Overcoming cisplatin resistance by mTOR inhibitor in lung cancer

BACKGROUND: Cisplatin resistance is complex and involves several different mechanisms. Employing cDNA microarray analysis, we have found that cisplatin resistant cells share the common characteristic of increase in ribosomal proteins and elongation factors. We hypothesize that in order to survive cisplatin treatment, cells have to synthesize DNA repair proteins, antiapoptotic proteins and growth-stimulating proteins. Thus, by blocking the translation of these proteins, one should be able to restore cisplatin sensitivity. We have studied the role of CCI-779, an ester analog of rapamycin which is known to inhibit translation by disabling mTOR, in restoring cisplatin sensitivity in a panel of cisplatin resistant cell lines. We have also determined the role of CCI-779 in P-gp1 and MRP1 mediated resistance. RESULTS: Our data show that CCI-779 possess antiproliferative effects in both cisplatin sensitive and resistant cell lines, but shows no effect in P-gp1 and MRP1 overexpressing cell lines. Importantly, CCI-779 at 10 ng/ml (less that 10% of the growth inhibitory effect) can increase the growth inhibition of cisplatin by 2.5–6 fold. Moreover, CCI-779 also enhances the apoptotic effect of cisplatin in cisplatin resistant cell lines. In these resistant cells, adding CCI-779 decreases the amount of 4E-BP phosphorylation and p-70S6 kinase phosphorylation as well as lower the amount of elongation factor while cisplatin alone has no effect. However, CCI-779 can only reverse P-gp mediated drug resistance at a higher dose(1 ug/ml). CONCLUSION: We conclude that CCI-779 is able to restore cisplatin sensitivity in small cell lung cancer cell lines selected for cisplatin resistance as well as cell lines derived from patients who failed cisplatin. These findings can be further explored for future clinical use. On the other hand, CCI-779 at achievable clinical concentration, has no growth inhibitory effect in P-gp1 or MRP1 overexpressing cells. Furthermore, CCI-779 also appears to be a weak MDR1 reversal agent. Thus, it is not a candidate to use in MDR1 or MRP1 overexpressing cells

The Relevance of mTOR and Hypoxia Inducible Factor to 2-Deoxy-D-Glucose Toxicity in Lung Cancer Cell Lines Under Hypoxia

Hypoxic regions found in most solid tumors often contain cells which are resistant to various cancer therapies. However, hypoxia also forces cells to rely solely on the catabolism of glucose through glycolysis for ATP production and survival, thereby creating a therapeutic window that can be exploited by glycolytic inhibitors, such as 2-deoxy-D-glucose (2-DG). Previous studies in our lab demonstrated that activation of Hypoxia Inducible Factor (HIF-1) in hypoxic tumor cells confers resistance to glycolytic inhibition by 2-DG. In surveying a number of tumor types for differences in intrinsic levels of HIF-1 alpha under hypoxia, we found that pathways upstream of HIF -- i.e. AKT and mammalian target of rapamycin (mTOR) -- have significantly reduced activity in 2 human non-small lung cancer cell lines (NSCLC) as compared to 4 small cell lung cancer cell (SCLC) lines. This reduced activity of AKT and mTOR correlated with increased sensitivity to 2-DG under hypoxia. Since HIF-1 alpha translation is regulated by the mammalian target of rapamycin (mTOR), we examined the effects of blocking mTOR with an analog of rapamycin (CCI-779) in SCLC cells which express high levels of mTOR activity. Under hypoxia, treatment with CCI-779 resulted in HIF-1 alpha down-regulation. Furthermore, CCI-779 potentiated the cytotoxic effects of 2-DG in hypoxic SCLC cells. Conversely, CCI-779 did not increase 2-DG toxicity in NSCLC lines that do not express HIF, SCLC lines treated with siRNA against HIF-1 alpha, or HIF-deficient mutants. These latter results support the hypothesis that, although mTOR modulates numerous downstream pathways, mTOR inhibition by CCI-779 increases the toxicity of 2-DG in hypoxic cells through down-regulation of HIF-1 alpha. Overall, our findings show that CCI-779 hyper-sensitizes HIF-expressing hypoxic tumor cells to 2-DG. Additionally, our results suggest that the intrinsic expression of AKT, mTOR, and HIF in many tumor types may be important predictors of clinical responsiveness to 2-DG and could be used to guide future treatment decisions on whether to use 2-DG alone or in combination with an mTOR inhibitor

