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Shaban N, Kamashev D, Emelianova A, Buzdin A. Targeted Inhibitors of EGFR: Structure, Biology, Biomarkers, and Clinical Applications. Cells 2023; 13:47. [PMID: 38201251 PMCID: PMC10778338 DOI: 10.3390/cells13010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 12/20/2023] [Accepted: 12/21/2023] [Indexed: 01/12/2024] Open
Abstract
Members of the EGFR family of tyrosine kinase receptors are major regulators of cellular proliferation, differentiation, and survival. In humans, abnormal activation of EGFR is associated with the development and progression of many cancer types, which makes it an attractive target for molecular-guided therapy. Two classes of EGFR-targeted cancer therapeutics include monoclonal antibodies (mAbs), which bind to the extracellular domain of EGFR, and tyrosine kinase inhibitors (TKIs), which mostly target the intracellular part of EGFR and inhibit its activity in molecular signaling. While EGFR-specific mAbs and three generations of TKIs have demonstrated clinical efficacy in various settings, molecular evolution of tumors leads to apparent and sometimes inevitable resistance to current therapeutics, which highlights the need for deeper research in this field. Here, we tried to provide a comprehensive and systematic overview of the rationale, molecular mechanisms, and clinical significance of the current EGFR-targeting drugs, highlighting potential candidate molecules in development. We summarized the underlying mechanisms of resistance and available personalized predictive approaches that may lead to improved efficacy of EGFR-targeted therapies. We also discuss recent developments and the use of specific therapeutic strategies, such as multi-targeting agents and combination therapies, for overcoming cancer resistance to EGFR-specific drugs.
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Affiliation(s)
- Nina Shaban
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow 117997, Russia; (D.K.); (A.B.)
- Laboratory for Translational Genomic Bioinformatics, Moscow Institute of Physics and Technology, Dolgoprudny 141701, Russia
| | - Dmitri Kamashev
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow 117997, Russia; (D.K.); (A.B.)
- Laboratory for Translational Genomic Bioinformatics, Moscow Institute of Physics and Technology, Dolgoprudny 141701, Russia
- Institute of Personalized Oncology, I.M. Sechenov First Moscow State Medical University, Moscow 119991, Russia
| | - Aleksandra Emelianova
- World-Class Research Center “Digital Biodesign and Personalized Healthcare”, Sechenov First Moscow State Medical University, Moscow 119991, Russia;
| | - Anton Buzdin
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Moscow 117997, Russia; (D.K.); (A.B.)
- Laboratory for Translational Genomic Bioinformatics, Moscow Institute of Physics and Technology, Dolgoprudny 141701, Russia
- Institute of Personalized Oncology, I.M. Sechenov First Moscow State Medical University, Moscow 119991, Russia
- PathoBiology Group, European Organization for Research and Treatment of Cancer (EORTC), 1200 Brussels, Belgium
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Racea RC, Macasoi IG, Dinu S, Pinzaru I, Marcovici I, Dehelean C, Rusu LC, Chioran D, Rivis M, Buzatu R. Eugenol: In Vitro and In Ovo Assessment to Explore Cytotoxic Effects on Osteosarcoma and Oropharyngeal Cancer Cells. PLANTS (BASEL, SWITZERLAND) 2023; 12:3549. [PMID: 37896013 PMCID: PMC10610311 DOI: 10.3390/plants12203549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 10/09/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
Cancer is a significant health problem worldwide; consequently, new therapeutic alternatives are being investigated, including those found in the vegetable kingdom. Eugenol (Eug) has attracted attention for its therapeutic properties, especially in stomatology. The purpose of this study was to investigate the cytotoxicity of Eug, in vitro, on osteosarcoma (SAOS-2) and oropharyngeal squamous cancer (Detroit-562) cells, as well as its potential irritant effect in ovo at the level of the chorioallantoic membrane (CAM). The data obtained following a 72 h Eug treatment highlighted the reduction in cell viability up to 41% in SAOS-2 cells and up to 37% in Detroit-562 cells, respectively. The apoptotic-like effect of Eug was indicated by the changes in cell morphology and nuclear aspect; the increase in caspase-3/7, -8 and -9 activity; the elevated expression of Bax and Bad genes; and the increase in luminescence signal (indicating phosphatidylserine externalization) that preceded the increase in fluorescence signal (indicating the compromise of membrane integrity). Regarding the vascular effects, slight signs of coagulation and vascular lysis were observed, with an irritation score of 1.69 for Eug 1 mM. Based on these results, the efficiency of Eug in cancer treatment is yet to be clarified.
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Affiliation(s)
- Robert-Cosmin Racea
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (R.-C.R.); (L.-C.R.); (D.C.); (M.R.); (R.B.)
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Ioana-Gabriela Macasoi
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.-G.M.); (I.P.); (I.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Stefania Dinu
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (R.-C.R.); (L.-C.R.); (D.C.); (M.R.); (R.B.)
- Pediatric Dentistry Research Center, Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 No., Revolutiei Bv., 300041 Timisoara, Romania
| | - Iulia Pinzaru
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.-G.M.); (I.P.); (I.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Iasmina Marcovici
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.-G.M.); (I.P.); (I.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Cristina Dehelean
- Faculty of Pharmacy, “Victor Babes” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania; (I.-G.M.); (I.P.); (I.M.); (C.D.)
