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bioRxiv · 10.1101/2025.01.17.633515

Concurrent PIK3CA mutant drives cachexia through inflammatory signaling in EGFR mutant lung cancer

Yue, M.·Qin, Z.·Tang, S.·Cai, X.·Zhao, Y.·Chen, L.·Ji, h.
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Abstract

PIK3CA mutation is frequently concurrent with known oncogenic drivers such as EGFR mutation in lung cancer, raising an interesting question about its real function. Cachexia is a systemic disease involving complex interaction between primary tumors and distant organs, significantly contributing to cancer-related mortality. Through integrative study of genetically engineered mouse models (GEMMs) and clinical data, we find concurrent PIK3CA mutant preferentially drives cachexia in EGFR-mutant lung cancer, promoting malignant progression instead of cancer initiation. PIK3CA mutant-mediated cachexia could be overcome by osimertinib (Osi) treatment in Osi-sensitive GEMM. In contrast, chemotherapy, routinely used in clinic for those relapsed from Osi therapy, fails to ameliorate cachexia in Osi-resistant GEMM despite notable tumor suppression. PIK3CA mutant-driven cachexia is mediated through NF-{kappa}B activation and could be dampened by combined aspirin treatment. This work uncovers the biological function of PIK3CA mutant and mechanism behinds its clinical impacts, and proposes a potentially effective strategy for clinical management.

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Yue, M., Qin, Z., Tang, S., Cai, X., Zhao, Y., Chen, L., Ji, h.. 2025-01-21. Concurrent PIK3CA mutant drives cachexia through inflammatory signaling in EGFR mutant lung cancer. https://doi.org/10.1101/2025.01.17.633515

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