University of Milan, Department of Oncology and Hemato-oncology, Milan 20122, Italy; IFOM, FIRC Institute of Molecular Oncology, Milan 20139, Italy.
IFOM, FIRC Institute of Molecular Oncology, Milan 20139, Italy.
Cell Metab. 2021 Nov 2;33(11):2247-2259.e6. doi: 10.1016/j.cmet.2021.10.008.
Metastatic tumors remain lethal due to primary/acquired resistance to therapy or cancer stem cell (CSC)-mediated repopulation. We show that a fasting-mimicking diet (FMD) activates starvation escape pathways in triple-negative breast cancer (TNBC) cells, which can be identified and targeted by drugs. In CSCs, FMD lowers glucose-dependent protein kinase A signaling and stemness markers to reduce cell number and increase mouse survival. Accordingly, metastatic TNBC patients with lower glycemia survive longer than those with higher baseline glycemia. By contrast, in differentiated cancer cells, FMD activates PI3K-AKT, mTOR, and CDK4/6 as survival/growth pathways, which can be targeted by drugs to promote tumor regression. FMD cycles also prevent hyperglycemia and other toxicities caused by these drugs. These data indicate that FMD has wide and differential effects on normal, cancer, and CSCs, allowing the rapid identification and targeting of starvation escape pathways and providing a method potentially applicable to many malignancies.
转移性肿瘤仍然具有致命性,这是由于对治疗的原发性/获得性耐药或癌症干细胞 (CSC) 介导的再增殖。我们表明,禁食模拟饮食 (FMD) 可激活三阴性乳腺癌 (TNBC) 细胞中的饥饿逃逸途径,这些途径可以通过药物来识别和靶向。在 CSCs 中,FMD 降低了葡萄糖依赖性蛋白激酶 A 信号和干性标志物,从而减少了细胞数量并增加了小鼠的存活率。相应地,血糖水平较低的转移性 TNBC 患者比基线血糖水平较高的患者存活时间更长。相比之下,在分化的癌细胞中,FMD 激活了 PI3K-AKT、mTOR 和 CDK4/6 作为生存/生长途径,这些途径可以通过药物靶向以促进肿瘤消退。FMD 周期还可以预防这些药物引起的高血糖和其他毒性。这些数据表明,FMD 对正常细胞、癌症和 CSCs 具有广泛而不同的影响,允许快速识别和靶向饥饿逃逸途径,并提供一种可能适用于许多恶性肿瘤的方法。
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