小分子酪氨酸激酶抑制剂耐药机制

表皮生长因子受体（epidermal growth factor receptor,EGFR）通路异常在肿瘤发生、发展过程中起到非常重要的作用,特异性抑制该通路的小分子受体酪氨酸激酶抑制剂在肿瘤治疗上取得了显著的效果,但是该药在临床上已经出现耐药现象,现将有关EGFR基因突变、EGFR旁路信号通路的激活、下游信号分子的结构性活化3个方面对EGFR抑制剂耐药机制的研究进展进行综述。     

靶向EGFR家族的抗肿瘤药物研究进展

表皮生长因子受体（EGFR,ErbB）家族在肿瘤的发生、发展中具有重要的作用。很多实体肿瘤中存在EGFR家族受体过表达或异常激活。靶向EGFR家族的抗肿瘤药物研发已经成为一个热点领域,并且成功地应用于临床。靶向EGFR家族的抗肿瘤药物可以分为单克隆抗体和小分子酪氨酸激酶抑制剂两大类。单克隆抗体与受体胞外区结合阻止配体．受体的结合或者阻止配体结合引起的受体活化;而小分子酪氨酸激酶抑制剂则结合于胞内激酶区,抑制激酶自磷酸化和下游信号通路激活。     

EGFR家族受体的分子结构与药物作用机制

表皮生长因子受体(EGFR)及其同源蛋白HER2,HER3,HER4是调控细胞生长与分化的重要酪氨酸激酶受体.这些受体的突变或过表达将会引起激酶活性的失调,并导致包括肺癌与乳腺癌在内的各种癌症.因此,这些受体是治疗癌症的重要药物靶点.虽然目前对于EGFR激酶突变所引起的激酶活性失调及其致癌机制已有较深入的研究,但对于由EGFR或HER2过表达所引发的跨膜信号变化,相应的分子结构,以及由此导致的癌症发生与耐药性产生的分子机制则均不甚明了,在临床上也缺乏有效的靶向性药物或治疗窗口.本文将对EGFR家族受体的分子结构、跨膜信号传导机制,以及EGFR靶向药物的研究进行回顾和展望.     

EGFR基因在非小细胞肺癌、乳腺癌中突变的研究

表皮生长因子受体(EGFR)基因酪氨酸激酶域体细胞突变与非小细胞肺癌(NSCLC)患者对酪氨酸激酶抑制剂吉非替尼敏感性密切相关。文章分析和检测本院75例非小细胞肺癌、10例乳腺癌患者石蜡包埋标本EGFR基因突变状况。采用PCR技术进行EGFR基因19和21外显子突变分析。结果显示:75例NSCLC患者中有13例(13/75,17.33%)酪氨酸激酶域存在体细胞突变。其中7例(7/75,9.33%)为19外显子缺失突变,6例(6/75,8%)为21外显子替代突变(2573T>G,L858R)。病理分型显示,腺癌突变率高于其他几种类型NSCLC。乳腺癌患者均为免疫组化HER-2阳性女性,EGFR基因的19、21外显子中未见突变发生。中国非小细胞肺癌患者总突变率高于高加索人种,女性患者较男性患者突变率高,提示肺腺癌的患者突变率高可能在吉非替尼的治疗中获益。     

酪氨酸激酶抑制剂类抗肿瘤药物研究方法进展

酪氨酸激酶(protein tyrosine kinases,PTKs)在肿瘤细胞的增殖、分化、迁移、侵袭等相关信号通路中起到了关键的调控作用,已经成为肿瘤靶向性治疗的重要靶点.本文对靶向酪氨酸激酶的小分子抑制剂的筛选和评价方法进行综述,以期促进酪氨酸激酶抑制剂类抗肿瘤药物的研究.     

