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2016 ; 7
(ä): 50-61
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Co-targeting hexokinase 2-mediated Warburg effect and ULK1-dependent autophagy
suppresses tumor growth of PTEN- and TP53-deficiency-driven castration-resistant
prostate cancer
#MMPMID27322458
Wang L
; Wang J
; Xiong H
; Wu F
; Lan T
; Zhang Y
; Guo X
; Wang H
; Saleem M
; Jiang C
; Lu J
; Deng Y
EBioMedicine
2016[May]; 7
(ä): 50-61
PMID27322458
show ga
Currently, no therapeutic options exist for castration-resistant prostate cancer
(CRPC) patients who have developed resistance to the second generation
anti-androgen receptor (AR) axis therapy. Here we report that co-deletion of Pten
and p53 in murine prostate epithelium, often observed in human CRPC, leads to
AR-independent CRPC and thus confers de novo resistance to second generation
androgen deprivation therapy (ADT) in multiple independent yet complementary
preclinical mouse models. In contrast, mechanism-driven co-targeting hexokinase 2
(HK2)-mediated Warburg effect with 2-deoxyglucose (2-DG) and ULK1-dependent
autophagy with chloroquine (CQ) selectively kills cancer cells through intrinsic
apoptosis to cause tumor regression in xenograft, leads to a near-complete tumor
suppression and remarkably extends survival in Pten-/p53-deficiency-driven CRPC
mouse model. Mechanistically, 2-DG causes AMPK phosphorylation, which in turn
inhibits mTORC1-S6K1 translation signaling to preferentially block anti-apoptotic
protein MCL-l synthesis to prime mitochondria-dependent apoptosis while
simultaneously activates ULK1-driven autophagy for cell survival to counteract
the apoptotic action of anti-Warburg effect. Accordingly, inhibition of autophagy
with CQ sensitizes cancer cells to apoptosis upon 2-DG challenge. Given that 2-DG
is recommended for phase II clinical trials for prostate cancer and CQ has been
clinically used as an anti-malaria drug for many decades, the preclinical results
from our proof-of-principle studies in vivo are imminently translatable to
clinical trials to evaluate the therapeutic efficacy by the combination modality
for a subset of currently incurable CRPC harboring PTEN and TP53 mutations.