Activation of epigenetic reprogramming via crotonylation overcomes resistance to EGFR-TKI therapy in lung cancer

S Sihong Chen (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) M Mengyan Zhong (Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University) X Xiaoyuan Wang (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) Y Youwei Su (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) Y Yingxi Zhao (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) S Simeng Wang (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) S Shougeng Liu (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) Y Yongshan Zhao (Department of Biochemistry and Molecular Biology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) Y Yang Zhang X Xinyu Fan (Department of Pharmacy, Shengjing Hospital of China Medical University) Z Zongang Liu L Lina Jia (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) X Xuefei Bao (Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University) W Wei Cui (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) J Jingyu Yang (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) C Chunfu Wu (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University) G Guoliang Chen (Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University) L Lihui Wang (Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University)

Abstract

Posttranslational modifications (PTMs) on histones play critical roles in cellular processes, including gene expression and tumorigenesis. However, the regulatory mechanisms and functional consequences of newly identified lysine acylation modifications in cancer therapy remain to be elucidated. Here, we established diverse preclinical tumor models resistant to epithelial growth factor receptor tyrosine kinase inhibitors (EGFR-TKIs) and focused on histone lysine crotonylation (Kcr), as it exhibited more pronounced alterations compared to other acylations. Next, we identified acyl-CoA synthetase short-chain family member 2 as a key regulator responsible for the resistance-associated decrease in crotonylation levels. Furthermore, integrated crotonylomic, transcriptomic, and epigenomic profiling, supplemented by gene manipulation studies, revealed that EGFR-TKI resistance resulted from transcriptional suppression of HNF1A and activation of the PI3K/AKT signaling pathway, which were regulated by reduced histone H3 lysine 56 crotonylation. Importantly, through pharmacological screening, we identified a histone decrotonylase inhibitor that enhanced EGFR-TKI sensitivity by activating epigenetic reprogramming through the selective upregulation of histone Kcr levels across multiple models in vitro and in vivo. Collectively, our findings uncover a previously unrecognized epigenetic mechanism driven by crotonylation that contributes to EGFR-TKI resistance, highlighting the potential of modulating crotonylation as a novel therapeutic strategy to enhance the efficacy of EGFR-TKIs in lung cancer.

Article Details

Volume / Issue Vol. 122, Issue 40
Published October 07, 2025
ISSN 0027-8424
Publisher National Academy of Sciences

Authors (18)

S

Sihong Chen

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

M

Mengyan Zhong

Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University

X

Xiaoyuan Wang

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

Y

Youwei Su

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

Y

Yingxi Zhao

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

S

Simeng Wang

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

S

Shougeng Liu

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

Y

Yongshan Zhao

Department of Biochemistry and Molecular Biology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

Y

Yang Zhang

X

Xinyu Fan

Department of Pharmacy, Shengjing Hospital of China Medical University

Z

Zongang Liu

L

Lina Jia

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

X

Xuefei Bao

Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University

W

Wei Cui

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

J

Jingyu Yang

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

C

Chunfu Wu

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University

G

Guoliang Chen

Key Laboratory of Structure-Based Drug Design and Discovery of Ministry of Education, Department of Medicinal Chemistry, School of Pharmaceutical Engineering, Shenyang Pharmaceutical University

L

Lihui Wang

Department of Pharmacology, School of Life Science and Biopharmaceutics, Shenyang Pharmaceutical University