Phase 1

Week 1 1st -7th May

1.

Vector design:The vector design of pET-24(+)_peptide was completed.

Figure 1 Vector design of pET-24d(+)-Ebp

Week 2 8th -14th May

2.

Transformation to TOP10: Ligated products were transformed into competent TOP10 cells through the heat shock method. As seen in Figure 2, the plate for pET-24d showed multiple colonies after overnight incubation on LB-Kan agar plates without any contamination.

Figure 2 LB agar plate with pET-24d(+)- Ebp transformants (TOP10)

Week 3 15th - 21st May

2.

Colonies are picked and inoculated: Two individual colonies were selected from the ligation plate, and each colony was inoculated into a separate tube containing LB broth. The tubes were incubated overnight at 37°C with shaking.

3.

Recombinant plasmid purification: The recombinant plasmid was purified from the cell suspension using TIANprep Mini Plasmid Kit.

4.

Transformation to BL21(DE3) The purified recombinant plasmid was transformed into competent BL21(DE3) cells using the heat shock method. As seen in Figure 3, the plate for pET24d showed multiple colonies after overnight incubation on LB-Kan agar plates; no contamination occurred.

Figure 3 LB agar plate with pET-24d(+)-Ebp transformants [BL21(DE3)]

Week 4 22nd - 28th May

6.

Expression: BL21(DE3) cells carrying the recombinant plasmid pET-24d(+)-Ebp were induced with 0.2 mM IPTG and cultured at 25 °C overnight. Subsequently, the expressed peptide was extracted using lysis buffer and loaded onto a SDS PAGE gel to check for expression. However, the expected size of the peptide (2.4 kDa) was not observed in the SDS PAGE gel.

Troubleshooting:

We reasoned that the failure of expression could be attributed to the insolubility of the protein, which may have been caused by bacterial rupture or peptide degradation. Therefore, for our phase 2 experiment, we designed and tested a cyclic form of the peptide, which is believed to be more resistant to peptide degradation.

Phase 2

Week 5 29th - 4th June

1.

Vector design: The vector designs of pET-24d(+)-Ebp-Ssp-Mxe (ES) and pET-24d(+)-Scrb-Ssp-Mxe (SS) were completed.

Figure 4 Vector design of pET-24d(+)-Ebp-Ssp-Mxe (ES)
Figure 5 Vector design of pET-24d(+)-Scrb-Ssp-Mxe (SS)
2.

Restriction digestion of insert: The PUC-Ebp-Ssp-Mxe and PUC-Scrb-Ssp-Mxe vectors were subjected to restriction digestion using XbaI and HindIII enzymes to generate compatible ends. Subsequently, DNA gel electrophoresis was performed on the restriction-digested products. Upon examination of the gel image (refer to Figure 6), fragments of the desired length (~1500 bp size) were observed in each lane. However, an additional third band was present, indicating the presence of an uncut vector. This is believed to be a result of inadequate reaction time, which did not allow for complete digestion.

Figure 6 DNA gel electrophoresis result of restriction digested vector. Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 and 3, restriction digested pUC-Ebp-Ssp-Mxe (ES); lane 4 and 5, pUC-Scrb-Ssp-Mxe (SS).
3.

Restriction digestion of vector: Restriction digestion of pET-24d(+) vector with XbaI and HindIII to generate compatible ends.

4.

Gel purification of restriction-digested products: Promega gel purification kit was used to purify the digested DNA from the gel. Subsequently, the concentrations were determined using the Nanodrop Spectrophotometer.

5.

Ligation reaction: The digested products were subjected to ligation using T4 DNA Ligase. The resulting ligated product was stored at -20°C in the refrigerator until the next transformation.

Week 6 5th - 11th June

6.

Transformation to TOP10: Ligated products were transformed into competent TOP10 cells through the heat shock method. As seen in Figure 7 and Figure 8, the plate for pET-24d showed multiple colonies after overnight incubation on LB-Kan agar plates without any contamination.

Figure 7 LB agar plate with pET-24d(+)-Ebp-Ssp-Mxe transformants (TOP10).
Figure 8 LB agar plate with pET-24d(+)-Scrb-Ssp-Mxe transformants (TOP10).

Week 7 12th - 18th June

7.

