| Autor: |
Codony-Servat C; Pangaea Oncology, Barcelona, Spain., Codony-Servat J; Pangaea Oncology, Barcelona, Spain., Karachaliou N; Instituto Oncológico Dr Rosell (IOR), University Hospital Sagrat Cor, Barcelona, Spain., Molina MA; Pangaea Oncology, Barcelona, Spain., Chaib I; Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain., Ramirez JL; Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain.; Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain., de Los Llanos Gil M; Instituto Oncológico Dr Rosell (IOR), Quirón-Dexeus University Institute, Barcelona, Spain., Solca F; Boehringer Ingelheim RCV GmbH and Co. KG, Vienna, Austria., Bivona TG; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, United States., Rosell R; Institut d'Investigació en Ciències Germans Trias i Pujol, Badalona, Spain.; Institut Català d'Oncologia, Hospital Germans Trias i Pujol, Badalona, Spain. |
| Abstrakt: |
Gefitinib, erlotinib or afatinib are the current treatment for non-small-cell lung cancer (NSCLC) harboring an activating mutation of the epidermal growth factor receptor (EGFR), but less than 5% of patients achieve a complete response and the median progression-free survival is no longer than 12 months. Early adaptive resistance can occur as soon as two hours after starting treatment by activating signal transducer and activation of transcription 3 (STAT3) signaling. We investigated the activation of STAT3 in a panel of gefitinib-sensitive EGFR mutant cell lines, and gefitinib-resistant PC9 cell lines developed in our laboratory. Afatinib has great activity in gefitinib-sensitive as well as in gefitinib-resistant EGFR mutant NSCLC cell lines. However, afatinib therapy causes phosphorylation of STAT3 tyrosine 705 (pSTAT3Tyr705) and elevation of STAT3 and RANTES mRNA levels. The combination of afatinib with TPCA-1 (a STAT3 inhibitor) ablated pSTAT3Tyr705 and down-regulated STAT3 and RANTES mRNA levels with significant growth inhibitory effect in both gefitinib-sensitive and gefitinib-resistant EGFR mutant NSCLC cell lines. Aldehyde dehydrogenase positive (ALDH+) cells were still observed with the combination at the time that Hairy and Enhancer of Split 1 (HES1) mRNA expression was elevated following therapy. Although the combination of afatinib with STAT3 inhibition cannot eliminate the potential problem of a remnant cancer stem cell population, it represents a substantial advantage and opportunity to further prolong progression free survival and probably could increase the response rate in comparison to the current standard of single therapy. |
