Reactivation of ERK signaling causes resistance to EGFR Kinase inhibitors Academic Article uri icon


MeSH Major

  • Adenocarcinoma
  • Colonic Neoplasms
  • Intestinal Mucosa
  • Phosphoprotein Phosphatases
  • Protein-Tyrosine Kinases
  • Retroviridae Proteins


  • The clinical efficacy of epidermal growth factor receptor (EGFR) kinase inhibitors is limited by the development of drug resistance. The irreversible EGFR kinase inhibitor WZ4002 is effective against the most common mechanism of drug resistance mediated by the EGFR T790M mutation. Here, we show, in multiple complementary models, that resistance to WZ4002 develops through aberrant activation of extracellular signal-regulated kinase (ERK) signaling caused by either an amplification of mitogen-activated protein kinase 1 (MAPK1) or by downregulation of negative regulators of ERK signaling. Inhibition of MAP-ERK kinase (MEK) or ERK restores sensitivity to WZ4002 and prevents the emergence of drug resistance. We further identify MAPK1 amplification in an erlotinib-resistant EGFR-mutant non-small cell lung carcinoma patient. In addition, the WZ4002-resistant MAPK1-amplified cells also show an increase both in EGFR internalization and a decrease in sensitivity to cytotoxic chemotherapy. Our findings provide insights into mechanisms of drug resistance to EGFR kinase inhibitors and highlight rational combination therapies that should be evaluated in clinical trials.

publication date

  • October 2012



  • Academic Article



  • eng

PubMed Central ID

  • PMC5634832

Digital Object Identifier (DOI)

  • 0.1158/2159-8290.CD-12-0103

PubMed ID

  • 29046822

Additional Document Info

start page

  • 934

end page

  • 47


  • 2


  • 10