4.7 Review

Impact of cancer metabolism on therapy resistance - Clinical implications

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Summary: Ovarian cancer, particularly high grade serous carcinoma (HGSOC), is associated with deficiency in homologous recombination (HR) and often involves loss of function of BRCA1 or BRCA2 genes. Inhibition of poly-ADP-ribose polymerase (PARP) is synthetic lethal with HR deficiency and has significantly improved outcomes in HGSOC patients, although resistance to PARP inhibitors is common. Various mechanisms of resistance include upregulation of efflux pumps, mutations in PARP1 protein, restoration of HR, and protection of the replicative fork. Understanding these mechanisms is crucial for developing new treatment strategies for individual HGSOC patients.

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Chitinase 3-like-1 and fibronectin in the cargo of extracellular vesicles shed by human macrophages influence pancreatic cancer cellular response to gemcitabine

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Exogenous and Endogenous Sources of Serine Contribute to Colon Cancer Metabolism, Growth, and Resistance to 5-Fluorouracil

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Immuno-Metabolism: The Role of Cancer Niche in Immune Checkpoint Inhibitor Resistance

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Summary: The use of immune checkpoint inhibitors has revolutionized cancer treatment by reactivating immune responses, but only a subset of patients benefit while others remain unresponsive or develop resistance. Metabolic machinery in the tumor microenvironment plays a role in the development of ICI resistance, suggesting that targeting metabolic pathways of immune cells may strengthen the efficacy of ICIs.

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Glycolysis-induced drug resistance in tumors-A response to danger signals?

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HMGCS1 drives drug-resistance in acute myeloid leukemia through endoplasmic reticulum-UPR-mitochondria axis

Cheng Zhou et al.

Summary: HMGCS1, a key enzyme in the mevalonate pathway of cholesterol synthesis, is often dysregulated in solid tumors and AML patients. Inhibition of HMGCS1 enhanced chemo-sensitivity in AML cells and protected mitochondria and ER under stress, indicating its potential as a target for treatment of chemotherapy-resistant AML patients. The transcription factor GATA1 was identified as an upstream regulator of HMGCS1, suggesting a potential mechanism for HMGCS1-induced drug resistance.

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The cross-talk between tumor cells and activated fibroblasts mediated by lactate/BDNF/TrkB signaling promotes acquired resistance to anlotinib in human gastric cancer

Zhijian Jin et al.

Summary: In this study, anlotinib inhibited gastric cancer (GC) cell growth by inducing apoptosis and G2/M phase arrest in a dose- and time-dependent manner. The interaction between epithelial and stromal cells in the tumor microenvironment affects the response of GC cells to anlotinib. Secreted lactate from GC cells activates cancer-associated fibroblasts (CAFs) to produce BDNF in a NF-kappa B-dependent manner, reducing the sensitivity of GC cells to anlotinib. Targeting the BDNF-TrkB pathway increased the sensitivity of GC cells to anlotinib in a human patient-derived organoid model.

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Mitochondrial metabolism supports resistance to IDH mutant inhibitors in acute myeloid leukemia

Lucille Stuani et al.

Summary: Mutations in IDH lead to enhanced mitochondrial oxidative metabolism in AML, involving increased electron transport chain activity and fatty acid oxidation. IDH1 mutant inhibitors reduce 2-HG levels and CEBPα methylation, but do not reverse fatty acid oxidation and OxPHOS. Targeting mitochondrial activities may improve anti-AML efficacy of IDH mutant inhibitors.

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Everolimus regulates the activity of gemcitabine-resistant pancreatic cancer cells by targeting the Warburg effect via PI3K/AKT/mTOR signaling

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Liver x receptor alpha drives chemoresistance in response to side-chain hydroxycholesterols in triple negative breast cancer

Samantha A. Hutchinson et al.

Summary: Triple negative breast cancer (TNBC) is difficult to treat due to lack of targeted therapies, with chemotherapy often failing in patients with high circulating cholesterol. The study reveals that LXR ligands can lead to chemotherapy resistance in TNBC, with LXRalpha and P-glycoprotein being markers of poor prognosis in patients with cancer recurrences. Targeting the LXRalpha:P-glycoprotein axis may offer new treatment options for TNBC patients who do not respond well to systemic chemotherapy.

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Leukemia stemness and co-occurring mutations drive resistance to IDH inhibitors in acute myeloid leukemia

Feng Wang et al.

Summary: The authors found that stemness features are the major drivers of primary resistance to IDH inhibitors, while high-risk mutations are the main drivers of acquired resistance. Targeting stemness and certain high-risk co-occurring mutations may help overcome resistance to IDH inhibitors in AML.

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Mitochondrial ATP fuels ABC transporter-mediated drug efflux in cancer chemoresistance

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Integration of machine learning and genome-scale metabolic modeling identifies multi-omics biomarkers for radiation resistance

Joshua E. Lewis et al.

Summary: Resistance to ionizing radiation is a major clinical challenge in cancer treatment. Personalized prediction of tumor radiosensitivity is hindered by insufficient accuracy of existing machine learning classifiers, which do not include metabolomics data. By integrating metabolic features with other multi-omics datasets using machine learning, improved classification accuracy can be achieved, facilitating the development of precision medicine workflows for cancer treatment.

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Summary: The study found that adipocytes release free fatty acids in the presence of acute lymphoblastic leukemia cells, which are taken up by the leukemia cells and incorporated into triglycerides and phospholipids. Adipocyte-derived lipids can relieve ALL cell endogenous lipogenesis and reverse the cytotoxicity of chemotherapy, altering cell metabolism from glucose to fatty acid oxidation. Targeting lipid synthesis and metabolism may potentially reverse adipocyte protection of ALL cells.

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Giuseppina Barrera et al.

Summary: Chemoresistance poses a significant challenge to cancer treatment by affecting the efficacy of conventional and targeted therapies. Metabolic remodeling, particularly the control of redox status, and the upregulation of antioxidant systems contribute to cancer cell survival post-therapy. The master regulator Nrf2, along with other transcription factors, plays crucial roles in maintaining high antioxidant levels in chemoresistant cancer cells.

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Peroxidation of n-3 and n-6 polyunsaturated fatty acids in the acidic tumor environment leads to ferroptosis-mediated anticancer effects

Emeline Dierge et al.

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Long Jin et al.

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Zsolt Matula et al.

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