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Cserepes M, Nelhűbel GA, Meilinger-Dobra M, Herczeg A, Türk D, Hegedűs Z, Svajda L, Rásó E, Ladányi A, Csikó KG, Kenessey I, Szöőr Á, Vereb G, Remenár É, Tóvári J. EGFR R521K Polymorphism Is Not a Major Determinant of Clinical Cetuximab Resistance in Head and Neck Cancer. Cancers (Basel) 2022; 14:cancers14102407. [PMID: 35626010 PMCID: PMC9140151 DOI: 10.3390/cancers14102407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/02/2022] [Accepted: 05/11/2022] [Indexed: 02/05/2023] Open
Abstract
Background: Head and neck squamous cell carcinomas (HNSCCs) are among the most abundant malignancies worldwide. Patients with recurrent/metastatic disease undergo combination chemotherapy containing cetuximab, the monoclonal antibody used against the epidermal growth factor receptor (EGFR). Cetuximab augments the effect of chemotherapy; however, a significant number of patients show therapy resistance. The mechanism of resistance is yet to be unveiled, although extracellular alterations of the receptor have been reported, and their role in cetuximab failure has been proposed. Aims: Here, we investigate possible effects of the multi-exon deletion variant (EGFRvIII), and the single nucleotide polymorphism EGFR R521K on cetuximab efficacy. Results: Our results show that in HNSCC patients, the EGFRvIII allele frequency is under 1%; therefore, it cannot lead to common resistance. EGFR R521K, present in 42% of the patients, is investigated in vitro in four HNSCC cell lines (two wild-type and two heterozygous for EGFR R521K). While no direct effect is found to be related to the EGFR status, cells harboring R521K show a reduced sensitivity in ADCC experiments and in vivo xenograft experiments. However, this preclinical difference is not reflected in the progression-free or overall survival of HNSCC patients. Furthermore, NK cell and macrophage presence in tumors is not related to EGFR R521K. Discussion: Our results suggest that EGFR R521K, unlike reported previously, is unable to cause cetuximab resistance in HNSCC patients; therefore, its screening before therapy selection is not justifiable.
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Affiliation(s)
- Mihály Cserepes
- Department of Experimental Pharmacology, National Institute of Oncology, Ráth György utca 7-9, H-1122 Budapest, Hungary; (M.C.); (G.A.N.); (D.T.); (Z.H.); (L.S.)
- National Tumor Biology Laboratory, National Institute of Oncology, H-1122 Budapest, Hungary; (A.L.); (I.K.)
| | - Györgyi A. Nelhűbel
- Department of Experimental Pharmacology, National Institute of Oncology, Ráth György utca 7-9, H-1122 Budapest, Hungary; (M.C.); (G.A.N.); (D.T.); (Z.H.); (L.S.)
| | - Mónika Meilinger-Dobra
- The Multidisciplinary Head and Neck Cancer Center, National Institute of Oncology, H-1122 Budapest, Hungary; (M.M.-D.); (A.H.); (É.R.)
| | - Adrienn Herczeg
- The Multidisciplinary Head and Neck Cancer Center, National Institute of Oncology, H-1122 Budapest, Hungary; (M.M.-D.); (A.H.); (É.R.)
| | - Dóra Türk
- Department of Experimental Pharmacology, National Institute of Oncology, Ráth György utca 7-9, H-1122 Budapest, Hungary; (M.C.); (G.A.N.); (D.T.); (Z.H.); (L.S.)
| | - Zita Hegedűs
- Department of Experimental Pharmacology, National Institute of Oncology, Ráth György utca 7-9, H-1122 Budapest, Hungary; (M.C.); (G.A.N.); (D.T.); (Z.H.); (L.S.)
| | - Laura Svajda
- Department of Experimental Pharmacology, National Institute of Oncology, Ráth György utca 7-9, H-1122 Budapest, Hungary; (M.C.); (G.A.N.); (D.T.); (Z.H.); (L.S.)
| | - Erzsébet Rásó
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, H-1091 Budapest, Hungary;
| | - Andrea Ladányi
- National Tumor Biology Laboratory, National Institute of Oncology, H-1122 Budapest, Hungary; (A.L.); (I.K.)
