Cancer Chemotherapy and Pharmacology

, Volume 66, Issue 2, pp 381–388 | Cite as

Combined inhibition of IGFR enhances the effects of gefitinib in H1650: a lung cancer cell line with EGFR mutation and primary resistance to EGFR-TK inhibitors

  • Yun Jung Choi
  • Jin Kyung Rho
  • Byung-suk Jeon
  • Su Jin Choi
  • Su Cheol Park
  • Seung Sook Lee
  • Hye-Ryoun Kim
  • Cheol Hyeon Kim
  • Jae Cheol LeeEmail author
Original Article



H1650 non-small cell lung cancer (NSCLC) cells display primary resistance to epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) although they have a deletion mutation on exon 19 of the EGFR gene. We investigated the effect of inhibition of both insulin-like growth factor receptor (IGFR) and EGFR signaling considering that IGFR signaling pathway has been implicated in the development and progression with therapeutic resistance of various cancers including lung cancer.


Three human NSCLC cell lines with an EGFR mutation of PC-9, HCC827 and H1650 were used for experiment. Cell viability and proliferative activity were assessed by MTT and three-dimensional culture assay. Combination index was obtained by CalcuSyn software. The change of EGFR- and IGFR-related signals was evaluated by western blots.


H1650 cells were 1,000 times more resistant to gefitinib and erlotinib than HCC827 and PC-9 cells possessing the same EGFR mutation. Phosphatase and tensin homolog loss and sustained phosphorylation of Akt in spite of treatment with gefitinib were evident only in H1650 cells. Interestingly, IGFR phosphorylation was decreased by gefitinib in HCC827 and PC-9 cells while being maintained in H1650 cells. Combined treatment with the IGFR inhibitors α-IR3 and AG1024 enhanced gefitinib-induced growth inhibition and apoptosis, and down-regulated phosphorylation of Akt, EGFR and IGFR.


Combined inhibition of IGFR signaling enhances the growth inhibitory and apoptosis-inducing effects of gefitinib, suggesting that this approach could be useful to overcome the primary resistance to EGFR-TKIs in lung cancer.


Lung cancer Primary resistance EGFR IGFR 



We thank Sun Ah Park for expert technical assistance.

Conflict of interest statement



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Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Yun Jung Choi
    • 1
    • 3
  • Jin Kyung Rho
    • 1
  • Byung-suk Jeon
    • 1
    • 2
  • Su Jin Choi
    • 1
  • Su Cheol Park
    • 1
    • 4
  • Seung Sook Lee
    • 2
    • 3
  • Hye-Ryoun Kim
    • 1
  • Cheol Hyeon Kim
    • 1
  • Jae Cheol Lee
    • 1
    • 3
    Email author
  1. 1.Department of Internal Medicine, Korea Cancer Center HospitalKorea Institute of Radiological and Medical ScienceSeoulKorea
  2. 2.Department of Pathology, Korea Cancer Center HospitalKorea Institute of Radiological and Medical ScienceSeoulKorea
  3. 3.University of Science and TechnologyDaejeonKorea
  4. 4.Department of Internal MedicineKangwon National University College of MedicineChuncheonKorea

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