Supplementary Figure 3. Combined use of SHP099 with alectinib, crizotinib or osimertinib Cell viability after treatment with a single agent or a combination of agents relative to the control (set to 1). All drugs were loaded for 96 h. Error bars represent the standard error. *P < 0.01 (one-way ANOVA and the Bonferroni method). S, SHP099; A, alectinib; C, crizotinib; O, osimertinib.
ARTICLE ABSTRACTAfter molecular-targeted therapy, some cancer cells may remain that are resistant to therapies targeting oncogene alterations, such as those in the genes encoding the EGFR and anaplastic lymphoma kinase (ALK) as well as c-ros oncogene 1 (ROS1). The mechanisms underlying this type of resistance are unknown. In this article, we report the potential role of Src homology 2 domain–containing phosphatase 2 (SHP2) in the residual cells of ALK/ROS1/EGFR-altered non–small cell lung cancer (NSCLC). Molecular-targeted therapies failed to inhibit the ERK signaling pathway in the residual cells, whereas the SHP2 inhibitor SHP099 abolished their remaining ERK activity. SHP099 administered in combination with molecular-targeted therapy resulted in marked growth inhibition of cancer cells both in vitro and in vivo. Thus, treatment combining an SHP2 inhibitor and a tyrosine kinase inhibitor may be a promising therapeutic strategy for oncogene-driven NSCLC.