[PDF][PDF] Melanoma persister cells are tolerant to BRAF/MEK inhibitors via ACOX1-mediated fatty acid oxidation

S Shen, S Faouzi, S Souquere, S Roy, E Routier… - Cell reports, 2020 - cell.com
S Shen, S Faouzi, S Souquere, S Roy, E Routier, C Libenciuc, F André, G Pierron…
Cell reports, 2020cell.com
Emerging evidence indicates that non-mutational drug tolerance mechanisms underlie the
survival of residual cancer" persister" cells. Here, we find that BRAF (V600E) mutant
melanoma persister cells tolerant to BRAF/MEK inhibitors switch their metabolism from
glycolysis to oxidative respiration supported by peroxisomal fatty acid β-oxidation (FAO) that
is transcriptionally regulated by peroxisome proliferator-activated receptor alpha (PPARα).
Knockdown of the key peroxisomal FAO enzyme, acyl-CoA oxidase 1 (ACOX1), as well as …
Summary
Emerging evidence indicates that non-mutational drug tolerance mechanisms underlie the survival of residual cancer "persister" cells. Here, we find that BRAF(V600E) mutant melanoma persister cells tolerant to BRAF/MEK inhibitors switch their metabolism from glycolysis to oxidative respiration supported by peroxisomal fatty acid β-oxidation (FAO) that is transcriptionally regulated by peroxisome proliferator-activated receptor alpha (PPARα). Knockdown of the key peroxisomal FAO enzyme, acyl-CoA oxidase 1 (ACOX1), as well as treatment with the peroxisomal FAO inhibitor thioridazine, specifically suppresses the oxidative respiration of persister cells and significantly decreases their emergence. Consistently, a combination treatment of BRAF/MEK inhibitors with thioridazine in human-melanoma-bearing mice results in a durable anti-tumor response. In BRAF(V600E) melanoma samples from patients treated with BRAF/MEK inhibitors, higher baseline expression of FAO-related genes and PPARα correlates with patients' outcomes. These results pave the way for a metabolic strategy to overcome drug resistance.
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