- Research Center for Pharmaco-Toxicological Evaluations, Faculty of Pharmacy, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square No. 2, 300041 Timisoara, Romania
| | - Laura-Cristina Rusu
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (R.-C.R.); (L.-C.R.); (D.C.); (M.R.); (R.B.)
- Multidisciplinary Center for Research, Evaluation, Diagnosis and Therapies in Oral Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, Eftimie Murgu Square, No. 2, 300041 Timisoara, Romania
| | - Doina Chioran
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (R.-C.R.); (L.-C.R.); (D.C.); (M.R.); (R.B.)
| | - Mircea Rivis
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (R.-C.R.); (L.-C.R.); (D.C.); (M.R.); (R.B.)
| | - Roxana Buzatu
- Faculty of Dental Medicine, “Victor Babeș” University of Medicine and Pharmacy from Timisoara, 9 Revolutiei 1989 Ave., 300070 Timisoara, Romania; (R.-C.R.); (L.-C.R.); (D.C.); (M.R.); (R.B.)
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Palombo R, Paronetto MP. pncCCND1_B Engages an Inhibitory Protein Network to Downregulate CCND1 Expression upon DNA Damage. Cancers (Basel) 2022; 14:cancers14061537. [PMID: 35326688 PMCID: PMC8946712 DOI: 10.3390/cancers14061537] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 03/09/2022] [Accepted: 03/14/2022] [Indexed: 11/16/2022] Open
Abstract
Promoter-associated noncoding RNAs (pancRNAs) represent a class of noncoding transcripts driven from the promoter region of protein-coding or non-coding genes that operate as cis-acting elements to regulate the expression of the host gene. PancRNAs act by altering the chromatin structure and recruiting transcription regulators. PncCCND1_B is driven by the promoter region of CCND1 and regulates CCND1 expression in Ewing sarcoma through recruitment of a multi-molecular complex composed of the RNA binding protein Sam68 and the DNA/RNA helicase DHX9. In this study, we investigated the regulation of CCND1 expression in Ewing sarcoma cells upon exposure to chemotherapeutic drugs. Pan-inhibitor screening indicated that etoposide, a drug used for Ewing sarcoma treatment, promotes transcription of pncCCND1_B and repression of CCND1 expression. RNA immunoprecipitation experiments showed increased binding of Sam68 to the pncCCND1_B after treatment, despite the significant reduction in DHX9 protein. This effect was associated with the formation of DNA:RNA duplexes at the CCND1 promoter. Furthermore, Sam68 interacted with HDAC1 in etoposide treated cells, thus contributing to chromatin remodeling and epigenetic changes. Interestingly, inhibition of the ATM signaling pathway by KU 55,933 treatment was sufficient to inhibit etoposide-induced Sam68-HDAC1 interaction without rescuing DHX9 expression. In these conditions, the DNA:RNA hybrids persist, thus contributing to the local chromatin inactivation at the CCND1 promoter region. Altogether, our results show an active role of Sam68 in DNA damage signaling and chromatin remodeling on the CCND1 gene by fine-tuning transitions of epigenetic complexes on the CCND1 promoter.
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Affiliation(s)
- Ramona Palombo
- Laboratory of Molecular and Cellular Neurobiology, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy;
| | - Maria Paola Paronetto
- Laboratory of Molecular and Cellular Neurobiology, IRCCS Fondazione Santa Lucia, 00143 Rome, Italy;
- Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, Piazza Lauro de Bosis, 15, 00135 Rome, Italy
- Correspondence:
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de Kort WWB, Spelier S, Devriese LA, van Es RJJ, Willems SM. Predictive Value of EGFR-PI3K-AKT-mTOR-Pathway Inhibitor Biomarkers for Head and Neck Squamous Cell Carcinoma: A Systematic Review. Mol Diagn Ther 2021; 25:123-136. [PMID: 33686517 PMCID: PMC7956931 DOI: 10.1007/s40291-021-00518-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/15/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND Understanding molecular pathogenesis of head and neck squamous cell carcinomas (HNSCC) has considerably improved in the last decades. As a result, novel therapeutic strategies have evolved, amongst which are epidermal growth factor receptor (EGFR)-targeted therapies. With the exception of cetuximab, targeted therapies for HNSCC have not yet been introduced into clinical practice. One important aspect of new treatment regimes in clinical practice is presence of robust biomarkers predictive for therapy response. METHODS We performed a systematic search in PubMed, Embase and the Cochrane library. Articles were included if they investigated a biomarker for targeted therapy in the EGFR-PI3K-AKT-mTOR-pathway. RESULTS Of 83 included articles, 52 were preclinical and 33 were clinical studies (two studies contained both a preclinical and a clinical part). We classified EGFR pathway inhibitor types and investigated the type of biomarker (biomarker on epigenetic, DNA, mRNA or protein level). CONCLUSION Several EGFR-PI3K-AKT-mTOR-pathway inhibitor biomarkers have been researched for HNSCC but few of the investigated biomarkers have been adequately confirmed in clinical trials. A more systematic approach is needed to discover proper biomarkers as stratifying patients is essential to prevent unnecessary costs and side effects.
