Pharmacological activation of REV-ERBs is lethal in cancer and oncogene-induced senescence

The circadian clock imposes daily rhythms in cell proliferation, metabolism, inflammation and DNA damage response(1,2). Perturbations of these processes are hallmarks of cancer3 and chronic circadian rhythm disruption predisposes individuals to tumour development(1,4). This raises the hypothesis that pharmacological modulation of the circadian machinery may be an effective therapeutic strategy for combating cancer. REV-ERBs, the nuclear hormone receptors REV-ERBa (also known as NR1D1) and REV-ERB beta (also known as NR1D2), are essential components of the circadian clock(5,6). Here we show that two agonists of REVERBs- SR9009 and SR9011-are specifically lethal to cancer cells and oncogene-induced senescent cells, including melanocytic naevi, and have no effect on the viability of normal cells or tissues. The anticancer activity of SR9009 and SR9011 affects a number of oncogenic drivers (such as HRAS, BRAF, PIK3CA and others) and persists in the absence of p53 and under hypoxic conditions. The regulation of autophagy and de novo lipogenesis by SR9009 and SR9011 has a critical role in evoking an apoptotic response in malignant cells. Notably, the selective anticancer properties of these REV-ERB agonists impair glioblastoma growth in vivo and improve survival without causing overt toxicity in mice. These results indicate that pharmacological modulation of circadian regulators is an effective antitumour strategy, identifying a class of anticancer agents with a wide therapeutic window. We propose that REV-ERB agonists are inhibitors of autophagy and de novo lipogenesis, with selective activity towards malignant and benign neoplasms.