Pharmacologic ascorbate (P-AscH) suppresses hypoxia-inducible Factor-1α (HIF-1α) in pancreatic adenocarcinoma.

HIF-1α is a transcriptional regulator that functions in the adaptation of cells to hypoxic conditions; it strongly impacts the prognosis of patients with cancer. High-dose, intravenous, pharmacological ascorbate (P-AscH), induces cytotoxicity and oxidative stress selectively in cancer cells by acting as a pro-drug for the delivery of hydrogen peroxide (HO); early clinical data suggest improved survival and inhibition of metastasis in patients being actively treated with P-AscH. Previous studies have demonstrated that activation of HIF-1α is necessary for P-AscH sensitivity. We hypothesized that pancreatic cancer (PDAC) progression and metastasis could be be targeted by P-AscH via HO-mediated inhibition of HIF-1α stabilization. Our study demonstrates an oxygen- and prolyl hydroxylase-independent regulation of HIF-1α by P-AscH. Additionally, P-AscH decreased VEGF secretion in a dose-dependent manner that was reversible with catalase, consistent with an HO-mediated mechanism. Pharmacological and genetic manipulations of HIF-1α did not alter P-AscH-induced cytotoxicity. In vivo, P-AscH inhibited tumor growth and VEGF expression. We conclude that P-AscH suppresses the levels of HIF-1α protein in hypoxic conditions through a post-translational mechanism. These findings suggest potential new therapies specifically designed to inhibit the mechanisms that drive metastases as a part of PDAC treatment.