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短暂性 IGF-1R 抑制联合奥希替尼可根除 AXL 低表达 EGFR 突变型肺癌。

Transient IGF-1R inhibition combined with osimertinib eradicates AXL-low expressing EGFR mutated lung cancer.

机构信息

Division of Medical Oncology, Cancer Research Institute, Kanazawa University, Kanazawa, Japan.

Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, Guangzhou, China.

出版信息

Nat Commun. 2020 Sep 14;11(1):4607. doi: 10.1038/s41467-020-18442-4.

Abstract

Drug tolerance is the basis for acquired resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) including osimertinib, through mechanisms that still remain unclear. Here, we show that while AXL-low expressing EGFR mutated lung cancer (EGFRmut-LC) cells are more sensitive to osimertinib than AXL-high expressing EGFRmut-LC cells, a small population emerge osimertinib tolerance. The tolerance is mediated by the increased expression and phosphorylation of insulin-like growth factor-1 receptor (IGF-1R), caused by the induction of its transcription factor FOXA1. IGF-1R maintains association with EGFR and adaptor proteins, including Gab1 and IRS1, in the presence of osimertinib and restores the survival signal. In AXL-low-expressing EGFRmut-LC cell-derived xenograft and patient-derived xenograft models, transient IGF-1R inhibition combined with continuous osimertinib treatment could eradicate tumors and prevent regrowth even after the cessation of osimertinib. These results indicate that optimal inhibition of tolerant signals combined with osimertinib may dramatically improve the outcome of EGFRmut-LC.

摘要

药物耐受性是表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKIs)包括奥希替尼获得性耐药的基础,其机制尚不清楚。在这里,我们表明,虽然低表达 AXL 的 EGFR 突变型肺癌(EGFRmut-LC)细胞比高表达 AXL 的 EGFRmut-LC 细胞对奥希替尼更为敏感,但一小部分细胞会出现奥希替尼耐受性。这种耐受性是由胰岛素样生长因子-1 受体(IGF-1R)的转录因子 FOXA1 诱导其转录,导致其表达和磷酸化增加而介导的。在奥希替尼存在的情况下,IGF-1R 与 EGFR 和衔接蛋白(包括 Gab1 和 IRS1)保持关联,并恢复生存信号。在低表达 AXL 的 EGFRmut-LC 细胞衍生的异种移植和患者衍生的异种移植模型中,短暂的 IGF-1R 抑制联合持续的奥希替尼治疗可以消除肿瘤,并在停止奥希替尼治疗后防止肿瘤再次生长。这些结果表明,最佳抑制耐受信号联合奥希替尼可能会显著改善 EGFRmut-LC 的治疗效果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b5eb/7490421/f2efc4d6c81e/41467_2020_18442_Fig1_HTML.jpg

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