Abstract

Cancer cells accumulate iron to supplement their aberrant growth and metabolism. Depleting cells of iron by iron chelators has been shown to be selectively cytotoxic to cancer cells in vitro and in vivo. Iron chelators are effective at combating a range of cancers including those which are difficult to treat such as androgen insensitive prostate cancer and cancer stem cells. This review will evaluate the impact of iron chelation on cancer cell survival and the underlying mechanisms of action. A plethora of studies have shown iron chelators can reverse some of the major hallmarks and enabling characteristics of cancer. Iron chelators inhibit signalling pathways that drive proliferation, migration and metastasis as well as return tumour suppressive signalling. In addition to this, iron chelators stimulate apoptotic and ER stress signalling pathways inducing cell death even in cells lacking a functional p53 gene. Iron chelators can sensitise cancer cells to PARP inhibitors through mimicking BRCAness; a feature of cancers trademark genomic instability. Iron chelators target cancer cell metabolism, attenuating oxidative phosphorylation and glycolysis. Moreover, iron chelators may reverse the major characteristics of oncogenic transformation. Iron chelation therefore represent a promising selective mode of cancer therapy.

Highlights

  • Iron is vital for normal cell growth and survival

  • N-MYC downregulated gene 1 (NDRG1) has been proven to be the common link between the ability of iron chelators to reverse many of the hallmarks of cancer as overexpression of NDRG1 mimics the impact of iron chelation on several signalling pathways

  • Aggressive breast cancer cells have demonstrated a unique reaction to iron chelators, including the accumulation of iron, activation of oncogenic signalling pathways and a methuosis-like death

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Summary

Introduction

Iron is vital for normal cell growth and survival. Cancer is an evolutionary maverick, which exploits its trademark genomic instability to drain environmental resources. As iron can drive cellular proliferation, cancer cells have an adapted iron metabolism allowing increased iron accumulation. Studies have demonstrated cancer cells have an aberrant expression of iron metabolism genes, as well as an overexpression of iron import proteins and underexpression of iron export proteins [4,5,6,7]. This has led to iron accumulation being considered as a target for cancer therapies. Iron chelators selectively deplete cancer cells of iron, exploiting cancer’s iron addiction – a trait displayed by a range of different cancers

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