Abstract
Metabolic reprogramming in cancer cells can create metabolic liabilities which could be exploited therapeutically. Tumor suppressor KEAP1 is frequently mutated in lung cancer, and KEAP1-mutant lung cancers are refractory to most current therapies. Here we show that KEAP1 deficiency promotes glucose dependency in lung cancer cells, and KEAP1-mutant or -deficient lung cancer cells are more vulnerable to glucose deprivation than KEAP1-proficient lung cancer cells. Mechanistically, KEAP1 inactivation in lung cancer cells leads to constitutive activation of NRF2 transcription factor and aberrant expression of NRF2 target cystine transporter SLC7A11; under glucose limiting conditions, high cystine uptake in KEAP1-inactivated lung cancer cells results in toxic buildup of intracellular disulfide molecules, NADPH depletion, and subsequent cell death, which can be rescued by either genetic ablation of the NRF2-SLC7A11 signaling axis or treatments that prevent disulfide accumulation. Finally, we show that KEAP1-inactivated lung cancer cells or xenograft tumors are sensitive to glucose transporter (GLUT) inhibitor KL-11743. Together, our results reveal that KEAP1 deficiency induces glucose dependency in lung cancercells and uncover a metabolic liability that can be therapeutically targeted in KEAP1-mutant lung cancer.
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