Division of Hematology/Oncology, Department of Internal Medicine, University of California Davis School of Medicine, University of California Davis Comprehensive Cancer Center, Sacramento, California.
Medical Service, Veterans Affairs Northern California Health Care System, Mather, California.
Mol Cancer Ther. 2024 May 2;23(5):700-710. doi: 10.1158/1535-7163.MCT-23-0458.
There is an unmet clinical need to develop novel strategies to overcome resistance to tyrosine kinase inhibitors (TKI) in patients with oncogene-driven lung adenocarcinoma (LUAD). The objective of this study was to determine whether simvastatin could overcome TKI resistance using the in vitro and in vivo LUAD models. Human LUAD cell lines, tumor cells, and patient-derived xenograft (PDX) models from TKI-resistant LUAD were treated with simvastatin, either alone or in combination with a matched TKI. Tumor growth inhibition was measured by the 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium (MTS) assay and expression of molecular targets was assessed by immunoblots. Tumors were assessed by histopathology, IHC stain, immunoblots, and RNA sequencing. We found that simvastatin had a potent antitumor effect in tested LUAD cell lines and PDX tumors, regardless of tumor genotypes. Simvastatin and TKI combination did not have antagonistic cytotoxicity in these LUAD models. In an osimertinib-resistant LUAD PDX model, simvastatin and osimertinib combination resulted in a greater reduction in tumor volume than simvastatin alone (P < 0.001). Immunoblots and IHC stain also confirmed that simvastatin inhibited TKI targets. In addition to inhibiting 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase, RNA sequencing and Western blots identified the proliferation, migration, and invasion-related genes (such as PI3K/Akt/mTOR, YAP/TAZ, focal adhesion, extracellular matrix receptor), proteasome-related genes, and integrin (α3β1, αvβ3) signaling pathways as the significantly downregulated targets in these PDX tumors treated with simvastatin and a TKI. The addition of simvastatin is a safe approach to overcome acquired resistance to TKIs in several oncogene-driven LUAD models, which deserve further investigation.
临床上需要开发新的策略来克服驱动基因阳性肺腺癌(LUAD)患者对酪氨酸激酶抑制剂(TKI)的耐药性。本研究的目的是确定辛伐他汀能否通过体外和体内 LUAD 模型来克服 TKI 耐药性。用辛伐他汀单独或与匹配的 TKI 联合处理 TKI 耐药性 LUAD 的人 LUAD 细胞系、肿瘤细胞和患者来源的异种移植(PDX)模型。通过 3-(4,5-二甲基噻唑-2-基)-5-(3-羧基甲氧基苯基)-2-(4-磺基苯基)-2H-四唑(MTS)测定法测量肿瘤生长抑制,并用免疫印迹法评估分子靶标的表达。通过组织病理学、免疫组化染色、免疫印迹和 RNA 测序评估肿瘤。我们发现,辛伐他汀在测试的 LUAD 细胞系和 PDX 肿瘤中均具有强大的抗肿瘤作用,无论肿瘤基因型如何。在这些 LUAD 模型中,辛伐他汀和 TKI 联合用药没有产生拮抗的细胞毒性。在奥希替尼耐药性 LUAD PDX 模型中,与单独使用辛伐他汀相比,辛伐他汀和奥希替尼联合使用导致肿瘤体积减小更大(P<0.001)。免疫印迹和免疫组化染色也证实了辛伐他汀抑制 TKI 靶标。除了抑制 3-羟基-3-甲基戊二酰基辅酶 A(HMG-CoA)还原酶外,RNA 测序和 Western blot 还确定了增殖、迁移和侵袭相关基因(如 PI3K/Akt/mTOR、YAP/TAZ、焦点黏附、细胞外基质受体)、蛋白酶体相关基因和整合素(α3β1、αvβ3)信号通路作为这些用辛伐他汀和 TKI 治疗的 PDX 肿瘤中显著下调的靶标。添加辛伐他汀是克服几种驱动基因阳性 LUAD 模型中获得性 TKI 耐药性的安全方法,值得进一步研究。