Biphasic function of GSK3β in gefitinib‑resistant NSCLC with or without EGFR mutations.

Epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs), such as gefitinib, are effective in the treatment of non-small cell lung cancer (NSCLC) harboring EGFR mutations. However, the mechanism underlying acquired resistance to EGFR-TKIs remains largely unknown. Therefore, the present study generated gefitinib-resistant PC-9 (PC-9G) cells, which were revealed to be more resistant to gefitinib-induced reductions in proliferation, migration and invasion, and increases in apoptosis, and had no detectable EGFR mutations compared with the control PC-9 cell line. In addition, the present study performed genome-wide transcriptomic analysis of differentially expressed genes between PC-9 and PC-9G cell lines. Cell proliferation, colony formation, invasion, migration and flow cytometry analyses were also performed. The genome-wide transcriptomic analysis revealed that glycogen synthase kinase 3β (GSK3β) was downregulated in PC-9G cells compared with that in PC-9 cells. Furthermore, GSK3β overexpression increased the proliferation, migration and invasion of PC-9 and H1975 gefitinib-resistant cells. Conversely, overexpression of GSK3β suppressed the proliferation, migration and invasion of PC-9G cells. Furthermore, AKT inhibition reduced the proliferation, migration and invasion, and induced the apoptosis of PC-9, PC-9G and H1975 cells, the effects of which were reversed following AKT activation; notably, the tumor suppressor function of GSK3β was inconsistent with the tumor promotor role of the AKT pathway in PC-9G cells without EGFR mutation. The present study may provide novel insights into the distinctive role of GSK3β in gefitinib-resistant NSCLC with or without EGFR mutations, suggesting that a more detailed investigation on GSK3β as a therapeutic target for gefitinib-resistant NSCLC may be warranted.