Abstract

BackgroundThe objective of this study was to evaluate the effect of platinum-based drugs on nuclear-factor erythroid2 like 2 (NRF2) signaling in non-small cell lung cancer cell lines with or without Kelch-like ECH-associated protein 1 (KEAP1) mutations and to determine the role of NRF2 and KEAP1 on platinum-based drug treatment.MethodsWe used real-time PCR to assess relative mRNA expression and used western blotting and immunofluorescence assays to assess protein expression. Small interfering RNA and shuttle plasmids were used to modulate the expression of NRF2, wild-type KEAP1, and mutant KEAP1. Drug sensitivity to platinum-based drugs was evaluated with Cell Count Kit-8.ResultsWe found that platinum-based therapies modified the NRF2 signaling pathway differently in KEAP1-mutated non-small cell lung cancer (NSCLC) cell lines compared with wild-type KEAP1 cell lines. The reactive degree of NRF2 signaling also varies between nedaplatin and cisplatin. The modification of NRF2 or KEAP1 expression in NSCLC cell lines disrupted downstream gene expression and cell sensitivity to platinum-based drugs. Finally, gene expression data retrieved from The Cancer Genome Atlas (TCGA) consortium indicated that KEAP1 mutation significantly affects NRF2 signaling activity in patients with NSCLC.ConclusionsOur findings suggest that NRF2 signaling plays an indispensable role in NSCLC cell sensitivity to platinum-based treatments and provides a rationale for using NRF2 as a specific biomarker for predicting which patients will be most likely to benefit from platinum-based treatment.

Highlights

  • The objective of this study was to evaluate the effect of platinum-based drugs on nuclear-factor erythroid2 like 2 (NRF2) signaling in non-small cell lung cancer cell lines with or without Kelch-like ECH-associated protein 1 (KEAP1) mutations and to determine the role of NRF2 and KEAP1 on platinum-based drug treatment

  • We sought to elucidate the role of NRF2 in platinum-based chemotherapy for Non-small cell lung cancer (NSCLC), and we identified KEAP1 mutation as a key factor contributing to platinum sensitivity

  • We evaluated basal protein levels of KEAP1 and components of the NRF2 signaling pathway in the four NSCLC cell lines

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Summary

Introduction

The objective of this study was to evaluate the effect of platinum-based drugs on nuclear-factor erythroid like 2 (NRF2) signaling in non-small cell lung cancer cell lines with or without Kelch-like ECH-associated protein 1 (KEAP1) mutations and to determine the role of NRF2 and KEAP1 on platinum-based drug treatment. Platinum-based treatment regimens remain the standard of care recommended by the lung cancer guidelines for squamous lung cancer or adenocarcinoma with undefined mutation status [6]. Studies [7, 8] have revealed that a nedaplatin-based treatment regimen is associated with a favorable response in patients with squamous cell lung cancer. Platinum-based drugs are defined as DNA adduct-forming agents that exert antineoplastic effects by inducing the formation of double-stranded DNA cross-links, resulting in irreversible DNA damage [9]. Accumulating DNA damage eventually leads to apoptosis [10, 11]

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