Cited by 2,011Ferroptosis and cancer prognosisCancer, Lipids, and MetabolismCancer Cells and Metastasis

Dependency of a therapy-resistant state of cancer cells on a lipid peroxidase pathway

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Viswanathan, Vasanthi S., Ryan, Matthew J., Dhruv, Harshil D., Gill, Shubhroz, Eichhoff, Ossia M., Seashore-Ludlow, Brinton, Kaffenberger, Samuel D., Eaton, John K. +32 more·2017·Nature

Abstract

Plasticity of the cell state has been proposed to drive resistance to multiple classes of cancer therapies, thereby limiting their effectiveness. A high-mesenchymal cell state observed in human tumours and cancer cell lines has been associated with resistance to multiple treatment modalities across diverse cancer lineages, but the mechanistic underpinning for this state has remained incompletely understood. Here we molecularly characterize this therapy-resistant high-mesenchymal cell state in human cancer cell lines and organoids and show that it depends on a druggable lipid-peroxidase pathway that protects against ferroptosis, a non-apoptotic form of cell death induced by the build-up of toxic lipid peroxides. We show that this cell state is characterized by activity of enzymes that promote the synthesis of polyunsaturated lipids. These lipids are the substrates for lipid peroxidation by lipoxygenase enzymes. This lipid metabolism creates a dependency on pathways converging on the phospholipid glutathione peroxidase (GPX4), a selenocysteine-containing enzyme that dissipates lipid peroxides and thereby prevents the iron-mediated reactions of peroxides that induce ferroptotic cell death. Dependency on GPX4 was found to exist across diverse therapy-resistant states characterized by high expression of ZEB1, including epithelial-mesenchymal transition in epithelial-derived carcinomas, TGFβ-mediated therapy-resistance in melanoma, treatment-induced neuroendocrine transdifferentiation in prostate cancer, and sarcomas, which are fixed in a mesenchymal state owing to their cells of origin. We identify vulnerability to ferroptic cell death induced by inhibition of a lipid peroxidase pathway as a feature of therapy-resistant cancer cells across diverse mesenchymal cell-state contexts.

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  • Mesenchymal-derived tissues have high sensitivity to ferroptosis.

    “reports demonstrating high sensitivity to ferroptosis among mesenchymal-derived tissues (41)”

    From Eprenetapopt triggers ferroptosis, inhibits NFS1 cysteine desulfurase, and synergizes with serine and glycine dietary restriction (2022) · cites this paper as [41]

    The Abstract reports that ferroptosis-inducing compounds were especially selective for cancer cell lines of mesenchymal origin, including sarcomas. The claim extends this finding from cancer cell lines to mesenchymal-derived tissues generally, which the paper does not establish. (LLM, conf=0.86)

    Experimental — accuracy not yet measured
  • Cancer cells become susceptible to lipoxygenase/Fenton reaction-induced lipid-ROS damage and are dependent on GPX4 activity to maintain viability.

    “While changes in the polyunsaturation of membrane lipids facilitate the invasive and motile cancer phenotype (9), cancer cells become susceptible to lipoxygenase/Fenton reaction–induced lipid-ROS damage and are dependent on the activity of GPX4 to maintain viability (6).”

    From Secreted Apoe rewires melanoma cell state vulnerability to ferroptosis (2024) · cites this paper as [6]

    The Abstract describes lipoxygenase-mediated lipid peroxidation and GPX4 protection against iron-mediated ferroptotic cell death; Extended Data Figure 10 shows that inhibiting lipoxygenases prevents death after GPX4 inhibition. The demonstrated GPX4 dependency is concentrated in therapy-resistant, high-mesenchymal cancer cells, not cancer cells generally. The copy describes iron-mediated reactions but does not specifically call them Fenton reactions. (LLM, conf=0.87)

    Experimental — accuracy not yet measured
  • During multistage cell state transitions, cancer cells acquire a dependency on the ability to detoxify lipid peroxides.

    “In particular, during multistage cell state transitions, cancer cells acquire a dependency on the ability to detoxify lipid peroxides (6).”