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Affiliation(s)
- W W B de Kort
- Department of Pathology, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands.
| | - S Spelier
- Department of Pathology, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands
| | - L A Devriese
- Department of Medical Oncology, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands
| | - R J J van Es
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands.,Department of Head and Neck Surgical Oncology, Utrecht Cancer Center, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands
| | - S M Willems
- Department of Pathology, University Medical Center Utrecht, PO Box 885500, 3508 GA, Utrecht, The Netherlands.,Department of Pathology, University Medical Center Groningen, PO Box 30001, 9700 RB, Groningen, The Netherlands
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Wilson GD, Wilson TG, Hanna A, Dabjan M, Buelow K, Torma J, Marples B, Galoforo S. Dacomitinib and gedatolisib in combination with fractionated radiation in head and neck cancer. Clin Transl Radiat Oncol 2020; 26:15-23. [PMID: 33251343 PMCID: PMC7677653 DOI: 10.1016/j.ctro.2020.11.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 01/05/2023] Open
Abstract
We evaluated radiation with dual EGFR and PI3K targeting in head and neck cancer. Dacomitinib, showed an inverse correlation between growth inhibition and EGFR expression. Gedatolisib was effective in each cell line. Neither drug caused radiosensitization in vitro. Gedatolisib was relatively ineffective in vivo in combination with dacomitinib and/or radiation. Dacomitinib was highly effective alone and in combination with radiation and/or gedatolisib. Immunoblotting studies in vivo mirrored the effects seen with growth delay.
Background and purpose There has been little success targeting individual genes in combination with radiation in head and neck cancer. In this study we investigated whether targeting two key pathways simultaneously might be more effective. Materials and methods We studied the effect of combining dacomitinib (pan-HER, irreversible inhibitor) and gedatolisib (dual PI3K/MTOR inhibitor) with radiation in well characterized, low passage xenograft models of HNSCC in vitro and in vivo. Results Dacomitinib showed differential growth inhibition in vitro that correlated to EGFR expression whilst gedatolisib was effective in both cell lines. Neither agent radiosensitized the cell lines in vitro. In vivo studies demonstrated that dacomitinib was an effective agent alone and in combination with radiation whilst the addition of gedatolisib did not enhance the effect of these two modalities despite inhibiting phosphorylation of key genes in the PI3K/MTOR pathway. Conclusions Our results showed that combining two drugs with radiation provided no added benefit compared to the single most active drug. Dacomitinib deserves more investigation as a radiation sensitizing agent in HNSCC.
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Affiliation(s)
- George D Wilson
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
| | - Thomas G Wilson
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
| | - Alaa Hanna
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
| | - Mohamad Dabjan
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
| | - Katie Buelow
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
| | - John Torma
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
| | - Brian Marples
- Department of Radiation Oncology, University of Rochester, Rochester, NY, United States
| | - Sandra Galoforo
- Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI, United States
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Afatinib is active in osteosarcoma in osteosarcoma cell lines. J Cancer Res Clin Oncol 2020; 146:1693-1700. [PMID: 32333142 DOI: 10.1007/s00432-020-03220-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2020] [Accepted: 04/15/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE Osteosarcoma is the most common bone tumor, mainly affecting adolescents and young adults, and metastatic disease has poor outcomes with a dismal overall survival. Currently, chemotherapy is the standard of care with limited results, finding that new therapies could improve these outcomes. Preclinical and clinical studies have suggested a possible important role of ErbB pathway aberrations in osteosarcoma etiology. The present study shows the effect of afatinib, an irreversible ErbB family blocker in osteosarcoma cell lines. METHODS Within a panel of human osteosarcoma cell lines, we addressed cell viability assay using afatinib at increasing concentrations. Motility was measured in wound-healing assays and invasion capacity was assessed in Transwell chamber assays. Finally, to monitor ErbB pathway modulation by afatinib and related compounds, we used Western blot analyses. RESULTS Cell viability inhibition, as well as a reduction of motility and migration of osteosarcoma cell line were observed after treatment with afatinib. Likewise, in the HOS cell line, afatinib decreased phosphorylation of key components in the ErbB signaling pathway. CONCLUSIONS Afatinib shows relevant antitumor effect in several osteosarcoma cell lines, as it causes a significant impact on cell viability, motility, and migration with a significant decrease in the activation of ErbB pathway activity.
