YM155 sensitizes non-small cell lung cancer cells to EGFR-tyrosine kinase inhibitors through the mechanism of autophagy induction

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Highlights

  • YM155 sensitizes NSCLC cells to erlotinib by downregulating survivin expression.

  • YM155 sensitizes NSCLC cells to erlotinib through autophagy induction mechanism.

  • Combination of YM155 and erlotinib produces autophagy-dependent apoptosis.

  • YM155 combined with erlotinib induced NSCLC cell DNA damage is autophagy-dependent.

  • Erlotinib sensitization by YM155 is demonstrated in vivo NSCLC tumor xenograft.

Abstract

Resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), such as erlotinib and gefitinib, is a major clinical problem in the treatment of patients with non-small cell lung cancer (NSCLC). YM155 is a survivin small molecule inhibitor and has been demonstrated to induce cancer cell apoptosis and autophagy. EGFR-TKIs have been known to induce cancer cell autophagy. In this study, we showed that YM155 markedly enhanced the sensitivity of erlotinib to EGFR-TKI resistant NSCLC cell lines H1650 (EGFR exon 19 deletion and PTEN loss) and A549 (EGFR wild type and KRAS mutation) through inducing autophagy-dependent apoptosis and autophagic cell death. The effects of YM155 combined with erlotinib on apoptosis and autophagy inductions were more obvious than those of YM155 in combination with survivin knockdown by siRNA transfection, suggesting that YM155 induced autophagy and apoptosis in the NSCLC cells partially depend on survivin downregulation. Meanwhile, we found that the AKT/mTOR pathway is involved in modulation of survivin downregulation and autophagy induction caused by YM155. In addition, YM155 can induce DNA damage in H1650 and A549 cell lines. Moreover, combining erlotinib further augmented DNA damage by YM155, which were retarded by autophagy inhibitor 3MA, or knockdown of autophagy-related protein Beclin 1, revealing that YM155 induced DNA damage is autophagy-dependent. Similar results were also observed in vivo xenograft experiments. Therefore, combination of YM155 and erlotinib offers a promising therapeutic strategy in NSCLC with EGFR-TKI resistant phenotype.

Abbreviations

EGFR
epidermal growth factor receptor
TKIs
tyrosine kinase inhibitors
NSCLC
non-small cell lung cancer
PTEN
phosphatase and tensin homolog deleted on chromosome ten
CQ
chloroquine
3MA
3-methyladenine
PARP
poly (ADP-ribose) polymerase
LC3
microtubule-associated protein 1 light chain 3
ATG
autophagy-related gene
Beclin1
Bcl-2-interacting protein1
siRNA
small interfering RNA
SQSTM1
sequestosome 1
mTOR
mammalian target of rapamycin
AKT
protein kinase B
ERK
extracellular signal-regulated kinase
JNK
c-jun N-terminal kinase
ATM
ataxia telangiectasia mutated
DDR
DNA repair response
DSB
double strand breaks

Keywords

Non-small cell lung cancer
Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs)
Erlotinib
Resistance
YM155
Survivin

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These authors contributed equally to this work.