NEK7 induced phosphorylation of EGFR on serine 1070 drive the acquired lenvatinib resistance in hepatocellular carcinoma

Background and Aims: Lenvatinib is recognized as a first-line therapy for inoperable hepatocellular carcinoma (HCC) patients. Growing evidence indicates that the lenvatinib resistance can be acquired in HCC cells via kinase rewiring. Approach and Results: We established acquired lenvatinib resistance organoids and HCC cell lines. NIMA-related coiled-coil kinase 7 (NEK7) was identified as an HCC lenvatinib acquired resistance gene by kinase CRISPR–Cas9 genetic screen. Functional analyses demonstrate that NEK7 enhanced lenvatinib resistance in HCC and NEK7 knock down or knock out display the anti-tumor effects in acquired lenvatinib HCC cells and organoids. Mechanistically, NEK7 binds to EGFR, leading to the phosphorylation of EGFR (Endothelial growth factor receptor) specifically at the serine 1070 residue, which contributes to the activation of MAPK (Mitogen-activated protein kinase) and PI3K/AKT (Phosphoinositide 3-kinase/Akt) signaling pathways. Consistently, designed inhibitory peptides targeting domain from amino acids 979 to 1099 were proved to inhibit phosphorylation of EGFR S1070 site and therapeutically inhibit anti-tumor of acquired lenvatinib resistance HCC. Conclusions: Our results unveil insights into the acquired lenvatinib resistance mechanism that NEK7 phosphorylates EGFR at S1070 to promote acquired lenvatinib resistance in HCC.