RB loss in resistant EGFR mutant lung adenocarcinomas that transform to small-cell lung cancer
Matthew J Niederst, Lecia V Sequist, John T Poirier, Craig H Mermel, Elizabeth L Lockerman, Angel R Garcia, Ryohei Katayama, Carlotta Costa, Kenneth N Ross, Teresa Moran, Emily Howe, Linnea E Fulton, Hillary E Mulvey, Lindsay A Bernardo, Farhiya Mohamoud, Norikatsu Miyoshi, Paul A VanderLaan, Daniel B Costa, Pasi A Jänne, Darrell R Borger, Sridhar Ramaswamy, Toshi Shioda, Anthony J Iafrate, Gad Getz, Charles M Rudin, Mari Mino-Kenudson, Jeffrey A Engelman, Matthew J Niederst, Lecia V Sequist, John T Poirier, Craig H Mermel, Elizabeth L Lockerman, Angel R Garcia, Ryohei Katayama, Carlotta Costa, Kenneth N Ross, Teresa Moran, Emily Howe, Linnea E Fulton, Hillary E Mulvey, Lindsay A Bernardo, Farhiya Mohamoud, Norikatsu Miyoshi, Paul A VanderLaan, Daniel B Costa, Pasi A Jänne, Darrell R Borger, Sridhar Ramaswamy, Toshi Shioda, Anthony J Iafrate, Gad Getz, Charles M Rudin, Mari Mino-Kenudson, Jeffrey A Engelman
Abstract
Tyrosine kinase inhibitors are effective treatments for non-small-cell lung cancers (NSCLCs) with epidermal growth factor receptor (EGFR) mutations. However, relapse typically occurs after an average of 1 year of continuous treatment. A fundamental histological transformation from NSCLC to small-cell lung cancer (SCLC) is observed in a subset of the resistant cancers, but the molecular changes associated with this transformation remain unknown. Analysis of tumour samples and cell lines derived from resistant EGFR mutant patients revealed that Retinoblastoma (RB) is lost in 100% of these SCLC transformed cases, but rarely in those that remain NSCLC. Further, increased neuroendocrine marker and decreased EGFR expression as well as greater sensitivity to BCL2 family inhibition are observed in resistant SCLC transformed cancers compared with resistant NSCLCs. Together, these findings suggest that this subset of resistant cancers ultimately adopt many of the molecular and phenotypic characteristics of classical SCLC.
Conflict of interest statement
J.A.E. is a consultant for Novartis, Sanofi-Aventis, Genentech and Astra Zeneca; owns equity in Gatekeeper Pharmaceuticals, which has interest in T790M inhibitors; is a Scientific Advisory Board member for Sanofi-Aventis; has research agreements with Novartis, Sanofi-Aventis and Astra Zeneca. A.J.I. is a consultant for Pfizer and Bioreference Laboratories. P.A.J. is a consultant for AstraZeneca, Boehringer Ingelheim, Chugai Pharma, Clovis, Genentech, Merrimack Pharmaceuticals, Pfizer and Sanofi; owns stock in Gatekeeper Pharmaceutical; receives other renumeration from LabCorp. C.M.R. has been a recent consultant for AbbVie, Biodesix, Boehringer Ingelheim, Glaxo Smith Kline and Merck regarding cancer drug development. The remaining authors declare no competing financial interests.
Figures
![Figure 1. SCLC transformed cell lines exhibit…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4382681/bin/ncomms7377-f1.jpg)
![Figure 2. Resistant SCLCs respond to ABT-263…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4382681/bin/ncomms7377-f2.jpg)
![Figure 3. NGS reveals specific genetic alterations…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4382681/bin/ncomms7377-f3.jpg)
![Figure 4. Resistant EGFR mutant SCLCs have…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4382681/bin/ncomms7377-f4.jpg)
![Figure 5. RB is invariably absent in…](https://www.ncbi.nlm.nih.gov/pmc/articles/instance/4382681/bin/ncomms7377-f5.jpg)
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Source: PubMed