AXL Mediates Cetuximab and Radiation Resistance through Tyrosine 821 and the c-ABL Kinase Pathway in Head and Neck Cancer

Nellie K. McDaniel, Mari Iida, Kwangok P. Nickel, Colin A. Longhurst, Samantha R. Fischbach, Tamara S. Rodems, Carlene A. Kranjac, Amber Y. Bo, Qianyun Luo, Meghan M. Gallagher, Noah B. Welke, Kaitlyn R. Mitchell, Alison E. Schulz, Jaimee C. Eckers, Rong Hu, Ravi Salgia, Seungpyo Hong, Justine Y. Bruce, Randall J. Kimple, Deric L. Wheeler

Research output: Contribution to journalArticlepeer-review

14 Citations (Scopus)


Purpose: Radiation and cetuximab are therapeutics used in management of head and neck squamous cell carcinoma (HNSCC). Despite clinical success with these modalities, development of both intrinsic and acquired resistance is an emerging problem in the management of this disease. The purpose of this study was to investigate signaling of the receptor tyrosine kinase AXL in resistance to radiation and cetuximab treatment. Experimental Design: To study AXL signaling in the context of treatment-resistant HNSCC, we used patient-derived xenografts (PDXs) implanted into mice and evaluated the tumor response to AXL inhibition in combination with cetuximab or radiation treatment. To identify molecular mechanisms of how AXL signaling leads to resistance, three tyrosine residues of AXL (Y779, Y821, Y866) were mutated and examined for their sensitivity to cetuximab and/or radiation. Furthermore, reverse phase protein array (RPPA) was employed to analyze the proteomic architecture of signaling pathways in these genetically altered cell lines. Results: Treatment of cetuximab- and radiation-resistant PDXs with AXL inhibitor R428 was sufficient to overcome resistance. RPPA analysis revealed that such resistance emanates from signaling of tyrosine 821 of AXL via the tyrosine kinase c-ABL. In addition, inhibition of c-ABL signaling resensitized cells and tumors to cetuximab or radiotherapy even leading to complete tumor regression without recurrence in head and neck cancer models. Conclusions: Collectively, the studies presented herein suggest that tyrosine 821 of AXL mediates resistance to cetuximab by activation of c-ABL kinase in HNSCC and that targeting of both EGFR and c-ABL leads to a robust antitumor response.

Original languageEnglish
Pages (from-to)4349-4359
Number of pages11
JournalClinical Cancer Research
Issue number16
Publication statusPublished - 2020 Aug 15

Bibliographical note

Funding Information:
R.J. Kimple reports receiving commercial research grants from Ignyta and is an unpaid consultant/advisory board member for Galera Therapeutics. No potential conflicts of interest were disclosed by the other authors.

Publisher Copyright:
©2020 American Association for Cancer Research.

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research


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