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阿司匹林与癌症的代谢特征:结直肠癌的新型治疗机遇

Aspirin and the metabolic hallmark of cancer: novel therapeutic opportunities for colorectal cancer.

作者信息

Hoskin Ashley J, Holt Amy K, Legge Danny N, Collard Tracey J, Williams Ann C, Vincent Emma E

机构信息

Department of Cellular and Molecular Medicine, Biomedical Sciences Building, University of Bristol, BS8 1TW Bristol, UK.

Department of Translational Health Sciences, Dorothy Hodgkin Building, University of Bristol, BS1 3NY Bristol, UK.

出版信息

Explor Target Antitumor Ther. 2023;4(4):600-615. doi: 10.37349/etat.2023.00155. Epub 2023 Aug 28.

Abstract

Aspirin is a well-known nonsteroidal anti-inflammatory drug (NSAID) that has a recognized role in cancer prevention as well as evidence to support its use as an adjuvant for cancer treatment. Importantly there has been an increasing number of studies contributing to the mechanistic understanding of aspirins' anti-tumour effects and these studies continue to inform the potential clinical use of aspirin for both the prevention and treatment of cancer. This review focuses on the emerging role of aspirin as a regulator of metabolic reprogramming, an essential "hallmark of cancer" required to support the increased demand for biosynthetic intermediates needed for sustained proliferation. Cancer cells frequently undergo metabolic rewiring driven by oncogenic pathways such as hypoxia-inducible factor (HIF), wingless-related integration site (Wnt), mammalian target of rapamycin (mTOR), and nuclear factor kappa light chain enhancer of activated B cells (NF-κB), which supports the increased proliferative rate as tumours develop and progress. Reviewed here, cellular metabolic reprogramming has been identified as a key mechanism of action of aspirin and include the regulation of key metabolic drivers, the regulation of enzymes involved in glycolysis and glutaminolysis, and altered nutrient utilisation upon aspirin exposure. Importantly, as aspirin treatment exposes metabolic vulnerabilities in tumour cells, there is an opportunity for the use of aspirin in combination with specific metabolic inhibitors in particular, glutaminase (GLS) inhibitors currently in clinical trials such as telaglenastat (CB-839) and IACS-6274 for the treatment of colorectal and potentially other cancers. The increasing evidence that aspirin impacts metabolism in cancer cells suggests that aspirin could provide a simple, relatively safe, and cost-effective way to target this important hallmark of cancer. Excitingly, this review highlights a potential new role for aspirin in improving the efficacy of a new generation of metabolic inhibitors currently undergoing clinical investigation.

摘要

阿司匹林是一种著名的非甾体抗炎药(NSAID),在癌症预防中具有公认的作用,并且有证据支持其作为癌症治疗辅助药物的用途。重要的是,越来越多的研究有助于对阿司匹林抗肿瘤作用的机制理解,这些研究继续为阿司匹林在癌症预防和治疗中的潜在临床应用提供信息。本综述重点关注阿司匹林作为代谢重编程调节剂的新兴作用,代谢重编程是支持持续增殖所需生物合成中间体需求增加所必需的“癌症标志”。癌细胞经常经历由致癌途径驱动的代谢重布线,如缺氧诱导因子(HIF)、无翅相关整合位点(Wnt)、雷帕霉素哺乳动物靶标(mTOR)和活化B细胞的核因子κB轻链增强子(NF-κB),这支持肿瘤发展和进展过程中增殖率的增加。本文综述了细胞代谢重编程已被确定为阿司匹林的关键作用机制,包括对关键代谢驱动因素的调节、对糖酵解和谷氨酰胺分解中涉及的酶的调节,以及阿司匹林暴露后营养物质利用的改变。重要的是,由于阿司匹林治疗暴露了肿瘤细胞中的代谢脆弱性,有机会将阿司匹林与特定的代谢抑制剂联合使用,特别是目前正在临床试验中的谷氨酰胺酶(GLS)抑制剂,如替拉格司他(CB-839)和IACS-6274,用于治疗结直肠癌及其他潜在癌症。越来越多的证据表明阿司匹林会影响癌细胞的代谢,这表明阿司匹林可以提供一种简单、相对安全且具有成本效益的方法来针对这一重要的癌症标志。令人兴奋的是,本综述突出了阿司匹林在提高目前正在进行临床研究的新一代代谢抑制剂疗效方面的潜在新作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d0f9/10501897/51d43d752a01/etat-04-1002155-g001.jpg

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