Colonies picking and inoculation: Five individual colonies were picked from the pET24d-Ebp-Ssp-Mxe ligation plate, and each colony was inoculated into a separate tube of LB broth. The tubes were incubated overnight at 37°C with shaking.

8.

Recombinant plasmid purification: The recombinant plasmid was purified from the cell suspension using TIANprep Mini Plasmid Kit.

9.

R.E. of recomb. plasmid S1 for colony selection: The recombinant plasmid was digested with XbaI and HindIII enzymes and subsequently subjected to gel electrophoresis. As shown in Figure 9, all lanes exhibited two bands with lengths of approximately 5000 bp and 1500 bp, equivalent to the sizes of pET and Ebp-Ssp-Mxe, respectively. The insert ES was present in the recombinant plasmid in the TOP10 cells.

Figure 9 DNA gel electrophoresis result of restriction digested pET-24d(+)-Ebp-Ssp-Mxe (ES). Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 to 6, restriction digested pET-24d(+)-Ebp-Ssp-Mxe (ES) from different colonies.

Week 8 19th - 25th June

10.

Colony PCR: Eight individual colonies were picked from the pET-24d-Scrb-Ssp-Mxe ligation plate, and each colony was inoculated into a separate tube of LB broth, as well as a PCR tube containing the master mix. Colony PCR and gel electrophoresis were performed to confirm successful insertion. As seen in Figure 10, all lanes showed a fragment of the desired length (~1700 bp). The additional bands with a size of approximately 300 bp were believed to be primers.

Figure 10 DNA gel electrophoresis result of colony PCR of pET-24d(+)-Scrb-Ssp-Mxe (SS). Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 to 9, PCR products of Scrb-Ssp-Mxe (SS) from different colonies.
11.

Recombinant plasmid purification: TIANprep Mini Plasmid Kit was used to purify the recombinant plasmid in cell suspension.

12.

Glycerol stock: Cells with pET24d-Ebp-Ssp-Mxe and pET24d-Scrb-Ssp-Mxe were stored in glycerol.

Week 9 26th June - 2nd July

13.

Transformation to BL21(DE3): The purified product was transformed into competent BL21(DE3) cells using the heat shock method. As shown in Figure 11 and Figure 12, multiple colonies were observed on LB-Kan agar plates after overnight incubation, indicating successful transformation, and no contamination was detected.

Figure 11 LB agar plate with pET-24d(+)-Ebp-Ssp-Mxe transformants [BL21(DE3)].
Figure 12 LB agar plate with pET-24d(+)-Scrb-Ssp-Mxe transformants [BL21(DE3)].
14.

Colony sequencing result: Selected ES and SS plasmids were sent to BGI for sanger sequencing using the T7 promoter and T7 terminator. After aligning the designed sequence with the sequences sent for analysis, it was found that both the ES and SS sequences are correct.

Week 10 3rd - 9th July

15.

Expression: The Ebp-Ssp-Mxe (ES) expression was induced with IPTG at 25°C overnight. After harvesting the cells through centrifugation and lysing them to obtain soluble and insoluble proteins, the samples were heated at 90°C for 5 minutes and run on an SDS-PAGE gel. As seen in Figure 13, a distinct band with high intensity, corresponding to the overexpressed protein, was observed at approximately 50 kDa molecular weight, indicating successful expression of the soluble protein.

Figure 13 TGX stain free gel showing protein expression of Ebp-Ssp-Mxe (ES). Lane 1, Biorad Precision Plus Protein™ Unstained Protein Standards; lane 2, IPTG induced soluble fraction; lane 3, IPTG induced insoluble fraction; lane 4, uninduced soluble fraction; lane 5, uninduced insoluble fraction. Sol = soluble; Insol = insoluble.

The Scrb-Ssp-Mxe (SS) expression was induced with IPTG at 25°C overnight. After harvesting the cells through centrifugation and lysing the cells to obtain soluble and insoluble proteins, the samples were heated at 90°C for 5 minutes and run on an SDS-PAGE gel. As seen in Figure 14, a clear band with high intensity, corresponding to the overexpressed protein, was observed at approximately 50 kDa molecular weight, indicating successful expression of the soluble protein.

Figure 14 TGX stain free gel showing protein expression of Scrb-Ssp-Mxe (SS). Lane 1, Biorad Precision Plus Protein™ Unstained Protein Standards; lane 2, IPTG induced soluble fraction; lane 3, IPTG induced insoluble fraction; lane 4, uninduced soluble fraction; lane 5, uninduced insoluble fraction. Sol = soluble; Insol = insoluble.
16.

