β2-AR inhibition enhances EGFR antibody efficacy hampering the oxidative stress response machinery

Cell Death Dis. 2023 Sep 19;14(9):613. doi: 10.1038/s41419-023-06129-9.

Abstract

The β2-Adrenergic receptor (β2-ARs) is a cell membrane-spanning G protein-coupled receptors (GPCRs) physiologically involved in stress-related response. In many cancers, the β2-ARs signaling drives the tumor development and transformation, also promoting the resistance to the treatments. In HNSCC cell lines, the β2-AR selective inhibition synergistically amplifies the cytotoxic effect of the MEK 1/2 by affecting the p38/NF-kB oncogenic pathway and contemporary reducing the NRF-2 mediated antioxidant cell response. In this study, we aimed to validate the anti-tumor effect of β2-AR blockade and the synergism with MEK/ERK and EGFR pathway inhibition in a pre-clinical orthotopic mouse model of HNSCC. Interestingly, we found a strong β2-ARs expression in the tumors that were significantly reduced after prolonged treatment with β2-Ars inhibitor (ICI) and EGFR mAb Cetuximab (CTX) in combination. The β2-ARs down-regulation correlated in mice with a significant tumor growth delay, together with the MAPK signaling switch-off caused by the blockade of the MEK/ERK phosphorylation. We also demonstrated that the administration of ICI and CTX in combination unbalanced the cell ROS homeostasis by blocking the NRF-2 nuclear translocation with the relative down-regulation of the antioxidant enzyme expression. Our findings highlighted for the first time, in a pre-clinical in vivo model, the efficacy of the β2-ARs inhibition in the treatment of the HNSCC, remarkably in combination with CTX, which is the standard of care for unresectable HNSCC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antibodies
  • Antioxidants*
  • Cetuximab / pharmacology
  • Cetuximab / therapeutic use
  • ErbB Receptors
  • Head and Neck Neoplasms*
  • Mice
  • Mitogen-Activated Protein Kinase Kinases
  • Oxidative Stress
  • Squamous Cell Carcinoma of Head and Neck

Substances

  • Antioxidants
  • Antibodies
  • Cetuximab
  • ErbB Receptors
  • Mitogen-Activated Protein Kinase Kinases