乳腺癌组织中EGFR/KRAS/BRAF基因突变检测与分析

[目的]检测乳腺癌组织中表皮生长因子受体(EGFR)以及其下游KRAS、BRAF基因的突变类型和突变率,分析其各突变类型之间有无相关性,以期为乳腺癌药物靶点筛选和乳腺癌患者的分子靶向治疗提供更多依据。[方法]取自2016～2017年间宜昌市中心人民医院病理科收集的乳腺癌患者术后冰冻肿瘤组织样本60例以及健康人群DNA样本30例,分别提取基因组DNA,采用PCR扩增和基因测序的方法对基因组中的EGFR外显子18～21,KRAS外显子2、3以及BRAF外显子15进行基因突变分析。[结果]在检测的60例乳腺癌组织样本中,总计有8例样本存在错义突变。其中EGFR突变率为11.7%(7/60例),均为外显子18和20突变。包括第18号外显子P699A突变3例,突变率为5.0%;第20号外显子L778M、V819A突变各4例,突变率6.7%。并包含3例L778M合并V819A突变,另有2例中分别出现了I780M合并S783C和L788V合并L815F突变。BRAF外显子15仅出现了1例T599P突变,突变率为1.7%(1/60例)。30例正常人群对照组未检测到错义突变。[结论]EGFR在乳腺癌中的突变主要以外显子18和20为主,存在P699A、L778M、V819A突变且突变率高达11.7%。BRAF在乳腺癌中的突变率极低,仅为1.7%。未检测到乳腺癌组织中KRAS突变。与正常组织相比较,EGFR外显子18和20的高突变率提示其与乳腺癌的发病存在密切关系,EGFR突变是潜在的抗乳腺癌治疗靶点。     

Cloning and Expression of EGFR Tyrosine Kinase and Construction of the Screening Model for the Enzymatic Inhibitors

表皮生长因子受体(Epidermal growth factor receptor,EGFR)属受体酪氨酸激酶(Tyrosine kinase,TK)家族,其胞内的酪氨酸激酶在细胞信号转导通路中具有十分重要的作用。许多肿瘤的发生、发展都与EGFR胞内酪氨酸激酶的异常表达密切相关。因此,EGFR胞内酪氨酸激酶的抑制剂有可能成为治疗肿瘤的有效药物。本研究从人脐静脉内皮细胞(HUVEC) 提取总RNA,采用RT-PCR获得EGFR酪氨酸激酶催化域的编码基因。将其克隆至载体pET-30a,在E.coli BL21(DE3)中进行了成功表达,采用Ni-NTA亲和层析对其进行了纯化。通过对酶的活性的测定,证明重组EGFR酪氨酸激酶蛋白具有利用ATP催化底物发生磷酸化反应的激酶活性。以该重组激酶为靶位构建了酶抑制剂筛选模型,拟对微生物代谢产物进行筛选。     

表皮生长因子受体酪氨酸激酶的克隆表达和酶抑制剂筛选模型的构建

表皮生长因子受体（epidermal growth factor receptor,EGFR）属受体酪氨酸激酶（tyrosine kinase,TK）家族,其胞内的酪氨酸激酶在细胞信号转导通路中具有十分重要的作用。许多肿瘤的发生、发展都与EGFR胞内酪氨酸激酶的异常表达密切相关。因此,EGFR胞内酪氨酸激酶的抑制剂有可能成为治疗肿瘤的有效药物。从人脐静脉内皮细胞（HUVEC）提取总RNA,采用RT-PCR获得EGFR酪氨酸激酶催化域的编码基因。将其克隆至载体pET-30a,在E．coliBL21（DE3）中进行了成功表达,采用Ni-NTA亲和层析对其进行了纯化。通过对酶的活性的测定,证明重组EGFR酪氨酸激酶蛋白具有利用ATP催化底物发生磷酸化反应的激酶活性。以该重组激酶为靶位构建了酶抑制剂筛选模型,拟对微生物代谢产物进行筛选。     

c-Kit 激酶抑制剂的研究与开发

c-Kit 是典型的Ⅲ型受体酪氨酸激酶,在肿瘤的发生发展以及侵袭、迁移和复发过程中起着十分重要的作用,是目前肿瘤分子靶向治疗的热门靶标之一,其抑制剂也成为抗肿瘤药物研究与开发的热点。简介c-Kit 激酶及其激活型突变与肿瘤发生发展的关系,着重综述近年来已上市和处于临床试验阶段的c-Kit 激酶抑制剂及其耐药机制研究。     

