ELP-dependent expression of MCL1 promotes resistance to EGFR inhibition in triple-negative breast cancer cells

ABSTRACT Targeted therapies for the treatment of cancer are generally thought to exploit oncogene addiction, a phenomenon in which a single oncogene controls both the growth and survival of the tumor cell. Many well-validated examples of oncogene addiction exist; however, the utility of oncogene targeted therapies varies substantially by cancer context, even among cancers in which the targeted oncogene is similarly dysregulated. For instance, epidermal growth factor receptor (EGFR) signaling can be effectively targeted in EGFR-mutant non-small cell lung cancer (NSCLC), but not in triple-negative breast cancer (TNBC), where EGFR is activated to a similar degree. We find that EGFR controls a similar signaling/transcriptional network in TNBC and EGFR-mutant NSCLC cells, but only NSCLC cells respond to EGFR inhibition by activating cell death. To address this paradox and identify mechanisms that contribute to insensitivity to EGFR inhibition in TNBC, we performed a genome-wide CRISPR-Cas9 genetic knockout screen. Our screen identifies the Elongator (ELP) complex as a mediator of insensitivity to EGFR inhibition in TNBC. Depleting ELP proteins caused high levels of apoptotic cell death, in an EGFR inhibition-dependent manner. We find that the tRNA-modifying function of the ELP complex promotes drug insensitivity, by facilitating expression of the anti-apoptotic protein MCL1. Furthermore, pharmacological inhibition of MCL1 synergizes with EGFR inhibition across a panel of genetically diverse TNBC cells. Taken together, we find that TNBC “addiction” to EGFR signaling is masked by the ELP complex, and our study provides an actionable therapeutic strategy to overcome this resistance mechanism by co-targeting EGFR and MCL1. One sentence summary The Elongator Protein (ELP) Complex masks TNBC oncogene “addiction” to EGFR signaling, by promoting expression of the anti-apoptotic protein MCL1.