Perspective on the treatment of non-small cell lung cancer in the context of potential SARS-CoV-2 infection during the pandemic

SARS-CoV-2 infections are rising at an alarming rate and various aspects of this pandemic must be quickly and adequately addressed in order to enhance effective healthcare delivery and protect at risk populations such as cancer patients. Preventing Covid-19 infection must be a top system wide priority to avoid mortality, and considerable financial and disease burden. Most cancer patients, and in particular those with tumors resistant to chemotherapy are particularly vulnerable to infection. In this review, we connect potential viral infection of patients with lung tumors that have somewhat quiescence the immune response in the tumor microenvironment and categorize target molecules in metabolism that may be used to identify at risk patients leading to more effective treatment regimens; keeping continuity of therapy and disease prevention during a very tumultuous period of time surrounding the pandemic

Performance and Cost Evaluations of Synthetic Resin Technology for the Removal of Methyl Tert-Butyl Ether from Drinking Water

This study investigated the performance of synthetic carbonaceous resin technology for the treatment of methyl tert-butyl ether (MTBE) contaminated waters using rapid small-scale column tests (RSSCTs). The RSSCTs were conducted using Ambersorb 563 carbonaceous resin (Rohm and Haas Corp., Philadelphia, Pa.) under multisolute conditions of typical municipal water source, soluble fuel components or additive/by-product, and MTBE. Specifically, one RSSCT column run was conducted with groundwater from Arcadia Wellfield, Santa Monica, Calif., with tert-butyl alcohol (TBA) and MTBE, while the other RSSCT column run was performed with surface water from Lake Perris, Calif., with benzene, toluene, p -xylene (BTX) and MTBE. The results obtained were compared to RSSCTs performed using PCB coconut shell granulated activated carbon (GAC) (Calgon Corp., Philadelphia, Pa.). The adsorbent comparisons indicate that the performance (as characterized by indicators such as carbon usage rates or integrated column capacity) of the Ambersorb 563 synthetic resin in multisolute conditions of TBA or BTEX with MTBE in typical municipal water source is significantly superior to that of the coconut shell PCB GAC. Cost comparison for the coconut shell GAC and synthetic resin system was also performed. Under multisolute conditions of typical municipal water source, flow rates, and influent MTBE concentrations, the cost of the resin system, for most of the scenarios evaluated, is demonstrated to be significantly lower than the complementary GAC system under the costing procedure used. Further, when soluble fuel components such as BTX or fuel additives/byproducts such as TBA were present along with MTBE, the predicted higher adsorbent usage rates for the coconut shell GAC were translated into significantly higher treatment costs relative to the synthetic carbonaceous resin system

Evaluation of granular activated carbon technology for the removal of methyl tertiary butyl ether (MTBE) from drinking water

This study evaluated granular activated carbons (GACs) using rapid small-scale column tests (RSSCTs) on methyl tert-butyl ether (MTBE) levels from 20 to 2000 μg/L, with or without the presence of tert-butyl alcohol, benzene, toluene, p-xylene (BTX) in two groundwater (South Lake Tahoe Utility District [Lake Tahoe, CA] and Arcadia Well Field [Santa Monica, CA]) and a surface water source (Lake Perris, CA). Direct comparison between two GACs was made for RSSCTs conducted with surface water from Lake Perris. The impact of natural organic matter on GAC performance was investigated and found to correspond with total organic carbon concentration in the three source waters. Significant reduction in GAC performance for MTBE due to competitive adsorption from soluble fuel components (e.g., BTX) was observed. Little or no difference in GAC usage rate or bed life was detected as the empty-bed contact time is changed from 10 to 20 min for RSSCTs conducted in the two groundwater sources, whereas the RSSCTs conducted in the surface water source exhibited significant increase in GAC usage rate as the empty-bed contact time is decreased from 20 to 10 min. This finding suggests that the higher NOM content of the surface water over the groundwater sources caused a greater competitive-adsorption effect that made more sites on the GAC to be unavailable to MTBE, thus decreasing its rate of adsorption and GAC performance for MTBE. Finally, the impact of differential influent MTBE concentration on GAC performance was demonstrated