肺癌EGFR突变与酪氨酸激酶抑制剂临床敏感性的关系

表皮生长因子受体(EGFR)酪氨酸激酶抑制剂(TKI)是近年来在临床中使用的一类新的小分子靶向药物,主要用于晚期非小细胞肺癌(NSCLC)的治疗,然而并非所有的NSCLC患者对TKI敏感。近期研究发现,在NSCLC治疗过程中,EGFR突变与TKI临床敏感性密切相关,通过检测肺癌EGFR突变状况可以预测TKI治疗的效果。     

Interdependent epidermal growth factor receptor signalling and trafficking

Epidermal growth factor (EGF) receptor (EGFR) signalling regulates diverse cellular functions, promoting cell proliferation, differentiation, migration, cell growth and survival. EGFR signalling is critical during embryogenesis, in particular in epithelial development, and disruption of the EGFR gene results in epithelial immaturity and perinatal death. EGFR signalling also functions during wound healing responses through accelerating wound re-epithelialisation, inducing cell migration, proliferation and angiogenesis. Upregulation of EGFR signalling is often observed in carcinomas and has been shown to promote uncontrolled cell proliferation and metastasis. Therefore aberrant EGFR signalling is a common target for anticancer therapies. Various reports indicate that EGFR signalling primarily occurs at the plasma membrane and EGFR degradation following endocytosis greatly attenuates signalling. Other studies argue that EGFR internalisation is essential for complete activation of downstream signalling cascades and that endosomes can serve as signalling platforms. The aim of this review is to discuss current understanding of intersection between EGFR signalling and trafficking.     

超声激活血卟啉对S180 肿瘤细胞表面EGFR 表达量的影响

目的：探讨超声激活血卟啉处理S180肿瘤细胞后膜表面EGFR表达量的变化。方法：将腹水瘤细胞随机分为四组,U组和UH组细胞分别于频率1．8MHz、2．0W／cm^2的超声装置中照射3min,并分别在1h3h5h后取材,应用免疫组化方法在光镜下观察EGFR的表达情况。结果：1h、3h取材,U组和UH组平均光密度值明显低于Cr组和H组,UH组最低。而5h取材时,UH组平均光密度值显著下降,其它组基本无变化。结论：提示在高频低强度处理下,随着时间的延长,超声激活HpD对EGFR的抑制作用增加,显示可能是基因调控使EGFR表达下调,从而使肿瘤细胞增殖减慢。     

PTEN和EGFR在胃癌中的表达及相关性研究

目的:检测第10号染色体缺失的磷酸酶和张力蛋白同源物基因PTEN及表皮生长因子受体EGFR在胃癌组织中的表达,探讨两者与胃癌肿瘤行为的关系及意义。方法:采用免疫组织化学染色法(S-P法)检测105例胃癌组织及癌旁正常胃组织中EGFR和PTEN蛋白的表达水平,并将检测结果与临床病理参数进行综合分析。结果:胃癌组织PTEN的表达56.19%明显低于正常组织中的表达的表达92.3%,而胃癌组织EGFR的表达46.67%明显高于正常组织7.62%,(P<0.01)。二者的表达与性别和年龄无相关性(P>0.05),与胃癌的分化程度、浸润深度、淋巴结转移及临床分期有相关性(P<0.05)。结论:PTEN在胃癌组织中呈低表达,EGFR在胃癌组织中存在高表达,与胃癌的发生、发展有一定关系,并与胃癌的分化程度、浸润深度、淋巴结转移及临床分期密切相关,二者呈负相关。     

皮肤局部应用维甲酸引致的表皮增殖机制

维甲酸（retinoic acid,学名：视黄酸）在皮肤局部给药时,常刺激皮肤基底层角质细胞的异常增殖。证据表明,位于皮肤表皮基底层上层角质细胞中的维甲酸受体二聚体对维甲酸引起的基底层细胞增殖是必需的。可能的机制是,位于表皮基底层上层的维甲酸受体首先诱导位于同一细胞层中的肝素结合表皮生长因子（HB—EGF）表达上调,该生长因子通过旁分泌途径激活位于基底层的受体（erbB1和erbB2）,刺激基底层细胞增殖。     

