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Oncogenic Transformation by Inhibitor-Sensitive and -Resistant EGFR Mutants
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BACKGROUND: Somatic mutations in the kinase domain of the epidermal growth factor receptor tyrosine kinase gene EGFR are common in lung adenocarcinoma. The presence of mutations correlates with tumor sensitivity to the EGFR inhibitors erlotinib and gefitinib, but the transforming potential of specific mutations and their relationship to drug sensitivity have not been described. METHODS AND FINDINGS: Here, we demonstrate that EGFR active site mutants are oncogenic. Mutant EGFR can transform both fibroblasts and lung epithelial cells in the absence of exogenous epidermal growth factor, as evidenced by anchorage-independent growth, focus formation, and tumor formation in immunocompromised mice. Transformation is associated with constitutive autophosphorylation of EGFR, Shc phosphorylation, and STAT pathway activation. Whereas transformation by most EGFR mutants confers on cells sensitivity to erlotinib and gefitinib, transformation by an exon 20 insertion makes cells resistant to these inhibitors but more sensitive to the irreversible inhibitor CL-387,785. CONCLUSION: Oncogenic transformation of cells by different EGFR mutants causes differential sensitivity to gefitinib and erlotinib. Treatment of lung cancers harboring EGFR exon 20 insertions may therefore require the development of alternative kinase inhibition strategies.
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![Figure 3 Shc and STAT3 Signaling Pathways Are Constitutively Activated in Cells Expressing the Mutant EGFR (A) Cells expressing the wild-type or L858R mutant EGFR were placed in 0.5% calf serum for 24 h and left unstimulated or stimulated with 20 ng/ml EGF (“+EGF”) for 8 min. EGFR was immunoprecipitated from 200 μg of cell lysate, and eluted immune complexes were separated by SDS-PAGE and immunoblotted with anti-Shc. Shc constitutively coimmunoprecipitates with the L858R EGFR but not the wild-type EGFR. IP, immunoprecipitation; NL, no-lysate control immunoprecipitation. (B) Anti-phospho-Shc immunoblots (upper row of blots) and anti-Shc immunoblots (lower row) of whole cell lysates from the experiment in (A). All three Shc isoforms are constitutively phosphorylated in cells expressing the L858R EGFR. (C) Immunoblots of whole cell lysates with anti-phospho-STAT3 Y705 (upper row), total STAT3 (middle row), or actin as a loading control (lower row). STAT3 is constitutively phosphorylated in cells expressing any of the four mutant EGFR proteins, representative of the four classes of EGFR mutations observed in lung adenocarcinoma tumor DNA. del, L747_E749del A750P; ins, D770_N771insNPG; pBp, pBabe-Puro vector control; wt, wild-type EGFR. (D) M67 STAT3 luciferase reporter assay. NIH-3T3 cells expressing the indicated EGFR were transfected with a STAT-dependent reporter (m67-firefly luciferase) [25] and a control reporter expressing Renilla luciferase. STAT-dependent luciferase production was measured after 48 h and normalized to Renilla luciferase. The normalized luciferase values were divided by the values for cells expressing the wild-type EGFR to produce relative luciferase units. NIH-3T3 expressing mutant forms of EGFR exhibited elevated levels of STAT-dependent transcriptional activity relative to wild-type. ins, D770_N771insNPG EGFR; wt, wild-type EGFR. (E) Immunoblots of whole cell lysates with anti-phospho-Akt S473 (upper row), total Akt (middle row), or actin as a loading control (lower row). Akt is constitutively phosphorylated in cells expressing mutant EGFR. del, L747_E749del A750P; ins, D770_N771insNPG; wt, wild-type EGFR.](/paper-figures/22d89ab4c5d04fc088642d02357338eb/oncogenic-transformation-by-inhibitor-sensitive-and-resistant-egfr-mutants-figure-3.jpg)
