Abstract

Drug resistance of cancer cells is recognized as the primary cause of failure of chemotherapeutic treatment in most human cancers. Growing evidences support the idea that deregulated cellular metabolism is linked to such resistance. Indeed, both components of the glycolytic and mitochondrial pathways are involved in altered metabolism linked to chemoresistance of several cancers. Here we investigated the drug-induced metabolic adaptations able to confer advantages to docetaxel resistant prostate cancer (PCa) cells. We found that docetaxel-resistant PC3 cells (PC3-DR) acquire a pro-invasive behavior undergoing epithelial-to-mesenchymal-transition (EMT) and a decrease of both intracellular ROS and cell growth. Metabolic analyses revealed that PC3-DR cells have a more efficient respiratory phenotype than sensitive cells, involving utilization of glucose, glutamine and lactate by the mitochondrial oxidative phosphorylation (OXPHOS). Consequently, targeting mitochondrial complex I by metformin administration, impairs proliferation and invasiveness of PC3-DR cells without effects on parental cells. Furthermore, stromal fibroblasts, which cause a “reverse Warburg” phenotype in PCa cells, reduce docetaxel toxicity in both sensitive and resistant PCa cells. However, re-expression of miR-205, a microRNA strongly down-regulated in EMT and associated to docetaxel resistance, is able to shift OXPHOS to a Warburg metabolism, thereby resulting in an elevated docetaxel toxicity in PCa cells. Taken together, these findings suggest that resistance to docetaxel induces a shift from Warburg to OXPHOS, mandatory for conferring a survival advantage to resistant cells, suggesting that impairing such metabolic reprogramming could be a successful therapeutic approach.

Highlights

  • Docetaxel (Taxotere®) is a standard chemotherapy for patients with castration resistant metastatic prostate cancer [1, 2]

  • We evaluated the expression and activity of the key phosphate pathway (PPP) rate limiting enzyme glucose6-phosphate dehydrogenase (G6PD) as well as PPP flux by radioactive assay in PC3-DR and in sensitive cells (Figure 1C-1E)

  • PC3-DR cells are insensitive to G6PD inhibitors, Molecular Clip and Tweezer [31] (Figure 1F), suggesting that docetaxelresistance does not depend on PPP activation in the model analyzed

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Summary

Introduction

Docetaxel (Taxotere®) is a standard chemotherapy for patients with castration resistant metastatic prostate cancer [1, 2]. PTEN loss [5], activation of survival pathways (i.e., PI3K/AKT and mTOR) [6] and recently NOTCH2/ Hedgehog signaling pathways [7]. Recent findings both in vitro and from tumor samples support the presence of primary resistant cells harboring EMT/stem cell–like characteristics [8] suggesting a possible association between such aggressive features and chemotherapy failure. In tumor microenvironment, cancer-associated fibroblasts (CAFs) have been shown to promote aggressiveness of PCa cells in terms of EMT induction [18], OXPHOS metabolic shift [19, 20] and miRNAs deregulation [21]. We demonstrated that overexpression of miR-205, associated with a reversion of OXPHOS metabolism, is crucial to sensitize PC3-DR to the drug

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