
We developed neratinib-resistant HER2-mutant cancer cells by gradual dose escalation. RNA sequencing identified TORC1 signaling as an actionable mechanism of drug resistance. Primary and acquired neratinib resistance in HER2-mutant breast cancer patient-derived xenografts (PDXs) was also associated with TORC1 hyperactivity. Genetic suppression of RAPTOR or RHEB ablated P-S6 and restored sensitivity to the tyrosine kinase inhibitor. The combination of the TORC1 inhibitor everolimus and neratinib potently arrested the growth of neratinib-resistant xenografts and organoids established from neratinib-resistant PDXs. RNA and whole-exome sequencing revealed RAS-mediated TORC1 activation in a subset of neratinib-resistant models. DNA sequencing of HER2-mutant tumors clinically refractory to neratinib, as well as circulating tumor DNA profiling of patients who progressed on neratinib, showed enrichment of genomic alterations that converge to activate the mTOR pathway.
drug resistance, Receptor, ErbB-2, Breast Neoplasms, Mechanistic Target of Rapamycin Complex 1, HER2 mutations, TORC1, neratinib, Drug Resistance, Neoplasm, precision oncology, Cell Line, Tumor, Quinolines, Humans, Protein Kinase Inhibitors, HER2 mutations; TORC1; drug resistance; neratinib; precision oncology, Signal Transduction
drug resistance, Receptor, ErbB-2, Breast Neoplasms, Mechanistic Target of Rapamycin Complex 1, HER2 mutations, TORC1, neratinib, Drug Resistance, Neoplasm, precision oncology, Cell Line, Tumor, Quinolines, Humans, Protein Kinase Inhibitors, HER2 mutations; TORC1; drug resistance; neratinib; precision oncology, Signal Transduction
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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). | Top 10% | |
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