Abstract 4087: Metabolic changes associated with acquired cisplatin resistance

Abstract Although cisplatin is the drug of choice in treating lung cancer patients, acquired resistance appears to be a common and serious drawback to its effectiveness in the clinic. Using two pairs of cisplatin sensitive and resistant lung cancer cell lines developed in vitro, we have found significantly lowered hexokinase II (HKII) levels in both resistant cell lines. As a consequence of lowered HKII, these cell lines, when grown under anaerobic conditions, are markedly more sensitive to the glycolytic inhibitor 2-deoxy-D-glucose (2DG) than their parental cell lines from which they were derived. This was our first indication that lowered HKII levels in these cisplatin resistant cells has metabolic consequences in different environmental conditions. Thus, it appears that a fundamental difference in glucose metabolism is associated with resistance to cisplatin in these cell lines. It is the aim of this study to explore whether reduced HKII is a common occurrence in cisplatin resistant cells and whether these differences uncover metabolic targets that can be exploited for therapeutic gain. Much like the Atkins diet, when carbohydrates are lowered or glycolysis is inhibited, other sources of energy such as fatty acids and amino acids can be used to maintain cell viability. A trypan blue cytotoxicity assay was used to determine the sensitivity of our cisplatin resistant cell lines to a pharmacological inhibitor, etomoxir, toward fatty acid oxidation. Thus, we tested and found that one of these cisplatin resistant cell lines is sensitive to interference with fatty acid oxidation. Next, we placed our cell lines in glutamine free medium, and found that the second cisplatin resistant cell line is sensitive to glutamine deprivation. Moreover, when lactate production was measured in anaerobic conditions, cisplatin resistant cell lines produced less lactate when challenged with the glycolytic inhibitor, 2DG, than their cisplatin sensitive parental cell lines. Overall, our results indicate that lowered HKII levels in two cisplatin resistant cell lines appear to be associated with a decreased reliance on glucose metabolism, with a shift to either fatty acid oxidation or glutaminolysis. Moreover, these cisplatin resistant cells are sensitive to glycolytic inhibition when placed in oxygen-deprived conditions. Thus, these new metabolic targets may be exploited for therapeutic gain in the clinic. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 102nd Annual Meeting of the American Association for Cancer Research; 2011 Apr 2-6; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2011;71(8 Suppl):Abstract nr 4087. doi:10.1158/1538-7445.AM2011-4087</jats:p

Intrinsically lower AKT, mammalian target of rapamycin, and hypoxia-inducible factor activity correlates with increased sensitivity to 2-deoxy-D-glucose under hypoxia in lung cancer cell lines

Down-regulation by small interfering RNA or absence of hypoxia-inducible factor (HIF-1alpha) has been shown to lead to increased sensitivity to glycolytic inhibitors in hypoxic tumor cells. In surveying a number of tumor types for differences in intrinsic levels of HIF under hypoxia, we find that the reduction of the upstream pathways of HIF, AKT, and mammalian target of rapamycin (mTOR) correlates with increased toxic effects of 2-deoxy-D-glucose (2-DG) in lung cancer cell lines when treated under hypoxia. Because HIF-1alpha translation is regulated by mTOR, we examined the effects of blocking mTOR under hypoxia with an analogue of rapamycin (CCI-779) in those cell lines that showed increased mTOR and AKT activity and found that HIF-1alpha down-regulation coincided with increased 2-DG killing. CCI-779, however, was ineffective in increasing 2-DG toxicity in cell lines that did not express HIF. These results support the hypothesis that although mTOR inhibition leads to the blockage of numerous downstream targets, CCI-779 increases the toxicity of 2-DG in hypoxic cells through down-regulation of HIF-1alpha. Overall, our findings show that CCI-779 hypersensitizes hypoxic tumor cells to 2-DG and suggests that the intrinsic expression of AKT, mTOR, and HIF in lung cancer, as well as other tumor types, may be important in dictating the decision on how best to use 2-DG alone or in combination with CCI-799 to kill hypoxic tumor cells clinically