Purification: Glycerol stocks of ES and SS were used to do protein expression in 100 ml of medium, to obtain a sufficient amount of the desired protein. The cells were then harvested by centrifugation (7500 rpm, 4°C, 15 min) and lysed using sonication (30 s+, 30 s-, Amp 60%, 10 min). Subsequently, the soluble protein in the lysate was obtained through centrifugation (8500 rpm, 4°C, 5 min). The soluble protein, which contained the intein splicing BioBrick, was loaded onto the chitin column for one-step purification and cyclization. The column was first equilibrated by the B1 buffer. After loading the sample, B1 buffer was used to wash the unbounded molecules,while buffer B2 and buffer B4 were used for intein 1 and 2 cleavage, by incubation overnight.

17.

Liquid Chromatography-Electrospray Ionization-Mass Spectrometry (LC-ESI-MS) The elution obtained from the purification was subjected to LC-ESI-MS analysis. The analysis results showed that the desired cyclic peptide was not detected.

Troubleshooting:

The absence of the cyclic peptide is believed to be due to the incapability of the Ssp-Mxe intein system to generate short cyclic peptides. Therefore, we employed another intein system called Npu intein, which has been reported as an effective intein for short peptide cyclization.

Phase 3

Week 12 17th - 23th July

1.

Vector design: The vector designs of pET-24d(+)-Ebp-Npu-SsrA (EN), pET-24d(+)-Scrb-Npu-SsrA (SN) and pET-24d(+)-GFP-Npu-SsrA (GN) were completed.

Figure 15 Vector design of pET-24d(+)-Ebp-Npu-SsrA (EN)
Figure 16 Vector design of pET-24d(+)-Scrb-Npu-SsrA (SN)
Figure 17 Vector design of pET-24d(+)-eGFP-Npu-SsrA (GN)
2.

Restriction digestion of insert: The PUC-Ebp-Npu-SsrA, PUC-Scrb-Npu-SsrA, and PUC-GFP-Npu-SsrA vectors were subjected to restriction digestion using XbaI and HindIII enzymes to generate compatible ends. Subsequently, DNA gel electrophoresis was performed on the restriction-digested products. Upon examination of the gel image (refer to Figure 18), fragments of the desired lengths (972 bp and 1653 bp) were observed in each lane. However, an additional third band was present, indicating the presence of an uncut vector. This is believed to be a result of inadequate reaction time, which did not allow for complete digestion.

Figure 18 DNA gel electrophoresis result of restriction digested vector. Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 and 3, restriction digested pUC-Ebp-Npu-SsrA (EN); lane 4 and 5, pUC-Scrb-Npu-SsrA (SN); lane 6 and 7, pUC-GFP-Npu-SsrA (GN).
3.

Restriction digestion of vector: Restriction digestion of pET-24d(+) vector with XbaI and HindIII to generate compatible ends.

4.

Gel purification of restriction-digested products: Promega gel purification kit was used to purify the digested DNA from the gel. Subsequently, the concentrations were determined using the Nanodrop Spectrophotometer.

5.

Ligation reaction: The digested products were subjected to ligation using T4 DNA Ligase. The resulting ligated product was stored at -20°C in the refrigerator until the next transformation.

Week 13 24th - 30th July

6.

Transformation to TOP10: Ligated products were transformed into competent TOP10 cells through the heat shock method. As seen in Figure 19, Figure 20 and Figure 21, plates for pET24d showed multiple colonies after overnight incubation on LB-Kan agar plates without any contamination.

Figure 19 LB agar plate with pET-24d(+)-Ebp-Npu-SsrA transformants (TOP10).
Figure 20 LB agar plate with pET-24d(+)-Scrb-Npu-SsrA transformants (TOP10).
Figure 21 LB agar plate with pET-24d(+)-GFP-Npu-SsrA transformants (TOP10).
7.

Colonies picking and inoculation: Five individual colonies were picked from the pET24d-Ebp-Ssp-Mxe ligation plate, and each colony was inoculated into a separate tube of LB broth. The tubes were incubated overnight at 37°C with shaking.

8.

8. Recombinant plasmid purification: The recombinant plasmid was purified from the cell suspension using TIANprep Mini Plasmid Kit.

