Development of tyrosine kinase inhibitors (TKIs) against oncogenic drivers has significantly improved survival of patients with oncogene-mutated non-small cell lung cancer (NSCLC). However, acquired resistance to TKIs emerges over time in essentially all patients who initially respond. Recent evidence suggests that drug-tolerant persister (DTP) cells, which survive and adapt to targeted therapies during an early phase of treatment, play an important role in the emergence of drug resistance. A previous study reported that cluster of differentiation 74 (CD74) expression is upregulated in epidermal growth factor receptor (EGFR)-mutated lung cancer after treatment with EGFR-TKIs and that CD74 can be one of the DTP cell markers. However, both the mechanism underlying CD74 expression and the role of CD74 in DTP cells remain unclear.
In the current study, an attempt was made to identify the mechanism using cell culture systems and transgenic mouse models. The results confirmed CD74 upregulation at the messenger RNA (mRNA) level after treatments with TKIs in various oncogene-mutated cell lines, including those with EGFR mutations, ROS1 fusions, and ALK fusions. The class II transactivator (CIITA), upstream of CD74, and tumor necrosis factor (TNF)-α expression were induced by treatments with TKIs in tumor cells, leading to an increase in CD74 expression. In addition, the results showed that treatments with TKIs enhance the autocrine secretion of macrophage migration inhibitory factor (MIF), a ligand of CD74, from tumor cells. This implied that autocrine stimulation of CD74 signaling blocks apoptosis and causes emergence of DTP cells. To examine whether CD74 plays an important role in the emergence of resistance to TKIs in vivo, experiments were completed in which lung-specific EGFR-L858R-T790M transgenic mice were crossed with Cd74 knockout mice. The results showed that complete deletion of CD74 overcomes or delays resistance to TKIs. Taken together, the results of this study suggest that the MIF-CD74 axis can be a novel target to overcome resistance in driver-mutated NSCLC. / 2026-02-28T00:00:00Z
| Identifer | oai:union.ndltd.org:bu.edu/oai:open.bu.edu:2144/48295 |
| Date | 01 March 2024 |
| Creators | Lee, Meghan |
| Contributors | Spencer, Jean L., Kobayashi, Susumu |
| Source Sets | Boston University |
| Language | en_US |
| Detected Language | English |
| Type | Thesis/Dissertation |
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