Autophagy inhibitors increase the susceptibility of KRAS-mutant human colorectal cancer cells to a combined treatment of 2-deoxy-D-glucose and lovastatin

Acta Pharmacol Sin. 2021 Nov;42(11):1875-1887. doi: 10.1038/s41401-021-00612-9. Epub 2021 Feb 19.

Abstract

RAS-driven colorectal cancer relies on glucose metabolism to support uncontrolled growth. However, monotherapy with glycolysis inhibitors like 2-deoxy-D-glucose causes limited effectiveness. Recent studies suggest that anti-tumor effects of glycolysis inhibition could be improved by combination treatment with inhibitors of oxidative phosphorylation. In this study we investigated the effect of a combination of 2-deoxy-D-glucose with lovastatin (a known inhibitor of mevalonate pathway and oxidative phosphorylation) on growth of KRAS-mutant human colorectal cancer cell lines HCT116 and LoVo. A combination of lovastatin (>3.75 μM) and 2-deoxy-D-glucose (>1.25 mM) synergistically reduced cell viability, arrested cells in the G2/M phase, and induced apoptosis. The combined treatment also reduced cellular oxygen consumption and extracellular acidification rate, resulting in decreased production of ATP and lower steady-state ATP levels. Energy depletion markedly activated AMPK, inhibited mTOR and RAS signaling pathways, eventually inducing autophagy, the cellular pro-survival process under metabolic stress, whereas inhibition of autophagy by chloroquine (6.25 μM) enhanced the cytotoxic effect of the combination of lovastatin and 2-deoxy-D-glucose. These in vitro experiment results were reproduced in a nude mouse xenograft model of HCT116 cells. Our findings suggest that concurrently targeting glycolysis, oxidative phosphorylation, and autophagy may be a promising regimen for the management of RAS-driven colorectal cancers.

Keywords: 2DG; OXPHOS; autophagy; chloroquine; glycolysis; human colorectal cancers; hydroxychloroquine; lovastatin.

MeSH terms

  • Animals
  • Antimetabolites / administration & dosage
  • Autophagy / drug effects
  • Autophagy / physiology*
  • Cell Survival / drug effects
  • Cell Survival / physiology
  • Chloroquine / pharmacology
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / genetics*
  • Deoxyglucose / administration & dosage*
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Female
  • HCT116 Cells
  • HEK293 Cells
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage
  • Lovastatin / administration & dosage*
  • Mice
  • Mice, Inbred BALB C
  • Mice, Nude
  • Mutation / drug effects
  • Mutation / genetics*
  • Proto-Oncogene Proteins p21(ras) / genetics*
  • Xenograft Model Antitumor Assays / methods

Substances

  • Antimetabolites
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • KRAS protein, human
  • Chloroquine
  • Deoxyglucose
  • Lovastatin
  • Proto-Oncogene Proteins p21(ras)