Week 14 31st July - 6th August

9.

R.E. of recomb. plasmid EN for colony selection. Recombinant plasmids were digested by XbaI and HindIII, and run through gel electrophoresis. As seen in Figure 22, all lanes showed 2 bands with lengths ~5000bp and ~1000bp which were equivalent to pET and Ebp-Npu-Ssra size. Insert EN was present in the recombinant plasmid in TOP10 cell.

Figure 22 DNA gel electrophoresis result of restriction digested pET-24d(+)-Ebp-Npu-SsrA (EN). Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 to 6, restriction digested pET-24d(+)-Ebp-Npu-SsrA (EN) from different colonies.
10.

Colony PCR: Eight individual colonies were picked from the pET24d-Scrb-Ebp-Npu-Ssp and pET24d-GFP-Npu-SsR ligation plate, and each colony was inoculated into a separate tube of LB broth, as well as a PCR tube containing master mix. Colony PCR and gel electrophoresis were performed to confirm successful insertion.

As seen in Figure 23 from SN, all lanes exhibited a fragment of the desired length (~1200 bp). The additional bands with a size of approximately 300 bp were believed to be primers.

Figure 23 DNA gel electrophoresis result of colony PCR of pET-24d(+)-Scrb-Npu-SsrA (SN). Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 to 8, PCR products of Scrb-Npu-SsrA (SN) from different colonies.

While, for GN in Figure 24 all lanes showed fragments with desired length (~1700bp). The extra bands with ~300bp size are believed to be primers.

Figure 24 DNA gel electrophoresis result of colony PCR of pET-24d(+)-GFP-Npu-SsrA (GN). Lane 1, Thermo Fisher Scientific GeneRuler 1kb DNA Ladder; lane 2 to 9, PCR products of eGFP-Npu-SsrA (GN) from different colonies.
11.

Glycerol stock: Cells with pET-24d(+)-Ebp-Npu-SsrA, pET-24d(+)-Scrb-Npu-SsrA and pET-24d(+)-GFP-Npu-SsrA were stored in glycerol.

12.

Transformation to BL21(DE3): The purified product is transformed into competent BL21(DE3) cells using the heat shock method. As shown in Figure 25, Figure 26, and Figure 27, the plates for pET24d-Ebp-NpuSsrA, pET24d-Scrb-NpuSsrA, and pET24d-GFP-NpuSsrA display multiple colonies after overnight incubation on LB-Kan agar plates, indicating successful transformation without any contamination.

Figure 25 LB agar plate with pET-24d(+)-Ebp-Npu-SsrA transformants [BL21(DE3)].
Figure 26 LB agar plate with pET-24d(+)-Scrb-Npu-SsrA transformants [BL21(DE3)].
Figure 27 LB agar plate with pET-24d(+)-GFP-Npu-SsrA transformants [BL21(DE3)].

Week 15 7th - 13th August

13.

Colony sequencing result: Selected EN, SN and GN plasmids were sent to BGI for sanger sequencing using the T7 promoter and T7 terminator. After aligning the designed sequence with the sequences sent for analysis, it was found that the sequences for EN, SN, and GN were correct.

14.

Expression: EN and SN expressions were induced by IPTG at 25°C for 6 hours. After harvesting the cells through centrifugation and obtaining the soluble and insoluble proteins using a lysis buffer, the samples were run on a PAGE gel under two different conditions. For denatured samples, they were heated at 90°C for 5 minutes, treated with SDS, and then loaded onto the gel. For native samples, they were treated with 2X native gel loading buffer, not boiled, and then loaded onto the gel.

As seen in Figure 28, a clear band with high intensity at the SDS protein lane was shown at ~37kD Mw, and soluble protein EN was successfully expressed.

Figure 28 TGX stain free gel showing protein expression of Ebp-Npu-SsrA (EN). Lane 1 and 6, Biorad Precision Plus Protein™ Unstained Protein Standards; lane 2 and 7, IPTG induced soluble fractions; lane 3 and 8, IPTG induced insoluble fractions; lane 4 and 9, uninduced soluble fractions; lane 5 and 10, uninduced insoluble fractions. Lane 2 to 5 are denatured samples while lane 7 to 10 are native samples. Sol = soluble; Insol = insoluble.