Design,synthesis and biological evaluation of novel 4-anilinoquinazolines with C-6 urea-linked side chains as inhibitors of the epidermal growth factor receptor

A novel series of anilinoquinazoline compounds with C-6 urea-linked side chains was designed and synthesized as reversible inhibitors of epidermal growth factor receptor (EGFR) based on the structure–activity relationships (SARs) of anilinoquinazoline inhibitors. All compounds demonstrated good inhibition of EGFR wild type (EGFR wt) (IC₅₀ = 0.024–1.715 μM) and inhibited proliferation of A431cell line (IC₅₀ = 0.116–22.008 μM). The binding mode of compounds 8a, 8d, 8k and 8o was consistent with the biological results. Moreover, compounds 8k and 8l almost completely blocked the phosphorylation of EGFR in A431 cell line at 0.01 μM. Interestingly, all of the compounds also demonstrated moderate inhibition of EGFR/T790M/L858R (IC₅₀ = 0.049–5.578 μM). In addition, compounds 8f and 8h blocked the autophosphorylation of EGFR in NCI-H1975 cells at high concentration (10 μM), and compound 8f was confirmed to be an irreversible inhibitor through the dilution method. Importantly, the compounds with C-6 urea-linked side chains which did not contain Michael acceptors demonstrated moderate to strong irreversible EGFR inhibition.     

Hydrogel-based protein array for quantifying epidermal growth factor receptor activity in cell lysates

Epidermal growth factor receptor (EGFR) signaling plays an important role in a majority of solid tumors, and therapeutics targeted against EGFR has demonstrated promise in slowing growth of these tumors. However, many of these drugs either have failed to reproduce promising preclinical model results in clinical settings or have been successful in only a subgroup of cancer patients due partly to incomplete assessment of EGFR status in cancer. A patient-customized, predictive diagnostic for the effects of specific anti-EGFR therapies may improve outcomes. Here we report the development of a hydrogel-based protein array for quantitative and reproducible determination of the activity of EGFR directly from cellular extracts. In this study, we used glutathione S-transferase-fused Eps15 (GST–Eps15) fusion proteins immobilized within a polyacrylamide hydrogel as a substrate for quantifying EGFR kinase activity from the extracts of EGFR-expressing cell lines. Significant EGFR up-regulation was detected in a mixture containing 7% EGFR-overexpressing cell lysate diluted in lysate from a cell line expressing low levels of EGFR. In addition, the GST–Eps15 protein array was capable of detecting inhibition of EGFR activity when incubated with different tyrosine kinase inhibitors. These findings establish the potential of this protein–acrylamide copolymer hydrogel array not only to evaluate EGFR status in cancer cell lysates but also to screen for the most promising therapeutics for individual patients and monitor treatment progression.     

Design,synthesis and biological evaluation of novel 6-alkenylamides substituted of 4-anilinothieno[2,3-d]pyrimidines as irreversible epidermal growth factor receptor inhibitors

A novel series of 6-alkenylamides of 4-anilinothieno[2,3-d]pyrimidine derivatives was designed, synthesized and evaluated as irreversible inhibitors of the epidermal growth factor receptor (EGFR). Most of the compounds exhibited good potency against EGFR wild type (EGFR wt) and EGFR T790M/L858R. Among these, the half-maximal inhibitory concentration (IC₅₀) values of 17 compounds against EGFR wt were less than 0.020 μM, and those of 12 compounds were less than 0.010 μM. The IC₅₀ values of 10 compounds against EGFR T790M/L858R were less than 0.005 μM. Compounds 8l, 9n, 9o, 9q and 9v almost completely blocked the phosphorylation of EGFR in the A431 cell line at 1 μM. Compounds 8l, 9n, 9o, 9q and 9v blocked the autophosphorylation of EGFR in NCI-H1975 cells at high concentration (1 μM), and compound 8l was confirmed to be an irreversible inhibitor through the dilution method.     

