INTRODUCTION
For the majority of patients with non-small cell lung cancer, response to epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKI) is suboptimal. In models of acquired resistance to EGFR-TKI, activation of Akt phosphorylation is frequently observed. Since Akt activation results in downstream initiation of cap-dependent protein translation, we hypothesized that a strategy of targeting cap-dependent translation in combination with erlotinib might enhance therapy.
METHODS
NSCLC cells that are wild-type for Egfr were assayed for sensitivity to erlotinib. Serum-starved NSCLC cells were assayed for EGFR signaling and downstream pathway activation by immunoblot after stimulation with EGF. EGFR signaling and signaling mediators of cap-dependent translation were assayed by immunoblot under serum replete conditions 24 hours after treatment with erlotinib. Finally, combination treatment with erlotinib and 2 different cap-dependent translation inhibitors were done to assess the effect on cell viability.
RESULTS
EGFR signaling is coupled to activation of cap-dependent translation in EGFR wild-type cells. Erlotinib inhibits EGFR phosphorylation in EGFR-TKI resistant cells, however, results in activation of downstream signaling molecules including Akt and ERK1/2 resulting in maintenance of eIF4F activation. eIF4F cap-complex formation is maintained in erlotinib resistant cells, but not in erlotinib sensitive cells. Finally, using an antisense oligonucleotide against eIF4E and a small-molecule inhibitor to disrupt eIF4F formation, we show that cap-dependent translation inhibition can enhance sensitivity to erlotinib.
Conclusions
The results of these studies support further clinical development of translation inhibitors for treatment of NSCLC in combination with erlotinib.