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Disrupting aberrant EGFR catalytic trimers reverses T790M gefitinib resistance

S. K. Roberts, I. Galdadas, N. Piasentin, S. R. Needham, L. C. Zanetti-Domingues, B. M. Davis, R. C. H. Man, D. T. Clarke, A. H. A. Clayton, D. J. Rolfe, G. O. Fruhwirth, F. L. Gervasio, M. L. Martin-Fernandez

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En palabras de los autores

Epidermal growth factor receptor (EGFR) mutations drive up to 50% of non-small-cell lung cancers (NSCLC). Although tyrosine kinase inhibitors provide substantial clinical benefit, remissions are prematurely terminated by the inevitable acquisition of on-target resistance. Beyond structural changes that alter ATP-pocket affinity, EGFR oligomerization drives this resistance, though the underlying mechanisms remain unclear. Here we show that progressive secondary and tertiary resistant NSCLC EGFR-mutants form ligand-free cell surface oligomers that contain catalytic trimers instead of the canonical dimers found within these oligomers in wild-type and gefitinib-sensitive EGFR-mutants. Genetically disrupting these pathological trimers into dimers via a single-point mutation rewires downstream signaling, decelerates tumor progression, and reverses gefitinib resistance in vivo. Conversely, genetic engineering of dimers into trimers reinstates normal tumor growth. These findings reveal a structural vulnerability specific to these refractory variants, demonstrating that targeting intra-oligomer interactions can overcome resistance, and providing a blueprint for protein-protein interface modulation strategies in NSCLC.

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Apareció: sábado, 26 de septiembre. bioRxiv. Preprint, todavía sin revisión por pares.

DOI: 10.64898/2026.09.24.754095