- Department of Surgical and Molecular Pathology, National Institute of Oncology, H-1122 Budapest, Hungary
| | - Kristóf György Csikó
- Department of Chest and Abdominal Tumors and Clinical Pharmacology, National Institute of Oncology, H-1122 Budapest, Hungary;
| | - István Kenessey
- National Tumor Biology Laboratory, National Institute of Oncology, H-1122 Budapest, Hungary; (A.L.); (I.K.)
- Department of Pathology, Forensic and Insurance Medicine, Semmelweis University, H-1091 Budapest, Hungary;
- Hungarian Cancer Registry, National Institute of Oncology, H-1122 Budapest, Hungary
| | - Árpád Szöőr
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (Á.S.); (G.V.)
| | - György Vereb
- Department of Biophysics and Cell Biology, Faculty of Medicine, University of Debrecen, H-4032 Debrecen, Hungary; (Á.S.); (G.V.)
| | - Éva Remenár
- The Multidisciplinary Head and Neck Cancer Center, National Institute of Oncology, H-1122 Budapest, Hungary; (M.M.-D.); (A.H.); (É.R.)
| | - József Tóvári
- Department of Experimental Pharmacology, National Institute of Oncology, Ráth György utca 7-9, H-1122 Budapest, Hungary; (M.C.); (G.A.N.); (D.T.); (Z.H.); (L.S.)
- National Tumor Biology Laboratory, National Institute of Oncology, H-1122 Budapest, Hungary; (A.L.); (I.K.)
- Correspondence: ; Tel.: +36-1-224-8778; Fax: +36-1-224-8724
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Cserepes M, Nelhűbel GA, Meilinger-Dobra M, Surguta SE, Rásó E, Ladányi A, Kenessey I, Szöőr Á, Vereb G, Remenár É, Tóvári J. [Consequences of extracellular alterations of EGFR on cetuximab therapy in HNSCC]. Magy Onkol 2021; 65:188-195. [PMID: 34081766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 05/12/2021] [Indexed: 06/12/2023]
Abstract
Head and neck squamous cell carcinomas (HNSCC) take many lifes worldwide. Patients with recurrent/metastatic disease receive combination chemotherapy containing anti-EGFR antibody cetuximab. However, resistance often hurdles therapy. The mechanism is yet to unveil, although EGFR extracellular alterations and activity of c-Met signaling were accused. We investigated the effects of EGFR-vIII and EGFR-R521K on cetuximab efficacy in HNSCC in cellular, xenograft, and clinical setup. Furthermore, we investigated the efficacy of c-Met inhibition in HNSCC in vitro and in vivo. We showed that EGFR-vIII is very rare in HNSCC, while the common R521K polymorphism abolishes antibody-dependent cellular cytotoxicity and in vivo antitumor effect of cetuximab. This selectivity was not reflected in immunophenotype or survival data of HNSCC patients, suggesting a more complex mechanism behind. Interestingly, c-Met inhibitor SU11274 was more effective in cetuximab-resistant, EGFR R521K heterozygous cells and xenografts, raising the possible importance of simultaneous targeting of the two receptors.
