A fluorescent prodrug to fight drug-resistant lung cancer cells via autophagy-driven ferroptosis

Lung cancer is the second most common malignant tumor worldwide. The problem of drug resistance in lung cancer leads to treatment failure and recurrence in more than 90% of cancer patients. Thus, developing chemical probes that can observe drug-resistant lung cancer cells in real-time and eliminate them is of great interest. However, such tools that can simultaneously probe drug-resistant lung cancer cells and therapeutic modes of action have not yet been developed. In this work, we reported a fluorescent prodrug that can be activated in cancer cell lysosomes to release amonafide (ANF) and aniline mustard, where the fluorescent signal of ANF (lambda ex/ lambda em = 405/570-620 nm) can be tracked by super-resolution imaging in live cancer cells. With imaging studies, we found that this new fluorescent prodrug uniquely displays an autophagy-driven ferroptosis-inducing effect, accompanied by the accumulation of intracellular ferrous ions and lipid peroxidation. More importantly, the fluorescent prodrug exhibits potential anti-proliferative activity, especially against drug-resistant A549R lung cancer cells (IC50, -3 mu M), better than the positive control drug cisplatin (IC50, -27 mu M). This work indicates that the development of fluorescent prodrugs as autophagy-driven ferroptosis inducers may represent a viable approach for targeting drug-resistant cancer cells.

Automated summary

Lung cancer is the second most common malignant tumor worldwide. Drug resistance in lung cancer leads to treatment failure and recurrence in majority of patients. This study developed a fluorescent prodrug that can be activated in cancer cells to release drugs, and its signal can be tracked by imaging. It shows a unique autophagy-driven ferroptosis effect, indicating its potential for targeting drug-resistant cancer cells.