Wild-type IDH1 maintains NSCLC stemness and chemoresistance through activation of the serine biosynthetic pathway.

Tumor-initiating cells (TICs) reprogram their metabolic features to meet their bioenergetic, biosynthetic, and redox demands. Our previous study established a role for wild-type isocitrate dehydrogenase 1 (IDH1^WT) as a potential diagnostic and prognostic biomarker for non–small cell lung cancer (NSCLC), but how IDH1^WT modulates NSCLC progression remains elusive. Here, we report that IDH1^WT activates serine biosynthesis by enhancing the expression of phosphoglycerate dehydrogenase (PHGDH) and phosphoserine aminotransferase 1 (PSAT1), the first and second enzymes of de novo serine synthetic pathway. Augmented serine synthesis leads to GSH/ROS imbalance and supports pyrimidine biosynthesis, maintaining tumor initiation capacity and enhancing gemcitabine chemoresistance. Mechanistically, we identify that IDH1^WT interacts with and stabilizes PHGDH and fragile X–related protein-1 (FXR1) by impeding their association with the E3 ubiquitin ligase parkin by coimmunoprecipitation assay and proximity ligation assay. Subsequently, stabilized FXR1 supports PSAT1 mRNA stability and translation, as determined by actinomycin D chase experiment and in vitro translation assay. Disrupting IDH1^WT-PHGDH and IDH1^WT-FXR1 interactions synergistically reduces NSCLC stemness and sensitizes NSCLC cells to gemcitabine and serine/glycine–depleted diet therapy in lung cancer xenograft models. Collectively, our findings offer insights into the role of IDH1^WT in serine metabolism, highlighting IDH1^WT as a potential therapeutic target for eradicating TICs and overcoming gemcitabine chemoresistance in NSCLC. Editor's summary: Tumor-initiating cells (TICs) have high metabolic plasticity and have been suggested as the cause for tumorigenesis and relapse in many cancers including non–small cell lung cancer (NSCLC). Here, Zhang et al. have examined the role of serine synthesis in TICs IDH1 wild-type NSCLC and identified that inhibiting this pathway sensitizes cells and xenografts to standard of care. Their study suggests a potential metabolic target for treated NSCLC that requires further study. —Dorothy Hallberg [ABSTRACT FROM AUTHOR]