1. Activation of the Mevalonate Pathway in Response to Anti-cancer Treatments Drives Glioblastoma Recurrences Through Activation of Rac-1
- Author
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He, Ling, Ioannidis, Angeliki, Hoffman, Carter J, Arambula, Evelyn, Joshi, Purva, Whitelegge, Julian, Liau, Linda M, Kornblum, Harley I, and Pajonk, Frank
- Subjects
Biological Sciences ,Biomedical and Clinical Sciences ,Oncology and Carcinogenesis ,Rare Diseases ,Stem Cell Research - Nonembryonic - Human ,Stem Cell Research - Nonembryonic - Non-Human ,Brain Disorders ,Brain Cancer ,Orphan Drug ,Neurosciences ,Cancer ,Stem Cell Research ,Glioblastoma ,Mevalonic Acid ,Humans ,Animals ,rac1 GTP-Binding Protein ,Mice ,Brain Neoplasms ,Cell Line ,Tumor ,Temozolomide ,Hydroxymethylglutaryl-CoA Reductase Inhibitors ,Neoplasm Recurrence ,Local ,Xenograft Model Antitumor Assays ,Neoplastic Stem Cells ,Signal Transduction ,Dopamine Antagonists - Abstract
Glioblastoma (GBM) is the deadliest adult brain cancer. Under the current standard of care, almost all patients succumb to the disease and novel treatments are urgently needed. Recognizing that GBMs are addicted to cholesterol, past clinical trials have repurposed statins against GBM but failed. The purpose of this study was to test whether treatments that upregulate the cholesterol biosynthesis pathway in GBM would generate a metabolic vulnerability that can be exploited using statins and to determine the underlying mechanisms.Effects of radiotherapy and temozolomide or dopamine receptor antagonists on the mevalonate pathway in GBM were assessed in vitro and in vivo. The impact of statins on self-renewal of glioma stem cells and median survival was studied. Branches of the mevalonate pathway were probed to identify relevant effector proteins.Cells surviving combination treatments that converge in activating the immediate early response, universally upregulated the mevalonate pathway and increased stemness of GBM cells through activation of the Rho-GTPase Rac-1. Activation of the mevalonate pathway and Rac-1 was inhibited by statins, which led to improved survival in mouse models of glioblastoma when combined with radiation and drugs that target the glioma stem cell pool and plasticity of glioma cells.We conclude that a combination of dopamine receptor antagonists and statins could potentially improve radiotherapy outcome and warrants further investigation.SignificanceCombination therapies that activate the mevalonate pathway in GBM cells after sublethal treatment enhance self-renewal and migratory capacity through Rac-1 activation, which creates a metabolic vulnerability that can be further potentially exploited using statins.
- Published
- 2024