Non-genomic resistance mechanisms in EGFR-mutant lung cancer

EGFR突变肺癌的非基因组耐药机制

• 批准号: 10442329
• 负责人: Aaron N Hata
• 金额: $ 40.85万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-03-01 至 2027-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10442329
• 关键词: Automobile Driving; BRAF gene; Biological Assay; Biopsy; Blood; Cancer Patient; Cells; Clinical; Clinical Research; Complement; DNA Sequence Alteration; Development; Drug resistance; Epidermal Growth Factor Receptor; Epidermal Growth Factor Receptor Tyrosine Kinase Inhibitor; Fibroblasts; Future; Gene Expression Profile; Generations; Genomics; Histologic; Immune; Infrastructure; Investigation; Laboratories; Malignant Neoplasms; Malignant neoplasm of lung; Modeling; Molecular Analysis; Mutation; Non-Small-Cell Lung Carcinoma; Patient Care; Patients; Pharmaceutical Preparations; Plasma; Population Heterogeneity; Quality of life; RNA; Resistance; Role; Stromal Neoplasm; Tissues; Tumor Cell Line; Tumor Tissue; Tumor-Derived; acquired drug resistance; base; clinically relevant; cohort; drug development; effective therapy; immune activation; improved; innovation; liquid biopsy; molecular targeted therapies; mutant; neoplastic cell; new therapeutic target; non-genomic; novel; novel therapeutics; pre-clinical; relapse patients; resistance mechanism; resistance mutation; response; standard of care; targeted treatment; therapy development; tumor; tumor heterogeneity; tumor microenvironment

Project Summary Osimertinib, a third-generation EGFR tyrosine kinase inhibitor (TKI), is the current standard of care for first-line therapy for EGFR mutant lung cancer patients. While osimertinib is effective in inducing tumor regressions, improving quality of life and prolonging survival in most patients, it is not curative. Early studies of acquired resistance suggest that even after standard histologic and genomic assessments for resistance mechanisms, a substantial portion of osimertinib resistance remains uncharacterized. This incomplete understanding of osimertinib resistance poses a significant barrier to developing new and effective therapies for clinical use. We hypothesize that, in contrast to earlier generation EGFR inhibitors, non-genomic mechanisms are driving the majority of acquired resistance to first-line osimertinib. To date, assessments of EGFR TKI acquired resistance mechanisms have focused on genomic resistance mutations, amplifications, and fusions, in part because these can be readily detected in tumor tissue or in blood-based ctDNA liquid biopsies. In this project we seek to discover the spectrum of non-genomic osimertinib resistance. Our main objective is to identify both tumor intrinsic mechanisms of osimertinib resistance as well as tumor extrinsic microenvironmental resistance mechanisms. In Aim 1, we will use RARE-Seq, a novel blood-based assay to quantify tumor gene expressions patterns of resistance in EGFR mutant NSCLC patients relapsing on osimertinib. In Aim 2, we will investigate tumor cell extrinsic mechanisms of osimertinib resistance by leveraging our robust translational infrastructure to develop cancer-associated fibroblast models from osimertinib resistance biopsies. We will use these models to dissect functional interactions between CAFs, tumor cells and immune cells, and we will integrate these results with spatial molecular analysis of clinical biopsies. Collectively, the studies described in this proposal will generate a comprehensive picture of osimertinib resistance and set the stage for future development of therapies that overcome resistance to osimertinib.

项目总结