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Affiliation(s)
- Mihály Cserepes
- Kísérletes Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Györgyi A Nelhűbel
- Kísérletes Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Mónika Meilinger-Dobra
- Fej-nyaki Daganatok Multidiszciplináris Központ, Országos Onkológiai Intézet, Budapest, Hungary
| | - Sára Eszter Surguta
- Kísérletes Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
| | - Erzsébet Rásó
- II. Sz. Patológiai Intézet, Semmelweis Egyetem, Budapest, Hungary
| | - Andrea Ladányi
- Sebészeti és Molekuláris Patológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary
| | - István Kenessey
- Nemzeti Rákregiszter, Országos Onkológiai Intézet, Budapest, Hungary
| | - Árpád Szöőr
- Általános Orvostudományi Kar, Debreceni Egyetem, Biofizikai és Sejtbiológiai Intézet, Debrecen, Hungary
| | - György Vereb
- Általános Orvostudományi Kar, Debreceni Egyetem, Biofizikai és Sejtbiológiai Intézet, Debrecen, Hungary
| | - Éva Remenár
- Fej-nyaki Daganatok Multidiszciplináris Központ, Országos Onkológiai Intézet, Budapest, Hungary
| | - József Tóvári
- Kísérletes Farmakológiai Osztály, Országos Onkológiai Intézet, Budapest, Hungary.
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Nelhűbel GA, Cserepes M, Szabó B, Türk D, Kárpáti A, Kenessey I, Rásó E, Barbai T, Hegedűs Z, László V, Szokol B, Dobos J, Őrfi L, Tóvári J. EGFR Alterations Influence the Cetuximab Treatment Response and c-MET Tyrosine-Kinase Inhibitor Sensitivity in Experimental Head and Neck Squamous Cell Carcinomas. Pathol Oncol Res 2021; 27:620256. [PMID: 34257586 PMCID: PMC8262169 DOI: 10.3389/pore.2021.620256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 04/01/2021] [Indexed: 12/12/2022]
Abstract
Background: Anti-EGFR antibody therapy is still one of the clinical choices in head and neck squamous cell carcinoma (HNSCC) patients, but the emergence of cetuximab resistance questioned its effectiveness and reduced its applicability. Although several possible reasons of resistance against the antibody treatment and alternative therapeutic proposals have been described (EGFR alterations, activation of other signaling pathways), there is no method to predict the effectiveness of anti-EGFR antibody treatments and to suggest novel therapeutics. Our study investigated the effect of EGFR R521K alteration on efficiency of cetuximab therapy of HNSCC cell lines and tried to find alternative therapeutic approaches against the resistant cells. Methods: After genetic characterization of HNSCC cells, we chose one wild type and one R521K+ cell line for in vitro proliferation and apoptosis tests, and in vivo animal models using different therapeutic agents. Results: Although the cetuximab treatment affected EGFR signalization in both cells, it did not alter in vitro cell proliferation or apoptosis. In vivo cetuximab therapy was also ineffective on R521K harboring tumor xenografts, while blocked the tumor growth of EGFR-wild type xenografts. Interestingly, the cetuximab-resistant R521K tumors were successfully treated with c-MET tyrosine kinase inhibitor SU11274. Conclusion: Our results suggest that HNSCC cell line expressing the R521K mutant form of EGFR does not respond well to cetuximab treatment in vitro or in vivo, but hopefully might be targeted by c-MET tyrosine kinase inhibitor treatment.
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Affiliation(s)
- Györgyi A Nelhűbel
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary.,2 Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Mihály Cserepes
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Balázs Szabó
- Department of Otolaryngology and Head and Neck Surgery, Semmelweis University, Budapest, Hungary
| | - Dóra Türk
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Adél Kárpáti
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - István Kenessey
- 2 Institute of Pathology, Semmelweis University, Budapest, Hungary.,Hungarian Cancer Registry, National Institute of Oncology, Budapest, Hungary
| | - Erzsébet Rásó
- 2 Institute of Pathology, Semmelweis University, Budapest, Hungary
| | - Tamás Barbai
- 2 Institute of Pathology, Semmelweis University, Budapest, Hungary
| | - Zita Hegedűs
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
| | - Viktória László
- Department of Thoracic Surgery, Medical University of Vienna, Vienna, Austria.,Department of Tumor Biology, National Korányi Institute of Pulmonology, Budapest, Hungary
| | | | | | | | - József Tóvári
- Department of Experimental Pharmacology, National Institute of Oncology, Budapest, Hungary
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