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Resistance of HNSCC cell models to pan-FGFR inhibition depends on the EMT phenotype associating with clinical outcome

Authors: Broghammer, Felix; Korovina, Irina; Gouda, Mahesh; Celotti, Martina; van Es, Johan; Lange, Inga; Brunner, Cornelia; +6 Authors

Resistance of HNSCC cell models to pan-FGFR inhibition depends on the EMT phenotype associating with clinical outcome

Abstract

Abstract Background Focal adhesion signaling involving receptor tyrosine kinases (RTK) and integrins co-controls cancer cell survival and therapy resistance. However, co-dependencies between these receptors and therapeutically exploitable vulnerabilities remain largely elusive in HPV-negative head and neck squamous cell carcinoma (HNSCC). Methods The cytotoxic and radiochemosensitizing potential of targeting 10 RTK and β1 integrin was determined in up to 20 3D matrix-grown HNSCC cell models followed by drug screening and patient-derived organoid validation. RNA sequencing and protein-based biochemical assays were performed for molecular characterization. Bioinformatically identified transcriptomic signatures were applied to patient cohorts. Results Fibroblast growth factor receptor (FGFR 1–4) targeting exhibited the strongest cytotoxic and radiosensitizing effects as monotherapy and combined with β1 integrin inhibition, exceeding the efficacy of the other RTK studied. Pharmacological pan-FGFR inhibition elicited responses ranging from cytotoxicity/radiochemosensitization to resistance/radiation protection. RNA sequence analysis revealed a mesenchymal-to-epithelial transition (MET) in sensitive cell models, whereas resistant cell models exhibited a partial epithelial-to-mesenchymal transition (EMT). Accordingly, inhibition of EMT-associated kinases such as EGFR caused reduced adaptive resistance and enhanced (radio)sensitization to FGFR inhibition cell model- and organoid-dependently. Transferring the EMT-associated transcriptomic profiles to HNSCC patient cohorts not only demonstrated their prognostic value but also provided a conclusive validation of the presence of EGFR-related vulnerabilities that can be strategically exploited for therapeutic interventions. Conclusions This study demonstrates that pan-FGFR inhibition elicits a beneficial radiochemosensitizing and a detrimental radioprotective potential in HNSCC cell models. Adaptive EMT-associated resistance appears to be of clinical importance, and we provide effective molecular approaches to exploit this therapeutically.

Keywords

Cancer Research, Squamous Cell/drug therapy, Integrin beta1/genetics, Radioprotection, Epithelial-Mesenchymal Transition, Adaptive resistance, Integrin, Antineoplastic Agents, HNSCC, Cell Line, Tumor [MeSH] ; Adaptive resistance ; Epidermal growth factor receptor ; Humans [MeSH] ; β1 integrin ; Head and Neck Neoplasms/genetics [MeSH] ; Squamous Cell Carcinoma of Head and Neck/drug therapy [MeSH] ; Head and Neck Neoplasms/drug therapy [MeSH] ; Carcinoma, Squamous Cell/drug therapy [MeSH] ; Squamous Cell Carcinoma of Head and Neck/genetics [MeSH] ; Radiosensitization ; Epithelial-Mesenchymal Transition/genetics [MeSH] ; ErbB Receptors/metabolism [MeSH] ; Epithelial-to-mesenchymal transition ; Receptor Protein-Tyrosine Kinases/genetics [MeSH] ; HNSCC ; Integrin beta1/genetics [MeSH] ; Research ; Radioprotection ; Antineoplastic Agents/therapeutic use [MeSH] ; Carcinoma, Squamous Cell/genetics [MeSH] ; Carcinoma, Squamous Cell/pathology [MeSH] ; Phenotype [MeSH] ; Fibroblast growth factor receptor, Cell Line, β1 integrin, Epithelial-Mesenchymal Transition/genetics, Cell Line, Tumor, Squamous Cell Carcinoma of Head and Neck/drug therapy, Humans, RC254-282, Radiosensitization, ErbB Receptors/metabolism, Tumor, FGFR, Epidermal growth factor receptor, Squamous Cell Carcinoma of Head and Neck, Receptor Protein-Tyrosine Kinases/genetics, Research, Integrin beta1, Carcinoma, EMT, Antineoplastic Agents/therapeutic use, Neoplasms. Tumors. Oncology. Including cancer and carcinogens, Receptor Protein-Tyrosine Kinases, Head and Neck Neoplasms/drug therapy, Fibroblast growth factor receptor, ErbB Receptors, Phenotype, Oncology, Epithelial-to-mesenchymal transition, Head and Neck Neoplasms, Carcinoma, Squamous Cell, Molecular Medicine

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    influence
    This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
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    impulse
    This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
10
Top 10%
Average
Top 10%
Green
gold