Understanding resistance to EGFR inhibitors—impact on future treatment strategies

Wheeler, Deric L.; Dunn, Emily F.; Harari, Paul M.

doi:10.1038/nrclinonc.2010.97

Cited by 687HER2/EGFR in Cancer ResearchLung Cancer Treatments and MutationsColorectal Cancer Treatments and Studies

Understanding resistance to EGFR inhibitors—impact on future treatment strategies

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Wheeler, Deric L., Dunn, Emily F., Harari, Paul M.·2010·Nature Reviews Clinical Oncology

DOI 10.1038/nrclinonc.2010.97PMC PMC2929287

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Abstract

EGFR is a tyrosine kinase that participates in the regulation of cellular homeostasis. Following ligand binding, EGFR stimulates downstream cell signaling cascades that influence cell proliferation, apoptosis, migration, survival and complex processes, including angiogenesis and tumorigenesis. EGFR has been strongly implicated in the biology of human epithelial malignancies, with therapeutic applications in cancers of the colon, head and neck, lung, and pancreas. Accordingly, targeting EGFR has been intensely pursued, with the development of a series of promising molecular inhibitors for use in clinical oncology. As is common in cancer therapy, challenges with respect to treatment resistance emerge over time. This situation is certainly true of EGFR inhibitor therapies, where intrinsic and acquired resistance is now well recognized. In this Review, we provide a brief overview regarding the biology of EGFR, preclinical and clinical development of EGFR inhibitors, and molecular mechanisms that underlie the development of treatment resistance. A greater understanding of the mechanisms that lead to EGFR resistance may provide valuable insights to help design new strategies that will enhance the impact of this promising class of inhibitors for the treatment of cancer.

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Other PI3K pathway activating lesions commonly found in GBM, such as activation of other RTKs, could also promote increased LDLR expression.
“Therefore, other PI3K pathway activating lesions commonly found in GBM, such as the activation of other RTKs (6, 12, 39), could also promote increased LDLR expression.”
From An LXR Agonist Promotes Glioblastoma Cell Death through Inhibition of an EGFR/AKT/SREBP-1/LDLR–Dependent Pathway (2011) · cites this paper as [39]
The ‘Role of IGF-1R in resistance to EGFR inhibitors’ section reports that IGF-1R, an RTK, was upregulated in two primary GBM cell lines and sustained PI3K/AKT signaling. That supports the citation attached to activation of other RTKs, but the section does not establish that such activation is commonly found in GBM. The proposed increase in LDLR expression is the citing authors’ own inference, not the point to which this citation is attached. (LLM, conf=0.82)
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[137]Ahrendt SA Cigarette smoking is strongly associated with mutation of the K-ras gene in patients with primary adenocarcinoma of the lung Cancer 2001 92 1525 1530 11745231
[168]Liu B Induction of apoptosis and activation of the caspase cascade by anti-EGF receptor monoclonal antibodies in DiFi human colon cancer cells do not involve the c-jun N-terminal kinase activity Br. J. Cancer 2000 82 1991 1999 10864208 PMC2363248

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Authors: Wheeler, D. L., Dunn, E. F., & Harari, P. M.
Affiliations: University of Wisconsin–Madison (US)
Corresponding author: Wheeler, Deric L.
ORCID: Wheeler, Deric L.
Dunn, Emily F.
Harari, Paul M.
Venue: Nature Reviews Clinical Oncology
Publisher: Springer Science and Business Media LLC
Published: 2010-06-15
Volume: 7
Issue: 9
Pages: 493-507
ISSN: 1759-4774 (ISSN-L)
1759-4782
DOI: 10.1038/nrclinonc.2010.97
PMC: PMC2929287
OpenAlex: W2053439872
Cited by: 683
References: 182
Citations by year: 2026: 21 · 2025: 20 · 2024: 35 · 2023: 29 · 2022: 31 · 2021: 29 · 2020: 44 · 2019: 25 · 2018: 36 · 2017: 50 · 2016: 46 · 2015: 61 · 2014: 66 · 2013: 68 · 2012: 64
FWCI: 6.61
Type: journal article
Language: en
Open access: green
www.ncbi.nlm.nih.gov
Licence: www.springer.com/tdm (tdm)
Locations: Nature Reviews Clinical Oncology (publishedVersion)
PubMed (publishedVersion)
PubMed Central (acceptedVersion)
Funders: National Institutes of Health (5t32ca009614-25)
U.S. Public Health Service (P30CAO14520)
National Cancer Institute (T-32 CA 0096-14, R01CA113448)
National Center for Research Resources (UL1RR025011)
Topics: Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
Health Sciences › Medicine › Oncology › Colorectal Cancer Treatments and Studies
Keywords: EGFR inhibitors, EGFR, acquired drug resistance, intrinsic resistance, tyrosine kinase inhibitors, resistance mechanisms, EGFR signaling, epithelial malignancies, lung cancer, head and neck cancer, colon cancer, pancreatic cancer, combination therapy
MeSH terms: Cetuximab, Erlotinib Hydrochloride, Gefitinib, Panitumumab, Antibodies, Monoclonal, Antineoplastic Agents, Humans, Neoplasms, Proto-Oncogene Proteins, Quinazolines, Proto-Oncogene Proteins p21(ras), Treatment Outcome, Disease Progression, ras Proteins, Drug Resistance, Neoplasm, Protein Kinase Inhibitors, Antibodies, Monoclonal, Humanized, ErbB Receptors

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