College of Pharmacy, Natural Products Research Institute, Seoul National University, Seoul, 08826, Korea.
Cell Death Dis. 2019 May 1;10(5):361. doi: 10.1038/s41419-019-1601-6.
Acquired resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) has been a major obstacle in the treatment of non-small cell lung cancer (NSCLC) patients. AXL has been reported to mediate EGFR-TKIs. Recently, third generation EGFR-TKI osimertinib has been approved and yet its acquired resistance mechanism is not clearly understood. We found that AXL is involved in both gefitinib and osimertinib resistance using in vitro and in vivo model. In addition, AXL overexpression was correlated with extended protein degradation rate. We demonstrate targeting AXL degradation is an alternative route to restore EGFR-TKIs sensitivity. We confirmed that the combination effect of YD, an AXL degrader, and EGFR-TKIs can delay or overcome EGFR-TKIs-driven resistance in EGFR-mutant NSCLC cells, xenograft tumors, and patient-derived xenograft (PDX) models. Therefore, combination of EGFR-TKI and AXL degrader is a potentially effective treatment strategy for overcoming and delaying acquired resistance in NSCLC.
获得性表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)耐药性是治疗非小细胞肺癌(NSCLC)患者的主要障碍。AXL 已被报道可介导 EGFR-TKIs。最近,第三代 EGFR-TKI 奥希替尼已被批准,但获得性耐药机制尚不清楚。我们发现 AXL 参与了吉非替尼和奥希替尼的耐药性,使用了体外和体内模型。此外,AXL 过表达与延长的蛋白降解率相关。我们证明靶向 AXL 降解是恢复 EGFR-TKIs 敏感性的另一种途径。我们证实,AXL 降解剂 YD 与 EGFR-TKIs 的联合作用可以延迟或克服 EGFR-TKIs 驱动的 EGFR 突变型 NSCLC 细胞、异种移植肿瘤和患者来源的异种移植(PDX)模型中的耐药性。因此,EGFR-TKI 和 AXL 降解剂的联合应用是克服和延迟 NSCLC 获得性耐药的一种潜在有效治疗策略。