Abstract B19: Disruption of energy homeostasis as an approach to block the proliferation of colon carcinomatosis

Abstract

Abstract Strategies aimed at obtaining a complete cytoreduction are needed to improve long-term survival for patients with colorectal cancer peritoneal carcinomatosis (CRC-pc). We established organoid models that presented cancer stem cell characteristics from naïve CRC-pc surgical samples of two patients (C1 and C2). The organoids recapitulated their corresponding clinical samples in terms of 3D structure and immmunoistochemical profile and were enriched in LGR5 positive cancer stem cells. Proteomic analyses of organoids highlighted their strong dependence on energy producing pathways, suggesting that their targeting may be an effective therapeutic approach for the ablation of cancer cell malignancies. To test this hypothesis we treated organoids with an inhibitor of MIF/CD74 signaling axis, 4-iodo-6-phenylpyrimidine (4-IPP), and metformin, which inhibits mitochondrial oxidation. Both the drugs target metabolism acting on AMP-activated protein kinase (AMPK), the main regulator of cellular energy homeostasis. AMPK inhibits the major anabolic processes sustaining cancer cell proliferation and growth and confers cell plasticity to survive under conditions of metabolic stress, such as hypoxia and glucose deprivation, which is commonly observed in tumors with rapid growth. As a new finding we observed that treatment of organoids with 4-IPP resulted in decreased AMPK signaling activity, inducing a stress-signaling response and death of cultured organoids. Conversely, metformin treatment enhanced AMPK activation under energy stress, decreasing the activity of the anabolic factors ribosomal protein S6 and p4EBP-1 and inhibiting the mitochondrial activity, hindering cell proliferation. Furthermore, metformin treated organoids exhibited a Warburg-like metabolic profile. Our results show that organoid metabolism can be disrupted by metformin-induced AMPK activation but also through a strong reduction in AMPK functions caused by the removal of MIF/CD74 signaling axis that induces an irreversible disruption of energy homeostasis and ultimately causes cell death. Overall, we suggest that AMPK functions are crucial for energy metabolism of colorectal cancer peritoneal carcinomatosis, and regulation of AMPK activity could be a potential molecular target for the treatment of CRC-pc. Citation Format: Fabio Bozzi, Angela Mogavero, Luca Varinelli, Annunziata Gloghini, Valerio Leoni, Galina V. Beznoussenko, Alexandre A. Mironov, Ermanno Leo, Marco A. Pierotti, Italia Bongarzone, Manuela Gariboldi. Disruption of energy homeostasis as an approach to block the proliferation of colon carcinomatosis. [abstract]. In: Proceedings of the AACR Special Conference on Colorectal Cancer: From Initiation to Outcomes; 2016 Sep 17-20; Tampa, FL. Philadelphia (PA): AACR; Cancer Res 2017;77(3 Suppl):Abstract nr B19.