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Amplification of EGFR T790M causes resistance to an irreversible EGFR inhibitor

Oncogene volume 29, pages 2346–2356 (2010)Cite this article

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Abstract

Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors, gefitinib and erlotinib are effective therapies against mutant non-small cell lung cancers (NSCLCs). Treatment is limited by the development of resistance in part explained by the gain of a secondary EGFR mutation, T790M, at the gatekeeper residue. Irreversible EGFR inhibitors, including PF00299804, are effective in vitro and in vivo against EGFR mutant tumors that contain EGFR T790M and are currently under clinical development. In this study, we generate models of resistance to PF00299804, using cell lines with EGFR T790M and show that the PF00299804-resistant models develop focal amplification of EGFR that preferentially involves the T790M-containing allele. These PF00299804-resistant cell lines remain dependent on EGFR for growth as downregulation of EGFR by shRNA compromises their viability. We show that resistance to PF00299804 arises, at least in part, through selection of a pre-existing EGFR T790M-amplified clone both in vitro and using a xenograft model in vivo. Our findings show that EGFR T790M is a common resistance mechanism to both reversible, and when amplified, the irreversible EGFR kinase inhibitors further emphasizing the need to develop more potent therapies against EGFR T790M. These findings can be used to guide studies of patient tumor specimens from ongoing clinical trials of irreversible EGFR kinase inhibitors.

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Acknowledgements

Supported by grants from the National Institutes of Health RO1CA114465-04 (PAJ), R01CA135257-01 (PAJ, JAE, CL), R01CA137008-01 (JAE, PAJ), National Cancer Institute Lung SPORE P50CA090578 (PAJ, JAE and DJK), American Cancer Society RSG0610201CCE (PAJ, JAE), and the Hazel and Samuel Bellin research fund (PAJ).

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Authors and Affiliations

  1. Lowe Center for Thoracic Oncology, Dana–Farber Cancer Institute, Boston, MA, USA

    D Ercan, K Zejnullahu, K Yonesaka, M Capelletti, A Rogers & P A Jänne

  2. Department of Medical Oncology, Dana–Farber Cancer Institute, Boston, MA, USA

    D Ercan, K Zejnullahu, K Yonesaka, M Capelletti, A Rogers & P A Jänne

  3. Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA

    Y Xiao & C Lee

  4. Massachusetts General Hospital Cancer Center, Boston, MA, USA

    E Lifshits & J A Engelman

  5. Harvard Partners Center for Genetics and Genomics, Harvard Medical School, Cambridge, MA, USA

    A Brown

  6. Department of Research Pharmacology, Pfizer Global Research and Development, La Jolla Labs, La Jolla, CA, USA

    J G Christensen

  7. Division of Translational Medicine, Brigham and Women's Hospital, Boston, MA, USA

    D J Kwiatkowski

  8. Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA

    P A Jänne

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Correspondence to P A Jänne.

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Competing interests

Dr Jänne receives royalties as a co-inventor on a patent awarded for the discovery of EGFR mutations, licensed to Genzyme Genetics, which was not involved in this study. Dr Christensen is an employee of Pfizer.

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Ercan, D., Zejnullahu, K., Yonesaka, K. et al. Amplification of EGFR T790M causes resistance to an irreversible EGFR inhibitor. Oncogene 29, 2346–2356 (2010). https://doi.org/10.1038/onc.2009.526

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  • DOI: https://doi.org/10.1038/onc.2009.526

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