    From Secreted Apoe rewires melanoma cell state vulnerability to ferroptosis (2024) · cites this paper as [6]

    The paper’s main text (indexed under Abstract; page unavailable) reports that cancer cells acquiring therapy-resistant, high-mesenchymal states can become dependent on GPX4, which detoxifies lipid peroxides. It examines several cell-state transitions, but does not establish that those transitions are multistage or that the dependency arises during a defined sequence of stages. (LLM, conf=0.82)

    Experimental — accuracy not yet measured
  • Malignant cells with a mesenchymal phenotype reportedly acquire an accrued dependency on GPX4 activity, which can be exploited therapeutically.

    “malignant cells with a mesenchymal phenotype (which are generally more resistant to treatment) reportedly acquire an accrued dependency on GPX4 activity, which can be exploited therapeutically [600].”
  • Mesenchymal cells marked by high ZEB1 expression appear to be especially sensitive to GPX4 inhibition.

    “Mesenchymal cells marked by high ZEB1 expression appear to be especially sensitive to GPX4 inhibition [119].”

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Authors
Viswanathan, V. S., Ryan, M. J., Dhruv, H. D., Gill, S., Eichhoff, O. M., Seashore-Ludlow, B., Kaffenberger, S. D., Eaton, J. K., Shimada, K., Aguirre, A. J., Viswanathan, S. R., Chattopadhyay, S., Tamayo, P., Yang, W. S., Rees, M. G., Chen, S., Boskovic, Z. V., Javaid, S., Huang, C., Wu, X., Tseng, Y.-Y., Roider, E. M., Gao, D., Cleary, J. M., Wolpin, B. M., Mesirov, J. P., Haber, D. A., Engelman, J. A., Boehm, J. S., Kotz, J. D., Hon, C. S., Chen, Y., Hahn, W. C., Levesque, M. P., Doench, J. G., Berens, M. E., Shamji, A. F., Clemons, P. A., Stockwell, B. R., & Schreiber, S. L.
Affiliations
  • Broad Institute (US)
  • Translational Genomics Research Institute (US)
  • University of Zurich (CH)
  • Memorial Sloan Kettering Cancer Center (US)
  • Harvard University (US)
  • St. John's University (US)
  • Massachusetts General Hospital (US)
  • Dana-Farber Cancer Institute (US)
  • Howard Hughes Medical Institute (US)
  • Columbia University (US)
Corresponding author
Schreiber, Stuart L.
Venue
Nature
Published
2017-07
Volume
547
Issue
7664
Pages
453-457
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W2727828415
Cited by
2,011
References
36
Citations by year
2026: 231 · 2025: 280 · 2024: 345 · 2023: 300 · 2022: 261 · 2021: 230 · 2020: 159 · 2019: 115 · 2018: 64 · 2017: 18 · 2016: 3 · 2015: 1 · 2014: 1
FWCI
80.76
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
  • Europe PMC (PubMed Central) (acceptedVersion)
  • PubMed Central (acceptedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
  • Howard Hughes Medical Institute
  • National Institutes of Health (UL1TR001102)
  • National Cancer Institute (R35CA209896, R01CA208100, U24CA194107, R01CA154480, R01CA097061, U01CA217848, U01CA176152, R01CA161061, U01CA168397, R01CA121941, U01CA176058, U01CA199253, K08CA218420, P30CA008748, R01CA129933, P50CA092629, R01CA193837)
  • National Institute of General Medical Sciences (R01GM085081, R01GM038627, R01GM074024)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P30DK043351)
  • National Center for Advancing Translational Sciences
Topics
  • Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Ferroptosis and cancer prognosis
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
  • Health Sciences › Medicine › Oncology › Cancer Cells and Metastasis
Keywords
treatment resistance, cancer cell states, mesenchymal phenotype, ferroptosis, GPX4, lipid peroxidation, lipoxygenase, lipid metabolism, ZEB1, epithelial-mesenchymal transition, TGF-beta, neuroendocrine transdifferentiation, sarcoma, organoids, drug repurposing
MeSH terms
Zinc Finger E-box-Binding Homeobox 1, Phospholipid Hydroperoxide Glutathione Peroxidase, Glutathione Peroxidase, Humans, Iron, Lipid Peroxides, Male, Melanoma, Mesoderm, Neoplasms, Prostatic Neoplasms, Reproducibility of Results, Lipid Peroxidation, Cadherins, Cell Death, Drug Resistance, Neoplasm, Cell Lineage, Proteomics, Cell Line, Tumor, Proto-Oncogene Proteins B-raf, Cell Transdifferentiation, Epithelial-Mesenchymal Transition

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