TNF-driven adaptive response mediates resistance to EGFR inhibition in lung cancer
Open accessAbstract
Although aberrant EGFR signaling is widespread in cancer, EGFR inhibition is effective only in a subset of non-small cell lung cancer (NSCLC) with EGFR activating mutations. A majority of NSCLCs express EGFR wild type (EGFRwt) and do not respond to EGFR inhibition. TNF is a major mediator of inflammation-induced cancer. We find that a rapid increase in TNF level is a universal adaptive response to EGFR inhibition in NSCLC, regardless of EGFR status. EGFR signaling actively suppresses TNF mRNA levels by inducing expression of miR-21, resulting in decreased TNF mRNA stability. Conversely, EGFR inhibition results in loss of miR-21 and increased TNF mRNA stability. In addition, TNF-induced NF-κB activation leads to increased TNF transcription in a feed-forward loop. Inhibition of TNF signaling renders EGFRwt-expressing NSCLC cell lines and an EGFRwt patient-derived xenograft (PDX) model highly sensitive to EGFR inhibition. In EGFR-mutant oncogene-addicted cells, blocking TNF enhances the effectiveness of EGFR inhibition. EGFR plus TNF inhibition is also effective in NSCLC with acquired resistance to EGFR inhibition. We suggest concomitant EGFR and TNF inhibition as a potentially new treatment approach that could be beneficial for a majority of lung cancer patients.
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The EGFR pathway is known to interact with the TNF-α signaling pathway, suggesting interplay between the two signaling pathways during ADD development.
“It is also noteworthy that the EGFR pathway is known to interact with the TNF-α signaling pathway41, which suggests interplay between the two signaling pathways during the ADD development.”
From New insights into the genetic etiology of Alzheimer’s disease and related dementias (2022) · cites this paper as [41]
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- Authors
- Gong, K., Guo, G., Gerber, D. E., Gao, B., Peyton, M., Huang, C., Minna, J. D., Hatanpaa, K. J., Kernstine, K., Cai, L., Xie, Y., Zhu, H., Fattah, F. J., Zhang, S., Takahashi, M., Mukherjee, B., Burma, S., Dowell, J., Dao, K., Papadimitrakopoulou, V. A., Olivas, V., Bivona, T. G., Zhao, D., & Habib, A. A.
- Affiliations
- Harold C. Simmons Comprehensive Cancer Center (US)
- The University of Texas Southwestern Medical Center (US)
- VA North Texas Health Care System (US)
- The University of Texas MD Anderson Cancer Center (US)
- University of California, San Francisco (US)
- Wake Forest University Health Sciences (US)
- Corresponding author
- Habib, Amyn A.
- ORCID
- Venue
- Journal of Clinical Investigation
- Published
- 2018-05-07
- Volume
- 128
- Issue
- 6
- Pages
- 2500-2518
- ISSN
- 0021-9738 (ISSN-L)
- 1558-8238
- PMC
- PMC5983340
- OpenAlex
- W2795384223
- Cited by
- 98
- References
- 63
- Citations by year
- 2026: 4 · 2025: 12 · 2024: 12 · 2023: 14 · 2022: 14 · 2021: 20 · 2020: 11 · 2019: 9 · 2018: 2
- FWCI
- 7.91
- Type
- journal article
- Language
- en
- Open access
- green
- europepmc.org
- Locations
- Journal of Clinical Investigation (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- NINDs (R01 NS062080)
- 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 › NF-κB Signaling Pathways
- Keywords
- TNF-α, EGFR inhibition, non-small cell lung cancer, acquired drug resistance, adaptive resistance, miR-21, NF-κB activation, feed-forward loop, EGFR-mutant lung cancer, combination therapy, inflammation in cancer
- MeSH terms
- A549 Cells, Animals, Carcinoma, Non-Small-Cell Lung, Female, Humans, Lung Neoplasms, Mice, Nude, Neoplasm Proteins, Neoplasms, Experimental, RNA, Messenger, RNA, Neoplasm, Tumor Necrosis Factor-alpha, Drug Resistance, Neoplasm, MicroRNAs, Mice, ErbB Receptors
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