Non-small
cell lung cancer (NSCLC) is challenging to treat due
to acquired drug resistance, leading to high mortality rates. NSCLC
patients with mutations in the epidermal growth factor receptor (EGFR)
region are treated with tyrosine kinase inhibitors (TKI) as a first-line
treatment, but many develop resistance within 1–2 years. AXL
overexpression contributes to drug resistance in over 25% of patients,
as shown by tumor analyses, prompting efforts to develop small-molecule
inhibitors targeting AXL. However, we found that AXL repression increases
compensatory FN14 signaling that could affect the therapeutic efficacy.
Therefore, we chose to evaluate therapeutic efficacy after silencing
both AXL and FN14 genes using short interfering RNA (siRNA) therapy.
While siRNAs are more selective than small-molecule inhibitors, they
are prone to in vivo degradation. To address this, we developed gelatin
nanoparticles carrying siRNAs targeting AXL and FN14 (GsiAF). These
nanoparticles were designed to protect siRNA from serum degradation
and to allow antibody functionalization on their surface. We demonstrate
that GsiAF selectively and effectively silences the respective genes
under both in vitro and in vivo conditions, thereby overcoming compensatory
FN14 signaling. Results indicate that GsiAF was successful in delivering
siRNAs to tumors and downregulating both AXL and FN14 genes. We show
that coinhibition of AXL and FN14 has effectively decreased TKI resistance
in cancer cells and significantly reduced tumor growth in mice bearing
lung cancer. The gelatin-siRNA nanoconstruct combined with TKI represents
a promising strategy for overcoming drug resistance in NSCLC and other
cancers, with potential for future clinical translation.