% IMPORTANT: The following is UTF-8 encoded. This means that in the presence
% of non-ASCII characters, it will not work with BibTeX 0.99 or older.
% Instead, you should use an up-to-date BibTeX implementation like “bibtex8” or
% “biber”.
@ARTICLE{Novoplansky:306283,
author = {O. Novoplansky and S. Jagadeeshan and M. Prasad and K. M.
Yegodayev and D. Marripati and R. A. Shareb and Y.
Greenshpan and S. Mathukkada and T. Ben-Lulu and B.
Bhattacharya and A. Porgador and D. Kong and J. Brägelmann
and J. S. Gutkind and M. Elkabets},
title = {{D}ual inhibition of {HER}s and {PD}-1 counteract
resistance in {KRASG}12{C}-mutant head and neck cancer.},
journal = {Journal of experimental $\&$ clinical cancer research},
volume = {43},
number = {1},
issn = {0392-9078},
address = {Heidelberg},
publisher = {Springer},
reportid = {DKFZ-2025-02509},
pages = {308},
year = {2024},
note = {#DKFZ-MOST-Ca222#},
abstract = {Basket clinical trials targeting the KRASG12C-mutation in
solid tumors have shown initial promise, including in orphan
KRASG12C head and neck cancer (HNC). However, development of
resistance to KRASG12C-mutant-specific inhibitors
(KRASG12Ci) remains a major obstacle. Here, we investigated
the intrinsic (tumor-cell autonomus) and
tumor-microenvironment (TME) mechanisms of resistance to the
KRASG12Ci-MRTX849 and AMG510 in a unique syngenic murine
KRASG12C-mutated HNC cell line.Western-blotting was used for
protein abundance and activation, overexpression, and ligand
activation studies to verify the intrinsic mechanism of
resistance to KRASG12Ci in KRASG12C-mutated HNC cell line,
4NQO-L. In vitro KRASG12C-acquired-resistant cells were
developed from 4NQO-L (4NQO-L-AcR). MRTX849/lapatinib
combination efficacy, and CD8+ T-cells depletion, were
assessed in C57BL/6 J mice and supplementation of anti-PD-1
(αPD-1) to MRTX849/lapatinib was also performed in 4NQO-L-
KRASG12Ci-senisitve and 4NQO-L-AcR tumors.
Immunohistochemistry (IHC) and Immunoflourescence (IF)
analyses were performed to profile the TME and programmed
death-ligand 1 (PD-L1) expression in tumors.Activation and
upregulation of EGFR and HER2/3 (pan-HERs) are the intrinsic
mechanism of resistance to KRASG12Ci in 4NQO-L cells, and
blocking pan-HERs signaling with lapatinib enhanced MRTX849
efficacy in vitro by inhibiting the MAPK and AKT/mTOR
pathways. 4NQO-L-AcR upregulated the expression of pan-HERs,
and lapatinib treatment re-sensitized 4NQO-L-AcR to MRTX849.
In mice, MRTX849 showed a slight anti-tumor effect, but in
combination with lapatinib a significant tumor growth delay
was observed, but all tumors progressed over time.
Histopathology analysis of the TME revealed infiltration of
CD8+ T-cells after treatment combination, and these CD8+
T-cells play a key role in MRTX849/lapatinib efficacy.
MRTX849/lapatinib treatment upregulated PD-L1 overexpression
in both stromal and tumor cells, which presumably suppressed
CD8+ T-cells and enabled immune escape and tumor
progression. Supplementation of αPD-1 prolonged the
progression-free survival of 4NQO-L-bearing mice treated
with MRTX849/lapatinib. MRTX849/lapatinib treatment delayed
tumor growth of 4NQO-L-AcR in mice; however, the percentages
of CD8+ T-cells in 4NQO-L-AcR were low, and supplementation
of MRTX849/lapatinib with αPD-1 did not improve the
outcome.Our study highlights the critical need for blocking
both intrinsic and extrinsic mechanisms of resistance for
the prolonged response and shows that such treatment is
ineffective in KRASG12Ci-AcR tumors.},
keywords = {Mice / Animals / Head and Neck Neoplasms: drug therapy /
Head and Neck Neoplasms: genetics / Head and Neck Neoplasms:
pathology / Head and Neck Neoplasms: metabolism /
Proto-Oncogene Proteins p21(ras): genetics / Proto-Oncogene
Proteins p21(ras): metabolism / Humans / Drug Resistance,
Neoplasm / Mutation / Programmed Cell Death 1 Receptor:
antagonists $\&$ inhibitors / Programmed Cell Death 1
Receptor: metabolism / Cell Line, Tumor / Adagrasib (Other)
/ Cell-autonomous (Other) / Drug resistance (Other) / HER
signaling (Other) / Head and neck cancer (Other) / KRASG12C
mutation (Other) / PD-L1/PD1 (Other) / Sotorasib (Other) /
Tumor microenvironment (Other) / Proto-Oncogene Proteins
p21(ras) (NLM Chemicals) / Programmed Cell Death 1 Receptor
(NLM Chemicals) / KRAS protein, human (NLM Chemicals)},
ddc = {610},
typ = {PUB:(DE-HGF)16},
pubmed = {pmid:39567998},
pmc = {pmc:PMC11577641},
doi = {10.1186/s13046-024-03227-0},
url = {https://inrepo02.dkfz.de/record/306283},
}