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Sun J, Hu R, Han M, Tan Y, Xie M, Gao S, Hu JF. Mechanisms underlying therapeutic resistance of tyrosine kinase inhibitors in chronic myeloid leukemia. Int J Biol Sci 2024; 20:175-181. [PMID: 38164178 PMCID: PMC10750272 DOI: 10.7150/ijbs.86305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 09/27/2023] [Indexed: 01/03/2024] Open
Abstract
Chronic myeloid leukemia (CML) is a malignant clonal disease involving hematopoietic stem cells that is characterized by myeloid cell proliferation in bone marrow and peripheral blood, and the presence of the Philadelphia (Ph) chromosome with BCR-ABL fusion gene. Treatment of CML has dramatically improved since the advent of tyrosine kinase inhibitors (TKI). However, there are a small subset of CML patients who develop resistance to TKI. Mutations in the ABL kinase domain (KD) are currently recognized as the leading cause of TKI resistance in CML. In this review, we discuss the concept of resistance and summarize recent advances exploring the mechanisms underlying CML resistance. Overcoming TKI resistance appears to be the most successful approach to reduce the burden of leukemia and enhance cures for CML. Advances in new strategies to combat drug resistance may rapidly change the management of TKI-resistant CML and expand the prospects for available therapies.
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MESH Headings
- Humans
- Tyrosine Kinase Inhibitors
- Drug Resistance, Neoplasm/genetics
- Fusion Proteins, bcr-abl/genetics
- Fusion Proteins, bcr-abl/therapeutic use
- Protein Kinase Inhibitors/therapeutic use
- Protein Kinase Inhibitors/pharmacology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
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Affiliation(s)
- Jingnan Sun
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Ruiping Hu
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Mengyuan Han
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Yehui Tan
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Mengqing Xie
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
- Oncology Department, Cancer hospital Chinese Academy of Medical Sciences, Langfang District, 065001, P.R. China
| | - Sujun Gao
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
| | - Ji-Fan Hu
- Hematology Department, First hospital of Jilin University, Changchun, Jilin, 130021, P.R. China
- Stanford University Medical School, Palo Alto Veterans Institute for Research, Palo Alto, CA94304, USA
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Wang TH, Wu CC, Huang KY, Leu YL, Yang SC, Chen CL, Chen CY. Integrated Omics Analysis of Non-Small-Cell Lung Cancer Cells Harboring the EGFR C797S Mutation Reveals the Potential of AXL as a Novel Therapeutic Target in TKI-Resistant Lung Cancer. Cancers (Basel) 2020; 13:cancers13010111. [PMID: 33396393 PMCID: PMC7795510 DOI: 10.3390/cancers13010111] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/13/2020] [Accepted: 11/23/2020] [Indexed: 12/21/2022] Open
Abstract
Simple Summary In this study, we employed CRISPR/Cas9 editing technology to introduce the EGFR C797S mutation into an NSCLC cell line harboring EGFR L858R/T790M to establish a cellular model for the investigation of the resistance mechanism associated with the acquired C797S mutation and to explore strategies to battle this type of TKI resistance. Transcriptome and proteome analyses revealed that the differentially expressed genes/proteins in the cells harboring the EGFR C797S mutation are associated with elevated expression of AXL. Furthermore, we presented evidence that inhibition of AXL is effective in slowing the growth of NSCLC cells harboring EGFR C797S. Our findings suggest that AXL inhibition could be a second-line or a potential adjuvant treatment for NSCLC harboring the EGFR C797S mutation. Abstract Oncogenic mutations of epidermal growth factor receptor (EGFR) are responsive to targeted tyrosine kinase inhibitor (TKI) treatment in non-small-cell lung cancer (NSCLC). However, NSCLC patients harboring activating EGFR mutations inevitably develop resistance to TKIs. The acquired EGFR C797S mutation is a known mechanism that confers resistance to third-generation EGFR TKIs such as AZD9291. In this work, we employed CRISPR/Cas9 genome-editing technology to knock-in the EGFR C797S mutation into an NSCLC cell line harboring EGFR L858R/T790M. The established cell model was used to investigate the biology and treatment strategy of acquired EGFR C797S mutations. Transcriptome and proteome analyses revealed that the differentially expressed genes/proteins in the cells harboring the EGFR C797S mutation are associated with a mesenchymal-like cell state with elevated expression of AXL receptor tyrosine kinase. Furthermore, we presented evidence that inhibition of AXL is effective in slowing the growth of NSCLC cells harboring EGFR C797S. Our findings suggest that AXL inhibition could be a second-line or a potential adjuvant treatment for NSCLC harboring the EGFR C797S mutation.
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Affiliation(s)
- Tong-Hong Wang
- Graduate Institute of Health Industry Technology and Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan;
- Tissue Bank, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
| | - Chih-Ching Wu
- Department of Medical Biotechnology and Laboratory Science, College of Medicine, Chang Gung University, Taoyuan 333, Taiwan;
- Molecular Medicine Research Center, Chang Gung University, Taoyuan 333, Taiwan
- Department of Otolaryngology-Head&Neck Surgery, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan
| | - Kuo-Yen Huang
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan; (K.-Y.H.); (S.-C.Y.); (C.-L.C.)
- Department and Graduate Institute of Microbiology and Immunology, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yann-Lii Leu
- Tissue Bank, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
- Graduate Institute of Natural Products, Chang Gung University, Taoyuan 333, Taiwan
| | - Shuenn-Chen Yang
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan; (K.-Y.H.); (S.-C.Y.); (C.-L.C.)
| | - Ci-Ling Chen
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan; (K.-Y.H.); (S.-C.Y.); (C.-L.C.)
| | - Chi-Yuan Chen
- Graduate Institute of Health Industry Technology and Research Center for Chinese Herbal Medicine, College of Human Ecology, Chang Gung University of Science and Technology, Taoyuan 333, Taiwan;
- Tissue Bank, Chang Gung Memorial Hospital at Linkou, Taoyuan 333, Taiwan;
- Correspondence: or ; Tel.: +886-3-2118999; Fax: +886-3-2118866
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