Autophagy inhibition facilitates erlotinib cytotoxicity in lung cancer cells through modulation of endoplasmic reticulum stress

Int J Oncol. 2016 Jun;48(6):2558-66. doi: 10.3892/ijo.2016.3468. Epub 2016 Apr 1.

Abstract

Epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) have revolutionized the treatment for non-small cell lung cancer patients, but acquired resistance limit the efficiency of this treatment. As a homeostatic cellular recycling mechanism, autophagy has been proposed to participate in the EGFR-TKI resistance. However, the role of autophagy in lung cancer treatment and the underlying mechanisms have not been clarified. In this study, we found the sensitivity to erlotinib, a well-used EGFR-TKI, was correlated with basal autophagy level. Erlotinib was able to induce autophagy not only in TKI-sensitive, but also TKI-resistant cancer cells. Inhibition of autophagy significantly enhanced cytotoxicity of erlotinib in TKI-resistant cancer cells via modulation of endoplasmic reticulum (ER) stress induced apoptosis. In this process, CCAAT/enhancer binding protein homologous protein (CHOP) acted as an executioner. Downregulation of CHOP with siRNA blocked the autophagy inhibition and erlotinib co-treatment induced apoptosis and prevented cancer cells from this co-treatment-induced cell death. Our findings suggest that autophagy inhibition overcomes erlotinib resistance through modulation of ER stress mediated apoptosis.

MeSH terms

  • Antineoplastic Agents / pharmacology*
  • Autophagy / drug effects*
  • Carcinoma, Non-Small-Cell Lung / drug therapy
  • Carcinoma, Non-Small-Cell Lung / metabolism*
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Cell Survival / drug effects
  • Chloroquine / pharmacology
  • Drug Resistance, Neoplasm / drug effects*
  • Drug Synergism
  • Endoplasmic Reticulum Stress / drug effects*
  • ErbB Receptors / antagonists & inhibitors
  • Erlotinib Hydrochloride / pharmacology*
  • Humans
  • Lung Neoplasms / drug therapy
  • Lung Neoplasms / metabolism
  • Protein Kinase Inhibitors / pharmacology
  • RNA, Small Interfering / pharmacology*
  • Transcription Factor CHOP / genetics

Substances

  • Antineoplastic Agents
  • DDIT3 protein, human
  • Protein Kinase Inhibitors
  • RNA, Small Interfering
  • Transcription Factor CHOP
  • Chloroquine
  • Erlotinib Hydrochloride
  • ErbB Receptors