Bent to Bind: Exploiting the Programmed Cell Death-1 (PD-1) Receptor Plasticity to Design Pembrolizumab H3 Loop Mimics

Checkpoint blockade of the Programmed cell Death-1 (PD-1) immunoreceptor with its ligand 1 (PD-L1) by the monoclonal antibody pembrolizumab provided compelling clinical results among various cancer types, yet the molecular mechanism by which this drug blocks the PD-1:PD-L1 binding interface and reactivates exhausted T cells remains unclear. To address this question, we examined the conformational motion of PD-1 associated with the binding of pembrolizumab. The largely overlooked innate plasticity of both PD-1 C’D and FG loops appears crucial to closing in the receptor edges on the drug. Herein, we describe how PD-1 bends to initiate the formation of a deep binding groove (371 Å3) across several epitopes while engaging pembrolizumab. Our analysis ultimately provided a rational design for mimicking the pembrolizumab H3 loop [RDYRFDMGFD] as a PD-1 inhibitor. A series of H3 loop mimics were synthesized and their folding characterized by CD and NMR spectroscopy. As a result, a first-in-class b-hairpin peptide inhibitor of the PD-1/PD-L1 interface was identified (IC50 of 0.6 ± 0.2 μM). Overall, this study demonstrates that the dynamic groove formed between the C’D and FG loops of PD-1 is an attractive target for the development of peptide-based PD-1 inhibitors

Hypoxia-inducible factor-1 confers resistance to the glycolytic inhibitor 2-deoxy-D-glucose

Hypoxic regions within solid tumors harbor cells that are resistant to standard chemotherapy and radiotherapy. Because oxygen is required to produce ATP by oxidative phosphorylation, under hypoxia, cells rely more on glycolysis to generate ATP and are thereby sensitive to 2-deoxy-d-glucose (2-DG), an inhibitor of this pathway. Universally, cells respond to lowered oxygen tension by increasing the amount of glycolytic enzymes and glucose transporters via the well-characterized hypoxia-inducible factor-1 (HIF). To evaluate the effects of HIF on 2-DG sensitivity, the following three models were used: (a) cells treated with oligomycin to block mitochondrial function in the presence (HIF(+)) or absence (HIF(-)) of hypoxia, (b) cells treated with small interfering RNA specific for HIF-1alpha and control cells cultured under hypoxia, and (c) a mutant cell line unable to initiate the HIF response and its parental HIF(+) counterpart under hypoxic conditions. In all three models, HIF increased resistance to 2-DG and other glycolytic inhibitors but not to other chemotherapeutic agents. Additionally, HIF reduced the effects of 2-DG on glycolysis (as measured by ATP and lactate assays). Because HIF increases glycolytic enzymes, it follows that greater amounts of 2-DG would be required to inhibit glycolysis, thereby leading to increased resistance to it under hypoxia. Indeed, hexokinase, aldolase, and lactate dehydrogenase were found to be increased as a function of HIF under the hypoxic conditions and cell types we used; however, phosphoglucose isomerase was not. Although both hexokinase and phosphoglucose isomerase are known to interact with 2-DG, our findings of increased levels of hexokinase more likely implicate this enzyme in the mechanism of HIF-mediated resistance to 2-DG. Moreover, because 2-DG is now in phase I clinical trials, our results suggest that glycolytic inhibitors may be more effective clinically when combined with agents that inhibit HIF