Cepharanthine Reverses Gefitinib Resistance in <scp>NSCLC</scp> by Concurrently Inhibiting <scp>AKT</scp> / <scp>P70S6K</scp> Survival Signaling and Activating <scp>STING</scp> ‐Mediated Immune Response

Acquired resistance to Epidermal Growth Factor Receptor (EGFR) tyrosine kinase inhibitors (TKIs), such as gefitinib, remains a major therapeutic challenge in EGFR-mutant non-small cell lung cancer (NSCLC). Here, we report that cepharanthine (CEP), a natural bisbenzylisoquinoline alkaloid, effectively reverses gefitinib resistance through concurrent suppression of the AKT/P70S6K survival axis and activation of the Stimulator of Interferon Genes (STING)-mediated innate immune pathway. In gefitinib-resistant H1975 cells (EGFR L858R/T790M), CEP monotherapy significantly inhibited proliferation and induced mitochondrial apoptosis. Notably, CEP synergized with gefitinib to enhance therapeutic efficacy. RNA sequencing and functional validation revealed that CEP activates the STING/TANK-Binding Kinase 1 (TBK1)/Interferon Regulatory Factor 3 (IRF3) signaling cascade, resulting in robust production of T-cell chemoattractants C-X-C Motif Chemokine Ligand 9 (CXCL9), C-X-C Motif Chemokine Ligand 10 (CXCL10), and C-C Motif Chemokine Ligand 5 (CCL5). Critically, the STING inhibitor H-151 abolished CEP's antitumor effects in vitro. Our findings reveal a novel dual mechanism action of CEP and nominate it as a potential candidate for overcoming TKI resistance in NSCLC.

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Publication Details

Journal
Chemical Biology & Drug Design
Published
2026-04-30
DOI
https://doi.org/10.1111/cbdd.70298
Primary Topic
interferon and immune responses
Type
article
Field-Weighted Citation Impact
0.00

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article

Cepharanthine Reverses Gefitinib Resistance in NSCLC by Concurrently Inhibiting AKT / P70S6K Survival Signaling and Activating STING ‐Mediated Immune Response

Tong- tong Lv, Zebo Jiang, Yuehua Chen, Donghui Huang et al.
Chemical Biology & Drug Design
interferon and immune responses
article

Cepharanthine Reverses Gefitinib Resistance in NSCLC by Concurrently Inhibiting AKT / P70S6K Survival Signaling and Activating STING ‐Mediated Immune Response

Tong- tong Lv, Zebo Jiang, Yuehua Chen, Donghui Huang, Liping Kang, Hui-Hui Chen, Hua-Jing Huang
article en

Abstract

Acquired resistance to Epidermal Growth Factor Receptor (EGFR) tyrosine kinase inhibitors (TKIs), such as gefitinib, remains a major therapeutic challenge in EGFR-mutant non-small cell lung cancer (NSCLC). Here, we report that cepharanthine (CEP), a natural bisbenzylisoquinoline alkaloid, effectively reverses gefitinib resistance through concurrent suppression of the AKT/P70S6K survival axis and activation of the Stimulator of Interferon Genes (STING)-mediated innate immune pathway. In gefitinib-resistant H1975 cells (EGFR L858R/T790M), CEP monotherapy significantly inhibited proliferation and induced mitochondrial apoptosis. Notably, CEP synergized with gefitinib to enhance therapeutic efficacy. RNA sequencing and functional validation revealed that CEP activates the STING/TANK-Binding Kinase 1 (TBK1)/Interferon Regulatory Factor 3 (IRF3) signaling cascade, resulting in robust production of T-cell chemoattractants C-X-C Motif Chemokine Ligand 9 (CXCL9), C-X-C Motif Chemokine Ligand 10 (CXCL10), and C-C Motif Chemokine Ligand 5 (CCL5). Critically, the STING inhibitor H-151 abolished CEP's antitumor effects in vitro. Our findings reveal a novel dual mechanism action of CEP and nominate it as a potential candidate for overcoming TKI resistance in NSCLC.

Chemical Biology & Drug DesignVol. 107(5)
Northeastern University (US), Dalian Medical University (CN), Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine (CN)
China Postdoctoral Science Foundation, Basic and Applied Basic Research Foundation of Guangdong Province
Good health and well-being
Openalex Percentile: Top 14%
interferon and immune responses
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