At the same time, in Figure 29, a distinct band at the native protein lane was shown at ~40kD Mw and soluble protein SN was successfully expressed.

Figure 29 TGX stain free gel showing protein expression of Scrb-Npu-SsrA (SN). Lane 1 and 6, Biorad Precision Plus Protein™ Unstained Protein Standards; lane 2 and 7, IPTG induced soluble fractions; lane 3 and 8, IPTG induced insoluble fractions; lane 4 and 9, uninduced soluble fractions; lane 5 and 10, uninduced insoluble fractions. Lane 2 to 5 are denatured samples while lane 7 to 10 are native samples. Sol = soluble; Insol = insoluble.

GN expression was induced by ITPG under 37C and 3 hours. After harvesting the cells through centrifugation and lysing the cells to obtain soluble and insoluble proteins, the samples were run on a PAGE gel under two different conditions. For denatured samples, they were heated at 90°C for 5 minutes and treated with SDS before loading onto the gel. For native samples, they were not boiled and treated with 2X native gel loading buffer prior to loading onto the gel. In Figure 30, there was very little soluble protein was expressed, instead, there was an intense band of insoluble protein at 60kDa.

Figure 30 TGX stain free native gel showing protein expression of eGFP-Npu-SsrA (GN). Lane 1 , Biorad Precision Plus Protein™ Unstained Protein Standards; lane 2, IPTG induced soluble fraction; lane 3, IPTG induced insoluble fraction; lane 4, uninduced soluble fraction; lane 5, uninduced insoluble fraction. Sol = soluble; Insol = insoluble.

Troubleshooting:

Inclusion body formation was believed to be caused by too rapid protein expression. A lower temperature with longer expression time was used (25C and 6 hours).

After adjusting the conditions, the expression was carried out again. The cells were harvested and the soluble and insoluble proteins were obtained using a lysis buffer. The samples were then run through native PAGE. Upon examining the gel image (refer to Figure 31), a clear band with high intensity in the native protein lane was observed at approximately 60 kDa molecular weight, indicating successful expression of the soluble protein GN.

Figure 31 TGX stain free native gel showing protein expression of eGFP-Npu-SsrA (GN). Lane 1 , Biorad Precision Plus Protein™ Unstained Protein Standards; lane 2, IPTG induced soluble fraction; lane 3, IPTG induced insoluble fraction; lane 4, uninduced soluble fraction; lane 5, uninduced insoluble fraction. Sol = soluble; Insol = insoluble.

To confirm the expression of eGFP, samples were observed under a UV box. As shown in Figure 32, strong fluorescence was observed in the eGFP-Npu-SsrA induced soluble group, indicating the successful expression of eGFP and the functionality of the BioBrick.

Figure 32 eGFP fluorescence of eGFP-Npu-SsrA

Week 16 14th - 20th August

15.

Purification: Glycerol stocks of EN, SN and GN were used to do protein expression in 100 ml of medium, to obtain a sufficient amount of the desired protein. The cells were then harvested through centrifugation with 7500 rpm for 15 minutes, subsequently lysed using sonication. The sonication cycles consisted of an on time of 20 seconds followed by an off time of 30 seconds. A total on time of 10 minutes and 60% Amplitude was employed. The soluble protein in the lysate was subsequently obtained through centrifugation with 8000 rpm for 5 minutes. The soluble protein, which contained the Npu splicing BioBrick, was loaded onto the chitin column for one-step purification and cyclization.

16.

Liquid Chromatography-Electrospray Ionization-Mass Spectrometry (LC-ESI-MS) After chitin column purification, the elution fractions from GN was subjected to LC-ESI-MS to determine the presence of the targeted eGFP protein. For GN, please refer to the result in Figure 33, where a peak at 26921 Da was observed. This peak aligned with the expected molecular mass of cyclic eGFP, which is 26923 Da, indicating that cyclic eGFP was detected in the elution fraction.

Figure 33 LC-ESI-MS spectrum of elution fraction after chitin column purification showing the molecular mass of a cyclic eGFP (26921 Da).
Phase 4

Week 17 21st - 27th August

1.

Chemical synthesis of EGFR peptide

In this week, we employed a quicker method to produce the cyclic peptide by using chemical synthesis. In brief, we weight the different amino acids needed for making the peptide. Then they were place inside the CEM LIbertyBlue microwave peptide synthesizer to begin the synthesis. After few hours, the synthesis was completed and the peptides were cleaved by TFA and purified by RP-HPLC. The HPLC and MS showed the correct and high purity of the peptide. To obtain peptide powder, lyophilisation was performed.

