<p>Oncogenic alterations in EGFR frequently co-occur with additional genetic alterations in EGFR-driven lung adenocarcinoma (LUAD), but how specific combinations of mutations affect tumor phenotypes and responses to targeted therapy is yet unknown. We leveraged a genetically engineered mouse model of <a href="https://www.ncbi.nlm.nih.gov/gene/1956">EGFR</a> mutant/<a href="https://www.ncbi.nlm.nih.gov/gene/22059">Trp53</a>-deficient LUAD to study the consequences of inactivating 10 different tumor suppressor genes on the fitness and tyorosine kinase inhibitor (TKI) sensitivity of these tumors. We found that loss of <a href="https://www.ncbi.nlm.nih.gov/gene/50868">Keap1</a> is associated with a reduced response to therapy. In patients, we found that mutations in the  <a href="https://www.ncbi.nlm.nih.gov/gene/9817">KEAP1</a>/<a href="https://www.ncbi.nlm.nih.gov/gene/4780">NFE2L2</a>/<a href="https://www.ncbi.nlm.nih.gov/gene/8452">CUL3</a> pathway are associated with a significantly shorter time to treatment failure for EGFR TKI therapy compared to matched patients with wild-type KEAP1/NFE2L2/CUL3 tumors. We also analyzed whole exome sequencing data from tumor specimens before TKI treatment and at the time of treatment resistance for mutations in the KEAP1 pathway and these data are being submitted here.  </p>

Genetic Determinants of EGFR-Driven Lung Cancer Growth and Therapeutic Response In Vivo

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