![Figure 4 Sensitivity of Cell Transformation Induced by Expression of Mutant EGFR Characterized by Missense Mutation or Exon 19 Deletion, but not Exon 20 Insertion, to Gefitinib and Erlotinib (A) Anchorage-independent growth of clonal NIH-3T3 cells transformed with mutant EGFR or EGF-stimulated wild-type EGFR treated with the indicated concentrations of erlotinib immediately prior to suspension in soft agar. Transformation induced by expression of L858R, G719S, and L747_E749del A750P EGFR, but not EGF-stimulated wild-type EGFR or D770_N771insNPG EGFR, was inhibited by 0.1 μM erlotinib. Representative photographs are shown. (B) Number of colonies formed in soft agar by clonal NIH-3T3 cells expressing L858R EGFR and D770_N771insNPG EGFR treated with the indicated concentrations of gefitinib or erlotinib immediately prior to suspension in soft agar. Transformation by cells expressing the L858R EGFR was inhibited by 0.1 μM gefitinib or erlotinib, whereas transformation by cells expressing the insertion mutant was resistant to low concentrations of these inhibitors. Colonies were quantitated by counting ten fields each of triplicate wells photographed with a 10× objective; mean ± standard deviation is shown. Ins, D770_N771insNPG EGFR. (C) Transformation induced by expression of D770_N771insNPG EGFR is inhibited 10-fold more efficiently by the irreversible EGFR inhibitor CL-387,785 [35]. Clonal NIH-3T3 cells expressing the insertion mutant were treated with the indicated concentrations of gefitinib, erlotinib, or CL-387,785 immediately prior to suspension in soft agar. This assay was not done in triplicate, but the results are representative of two independent experiments. The number of colonies was normalized to maximum colony formation for each treatment, and sigmoidal dose response curves were fitted to the data using Prism Graphpad software to determine IC50s.](/paper-figures/ccec189806e1410181ab0225729a28c0/oncogenic-transformation-by-inhibitor-sensitive-and-resistant-egfr-mutants-figure-4.jpg)

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“CL-387785 has also shown potential to overcome T790M mutation-related resistance at the functional level, possibly by effectively inhibiting downstream signaling pathways.”
From Recent advances in targeting the “undruggable” proteins: from drug discovery to clinical trials (2023) · cites this paper as [201]
In the citing paper
“These mutant kinases present a reduced affinity for the ATP, accounting for the increased sensitivity to EGFR TKIs compared with the wild type counterparts, since these inhibitors compete with ATP for binding to the catalytic site [10–12].”
From A decade of EGFR inhibition in EGFR-mutated non small cell lung cancer (NSCLC): Old successes and future perspectives (2015) · cites this paper as [10]
In the citing paper
“Most EGFR exon 20 insertion mutations are 1st generation EGFR-TKIs resistant mutations [15, 18, 19].”
In the citing paper
“Cell culture and transgenic mouse model studies have shown that mutant EGFR has transforming activity (Greulich et al., 2005; Ji et al., 2006; Politi et al., 2006).”
From ERBB Receptors: From Oncogene Discovery to Basic Science to Mechanism-Based Cancer Therapeutics (2014) · cites this paper as Greulich et al., 2005
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Cites
Lynch, T. J., Bell, D. W., Sordella, R., Gurubhagavatula, S., Okimoto, R. A., Brannigan, B. W., Harris, P. L., Haserlat, S. M., Supko, J. G., Haluska, F. G., et al. (2004) · New England Journal of Medicine · doi:10.1056/nejmoa040938 · Cited by 11,486
EGFR Mutations in Lung Cancer: Correlation with Clinical Response to Gefitinib Therapy
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Self-citationPao, W., Miller, V., Zakowski, M., Doherty, J., Politi, K., Sarkaria, I., Singh, B., Heelan, R., Rusch, V., Fulton, L., et al. (2004) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0405220101 · Cited by 4,338
EGFR Mutation and Resistance of Non–Small-Cell Lung Cancer to Gefitinib
Kobayashi, S., Boggon, T. J., Dayaram, T., Jänne, P. A., Kocher, O., Meyerson, M., Johnson, B. E., Eck, M. J., Tenen, D. G., & Halmos, B. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa044238 · Cited by 3,964
Self-citationPao, W., Miller, V. A., Politi, K. A., Riely, G. J., Somwar, R., Zakowski, M. F., Kris, M. G., & Varmus, H. (2005) · PLoS Medicine · doi:10.1371/journal.pmed.0020073 · Cited by 3,527 · cited 1×
“Patients who responded to gefitinib and subsequently relapsed were found to have T790M secondary mutations, also in exon 20 [19,20].”
