N6-methyladenosine regulated FGFR4 attenuates ferroptotic cell death in recalcitrant HER2-positive breast cancer

Y Zou, S Zheng, X Xie, F Ye, X Hu, Z Tian… - Nature …, 2022 - nature.com
Y Zou, S Zheng, X Xie, F Ye, X Hu, Z Tian, SM Yan, L Yang, Y Kong, Y Tang, W Tian, J Xie
Nature communications, 2022nature.com
Intrinsic and acquired anti-HER2 resistance remains a major hurdle for treating HER2-
positive breast cancer. Using genome-wide CRISPR/Cas9 screening in vitro and in vivo, we
identify FGFR4 as an essential gene following anti-HER2 treatment. FGFR4 inhibition
enhances susceptibility to anti-HER2 therapy in resistant breast cancer. Mechanistically,
m6A-hypomethylation regulated FGFR4 phosphorylates GSK-3β and activates β-
catenin/TCF4 signaling to drive anti-HER2 resistance. Notably, suppression of FGFR4 …
Abstract
Intrinsic and acquired anti-HER2 resistance remains a major hurdle for treating HER2-positive breast cancer. Using genome-wide CRISPR/Cas9 screening in vitro and in vivo, we identify FGFR4 as an essential gene following anti-HER2 treatment. FGFR4 inhibition enhances susceptibility to anti-HER2 therapy in resistant breast cancer. Mechanistically, m6A-hypomethylation regulated FGFR4 phosphorylates GSK-3β and activates β-catenin/TCF4 signaling to drive anti-HER2 resistance. Notably, suppression of FGFR4 dramatically diminishes glutathione synthesis and Fe2+ efflux efficiency via the β-catenin/TCF4-SLC7A11/FPN1 axis, resulting in excessive ROS production and labile iron pool accumulation. Ferroptosis, a unique iron-dependent form of oxidative cell death, is triggered after FGFR4 inhibition. Experiments involving patient-derived xenografts and organoids reveals a synergistic effect of anti-FGFR4 with anti-HER2 therapy in breast cancer with either intrinsic or acquired resistance. Together, these results pinpoint a mechanism of anti-HER2 resistance and provide a strategy for overcoming resistance via FGFR4 inhibition in recalcitrant HER2-positive breast cancer.
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