BMP4-driven morphogenetic reprogramming sustains EGFR-TKI resistance via SOX2 suppression and EMT activation - 23/04/26
, Jen-Chung Ko c, ⁎ 
Abstract |
Drug-resistant cells pose a major challenge to targeted therapy in EGFR-mutant lung adenocarcinoma (LUAD), yet the survival pathways they depend on remain unclear. Here, we identify BMP4 signaling as a key driver of resistance and therapeutic persistence. BMP4 is selectively enriched in EGFR-TKI–selected resistant cells, where it suppresses SOX2 and promotes an epithelial–mesenchymal transition (EMT)-like state. Knockdown of BMP4 or its receptor BMPR2 triggered apoptosis, upregulated pro-apoptotic factors (BAD, BMF), and impaired colony formation. Pharmacologic or inducible inhibition of BMP4 sensitized resistant cells, as well as residual tolerant populations in EGFR-TKI–sensitive cells, to osimertinib, while BMP4 enrichment also conferred cisplatin tolerance. Mechanistically, TGF-β1 induced BMP4 expression, and HDAC1/2 inhibition de-repressed BMP4, establishing a cytokine–epigenetic axis that maintains the BMP4 high /SOX2 low phenotype. Clinical analyses further revealed that BMP4 expression correlates with EMT signatures, chemoresistance pathways, and poor patient survival. These findings define a developmental signaling network in which BMP4 suppresses SOX2 to promote EMT, sustain resistant cell survival, and drive therapeutic resistance. Targeting the BMP4 axis presents a promising strategy for overcoming resistance in EGFR-mutant LUAD.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | BMP4 is enriched in EGFR-TKI–resistant cells and suppresses SOX2 expression. |
• | BMP4 promotes EMT and sustains survival of resistant LUAD cell populations. |
• | Targeting BMP4 or BMPR2 sensitizes EGFR-mutant cells to EGFR-TKIs and cisplatin. |
• | TGF-β1 and HDAC1/2–mediated epigenetic remodeling cooperatively induce BMP4 expression. |
• | High BMP4 expression is associated with EMT activation and poor prognosis in EGFR-mutant LUAD. |
Keywords : Resistance, EGFR, BMP4, LUAD, EMT
Plan
Vol 198
Article 119281- mai 2026 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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