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Acquired resistance is inevitable in the treatment of non-small cell lung cancer (NSCLC) with osimertinib, and one of the primary mechanisms responsible for this resistance is the epithelial-mesenchymal transition (EMT). We identify upregulation of the proviral integration site for Moloney murine leukemia virus 1 (PIM1) and functional inactivation of glycogen synthase kinase 3β (GSK3β) as drivers of EMT-associated osimertinib resistance. Upregulation of PIM1 promotes the growth, invasion, and resistance of osimertinib-resistant cells and is significantly correlated with EMT molecules expression. Functionally, PIM1 suppresses the ubiquitin-proteasome degradation of snail family transcriptional repressor 1 (SNAIL) and snail family transcriptional repressor 2 (SLUG) by deactivating GSK3β through phosphorylation. The stability and accumulation of SNAIL and SLUG facilitate EMT and encourage osimertinib resistance. Furthermore, treatment with PIM1 inhibitors prevents EMT progression and re-sensitizes osimertinib-resistant NSCLC cells to osimertinib. PIM1/GSK3β signaling is activated in clinical samples of osimertinib-resistant NSCLC, and dual epidermal growth factor receptor (EGFR)/PIM1 blockade synergistically reverse osimertinib-resistant NSCLC in vivo. These data identify PIM1 as a driver of EMT-associated osimertinib-resistant NSCLC cells and predict that PIM1 inhibitors and osimertinib combination therapy will provide clinical benefit in patients with EGFR-mutant NSCLC.
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http://dx.doi.org/10.1038/s41419-024-07039-0 | DOI Listing |
Cancer Lett
August 2025
Departments of Hematology and Medical Oncology and Emory University School of Medicine and Winship Cancer Institute of Emory University, Atlanta, GA, USA. Electronic address:
c-Myc inhibition is a critical mechanism in mediating the therapeutic efficacy of osimertinib against EGFR mutant (EGFRm) NSCLCs and accordingly targeting c-Myc is an effective strategy for overcoming osimertinib acquired resistance, a challenging issue in the clinic. However, lack of specific c-Myc inhibitors restricts the application of this strategy. The current study focused on determining the potential application of an alternative c-Myc inhibitory approach to overcome osimertinib acquired resistance via targeting the MKK3/c-Myc interaction that stabilizes c-Myc protein.
View Article and Find Full Text PDFNPJ Precis Oncol
August 2025
Department of Thoracic Surgery, Xiangya Hospital, Central South University, Changsha, Hunan Province, PR China.
Non-small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) mutations initially responds to the third-generation EGFR-tyrosine kinase inhibitor (TKI) Osimertinib. However, acquired resistance inevitably develops through various mechanisms, including secondary mutations and activation of bypass signaling pathways. Nuclear translocation of EGFR has been implicated in resistance to targeted therapies, but the molecular mechanisms linking EGFR subcellular localization to Osimertinib resistance remain poorly understood.
View Article and Find Full Text PDFAdv Sci (Weinh)
August 2025
Department of Pharmacy, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Osimertinib resistance is a global problem for NSCLC patients mediated by new EGFR mutations or bypass mechanisms. Proteolysis targeting chimeras (PROTACs) have been utilized to overcome drug resistance by degrading mutant EGFR, but most are restricted to their poor cell permeability and insufficient tumor-targeting ability. Meanwhile, these PROTACs has little effect on bypass resistance mechanisms.
View Article and Find Full Text PDFDiscov Oncol
August 2025
Department of Oncology, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, 7889 Changdong Avenue, Gaoxin District, Nanchang, 330006, Jiangxi Province, China.
Non-small cell lung cancer (NSCLC) is one of the most prevalent and deadliest cancers worldwide, accounting for a significant global health burden. Targeted therapies such as osimertinib, a third-generation EGFR inhibitor, have transformed the treatment landscape for EGFR-mutant NSCLC by offering improved progression-free survival. However, the inevitable development of resistance remains a formidable challenge, necessitating deeper insights into its molecular underpinnings.
View Article and Find Full Text PDFGenes (Basel)
June 2025
Division of Thoracic Oncology, European Institute of Oncology, IRCCS, 20141 Milan, Italy.
Epidermal growth factor receptor () mutations occur in approximately 10-20% of Caucasian and up to 50% of Asian patients with oncogene-addicted non-small cell lung cancer (NSCLC). Most frequently, alterations include exon 19 deletions and exon 21 L858R mutations, which confer sensitivity to EGFR tyrosine kinase inhibitors (TKIs). In the last decade, the third-generation EGFR-TKI osimertinib has represented the first-line standard of care for EGFR-mutant NSCLC.
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