No abstract

BACKGROUND: The majority of patients with non-small cell lung cancer (NSCLC) harboring activating epidermal growth factor receptor (EGFR) mutations respond well to osimertinib (AZD9291), a third-generation, mutation-selective EGFR inhibitor. The current study focuses on determining whether targeting MEK/ERK signaling prevents or delays the development of acquired resistance to osimertinib. METHODS: Drug effects on cell survival were determined by measuring cell number alterations. Apoptosis was assessed with flow cytometry for the detection of annexin V-positive cells and with Western blotting for protein cleavage. Alterations of proteins in cells were detected with Western blotting. Drug effects on delaying the emergence of osimertinib resistance were evaluated with colony formation in vitro and xenografts in nude mice in vivo. RESULTS: Osimertinib combined with an MEK or ERK inhibitor synergistically decreased cell survival with enhanced induction of apoptosis in EGFR-mutant NSCLC cells but not in EGFR wild-type NSCLC cells. These combinations were also very effective in killing cell clones with primary intrinsic resistance to osimertinib. Continuous and intermittent pharmacologic inhibition of MEK/ERK signaling delayed the emergence of osimertinib resistance both in vitro and in vivo. CONCLUSIONS: These results provide strong preclinical evidence in support of targeting MEK/ERK signaling as a strategy for delaying or preventing acquired resistance to osimertinib in the clinic to improve the long-term therapeutic efficacy of osimertinib. From a clinical standpoint, the data support the evaluation of an intermittent treatment schedule of osimertinib in combination with an MEK or ERK inhibitor in patients with EGFR-mutated NSCLC.

) is reported to be overexpressed in colorectal carcinoma (CRC), but the role of miR-191 in CRC progress remained unclear. This study demonstrated that High miR-191 expression was associated with clinical stage, lymph node metastasis, liver metastasis and depth of tumor invasion. Kaplan-Meier analysis indicated that patients with high miR-191 expression had a poor overall survival. Moreover, multivariate analysis showed that miR-191 was an independent prognostic factor in patients with CRC. Furthermore, we found that tissue inhibitor of metalloprotease 3 (TIMP3) was a direct target of miR-191 in colorectal cancer SW620 cells. TIMP3 downregulation mediated by miR-191 activated matrix metalloproteinases (MMPs) and thus promoted invasiveness of cancer cells. Anti-miR-191 could attenuate the invasiveness, suppress proliferation and induce apoptosis by restoring TIMP3 expression. Our results suggested that miR-191 might be a potential diagnostic and therapeutic target in patients with colorectal cancer.