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.
Authors
- Tong- tong Lv
- Zebo Jiang
- Yuehua Chen (ORCID: https://orcid.org/0009-0006-1343-7449)
- Donghui Huang (ORCID: https://orcid.org/0000-0002-2291-2524)
- Liping Kang
- Hui-Hui Chen
- Hua-Jing Huang
Institutions
- Northeastern University (US)
- Dalian Medical University (CN)
- Zhuhai Hospital of Integrated Traditional Chinese and Western Medicine (CN)
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
Funders
- China Postdoctoral Science Foundation
- Basic and Applied Basic Research Foundation of Guangdong Province