Abstract

Epidermal growth factor receptor (EGFR) activation plays a pivotal role in EGFR-driven non-small cell lung cancer (NSCLC) and is considered as a key target of molecular targeted therapy. EGFR tyrosine kinase inhibitors (TKIs) have been canonically used in NSCLC treatment. However, prevalent innate and acquired resistances and EGFR kinase-independent pro-survival properties limit the clinical efficacy of EGFR TKIs. Therefore, the discovery of novel EGFR degraders is a promising approach towards improving therapeutic efficacy and overcoming drug resistance. Here, we identified a 23-hydroxybetulinic acid derivative, namely DPBA, as a novel EGFR small-molecule ligand. It exerted potent in vitro and in vivo anticancer activity in both EGFR wild type and mutant NSCLC by degrading EGFR. Mechanistic studies disclosed that DPBA binds to the EGFR extracellular domain at sites differing from those of EGF and EGFR. DPBA did not induce EGFR dimerization, phosphorylation, and ubiquitination, but it significantly promoted EGFR degradation and repressed downstream survival pathways. Further analyses showed that DPBA induced clathrin-independent EGFR endocytosis mediated by flotillin-dependent lipid rafts and unaffected by EGFR TKIs. Activation of the early and late endosome markers rab5 and rab7 but not the recycling endosome marker rab11 was involved in DPBA-induced EGFR lysosomal degradation. The present study offers a new EGFR ligand for EGFR pharmacological degradation and proposes it as a potential treatment for EGFR-positive NSCLC, particularly NSCLC with innate or acquired EGFR TKI resistance. DPBA can also serve as a chemical probe in the studies on EGFR trafficking and degradation.

Highlights

  • Lung cancer is the most common cancer and the leading cause of cancer-related death, and non-small cell lung cancer (NSCLC) accounts for 84% of all lung cancer diagnoses.[1]

  • 10–20% of NSCLCs with Epidermal growth factor receptor (EGFR) mutation are insensitive to EGFR tyrosine kinase inhibitors (TKIs) and most NSCLCs with EGFR WT do not respond to TKIs despite EGFR up-regulation

  • DPBA reduces the viability of NSCLC cells by suppressing EGFR protein expression and the downstream pathways EGFR degraders were screened from >700 natural compounds and their derivatives (Supplementary Table 1)

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Summary

Introduction

Lung cancer is the most common cancer and the leading cause of cancer-related death, and non-small cell lung cancer (NSCLC) accounts for 84% of all lung cancer diagnoses.[1]. Most patients present with a T790M mutation after gefitinib treatment.[3] The second-generation EGFR TKI afatinib irreversibly binds to EGFR, but it lacks selectivity for EGFR WT and EGFR T790M and provokes adverse reactions.[4] The thirdgeneration EGFR TKI osimertinib is effective in patients with the T790M mutation.[5] certain patients develop other acquired resistances such as a C797S mutation.[6] The inhibition of EGFR kinase activity may result in “kinome rewiring”, which, in turn, causes compensatory feedback activation of alternative kinases.[7] 10–20% of NSCLCs with EGFR mutation are insensitive to EGFR TKIs and most NSCLCs with EGFR WT do not respond to TKIs despite EGFR up-regulation. This response is a manifestation of innate resistance.[8,9] Recent studies reveal that

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