SNX10 deficiency confers resistance to anti-HER2 antibody-drug conjugates via regulating endosomal trafficking

Antibody-drug conjugates (ADCs) are a rapidly developing therapeutic approach in cancer treatment that has shown remarkable efficacy in breast cancer. Despite the promising efficacy of anti-HER2 ADCs, many patients are still experiencing disease progression under treatment. Here, by analyzing the transcriptome data from patient-derived organoid models, I-SPY2 trial, and resistant cell lines, we identified that SNX10 deficiency conferred anti-HER2 ADCs resistance. Low levels of SNX10 attenuated HER2 recycling and promoted HER2 trafficking into lysosomes. We also noticed that the lack of interaction between SNX10 and the transcription factor STAT1 inhibited its activation, while STAT1 binds to the promoter region of RAB11A and regulates its transcription. Thus, the lack of SNX10 inhibited HER2 recycling by downregulating RAB11A, decreased cell-surface HER2, and caused anti-HER2 ADC resistance.