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Tuomainen K, Al-Samadi A, Potdar S, Turunen L, Turunen M, Karhemo PR, Bergman P, Risteli M, Åström P, Tiikkaja R, Grenman R, Wennerberg K, Monni O, Salo T. Human Tumor-Derived Matrix Improves the Predictability of Head and Neck Cancer Drug Testing. Cancers (Basel) 2019; 12:cancers12010092. [PMID: 31905951 PMCID: PMC7017272 DOI: 10.3390/cancers12010092] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 12/11/2019] [Accepted: 12/25/2019] [Indexed: 12/13/2022] Open
Abstract
In vitro cancer drug testing carries a low predictive value. We developed the human leiomyoma–derived matrix “Myogel” to better mimic the human tumor microenvironment (TME). We hypothesized that Myogel could provide an appropriate microenvironment for cancer cells, thereby allowing more in vivo–relevant drug testing. We screened 19 anticancer compounds, targeting the epidermal growth factor receptor (EGFR), MEK, and PI3K/mTOR on 12 head and neck squamous cell carcinoma (HNSCC) cell lines cultured on plastic, mouse sarcoma–derived Matrigel (MSDM), and Myogel. We applied a high-throughput drug screening assay under five different culturing conditions: cells in two-dimensional (2D) plastic wells and on top or embedded in Matrigel or Myogel. We then compared the efficacy of the anticancer compounds to the response rates of 19 HNSCC monotherapy clinical trials. Cancer cells on top of Myogel responded less to EGFR and MEK inhibitors compared to cells cultured on plastic or Matrigel. However, we found a similar response to the PI3K/mTOR inhibitors under all culturing conditions. Cells grown on Myogel more closely resembled the response rates reported in EGFR-inhibitor monotherapy clinical trials. Our findings suggest that a human tumor matrix improves the predictability of in vitro anticancer drug testing compared to current 2D and MSDM methods.
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Affiliation(s)
- Katja Tuomainen
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (K.T.); (A.A.-S.); (M.T.)
- Translational Immunology Research Program (TRIMM), University of Helsinki, 00014 Helsinki, Finland
| | - Ahmed Al-Samadi
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (K.T.); (A.A.-S.); (M.T.)
- Translational Immunology Research Program (TRIMM), University of Helsinki, 00014 Helsinki, Finland
| | - Swapnil Potdar
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00290 Helsinki, Finland; (S.P.); (L.T.); (K.W.)
| | - Laura Turunen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00290 Helsinki, Finland; (S.P.); (L.T.); (K.W.)
| | - Minna Turunen
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (K.T.); (A.A.-S.); (M.T.)
- Translational Immunology Research Program (TRIMM), University of Helsinki, 00014 Helsinki, Finland
| | - Piia-Riitta Karhemo
- Research Programs Unit, Genome-Scale Biology Program and Medicum, Biochemistry and Developmental Biology, University of Helsinki, 00014 Helsinki, Finland; (P.-R.K.); (O.M.)
| | - Paula Bergman
- Biostatistics Consulting, Department of Public Health, University of Helsinki and Helsinki University Hospital, 00014 Helsinki, Finland;
| | - Maija Risteli
- Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (M.R.); (P.Å.); (R.T.)
| | - Pirjo Åström
- Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (M.R.); (P.Å.); (R.T.)
| | - Riia Tiikkaja
- Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (M.R.); (P.Å.); (R.T.)
| | - Reidar Grenman
- Department of Otorhinolaryngology—Head and Neck Surgery, Turku University Hospital, University of Turku, 20520 Turku, Finland;
| | - Krister Wennerberg
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00290 Helsinki, Finland; (S.P.); (L.T.); (K.W.)
- Biotech Research and Innovation Center, Department of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark
| | - Outi Monni
- Research Programs Unit, Genome-Scale Biology Program and Medicum, Biochemistry and Developmental Biology, University of Helsinki, 00014 Helsinki, Finland; (P.-R.K.); (O.M.)
| | - Tuula Salo
- Department of Oral and Maxillofacial Diseases, Clinicum, Faculty of Medicine, University of Helsinki, 00014 Helsinki, Finland; (K.T.); (A.A.-S.); (M.T.)
- Translational Immunology Research Program (TRIMM), University of Helsinki, 00014 Helsinki, Finland
- Cancer and Translational Medicine Research Unit, University of Oulu, 90014 Oulu, Finland; (M.R.); (P.Å.); (R.T.)
- Medical Research Center, Oulu University Hospital, 90014 Oulu, Finland
- Helsinki University Hospital, 00029 Helsinki, Finland
- Correspondence: ; Tel.: +358-40-544-1560
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Michmerhuizen NL, Leonard E, Matovina C, Harris M, Herbst G, Kulkarni A, Zhai J, Jiang H, Carey TE, Brenner JC. Rationale for Using Irreversible Epidermal Growth Factor Receptor Inhibitors in Combination with Phosphatidylinositol 3-Kinase Inhibitors for Advanced Head and Neck Squamous Cell Carcinoma. Mol Pharmacol 2019; 95:528-536. [PMID: 30858165 DOI: 10.1124/mol.118.115162] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Accepted: 02/21/2019] [Indexed: 12/15/2022] Open
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a common and debilitating form of cancer characterized by poor patient outcomes and low survival rates. In HNSCC, genetic aberrations in phosphatidylinositol 3-kinase (PI3K) and epidermal growth factor receptor (EGFR) pathway genes are common, and small molecules targeting these pathways have shown modest effects as monotherapies in patients. Whereas emerging preclinical data support the combined use of PI3K and EGFR inhibitors in HNSCC, in-human studies have displayed limited clinical success so far. Here, we examined the responses of a large panel of patient-derived HNSCC cell lines to various combinations of PI3K and EGFR inhibitors, including EGFR agents with varying specificity and mechanistic characteristics. We confirmed the efficacy of PI3K and EGFR combination therapies, observing synergy with α isoform-selective PI3K inhibitor HS-173 and irreversible EGFR/ERBB2 dual inhibitor afatinib in most models tested. Surprisingly, however, our results demonstrated only modest improvement in response to HS-173 with reversible EGFR inhibitor gefitinib. This difference in efficacy was not explained by differences in ERBB target selectivity between afatinib and gefitinib; despite effectively disrupting ERBB2 phosphorylation, the addition of ERBB2 inhibitor CP-724714 failed to enhance the effect of HS-173 gefitinib dual therapy. Accordingly, although irreversible ERBB inhibitors showed strong synergistic activity with HS-173 in our models, none of the reversible ERBB inhibitors were synergistic in our study. Therefore, our results suggest that the ERBB inhibitor mechanism of action may be critical for enhanced synergy with PI3K inhibitors in HNSCC patients and motivate further preclinical studies for ERBB and PI3K combination therapies.
