A novel treatment strategy for lapatinib resistance in a subset of HER2-amplified gastric cancer

被引:18
作者
Ning, Gang [1 ]
Zhu, Qihui [1 ]
Kang, Wonyoung [1 ]
Lee, Hamin [2 ,3 ]
Maher, Leigh [1 ]
Suh, Yun-Suhk [4 ]
Michaud, Michael [1 ]
Silva, Mayerlin [1 ]
Kwon, Jee Young [1 ]
Zhang, Chengsheng [1 ,5 ]
Lee, Charles [1 ,2 ,5 ]
机构
[1] Jackson Lab Genom Med, 10 Discovery Dr, Farmington, CT 06032 USA
[2] Ewha Womans Univ, Dept Life Sci, Seoul 03760, South Korea
[3] Baylor Coll Med, Dept Mol & Human Genet, Houston, TX 77030 USA
[4] Seoul Natl Univ, Coll Med, Dept Surg, Seoul 03080, South Korea
[5] Xi An Jiao Tong Univ, Affiliated Hosp 1, Precis Med Ctr, 277 West Yanta Rd, Xian 710061, Shaanxi, Peoples R China
关键词
CRISPR; Cas9; screening; HER2; amplification; Lapatinib resistance; Gastric cancer; PI3K pathway; And MAPK pathway; SCALE CRISPR-CAS9 KNOCKOUT; ACTIVATION; HER2; TRASTUZUMAB; SENSITIVITY; COMBINATION; INHIBITION; PATHWAYS; THERAPY; KINASES;
D O I
10.1186/s12885-021-08283-9
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
Background Gastric cancer (GC) is one of the leading causes of cancer-related deaths worldwide. Human epidermal growth factor receptor 2 (HER2) amplification occurs in approximately 13-23% of all GC cases and patients with HER2 overexpression exhibit a poor prognosis. Lapatinib, a dual EGFR/HER2 tyrosine kinase inhibitor, is an effective agent to treat HER2-amplified breast cancer but it failed in gastric cancer (GC) clinical trials. However, the molecular mechanism of lapatinib resistance in HER2-amplified GC is not well studied. Methods We employed an unbiased, genome-scale screening with pooled CRISPR library on HER2-amplified GC cell lines to identify genes that are associated with resistance to lapatinib. To validate the candidate genes, we applied in vitro and in vivo pharmacological tests to confirm the function of the target genes. Results We found that loss of function of CSK or PTEN conferred lapatinib resistance in HER2-amplified GC cell lines NCI-N87 and OE19, respectively. Moreover, PI3K and MAPK signaling was significantly increased in CSK or PTEN null cells. Furthermore, in vitro and in vivo pharmacological study has shown that lapatinib resistance by the loss of function of CSK or PTEN, could be overcome by lapatinib combined with the PI3K inhibitor copanlisib and MEK inhibitor trametinib. Conclusions Our study suggests that loss-of-function mutations of CSK and PTEN cause lapatinib resistance by re-activating MAPK and PI3K pathways, and further proved these two pathways are druggable targets. Inhibiting the two pathways synergistically are effective to overcome lapatinib resistance in HER2-amplified GC. This study provides insights for understanding the resistant mechanism of HER2 targeted therapy and novel strategies that may ultimately overcome resistance or limited efficacy of lapatinib treatment for subset of HER2 amplified GC.
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页数:17
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