BackgroundThe ErbB signaling network: receptor heterodimerization in development and cancer
Olayioye, M. A., Neve, R. M., Lane, H. A., & Hynes, N. E. (2000) · The EMBO Journal · doi:10.1093/emboj/19.13.3159 · Cited by 2,489
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Creation of human tumour cells with defined genetic elements
Hahn, W. C., Counter, C. M., Lundberg, A. S., Beijersbergen, R. L., Brooks, M. W., & Weinberg, R. A. (1999) · Nature · doi:10.1038/22780 · Cited by 2,345
Self-citationZhong, Z., Wen, Z., & Darnell, J. E. (1994) · Science · doi:10.1126/science.8140422 · Cited by 2,070
Gefitinib-Sensitizing EGFR Mutations in Lung Cancer Activate Anti-Apoptotic Pathways
Sordella, R., Bell, D. W., Haber, D. A., & Settleman, J. E. (2004) · Science · doi:10.1126/science.1101637 · Cited by 1,605
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Epidermal growth factor receptor mutations in lung cancer
Sharma, S. V., Bell, D. W., Settleman, J., & Haber, D. A. (2007) · Nature Reviews Cancer · doi:10.1038/nrc2088 · Cited by 3,170
Herbst, R. S., Heymach, J. V., & Lippman, S. M. (2008) · New England Journal of Medicine · doi:10.1056/nejmra0802714 · Cited by 2,435
Shigematsu, H., Lin, L., Takahashi, T., Nomura, M., Suzuki, M., Wistuba, I. I., Fong, K. M., Lee, H., Toyooka, S., Shimizu, N., et al. (2005) · JNCI Journal of the National Cancer Institute · doi:10.1093/jnci/dji055 · Cited by 2,377
Screening for Epidermal Growth Factor Receptor Mutations in Lung Cancer
Rosell, R., Moran, T., Queralt, C., Porta, R., Cardenal, F., Camps, C., Majem, M., Lopez-Vivanco, G., Isla, D., Provencio, M., et al. (2009) · New England Journal of Medicine · doi:10.1056/nejmoa0904554 · Cited by 2,373
The T790M mutation in EGFR kinase causes drug resistance by increasing the affinity for ATP
Yun, C.-H., Mengwasser, K. E., Toms, A. V., Woo, M. S., Greulich, H., Wong, K.-K., Meyerson, M., & Eck, M. J. (2008) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.0709662105 · Cited by 2,118
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Metadata
- Authors
- Greulich, H., Chen, T.-H., Feng, W., Jänne, P. A., Alvarez, J. V., Zappaterra, M., Bulmer, S. E., Frank, D. A., Hahn, W. C., Sellers, W. R., & Meyerson, M.
- Affiliations
- Broad Institute (US)
- Brigham and Women's Hospital (US)
- Dana-Farber Cancer Institute (US)
- Corresponding author
- Greulich, Heidi
- Sellers, William R
- Meyerson, Matthew
- ORCID
- Venue
- PLoS Medicine
- Publisher
- Public Library of Science (PLoS)
- Published
- 2005-10-04
- Volume
- 2
- Issue
- 11
- Pages
- e313
- ISSN
- 1549-1277 (ISSN-L)
- 1549-1676
- PMC
- PMC1240052
- OpenAlex
- W2037873277
- Cited by
- 677
- References
- 35
- Citations by year
- 2026: 9 · 2025: 10 · 2024: 10 · 2023: 22 · 2022: 23 · 2021: 23 · 2020: 16 · 2019: 29 · 2018: 20 · 2017: 27 · 2016: 26 · 2015: 47 · 2014: 27 · 2013: 54 · 2012: 46
- FWCI
- 45.72
- Type
- journal article
- Language
- en
- Update notices
- correction (2024-09-16)
- Open access
- gold
- doi.org
- Locations
- PLoS Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- American Cancer Society
- Doris Duke Charitable Foundation
- Flight Attendant Medical Research Institute
- Barr Foundation
- National Institutes of Health
- National Cancer Institute
- 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
- EGFR mutation, oncogenic transformation, lung adenocarcinoma, erlotinib, gefitinib, EGFR inhibitors, exon 20 insertion, autophosphorylation, Shc phosphorylation, STAT pathway, drug resistance, kinase inhibitors
- MeSH terms
- Erlotinib Hydrochloride, Src Homology 2 Domain-Containing, Transforming Protein 1, Gefitinib, Animals, Antineoplastic Agents, Cell Transformation, Neoplastic, Exons, Humans, Mice, Nude, Mutation, Neoplasms, Experimental, Quinazolines, Transfection, Tumor Stem Cell Assay, Genetic Therapy, Drug Resistance, Neoplasm, NIH 3T3 Cells, Protein Kinase Inhibitors, Adaptor Proteins, Signal Transducing, STAT3 Transcription Factor, Proto-Oncogene Proteins c-akt, Mice, Shc Signaling Adaptor Proteins, ErbB Receptors
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