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Affiliation(s)
- Nicole L Michmerhuizen
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Elizabeth Leonard
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Chloe Matovina
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Micah Harris
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Gabrielle Herbst
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Aditi Kulkarni
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Jingyi Zhai
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Hui Jiang
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - Thomas E Carey
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
| | - J Chad Brenner
- Departments of Pharmacology (N.L.M., T.E.C., J.C.B.) and Otolaryngology-Head and Neck Surgery (N.L.M., E.L., C.M., M.H., G.H., A.K., T.E.C., J.C.B.), and Rogel Cancer Center (T.E.C., J.C.B.), University of Michigan Medical School, and Department of Biostatistics, University of Michigan School of Public Health (J.Z., H.J.), Ann Arbor, Michigan
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9
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Sola AM, Johnson DE, Grandis JR. Investigational multitargeted kinase inhibitors in development for head and neck neoplasms. Expert Opin Investig Drugs 2019; 28:351-363. [PMID: 30753792 DOI: 10.1080/13543784.2019.1581172] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Despite advances in treatment, head and neck squamous cell carcinoma (HNSCC) survival rates remain stagnant. Current treatment is associated with significant toxicities and includes chemotherapy, radiation, surgery, and few targeted treatments. Targeted treatments, epidermal growth factor receptor (EGFR)-targeted agent, cetuximab, and immune checkpoint inhibitors, pembrolizumab and nivolumab, show improved toxicity profiles and modestly improved survival in select patients. An urgent need remains to identify novel targeted treatments for single-agent or combined therapy use. AREAS COVERED Multitargeted kinase inhibitors are small molecule inhibitors with limited toxicity. This review will focus on early-stage investigations of multitargeted tyrosine kinase inhibitors (m-TKIs) (those that target at least two tyrosine kinases) for HNSCC. Preclinical and early trials investigating m-TKIs for various disease settings of HNSCC will be evaluated for efficacy, identification of significant biomarkers and potential for combination therapy. EXPERT OPINION Few single agent m-TKIs have demonstrated efficacy in unselected HNSCC populations. The most promising clinical results have been obtained when m-TKIs are tested in combination with other therapies, including immunotherapy, or in mutation-defined subgroups of patients. The future success of m-TKIs will rely on identification, in preclinical models and clinical trials, of predictive biomarkers of response and mechanisms of innate and acquired resistance.
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Affiliation(s)
- Ana Marija Sola
- a Department of Otolaryngology - Head and Neck Surgery , University of California , San Francisco , CA , USA
| | - Daniel E Johnson
- a Department of Otolaryngology - Head and Neck Surgery , University of California , San Francisco , CA , USA
| | - Jennifer R Grandis
- a Department of Otolaryngology - Head and Neck Surgery , University of California , San Francisco , CA , USA
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10
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Yee PS, Zainal NS, Gan CP, Lee BKB, Mun KS, Abraham MT, Ismail SM, Abdul Rahman ZA, Patel V, Cheong SC. Synergistic Growth Inhibition by Afatinib and Trametinib in Preclinical Oral Squamous Cell Carcinoma Models. Target Oncol 2019; 14:223-235. [DOI: 10.1007/s11523-019-00626-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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11
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De Pauw I, Lardon F, Van den Bossche J, Baysal H, Fransen E, Deschoolmeester V, Pauwels P, Peeters M, Vermorken JB, Wouters A. Simultaneous targeting of EGFR, HER2, and HER4 by afatinib overcomes intrinsic and acquired cetuximab resistance in head and neck squamous cell carcinoma cell lines. Mol Oncol 2018; 12:830-854. [PMID: 29603584 PMCID: PMC5983215 DOI: 10.1002/1878-0261.12197] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 02/24/2018] [Accepted: 03/15/2018] [Indexed: 01/30/2023] Open
Abstract
The epidermal growth factor receptor (EGFR, HER1) is a therapeutic target in head and neck squamous cell carcinoma (HNSCC). After initial promising results with EGFR-targeted therapies such as cetuximab, therapeutic resistance has become a major clinical problem, and new treatment options are therefore necessary. Moreover, the relationship between HER receptors, anti-EGFR therapies, and the human papillomavirus (HPV) status in HNSCC is not fully understood. In contrast to first-generation EGFR inhibitors, afatinib irreversibly inhibits multiple HER receptors simultaneously. Therefore, treatment with afatinib might result in a more pronounced therapeutic benefit, even in patients experiencing cetuximab resistance. In this study, the cytotoxic effect of afatinib as single agent and in