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安罗替尼联合奥希替尼通过靶向 c-MET/MYC/AXL 轴逆转 NSCLC 获得性奥希替尼耐药。

Anlotinib combined with osimertinib reverses acquired osimertinib resistance in NSCLC by targeting the c-MET/MYC/AXL axis.

机构信息

Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing 210011, Jiangsu, PR China.

Department of Respiratory Medicine, Nanjing First Hospital, Nanjing Medical University, Nanjing 210006, Jiangsu, PR China.

出版信息

Pharmacol Res. 2023 Feb;188:106668. doi: 10.1016/j.phrs.2023.106668. Epub 2023 Jan 18.


DOI:10.1016/j.phrs.2023.106668
PMID:36681369
Abstract

Favorable clinical evidence suggests that the next trend in new treatments for advanced non-small cell lung cancer (NSCLC) will be combination therapies. However, inevitable epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI) resistance greatly limits the clinical efficacy of patients carrying EGFR-activating mutants. In this study, we found a patient with clinical osimertinib resistance who regained a positive response after osimertinib plus anlotinib treatment. Two osimertinib-resistant cell lines were constructed, and AXL conferred resistance to osimertinib in NSCLC cell lines. The combined effects of anlotinib and osimertinib restored sensitivity to osimertinib in two osimertinib-resistant NSCLC cell lines and in xenografts. Moreover, anlotinib inhibits the phosphorylation of AXL in both resistant cell lines. Mechanistically, we confirmed that MYC binds to the promoter of AXL to promote its transcription in NSCLC cells, and we demonstrated that anlotinib combined with osimertinib treatment enhances the anti-tumor effect by inactivating the c-MET/MYC/AXL axis to reverse osimertinib resistance in NSCLC. In conclusion, our results provide strong support that this combination therapy may be effective in enhancing the efficacy of treatments in patients with advanced NSCLC.

摘要

有利的临床证据表明,针对晚期非小细胞肺癌(NSCLC)的新治疗方法的下一个趋势将是联合疗法。然而,不可避免的表皮生长因子受体酪氨酸激酶抑制剂(EGFR-TKI)耐药性极大地限制了携带 EGFR 激活突变的患者的临床疗效。在这项研究中,我们发现了一名临床奥希替尼耐药患者,在奥希替尼加安罗替尼治疗后恢复了阳性反应。构建了两种奥希替尼耐药细胞系,AXL 赋予 NSCLC 细胞系对奥希替尼的耐药性。安罗替尼和奥希替尼的联合作用恢复了两种奥希替尼耐药的 NSCLC 细胞系和异种移植物对奥希替尼的敏感性。此外,安罗替尼抑制两种耐药细胞系中 AXL 的磷酸化。在机制上,我们证实 MYC 结合到 AXL 的启动子上,促进 NSCLC 细胞中 AXL 的转录,我们证明安罗替尼联合奥希替尼治疗通过灭活 c-MET/MYC/AXL 轴增强抗肿瘤作用,从而逆转 NSCLC 中的奥希替尼耐药。总之,我们的结果提供了强有力的支持,表明这种联合治疗可能有效增强晚期 NSCLC 患者治疗的疗效。

相似文献

[1]
Anlotinib combined with osimertinib reverses acquired osimertinib resistance in NSCLC by targeting the c-MET/MYC/AXL axis.

Pharmacol Res. 2023-2

[2]
ONO-7475, a Novel AXL Inhibitor, Suppresses the Adaptive Resistance to Initial EGFR-TKI Treatment in -Mutated Non-Small Cell Lung Cancer.

Clin Cancer Res. 2020-5-1

[3]
Brigatinib, a newly discovered AXL inhibitor, suppresses AXL-mediated acquired resistance to osimertinib in EGFR-mutated non-small cell lung cancer.

Acta Pharmacol Sin. 2024-6

[4]
Activation of AXL as a Preclinical Acquired Resistance Mechanism Against Osimertinib Treatment in -Mutant Non-Small Cell Lung Cancer Cells.

Mol Cancer Res. 2018-11-21

[5]
Clinical outcomes and safety of osimertinib plus anlotinib for patients with previously treated EGFR T790M-positive NSCLC: A retrospective study.

J Clin Pharm Ther. 2022-5

[6]
Osimertinib plus savolitinib in patients with EGFR mutation-positive, MET-amplified, non-small-cell lung cancer after progression on EGFR tyrosine kinase inhibitors: interim results from a multicentre, open-label, phase 1b study.

Lancet Oncol. 2020-2-3

[7]
Activation of insulin-like growth factor-1 receptor confers acquired resistance to osimertinib in non-small cell lung cancer with EGFR T790M mutation.

Thorac Cancer. 2020-1

[8]
Targeting c-Myc to Overcome Acquired Resistance of EGFR Mutant NSCLC Cells to the Third-Generation EGFR Tyrosine Kinase Inhibitor, Osimertinib.

Cancer Res. 2021-9-15

[9]
Triple combination therapy comprising osimertinib, an AXL inhibitor, and an FGFR inhibitor improves the efficacy of EGFR-mutated non-small cell lung cancer.

Cancer Lett. 2024-8-28

[10]
MUSASHI-2 confers resistance to third-generation EGFR-tyrosine kinase inhibitor osimertinib in lung adenocarcinoma.

Cancer Sci. 2021-9

引用本文的文献

[1]
Role of anlotinib plus albumin paclitaxel regimen in stage IV non-small cell lung cancer and mental state.

World J Psychiatry. 2025-8-19

[2]
Rapid Progression of Primary Pulmonary NUT Midline Carcinoma: A Case Report and Literature Review.

Respirol Case Rep. 2025-8-4

[3]
Dauricine Overcomes Osimertinib Resistance in Lung Cancer by Inducing Ferroptosis via Stabilizing SAT1.

Cancer Sci. 2025-8

[4]
Anlotinib Plus Osimertinib in Osimertinib-Resistant Nonsquamous Nonsmall Cell Lung Cancer With Gradual Progression: A Retrospective Study.

Thorac Cancer. 2025-5

[5]
Efficacy and safety of anlotinib plus EGFR tyrosine kinase inhibitors in slow- or locally progressing non-small cell lung cancer after adjuvant therapy.

Transl Lung Cancer Res. 2025-4-30

[6]
Anlotinib enhances the efficacy of KRAS-G12C inhibitors through c-Myc/ORC2 axis inhibition in non-small cell lung cancer.

Cell Death Dis. 2025-5-2

[7]
RAF1 promotes anlotinib resistance in non-small cell lung cancer by inhibiting apoptosis.

J Cancer Res Clin Oncol. 2025-4-14

[8]
A novel mesenchymal epithelial transition (MET) inhibitor, CB538, relieves acquired resistance in -mutated -amplified non-small cell lung cancer.

Transl Cancer Res. 2025-3-30

[9]
Piperlongumine overcomes osimertinib resistance via governing ubiquitination-modulated Sp1 turnover.

JCI Insight. 2025-3-24

[10]
Anlotinib enhances the anti-tumor activity of osimertinib in patients with non-small cell lung cancer by reversing drug resistance.

Transl Lung Cancer Res. 2025-1-24

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