HER3 Augmentation via Blockade of EGFR/AKT Signaling Enhances Anticancer Activity of HER3-Targeting Patritumab Deruxtecan in EGFR-Mutated Non–Small Cell Lung Cancer

  • Kimio Yonesaka
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Junko Tanizaki
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Osamu Maenishi
    3Department of Pathology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Koji Haratani
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Hisato Kawakami
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Kaoru Tanaka
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Hidetoshi Hayashi
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Kazuko Sakai
    4Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Yasutaka Chiba
    5Clinical Research Center, Kindai University Hospital, Osaka-sayama, Osaka, Japan.
  • Asuka Tsuya
    6Department of Medical Oncology, Izumi City General Hospital, Izumi, Osaka, Japan.
  • Hiroki Goto
    7Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., Edogawa, Tokyo, Japan.
  • Eri Otsuka
    7Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., Edogawa, Tokyo, Japan.
  • Hiroaki Okida
    7Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., Edogawa, Tokyo, Japan.
  • Maki Kobayashi
    7Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., Edogawa, Tokyo, Japan.
  • Ryoto Yoshimoto
    7Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., Edogawa, Tokyo, Japan.
  • Masanori Funabashi
    7Translational Research Department, Daiichi Sankyo RD Novare Co., Ltd., Edogawa, Tokyo, Japan.
  • Yuuri Hashimoto
    8Oncology Research Laboratories I, Research Function, R&D Division, Daiichi Sankyo Co., Ltd., Shinagawa, Tokyo, Japan.
  • Kenji Hirotani
    9Early Clinical Development Department, Development Function, R&D Division, Daiichi Sankyo Co., Ltd., Shinagawa, Tokyo, Japan.
  • Takashi Kagari
    8Oncology Research Laboratories I, Research Function, R&D Division, Daiichi Sankyo Co., Ltd., Shinagawa, Tokyo, Japan.
  • Kazuto Nishio
    4Department of Genome Biology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.
  • Kazuhiko Nakagawa
    1Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka-sayama, Osaka, Japan.

抄録

<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Purpose:</jats:title> <jats:p>EGFR-tyrosine kinase inhibitor (TKI) is a standard first-line therapy for activated EGFR-mutated non–small cell lung cancer (NSCLC). Treatment options for patients with acquired EGFR-TKI resistance are limited. HER3 mediates EGFR-TKI resistance. Clinical trials of the HER3-targeting antibody–drug conjugate patritumab deruxtecan (HER3-DXd) demonstrated its anticancer activity in EGFR-mutated NSCLC; however, the mechanisms that regulate HER3 expression are unknown. This study was conducted with the aim to clarify the mechanisms underlying HER3 regulation in EGFR-mutated NSCLC tumors and explored the strategy for enhancing the anticancer activity of HER3-DXd in EGFR-mutated NSCLC.</jats:p> </jats:sec> <jats:sec> <jats:title>Experimental Design:</jats:title> <jats:p>Paired tumor samples were obtained from 48 patients with EGFR-mutated NSCLC treated with EGFR-TKI(s). HER3 expression was immunohistochemically quantified with H-score, and genomic alteration and transcriptomic signature were tested in tumors from pretreatment to post-EGFR-TKI resistance acquisition. The anticancer efficacy of HER3-DXd and osimertinib was evaluated in EGFR-mutated NSCLC cells.</jats:p> </jats:sec> <jats:sec> <jats:title>Results:</jats:title> <jats:p>We showed augmented HER3 expression in EGFR-mutated tumors with acquired EGFR-TKI resistance compared with paired pretreatment samples. RNA sequencing revealed that repressed PI3K/AKT/mTOR signaling was associated with HER3 augmentation, especially in tumors from patients who received continuous EGFR-TKI therapy. An in vitro study also showed that EGFR-TKI increased HER3 expression, repressed AKT phosphorylation in multiple EGFR-mutated cancers, and enhanced the anticancer activity of HER3-DXd.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions:</jats:title> <jats:p>Our findings help clarify the mechanisms of HER3 regulation in EGFR-mutated NSCLC tumors and highlight a rationale for combination therapy with HER3-DXd and EGFR-TKI in EGFR-mutated NSCLC.</jats:p> </jats:sec>

収録刊行物

  • Clinical Cancer Research

    Clinical Cancer Research 28 (2), 390-403, 2021-12-17

    American Association for Cancer Research (AACR)

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