combination with cisplatin was investigated in cetuximab-sensitive, intrinsically cetuximab-resistant, and acquired cetuximab-resistant HNSCC cell lines with different HPV status under normoxia and hypoxia. Furthermore, the influence of cetuximab resistance, HPV, and hypoxia on the expression of HER receptors was investigated. Our results demonstrated that afatinib was able to establish cytotoxicity in cetuximab-sensitive, intrinsically cetuximab-resistant, and acquired cetuximab-resistant HNSCC cell lines, independent of the HPV status. However, cross-resistance between cetuximab and afatinib might be possible. Treatment with afatinib caused a G0 /G1 cell cycle arrest as well as induction of apoptotic cell death. Additive to antagonistic interactions between afatinib and cisplatin could be observed. Neither cetuximab resistance nor HPV status significantly influenced the expression of HER receptors in HNSCC cell lines. In contrast, the expression of EGFR, HER2, and HER3 was significantly altered under hypoxia. Oxygen deficiency is a common characteristic of HNSCC tumors, and these hypoxic tumor regions often contain cells that are more resistant to treatment. However, we observed that afatinib maintained its cytotoxic effect under hypoxia. In conclusion, our preclinical data support the hypothesis that afatinib might be a promising therapeutic strategy to treat patients with HNSCC experiencing intrinsic or acquired cetuximab resistance.
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Affiliation(s)
- Ines De Pauw
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
| | - Filip Lardon
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
| | | | - Hasan Baysal
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
| | - Erik Fransen
- StatUa Center for Statistics, University of Antwerp, Belgium
| | - Vanessa Deschoolmeester
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Department of Pathology, Antwerp University Hospital, Edegem, Belgium
| | - Patrick Pauwels
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Department of Pathology, Antwerp University Hospital, Edegem, Belgium
| | - Marc Peeters
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | - Jan Baptist Vermorken
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium.,Department of Medical Oncology, Antwerp University Hospital, Edegem, Belgium
| | - An Wouters
- Center for Oncological Research (CORE), University of Antwerp, Wilrijk, Belgium
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12
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Abstract
Afatinib (BIBW 2992, US: GilotrifTM, other countries: Giotrif©) is an irreversible blocker of the ErbB family, acting at the tyrosine kinases of these proteins. In 2013, it was approved by the FDA and the EMA for the treatment of adults with advanced, EGFR mutation-positive non-small-cell lung cancer. Further investigations for the treatment of many other tumors with afatinib, e.g., HNSCC and breast cancer, are ongoing.
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Affiliation(s)
- Helga Wecker
- Department of Haematology, Oncology and Stem Cell Transplantation, University Medical Centre Freiburg, and Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany
| | - Cornelius F Waller
- Department of Haematology, Oncology and Stem Cell Transplantation, University Medical Centre Freiburg, and Faculty of Medicine, University of Freiburg, Hugstetter Str. 55, 79106, Freiburg, Germany.
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13
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Clinical value of monoclonal antibodies and tyrosine kinase inhibitors in the treatment of head and neck squamous cell carcinoma. Med Oncol 2017; 34:60. [PMID: 28315228 PMCID: PMC5357244 DOI: 10.1007/s12032-017-0918-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 03/13/2017] [Indexed: 12/11/2022]
Abstract
Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous group of malignant tumours that affects over 500,000 patients per year. Treatment failure is generally due to the heterogeneity of these tumours and to the serious adverse effects associated with treatment. Immunological system impairment, which is common in HNSCC, further contributes to treatment failure by mediating tumour escape mechanisms. To date, the only clinically approved targeted therapy agent is cetuximab, a monoclonal antibody (mAb) that binds to, and inhibits, epidermal growth factor receptor, which is widely overexpressed in HNSCC. Cetuximab has been proven to induce antibody-dependent cellular cytotoxicity, further magnifying its therapeutic effect. DNA sequencing of HNSCC cells has identified the presence of mutated genes, thus making their protein products potential targets for therapeutic inhibition. Immune mechanisms have been found to have a significant impact on carcinogenesis, thus providing the rationale to support efforts to identify anticancer compounds with immunomodulatory properties. In the context of the rapid development of novel targeted agents, the aim of the present paper is to review our current understanding of HNSCC and to review the novel anticancer agents (mAbs and TKIs) introduced in recent years, including an assessment of their efficacy and mechanisms of action.
