression level of APE1 was closely associated with TKI resistance in LUAD. Our clinical data show that level of APE1 was inversely correlated with progression-free survival rate and median time to progression in EGFR-mutated LUAD patients. Additionally, we observed increased expression of APE1 in TKI-resistant LUAD cell lines compared to their parental cell lines. Overexpression of APE1-protected TKI-sensitive LUAD cells from TKI-induced cell growth inhibition and cell death. In contrast, inhibition of APE1-enhanced TKI-induced apoptosis, cell growth inhibition and tumor growth inhibition in TKI-resistant LUAD. In addition, we identified that APE1 positively regulates Akt activation and APE1 overexpression-induced TKI resistance was attenuated by inhibition of Akt activity. Finally, we demonstrated that inhibition of the redox function of APE1 enhances the sensitivity of TKI-resistant LUAD cells to TKI treatment and inhibits Akt phosphorylation in TKI-resistant LUAD cells, but not by inhibition of the APE1 DNA repair function. Taken together, our data show that increased expression of APE1 significantly contributes to TKI resistance development in LUAD, and targeting APE1 may reverse acquired resistance of LUAD cells to TKI treatment. Additionally, our data show that APE1 regulates TKI resistance in LUAD cells by activating Akt signaling through a redox-dependent mechanism.
表皮生长因子受体酪氨酸激酶抑制剂 (EGFR-TKIs) 已成为具有激活 EGFR 突变的晚期肺腺癌 (LUAD) 患者的标准一线治疗方法。然而,大多数患者对 EGFR-TKIs 表现出获得性耐药,从而导致总体生存获益有限。在这里,我们发现 APE1 的表达水平与 LUAD 中的 TKI 耐药密切相关。我们的临床数据表明,APE1 水平与 EGFR 突变型 LUAD 患者的无进展生存率和中位无进展时间呈负相关。此外,我们观察到与亲本细胞系相比,TKI 耐药 LUAD 细胞系中 APE1 的表达增加。APE1 的过表达可保护 TKI 敏感的 LUAD 细胞免受 TKI 诱导的细胞生长抑制和细胞死亡。相比之下,抑制 APE1 增强了 TKI 诱导的 TKI 耐药 LUAD 细胞的凋亡、细胞生长抑制和肿瘤生长抑制。此外,我们确定 APE1 可正向调节 Akt 激活,并且 APE1 过表达诱导的 TKI 耐药可通过抑制 Akt 活性减弱。最后,我们证明了抑制 APE1 的氧化还原功能可增强 TKI 耐药 LUAD 细胞对 TKI 治疗的敏感性,并抑制 TKI 耐药 LUAD 细胞中 Akt 的磷酸化,但不能通过抑制 APE1 的 DNA 修复功能。总之,我们的数据表明,APE1 的表达增加显著促进了 LUAD 中的 TKI 耐药发展,靶向 APE1 可能逆转 LUAD 细胞对 TKI 治疗的获得性耐药。此外,我们的数据表明,APE1 通过一种依赖氧化还原的机制通过激活 Akt 信号通路来调节 LUAD 细胞中的 TKI 耐药。
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