Potential use of transrenal DNA for non-invasive monitoring and prognosis of colorectal cancer

Background: Anti-EGFR mAb are recommended treatment for metastatic colorectal cancer (mCRC). Accurate mutation profiling and disease monitoring are challenging. The current study investigates the potential use of transrenal DNA as a biomarker for disease management.

Methods: Agreement between archival tissue specimens and transrenal DNA extracted from 200 post-treated mCRC patients was determined. Total DNA concentrations were measured and mutations within the KRAS and EGFR genes were profiled for each specimen. To ascertain therapy resistance; patients were serially monitored monthly.

Results: Concordance measurement with matched tissues at baseline was remarkably high (92%) for EGFR and KRAS mutations. Sensitivity and specificity were 98.4% and 89.1% respectively. Newly detectable mutations for a subgroup of patients with initial wildtype characteristics were evident after 4?months of anti-EGFR mAb therapy. Survival analysis using adjusted estimates showed that patients detected by transrenal DNA for key mutations or had higher mutant DNA content had poorer outcome.

Conclusion: Transrenal DNA offers new options to follow clinical treatment in mCRC. It demonstrates the ability to capture newly acquired mutations that has strong associative links to therapy resistance. Patients with these mutations fared poorly for survival outcomes and indicated possible prognostic value for transrenal DNA detection.     

Novel irreversible EGFR tyrosine kinase inhibitor 324674 sensitizes human colon carcinoma HT29 and SW480 cells to apoptosis by blocking the EGFR pathway

Background

Epidermal growth factor receptor (EGFR) is widely expressed in multiple solid tumors including colorectal cancer by promoting cancer cell growth and proliferation. Therefore, the inhibition of EGFR activity may establish a clinical strategy of cancer therapy.

Methods

In this study, using human colon adenocarcinoma HT29 and SW480 cells as research models, we compared the efficacy of four EGFR inhibitors in of EGFR-mediated pathways, including the novel irreversible inhibitor 324674, conventional reversible inhibitor AG1478, dual EGFR/HER2 inhibitor GW583340 and the pan-EGFR/ErbB2/ErbB4 inhibitor. Cell proliferation was assessed by MTT analysis, and apoptosis was evaluated by the Annexin-V binding assay. EGFR and its downstream signaling effectors were examined by western blotting analysis.

Results

Among the four inhibitors, the irreversible EGFR inhibitor 324674 was more potent at inhibiting HT29 and SW480 cell proliferation and was able to efficiently induce apoptosis at lower concentrations. Western blotting analysis revealed that AG1478, GW583340 and pan-EGFR/ErbB2/ErbB4 inhibitors failed to suppress EGFR activation as well as the downstream mitogen-activated protein kinase (MAPK) and PI3K/AKT/mTOR (AKT) pathways. In contrast, 324674 inhibited EGFR activation and the downstream AKT signaling pathway in a dose-dependent manner.

Conclusion

Our studies indicated that the novel irreversible EGFR inhibitor 324674 may have a therapeutic application in colon cancer therapy.     

Design,synthesis and biological evaluation of WZ4002 analogues as EGFR inhibitors

A series of thirty two anilinopyrimidines derived from WZ4002 has been synthesized and evaluated for percentage inhibition of six different EGFR kinases using LanthaScreen binding assay method (EGFR d746 – 750) or Z’LYTE assay method (EGFR-WT, EGFR d746 – 750, EGFR T790M, EGFR T790M L858R, EGFR C797S and EGFR T790M L858R C797S). Ortho-hydroxyacetamide 10 exhibited complete inhibition of all the six kinases at 10 µM. Against the triple mutant, EGFR T790M C797S L858R, compounds 9–12 exhibited complete inhibition at 10 µM and nearly complete inhibition at 1 µM. The target compounds were also evaluated using the MTT assay to determine their cytotoxic activity against human non-small cell lung cancer cells (PC9, PC9GR and H460) and mouse leukemic cells (Ba/F3 WT and Ba/F3T 3151). Overall, 7, 9–12, 30 and 31 were found to be the most potent compounds across all five cell lines.