Department of Hepatobiliary Surgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, 230001, China.
Anhui Province Key Laboratory of Hepatopancreatobiliary Surgery, Hefei, Anhui, 230001, China.
Adv Sci (Weinh). 2023 Aug;10(22):e2206798. doi: 10.1002/advs.202206798. Epub 2023 Jun 17.
Hepatocellular carcinoma (HCC) is one of the most lethal cancers worldwide. Donafenib is a multi-receptor tyrosine kinase inhibitor approved for the treatment of patients with advanced HCC, but its clinical effect is very limited. Here, through integrated screening of a small-molecule inhibitor library and a druggable CRISPR library, that GSK-J4 is synthetically lethal with donafenib in liver cancer is shown. This synergistic lethality is validated in multiple HCC models, including xenograft, orthotopically induced HCC, patient-derived xenograft, and organoid models. Furthermore, co-treatment with donafenib and GSK-J4 resulted in cell death mainly via ferroptosis. Mechanistically, through integrated RNA sequencing (RNA-seq) and assay for transposase-accessible chromatin with high throughput sequencing (ATAC-seq) analyses, that donafenib and GSK-J4 synergistically promoted the expression of HMOX1 and increased the intracellular Fe2+ level is found, eventually leading to ferroptosis. Additionally, through cleavage under targets & tagmentation followed by sequencing (CUT&Tag-seq), it is found that the enhancer regions upstream of HMOX1 promoter significantly increased under donafenib and GSK-J4 co-treatment. A chromosome conformation capture assay confirmed that the increased expression of HMOX1 is caused by the significantly enhanced interaction between the promoter and upstream enhancer under dual-drug combination. Taken together, this study elucidates a new synergistic lethal interaction in liver cancer.
肝细胞癌(HCC)是全球最致命的癌症之一。多纳非尼是一种多受体酪氨酸激酶抑制剂,已被批准用于治疗晚期 HCC 患者,但临床效果非常有限。在这里,通过对小分子抑制剂文库和可用药 CRISPR 文库的综合筛选,表明 GSK-J4 与多纳非尼在肝癌中具有合成致死性。这种协同致死性在多种 HCC 模型中得到了验证,包括异种移植、原位诱导 HCC、患者来源的异种移植和类器官模型。此外,多纳非尼和 GSK-J4 的联合治疗导致细胞死亡主要通过铁死亡。从机制上讲,通过整合 RNA 测序(RNA-seq)和高通量测序(ATAC-seq)分析,发现多纳非尼和 GSK-J4 协同促进 HMOX1 的表达并增加细胞内 Fe2+水平,最终导致铁死亡。此外,通过靶向切割和标签测序(CUT&Tag-seq)发现,在多纳非尼和 GSK-J4 联合治疗下,HMOX1 启动子上游的增强子区域显著增加。染色体构象捕获实验证实,在双重药物组合下,启动子和上游增强子之间的相互作用显著增强,导致 HMOX1 的表达增加。总之,这项研究阐明了肝癌中一种新的协同致死相互作用。