American Association for Cancer Research
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Supplementary Table S9 from Germline USP36 Mutation Confers Resistance to EGFR-TKIs by Upregulating MLLT3 Expression in Patients with Non–Small Cell Lung Cancer

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posted on 2024-04-01, 07:23 authored by Shaoxing Guan, Xi Chen, Yuru Wei, Fei Wang, Wen Xie, Youhao Chen, Heng Liang, Xia Zhu, Yunpeng Yang, Wenfeng Fang, Yan Huang, Hongyun Zhao, Xiaoxu Zhang, Shu Liu, Wei Zhuang, Min Huang, Xueding Wang, Li Zhang

Table S9.The frequency data of rs3744797.


National Natural Science Foundation of China (NSFC)

National Key Research and Development Program of China (NKPs)

Guangdong Provincial Key Laboratory of Construction Foundation (广东省重点实验室项目)

Science and Technology Program of Guangzhou

National Engineering and Technology Research Center for New drug Druggability Evaluation Seed Program of Guangdong Province

the 111 project

Natural Science Foundation of Guangdong Province

Wu Jie-ping Medical Foundation



Although somatic mutations were explored in depth, limited biomarkers were found to predict the resistance of EGFR tyrosine kinase inhibitors (EGFR-TKI). Previous studies reported N6-methyladenosine (m6A) levels regulated response of EGFR-TKIs; whether the germline variants located in m6A sites affected resistance of EGFR-TKIs is still unknown. Patients with non–small cell lung cancer (NSCLC) with EGFR-activating mutation were enrolled to investigate predictors for response of EGFR-TKIs using a genome-wide-variant-m6A analysis. Bioinformatics analysis and series of molecular biology assays were used to uncover the underlying mechanism. We identified the germline mutation USP36 rs3744797 (C > A, K814N) was associated with survival of patients with NSCLC treated with gefitinib [median progression-free survival (PFS): CC vs. CA, 16.30 vs. 10.50 months, P < 0.0001, HR = 2.45] and erlotinib (median PFS: CC vs. CA, 14.13 vs. 9.47 months, P = 0.041, HR = 2.63). Functionally, the C > A change significantly upregulated USP36 expression by reducing its m6A level. Meanwhile, rs3744797_A (USP36 MUT) was found to facilitate proliferation, migration, and resistance to EGFR-TKIs via upregulating MLLT3 expression in vitro and in vivo. More importantly, MLLT3 and USP36 levels are tightly correlated in patients with NSCLC, which were associated with prognosis of patients. Mechanistically, USP36 MUT stabilized MLLT3 by deubiquitinating MLLT3 in nucleoli and consequently activating its downstream signaling (HIF1α and Snai). Furthermore, inhibition of MLLT3 alleviated USP36 variant–induced EGFR-TKIs resistance in EGFR-mutant NSCLC. These findings characterized rs3744797 as an oncogenic variant in mediating EGFR-TKI resistance and tumor aggressiveness through deubiquitinating MLLT3, highlighting the variant as a predictive biomarker for EGFR-TKI response in NSCLC.