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14
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Liu X, Lv Z, Zou J, Liu X, Ma J, Wang J, Sa N, Jing P, Xu W. Afatinib down-regulates MCL-1 expression through the PERK-eIF2α-ATF4 axis and leads to apoptosis in head and neck squamous cell carcinoma. Am J Cancer Res 2016; 6:1708-1719. [PMID: 27648360 PMCID: PMC5004074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Accepted: 07/10/2016] [Indexed: 06/06/2023] Open
Abstract
Afatinib is the second generation of irreversible inhibitor of EGFR, HER2 and HER4, which has shown encouraging phase II and III clinical outcomes in the treatment of head and neck squamous cell carcinoma (HNSCC). However, the molecular mechanism of afatinib-induced apoptosis in HNSCC is poorly understood. In the present investigation, we discovered that down-regulation of MCL-1, an anti-apoptotic member of BCL-2 family, was responsible for afatinib-triggered apoptosis. And the inactivation of AKT-mTOR signaling caused by afatinib lead to translational inhibition of MCL-1 expression. As a crucial branch of ER stress, PERK-eIF2α-ATF4 axis was also stimulated in HNSCC cells after afatinib incubation. Silencing either eIF2α or ATF4 by siRNA transfection relieved afatinib-caused suppression of AKT-mTOR activity, attenuating MCL-1 down-regulation as well as subsequent apoptosis. Collectively, the results show that afatinib hampers AKT-mTOR activation by stimulating PERK-eIF2α-ATF4 signaling pathway, giving rise to MCL-1 down-regulation mediated apoptosis in HNSCC cells. Therefore, our findings reveal the elaborate molecular network of afatinib-induced apoptosis in HNSCC, which would provide substantial theoretical underpinnings for afatinib clinical application and highlight its promising prospect in HNSCC treatment.
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Affiliation(s)
- Xianfang Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
- Shandong Provincial Key Laboratory of OtologyJinan, P. R. China
| | - Zhenghua Lv
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
| | - Jidong Zou
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
| | - Xiuxiu Liu
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
- Shandong Provincial Key Laboratory of OtologyJinan, P. R. China
| | - Juke Ma
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
| | - Jinhua Wang
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
| | - Na Sa
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
| | - Peihang Jing
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
| | - Wei Xu
- Department of Otorhinolaryngology Head and Neck Surgery, Shandong Provincial Hospital Affiliated to Shandong UniversityJinan, P. R. China
- Shandong Provincial Key Laboratory of OtologyJinan, P. R. China
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15
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Clinicopathologic Features of Advanced Squamous NSCLC. J Thorac Oncol 2016; 11:1411-22. [PMID: 27296106 DOI: 10.1016/j.jtho.2016.05.024] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Revised: 05/19/2016] [Accepted: 05/19/2016] [Indexed: 12/31/2022]
Abstract
Lung cancer remains the leading cause of cancer-related death worldwide. NSCLC accounts for more than 85% of all lung cancers, and the prognosis for advanced-stage disease is typically poor. In recent years, the importance of histologic subtypes of NSCLC has been recognized, and the distinction between squamous and other NSCLC histologic subtypes is now critical to patient management. Squamous cell lung cancer (sqCLC) represents approximately 25% to 30% of NSCLC. The prognosis for patients with advanced NSCLC is poorer for those with sqCLC than for those with adenocarcinoma. This is partly due to a number of clinical characteristics that distinguish sqCLC from other NSCLC histologic subtypes, such as smoking history, comorbid diseases, age, and molecular profile. Together, these factors make sqCLC an especially challenging disease to manage. Herein, we review some of the key clinicopathologic features of sqCLC. Understanding these features to optimally address many of the unique therapeutic challenges of this disease is likely to be central to ultimately improving outcomes for patients with squamous NSCLC.
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Nakamura Y, Togashi Y, Nakahara H, Tomida S, Banno E, Terashima M, Hayashi H, de Velasco MA, Sakai K, Fujita Y, Okegawa T, Nutahara K, Hamada S, Nishio K. Afatinib against Esophageal or Head-and-Neck Squamous Cell Carcinoma: Significance of Activating Oncogenic HER4 Mutations in HNSCC. Mol Cancer Ther 2016; 15:1988-97. [PMID: 27207775 DOI: 10.1158/1535-7163.mct-15-0737] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 05/12/2016] [Indexed: 11/16/2022]
Abstract
The prognosis for patients with advanced esophageal or head-and-neck squamous cell carcinoma (ESCC or HNSCC) remains poor, and the identification of additional oncogenes and their inhibitors is needed. In this study, we evaluated the sensitivities of several ESCC and HNSCC cell lines to HER inhibitors (cetuximab, erlotinib, and afatinib) in vitro and found two cell lines that were hypersensitive to afatinib. Sequence analyses for the afatinib-targeted HER family genes in the two cell lines revealed that one cell line had a previously reported activating EGFR L861Q mutation, whereas the other had an HER4 G1109C mutation of unknown function. No amplification of HER family genes was found in either of the two cell lines. The phosphorylation level of HER4 was elevated in the HER4 G1109C mutation-overexpressed HEK293 cell line, and the mutation had a transforming potential and exhibited tumorigenicity in an NIH3T3 cell line, indicating that this HER4 mutation was an activating oncogenic mutation. Afatinib dramatically reduced the phosphorylation level of EGFR or HER4 and induced apoptosis in the two cell lines. In vivo, tumor growth was also dramatically decreased by afatinib. In a database, the frequencies of HER family gene mutations in ESCC or HNSCC ranged from 0% to 5%. In particular, HER4 mutations have been found relatively frequently in HNSCC. Considering the addiction of cancer cells to activating oncogenic EGFR or HER4 mutations for proliferation, HNSCC or ESCC with such oncogenic mutations might be suitable for targeted therapy with afatinib. Mol Cancer Ther; 15(8); 1988-97. ©2016 AACR.
