Fifteen percent of
lung cancer cases occur in never-smokers and show characteristics that are molecularly and clinically distinct from those in smokers.
Epidermal growth factor receptor (EGFR) gene mutations, which are correlated with sensitivity to EGFR-
tyrosine kinase inhibitors (EGFR-TKIs), are more frequent in never-smoker
lung cancers. In this study,
microRNA (
miRNA) expression profiling of 28 cases of never-smoker
lung cancer identified aberrantly expressed
miRNAs, which were much fewer than in
lung cancers of smokers and included
miRNAs previously identified (e.g., up-regulated miR-21) and unidentified (e.g., down-regulated miR-138) in those smoker cases. The changes in expression of some of these
miRNAs, including miR-21, were more remarkable in cases with EGFR mutations than in those without these mutations. A significant correlation between phosphorylated-EGFR (p-EGFR) and miR-21 levels in lung
carcinoma cell lines and the suppression of miR-21 by an EGFR-TKI,
AG1478, suggest that the EGFR signaling is a pathway positively regulating miR-21 expression. In the never-smoker-derived
lung adenocarcinoma cell line H3255 with mutant EGFR and high levels of p-EGFR and miR-21, antisense inhibition of miR-21 enhanced AG1478-induced apoptosis. In a never-smoker-derived
adenocarcinoma cell line H441 with wild-type EGFR, the antisense miR-21 not only showed the additive effect with
AG1478 but also induced apoptosis by itself. These results suggest that aberrantly increased expression of miR-21, which is enhanced further by the activated EGFR signaling pathway, plays a significant role in lung
carcinogenesis in never-smokers, as well as in smokers, and is a potential therapeutic target in both EGFR-mutant and wild-type cases.