Oxidative phosphorylation is a metabolic vulnerability of endocrine therapy and palbociclib resistant metastatic breast cancers

• Published in: Nature communications 2023-07, Vol.14 (1), p.4221-4221, Article 4221
• Main Authors: El-Botty, Rania, Morriset, Ludivine, Montaudon, Elodie, Tariq, Zakia, Schnitzler, Anne, Bacci, Marina, Lorito, Nicla, Sourd, Laura, Huguet, Léa, Dahmani, Ahmed, Painsec, Pierre, Derrien, Heloise, Vacher, Sophie, Masliah-Planchon, Julien, Raynal, Virginie, Baulande, Sylvain, Larcher, Thibaut, Vincent-Salomon, Anne, Dutertre, Guillaume, Cottu, Paul, Gentric, Géraldine, Mechta-Grigoriou, Fatima, Hutton, Scott, Driouch, Keltouma, Bièche, Ivan, Morandi, Andrea, Marangoni, Elisabetta
• Format: Article
• Language: English
• Subjects: 38/88; 38/91; 64; 64/60; 692/4028/67/1059/602; 692/4028/67/1347; 692/4028/67/2327; AKT1 protein; Animals; Breast cancer; Breast Neoplasms - drug therapy; Breast Neoplasms - genetics; Breast Neoplasms - metabolism; Cell Line, Tumor; Cyclin-dependent kinase 4; Disease Models, Animal; Drug Resistance, Neoplasm - genetics; Endocrine therapy; Estrogen receptors; Estrogens; Female; Gene expression; Genes; Glutathione; Glycogen; Glycogens; Humanities and Social Sciences; Humans; Life Sciences; Metabolism; Metabolites; Metabolomics; Metastases; Metastasis; multidisciplinary; Oxidation resistance; Oxidative Phosphorylation; Pentose; Pentose phosphate pathway; Phosphorylation; Receptors; Receptors, Estrogen - metabolism; Science; Science (multidisciplinary); Tumors; Xenotransplantation
• ISSN: 2041-1723; 2041-1723
• DOI: 10.1038/s41467-023-40022-5

Resistance to endocrine treatments and CDK4/6 inhibitors is considered a near-inevitability in most patients with estrogen receptor positive breast cancers (ER + BC). By genomic and metabolomics analyses of patients’ tumours, metastasis-derived patient-derived xenografts (PDX) and isogenic cell lines we demonstrate that a fraction of metastatic ER + BC is highly reliant on oxidative phosphorylation (OXPHOS). Treatment by the OXPHOS inhibitor IACS-010759 strongly inhibits tumour growth in multiple endocrine and palbociclib resistant PDX. Mutations in the PIK3CA / AKT1 genes are significantly associated with response to IACS-010759. At the metabolic level, in vivo response to IACS-010759 is associated with decreased levels of metabolites of the glutathione, glycogen and pentose phosphate pathways in treated tumours. In vitro, endocrine and palbociclib resistant cells show increased OXPHOS dependency and increased ROS levels upon IACS-010759 treatment. Finally, in ER + BC patients, high expression of OXPHOS associated genes predict poor prognosis. In conclusion, these results identify OXPHOS as a promising target for treatment resistant ER + BC patients. Patients with estrogen receptor positive breast cancer (ER + BC) treated with palbociclib (CDK4/6 inhibitor) frequently develop resistance. Here, the authors identify a reliance of palbociclib resistance on oxidative phosphorylation (OXPHOS) and therapeutically target this vulnerability using an OXPHOS inhibitor, restoring sensitivity in ER + BC preclinical models.