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头颈部癌和乳腺癌中EGFR靶向治疗的挑战与耐药机制:对RTK依赖性和非依赖性机制的见解

Challenges and resistance mechanisms to EGFR targeted therapies in head and neck cancers and breast cancer: Insights into RTK dependent and independent mechanisms.

作者信息

Shyamsunder Shreya, Lu Zhixin, Takiar Vinita, Waltz Susan E

机构信息

Department of Radiation Oncology, University of Cincinnati Medical Center, Cincinnati, OH 45267, USA.

Department of Cancer Biology, University of Cincinnati College of Medicine, Cincinnati, OH 45267, USA.

出版信息

Oncotarget. 2025 Jun 25;16:508-530. doi: 10.18632/oncotarget.28747.

Abstract

Epidermal Growth Factor Receptor (EGFR) targeted therapies have yielded variable results in clinical trials for breast and head and neck cancers, despite EGFR overexpression in these malignancies. Primary resistance to these therapies is common, with secondary resistance often arising due to the overexpression of other receptor tyrosine kinases (RTKs) and increased downstream signaling from these RTKs. Additionally, non-RTK-driven mechanisms also contribute to anti-EGFR therapy resistance. This review highlights the role of AXL, MET, and RON families of RTKs in tumor progression and resistance to anti-EGFR therapies, focusing on breast and head and neck cancers. In breast cancer, the review discusses the intricate relationship between EGFR expression and therapeutic outcomes, emphasizing the challenges and potential strategies for enhancing EGFR-targeted treatments. It details how EGFR inhibition affects tumor progression and survival in head and neck cancer, noting that small molecule inhibitors and monoclonal antibodies, such as cetuximab, can lead to trans-activation of other RTKs. The review further explores non-RTK-driven resistance mechanisms in breast cancer, including EGFR activation through EGF-related ligands, nuclear localization of EGFR, and the overexpression of resistance-conferring proteins. In head and neck cancer, resistance is also mediated by TLR4-MyD88 signaling activation, loss of tumor suppressor genes like PTEN, activating mutations in PI3K, and involvement of STAT3. By synthesizing current insights on both RTK and non-RTK mediated resistance against anti-EGFR therapies, this review aims to guide future research and improve therapeutic strategies for these cancers.

摘要

表皮生长因子受体(EGFR)靶向疗法在乳腺癌和头颈癌的临床试验中取得了不同的结果,尽管这些恶性肿瘤中存在EGFR过表达。对这些疗法的原发性耐药很常见,继发性耐药通常是由于其他受体酪氨酸激酶(RTK)的过表达以及这些RTK下游信号传导增加所致。此外,非RTK驱动的机制也导致了抗EGFR治疗耐药。本综述重点介绍了RTK的AXL、MET和RON家族在肿瘤进展和抗EGFR治疗耐药中的作用,重点关注乳腺癌和头颈癌。在乳腺癌方面,综述讨论了EGFR表达与治疗结果之间的复杂关系,强调了增强EGFR靶向治疗的挑战和潜在策略。它详细阐述了EGFR抑制如何影响头颈癌的肿瘤进展和生存,指出小分子抑制剂和单克隆抗体(如西妥昔单抗)可导致其他RTK的反式激活。综述进一步探讨了乳腺癌中非RTK驱动的耐药机制,包括通过EGF相关配体激活EGFR、EGFR的核定位以及赋予耐药性的蛋白质过表达。在头颈癌中,耐药也由TLR4-MyD88信号激活、PTEN等肿瘤抑制基因的缺失、PI3K的激活突变以及STAT3的参与介导。通过综合目前对RTK和非RTK介导的抗EGFR治疗耐药性的见解,本综述旨在指导未来的研究并改进这些癌症的治疗策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ba6e/12196329/9a7308df2a57/oncotarget-16-28747-g001.jpg

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