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Affiliation(s)
- Yu Nakamura
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan. Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Yosuke Togashi
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hirokazu Nakahara
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan. Department of Oral and Maxillofacial Surgery, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | - Shuta Tomida
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Eri Banno
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Masato Terashima
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Hidetoshi Hayashi
- Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Marco A de Velasco
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuko Sakai
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Yoshihiko Fujita
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan
| | - Takatsugu Okegawa
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Kikuo Nutahara
- Department of Urology, Kyorin University School of Medicine, Tokyo, Japan
| | - Suguru Hamada
- Department of Oral and Maxillofacial Surgery, Kindai University Faculty of Medicine, Osaka, Japan
| | - Kazuto Nishio
- Department of Genome Biology, Kindai University Faculty of Medicine, Osaka, Japan.
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17
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Specenier P, Vermorken J. Afatinib in squamous cell carcinoma of the head and neck. Expert Opin Pharmacother 2016; 17:1295-301. [PMID: 27160335 DOI: 10.1080/14656566.2016.1183647] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Recently new data on the efficacy of afatinib in head and neck squamous cell carcinoma (HNSCC) have been published. AREAS COVERED We searched the literature for published and ongoing studies with afatinib in HNSCC. Phase I data and results of phase II and III studies of afatinib in HNSCC are discussed. The maximum tolerated dose (MTD) of afatinib monotherapy with continuous administration was determined at 40 or 50 mg/day, rash and diarrhea being the principal dose-limiting toxicities. The MTD was lower when combined with chemotherapy. Studies with afatinib have been conducted or are ongoing both in the recurrent or metastatic (R/M) and in the locoregionally advanced (LA) HNSCC disease setting. EXPERT OPINION Comparable disease control and tumor shrinkage rates were observed with cetuximab and afatinib in HNSCC progressing after platinum-containing chemotherapy. In patients with R/M- Squamous cell carcinoma of the head and neck (SCCHN) who had progressed on/after first-line platinum-based therapy, afatinib induced significantly higher disease control rate, longer progression-free survival and improved patient-reported outcome compared to methotrexate. Randomized phase III trials studying the role of adjuvant afatinib after definitive or postoperative chemoradiation in LA-HNSCC are ongoing.
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Affiliation(s)
- Pol Specenier
- a Department of Medical Oncology , Universitair Ziekenhuis Antwerpen , Edegem , Belgium.,b Faculty of Medicine and Health Sciences , Universiteit Antwerpen , Wilrijk , Belgium
| | - Jan Vermorken
- a Department of Medical Oncology , Universitair Ziekenhuis Antwerpen , Edegem , Belgium.,b Faculty of Medicine and Health Sciences , Universiteit Antwerpen , Wilrijk , Belgium
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18
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Xue C, Tian Y, Zhang J, Zhao Y, Zhan J, Fang W, Zhang L. In vitro and in vivo efficacy of afatinib as a single agent or in combination with gemcitabine for the treatment of nasopharyngeal carcinoma. DRUG DESIGN DEVELOPMENT AND THERAPY 2016; 10:1299-306. [PMID: 27099475 PMCID: PMC4821387 DOI: 10.2147/dddt.s94432] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Purpose Epidermal growth factor receptor (EGFR) is usually overexpressed in nasopharyngeal carcinoma (NPC). We tested the antitumor effects of irreversible ErbB family inhibitor afatinib on human NPC using in vitro and in vivo models. Materials and methods The effect of afatinib on NPC cells was evaluated using the Cell Counting Kit 8 (CCK8) assay, flow cytometry, and Western blot analyses. The effect of afatinib, as either a single agent or in combination with gemcitabine (GEM), on tumor growth was determined using NPC tumor xenografts in mice. Results Afatinib inhibited cell growth in all three NPC cell lines tested in a dose-dependent manner. Afatinib promoted cell cycle arrest at the S and G2/M phases, and it significantly inhibited epidermal growth factor (EGF)-induced activation of EGFR and its downstream signaling factors. Co-treatment with afatinib and GEM more effectively inhibited tumor growth than either drug alone but was associated with increased toxicity. Conclusion Afatinib induced cell cycle arrest and inhibited the proliferation of NPC cell lines. Afatinib in combination with GEM demonstrated significant antitumor effect in an NPC xenograft model. The administration of afatinib with GEM in NPC needs to be modified in order to be effective and tolerable.
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Affiliation(s)
- Cong Xue
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Ying Tian
- Department of Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Jing Zhang
- Department of Medical Oncology, The First Affiliated Hospital of Guangzhou Traditional Chinese Medicine University, Guangzhou, Guangdong, People's Republic of China
| | - Yuanyuan Zhao
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Jianhua Zhan
- Department of Research, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Wenfeng Fang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
| | - Li Zhang
- Department of Medical Oncology, Sun Yat-Sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center of Cancer Medicine, Guangzhou, Guangdong, People's Republic of China
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