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AZ12756122, a novel fatty acid synthase inhibitor, decreases resistance features in EGFR-TKI resistant EGFR-mutated NSCLC cell models - 15/11/22

Doi : 10.1016/j.biopha.2022.113942 
Emma Polonio-Alcalá a, b , Rut Porta a, c , Santiago Ruiz-Martínez a , Carmen Vásquez-Dongo a, d , Joana Relat e, f, g , Joaquim Bosch-Barrera c , Joaquim Ciurana b, , Teresa Puig a,
a New Therapeutic Targets Laboratory (TargetsLab)-Oncology Unit, Department of Medical Sciences, University of Girona, Spain 
b Product, Process and Production Engineering Research Group (GREP), Department of Mechanical Engineering and Industrial Construction, University of Girona, Spain 
c Medical Oncology Department, Catalan Institute of Oncology, Spain 
d Department of Pathology, Dr. Josep Trueta University Hospital, Spain 
e Department of Nutrition, Food Sciences and Gastronomy, School of Pharmacy and Food Sciences, Food Torribera Campus, University of Barcelona, Spain 
f Institute of Nutrition and Food Safety of the University of Barcelona (INSA-UB), Spain 
g CIBER Physiopathology of Obesity and Nutrition (CIBER-OBN), Instituto de Salud Carlos III, Spain 

Correspondence to: Product, Process and Production Engineering Research Group (GREP), Department of Mechanical Engineering and Industrial Construction, University of Girona, 17003 Girona, Spain.Product, Process and Production Engineering Research Group (GREP), Department of Mechanical Engineering and Industrial Construction, University of GironaGirona17003Spain⁎⁎Correspondence to: New Therapeutic Targets Laboratory (TargetsLab)-Oncology Unit, Department of Medical Sciences, University of Girona, Girona 17003, Spain.New Therapeutic Targets Laboratory (TargetsLab)-Oncology Unit, Department of Medical Sciences, University of GironaGirona17003Spain

Abstract

Different EGFR tyrosine kinase inhibitors (TKIs) have been developed for the treatment of non-small cell lung cancer (NSCLC) patients harboring sensitizing mutations in the EGFR gene. Apart from acquired secondary mutations, multiple resistance mechanisms have been reported, such as the overexpression of fatty acid synthase (FASN), a multi-functional enzyme essential for the de novo lipogenesis, or the increase of cancer stem cells, a small subpopulation within the tumor responsible for relapse, metastasis, and resistance to therapies. Hence, the purpose of this work is to evaluate the novel FASN inhibitor AZ12756122, both alone and in combination with gefitinib and osimertinib, in EGFR-mutated (EGFRm) lung adenocarcinoma cell models sensitive and resistant to EGFR-TKIs. The molecular effect of AZ12756122 (alone and in combination with EGFR-TKI) on FASN, EGFR/STAT3, Akt/mTOR, and MAPK signaling pathways was analyzed using RT-qPCR and Western blot. FASN expression was also evaluated in samples from patients with EGFRm NSCLC through immunohistochemistry. Our findings revealed that AZ12756122 caused cytotoxic effects inducing apoptosis, downregulated FASN expression and activity, decreased the activation of EGFR and Akt/mTOR pathway, and reduced cancer stem-like cells. Furthermore, the combination of AZ12756122 and osimertinib sensitized cells to EGFR-TKI, showing a synergistic effect that resulted in a reduction in the activation of EGFR, Akt/mTOR, and MAPK signaling pathways. Our study also showed that FASN+ EGFRm NSCLC patients exhibited a longer mPFS in patients who responded to EGFR-TKI treatment. In conclusion, FASN inhibition should be further studied for the treatment, alone or in combination with EGFR-TKIs, for EGFRm NSCLC patients.

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Graphical Abstract




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Highlights

FASN inhibition is a promising strategy for the treatment of EGFRm NSCLC.
AZ12756122 causes cytotoxic effects in sensitive and resistant EGFRm NSCLC cells.
AZ12756122 combined with osimertinib overcome the resistance to the EGFR-TKI.
AZ12756122 has activity against cancer stem-like cells.
FASN+ EGFRm NSCLC patients show a longer progression-free survival.

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Abbreviations : CSCs, CI, EGFR, FASN, IC50, IHC, GR, LC3, mPFS, NSCLC, PARP, STAT3, TKI

Keywords : NSCLC, FASN, EGFR, Osimertinib, Drug combination


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