NSAIDs Overcome PIK3CA Mutation-Mediated Resistance to EGFR Inhibition in Head and Neck Cancer Preclinical Models

Abstract

Epidermal growth factor receptor (EGFR) inhibitors are approved by the Food and Drug Administration (FDA) but remain under active clinical investigation for the treatment of both newly diagnosed and recurrent/metastatic head and neck squamous cell carcinoma (HNSCC). Despite EGFR expression in the majority of HNSCC tumors, the levels of total or phosphorylated EGFR have not consistently been correlated with a response to EGFR targeting agents. The lack of predictive biomarkers represents a major obstacle to successful use of these drugs. Activation of phosphatidylinositol 3-kinase (PI3K) signaling by mutation of the PIK3CA oncogene represents a plausible mechanism for EGFR inhibitor drug resistance. We compared the impact of EGFR inhibitors, alone or in combination with non-steroidal anti-inflammatory drugs (NSAIDs), in preclinical HNSCC models harboring mutant versus wild-type PIK3CA. Our results demonstrate additive or synergistic effects of NSAIDs and EGFR inhibitors in vitro and in vivo in PIK3CA-mutated HNSCC models. These findings suggest that the addition of NSAIDs to EGFR inhibitors for the treatment of HNSCC may represent a promising therapeutic strategy in PIK3CA-mutated cancers.

Trial watch: beta-blockers in cancer therapy

“… 184 In a model of head and neck squamous cell carcinoma, COX-2 inhibition showed additive and synergistic effects with EGFR inhibitors enhancing tumor cell death both in vitro and in vivo , especially in PIK3CA-mutated cancers. 99 Altogether, the combination of COX-2 inhibitors with β-blockers seems to be a promising option to potentiate antitumor responses.…”

“…It also increases the secretion of granzyme B and IFN-γ contributing to immune-mediated anti-cancer responses in mice. 96 , 99 , 122 Additionally, SR59230A promotes the differentiation of stromal cells and increases the abundance of lymphoid, myeloid, and NK progenitor cells in the tumor microenvironment. Altogether, these effects may inhibit tumor progression, inflammation and angiogenesis.…”