Cited by 606Lung Cancer Treatments and MutationsHER2/EGFR in Cancer ResearchCancer Genomics and Diagnostics

The DOI matches its Crossref record; 41 of the 42 references it cites were found in a registry or an index, and 1 are not checked yet; 1 of the 16 sources its claims cite were checked for support.

The Allelic Context of the C797S Mutation Acquired upon Treatment with Third-Generation EGFR Inhibitors Impacts Sensitivity to Subsequent Treatment Strategies

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Published version of a preprint

Abstract

Purpose: A secondary EGFR mutation, T790M, is the most common resistance mechanism in EGFR-mutant adenocarcinomas that have progressed on erlotinib. Third-generation EGFR inhibitors capable of inhibiting mutant EGFR with T790M produce responses in nearly two thirds of patients. However, acquired resistance mechanisms in patients treated with these drugs are yet to be described. Experimental Design: To study acquired resistance to third-generation EGFR inhibitors, T790M-positive cells derived from an erlotinib-resistant cancer were made resistant to a third-generation TKI and then characterized using cell and molecular analyses. Results: Cells resistant to a third-generation TKI acquired an additional EGFR mutation, C797S, which prevented suppression of EGFR. Our results demonstrate that the allelic context in which C797S was acquired may predict responsiveness to alternative treatments. If the C797S and T790M mutations are in trans, cells will be resistant to third-generation EGFR TKIs, but will be sensitive to a combination of first- and third-generation TKIs. If the mutations are in cis, no EGFR TKIs alone or in combination can suppress activity. If C797S develops in cells wild-type for T790 (when third-generation TKIs are administered in the first-line setting), the cells are resistant to third-generation TKIs, but retain sensitivity to first-generation TKIs. Conclusions: Mutation of C797S in EGFR is a novel mechanism of acquired resistance to third-generation TKIs. The context in which the C797S develops with respect to the other EGFR alleles affects the efficacy of subsequent treatments. Clin Cancer Res; 21(17); 3924–33. ©2015 AACR. See related commentary by Ayeni et al., p. 3818

Verified 2026-10-06 · 1 reference not checked yet

Overview

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Registry

Crossref · 10.1158/1078-0432.ccr-15-0560

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41 of 42 references verified0 citation errors · 0 not checkable

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  • It may state two separate claims as one. 21
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  • The paper relies on this without support.

    Acquired resistance mechanisms in patients treated with third-generation EGFR inhibitors have not yet been described.

    “However, acquired resistance mechanisms in patients treated with these drugs are yet to be described.”
  • The paper relies on this without support.

    PC9 cells are sensitive to all classes of EGFR inhibitors.

    “PC9, which is sensitive to all classes of EGFR inhibitors.”
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Metadata

Authors
Niederst, M. J., Hu, H., Mulvey, H. E., Lockerman, E. L., Garcia, A. R., Piotrowska, Z., Sequist, L. V., & Engelman, J. A.
Affiliations
Harvard University (US)
Corresponding author
Engelman, Jeffrey A.
Venue
Clinical Cancer Research
Published
2015-08-31
Volume
21
Issue
17
Pages
3924-3933
ISSN
  • 1078-0432 (ISSN-L)
  • 1557-3265
OpenAlex
W1908940658
Cited by
583
References
42
Citations by year
2026: 33 · 2025: 47 · 2024: 47 · 2023: 50 · 2022: 49 · 2021: 57 · 2020: 66 · 2019: 53 · 2018: 65 · 2017: 57 · 2016: 49 · 2015: 10
FWCI
48.25
Type
journal article
Language
en
Open access
Locations
  • Clinical Cancer Research (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
National Cancer Institute (R01CA137008)
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Treatments and Mutations
  • Health Sciences › Medicine › Oncology › HER2/EGFR in Cancer Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer Genomics and Diagnostics
Keywords
C797S mutation, T790M mutation, acquired drug resistance, third-generation EGFR tyrosine kinase inhibitors, erlotinib resistance, EGFR-mutant lung adenocarcinoma, predictive biomarkers
MeSH terms
Alleles, Antineoplastic Agents, Cell Survival, Codon, Humans, Mutation, Gene Expression, Drug Resistance, Neoplasm, Amino Acid Substitution, Cell Line, Tumor, Protein Kinase Inhibitors, ErbB Receptors

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