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Article

Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer

  • Authors:
    • Min Wu
    • Yuan Yuan
    • Yue-Yin Pan
    • Ying Zhang
  • View Affiliations / Copyright

    Affiliations: Department of Geriatrics, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230061, P.R. China, The Central Laboratory of Binhu Hospital, The Third Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230061, P.R. China, Department of Oncology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui 230022, P.R. China
  • Pages: 931-938
    |
    Published online on: May 16, 2014
       https://doi.org/10.3892/mmr.2014.2243
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Abstract

Currently, chemotherapy and targeted therapies share the principal limitation of the emergence of drug resistance, which prevents these strategies from having lasting clinical benefits. The combination of epidermal growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) with concurrent chemotherapy has been proposed as one strategy to overcome acquired resistance to EGFR-TKIs. The purpose of the present study was to investigate the combined effects of gefitinib and pemetrexed on EGFR-TKI-sensitive and EGFR‑TKI‑resistant human non-small cell lung cancer (NSCLC) cell lines. The antiproliferative effects of gefitinib and pemetrexed, alone and in combination, on the growth of NSCLC cell lines, were assessed using an MTT assay. The cytotoxic interaction between the two drugs was evaluated in vitro using the combination index (CI) method. Cell cycle distribution and apoptosis were analyzed by flow cytometry and alterations in signaling pathways were determined by western blot analysis. In the present study, it was identified that when cells were concurrently exposed to pemetrexed and gefitinib, cytotoxic synergism was present in the gefitinib-resistant PC9/GR human NSCLC cell line and antagonistic interactions were observed in the gefitinib-sensitive PC9 cell line. Synergism was associated with a combination of cell cycle effects of the different agents. In addition, the combination of pemetrexed and gefitinib decreased the levels of phosphorylated AKT, phosphorylated extracellular-signal-regulated kinase and B-cell lymphoma 2 as compared with those in the control. By contrast, antagonism was associated with gefitinib-induced G0/G1-phase blockade of gefitinib-sensitive cells, which interfered with the cell cycle-specific cytotoxicity of chemotherapy. The combination of pemetrexed and gefitinib generated synergistic effects in gefitinib-acquired resistant cells and antagonistic effects in gefitinib-sensitive cells, suggesting that EGFR-TKIs combined with pemetrexed may be a beneficial treatment strategy for NSCLC patients with acquired resistance to EGFR-TKIs.
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Copy and paste a formatted citation
Spandidos Publications style
Wu M, Yuan Y, Pan Y and Zhang Y: Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer. Mol Med Rep 10: 931-938, 2014.
APA
Wu, M., Yuan, Y., Pan, Y., & Zhang, Y. (2014). Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer. Molecular Medicine Reports, 10, 931-938. https://doi.org/10.3892/mmr.2014.2243
MLA
Wu, M., Yuan, Y., Pan, Y., Zhang, Y."Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer". Molecular Medicine Reports 10.2 (2014): 931-938.
Chicago
Wu, M., Yuan, Y., Pan, Y., Zhang, Y."Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer". Molecular Medicine Reports 10, no. 2 (2014): 931-938. https://doi.org/10.3892/mmr.2014.2243
Copy and paste a formatted citation
x
Spandidos Publications style
Wu M, Yuan Y, Pan Y and Zhang Y: Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer. Mol Med Rep 10: 931-938, 2014.
APA
Wu, M., Yuan, Y., Pan, Y., & Zhang, Y. (2014). Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer. Molecular Medicine Reports, 10, 931-938. https://doi.org/10.3892/mmr.2014.2243
MLA
Wu, M., Yuan, Y., Pan, Y., Zhang, Y."Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer". Molecular Medicine Reports 10.2 (2014): 931-938.
Chicago
Wu, M., Yuan, Y., Pan, Y., Zhang, Y."Combined gefitinib and pemetrexed overcome the acquired resistance to epidermal growth factor receptor tyrosine kinase inhibitors in non-small cell lung cancer". Molecular Medicine Reports 10, no. 2 (2014): 931-938. https://doi.org/10.3892/mmr.2014.2243
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