Then by using our unique bifunctional linker as reaction, the cyclic can be cyclised and conjugated on the monoclonal antibody. SDS-PAGE showed that the increase in molecular size of the mAb when different amount of cyclic peptides were conjugated on the antibody surface. At the end we chose 1:20 as best condition as no precipitation was observed after the conjugation.

Figure 34 RP-HPLC spectrum of purified EGFR-binding peptide.
Figure 35 Mass spectrometry of purified EGFR-binding peptide.
Figure 36 SDS-PAGE analysis of cyclic peptide, antibody conjugation reaction.

Week 18 28th August - 3nd September

2.

BsAb binding affinity - ELISA

This week, a series of experiments were conducted to assess the binding affinity of Polyneerab to the Epidermal Growth Factor Receptor (EGFR) and the Hepatocyte Growth Factor Receptor (c-MET). An Enzyme-Linked Immunosorbent Assay (ELISA) was performed to evaluate the affinity between the Polyneerab and the EGFR and c-MET antigens. To determine the Half Maximal Effective Concentration (EC50) of Polyneerab, the initial antibody dilution of the Polyneerab was set to 1:500, and the 1:500 stock was further diluted by 2-fold. The diluted Polyneerab was used to bind against fixed concentrations of EGFR (1 μg/mL) or c-MET (0.5 μg/mL) antigens. Results showed that the Polyneerab had a EC50 of 32.03 nM towards EGFR and 0.17 nM towards c-MET, respectively. This confirmed the Polyneerab targeted both EGFR and c-MET antigens at a nano-molar range.

Figure 37 Reaction profile during ELISA experiments
Figure 38 ELISA binding assay of Polyneerab against (A) c-MET and (B) EGFR.

Week 19-22 4th September - 1st October

3.

Functional assay - MTT

To test the cytotoxic effect of Polyneerab on Osimertinib-resistant HCC827 cells, we performed MTT cytotoxicity assay. We included the Osimertinib- sensitive HCC827 cell line (mock group) and the Osimertinib resistant HCC827 cell line (Osimertinib Resistant) in the MTT assay. In the first week we resuscitated the Mock group cells as well as the Osimertinib Resistant group cells . In the second week, we performed the experiment according to the plan and found that the Osimertinib concentration range was deviated from expected values and the cell growth rate was also limited. Based on the results of the experiments in the second week, we adjusted the Osimertinib concentration range and increased the number of cells in each well. In the third week, the results of the experiment showed that the Half maximal inhibitory concentration (IC50) of Mock group was 9.930 nM, while that of the Osimertinib Resistant group was 2.574 uM. Following the same experimental design, we repeated two more assays to verify the the IC50. Lastly, we concluded that the IC50 -of the HCC827 Osimertinib Resistant group was 270-fold higher than the Mock group. Thus, HCC827 Osimertinib Resistant cells showed a significant acquired Osimertinib resistance.

Figure 39 Reaction profile during MTT experiments
Figure 40 MTT assay of HCC827 cell lines (Mock and Osimertinib resistant). Dose response curve showing the cell viability under different Osimertinib concentrations over 72 h.

We believed the combination of Osimertinib and Polyneerab would have a synergistic effect in overcoming Osimertinib resistance in HCC827 cells. Therefore, in the last two weeks, we designed a series of experiments to demonstrate that Polyneerab combined with Osimertinib could reduce the viability of Osimertinib Resistant HCC827. The experimental results showed that Polyneerab in combination with Osimertinib exerted maximum synergistic growth inhibition in HCC827 Osimertinib Resistant group. The growth inhibitory effect of Polyneerab combined with Osimertinib group was more profound than that of c-MET antibody alone group and the EGFR peptide alone group. In conclusion, Polyneerab was synergistic in overcoming Osimertinib Resistance in HCC827 cells.

Figure 41 Combined treatment of Polyneerab with Osimertinib synergistically inhibited the growth of Osimertinib resistant HCC827 cells. Cells were treated with the indicated combination at different doses for 48 hrs. Cell viability was measured using MTT assay. Positive value in excess over Bliss indicated a synergistic effect in the combined treatment.