Abstract Colorectal and pancreatic cancer collectively comprise 20% of all cancer-related deaths in the United States. Despite therapeutic advancements, the current standard of care often results in significant toxicity. Therefore, there is an urgent need to develop more efficacious novel therapies. The imipridones, ONC201/TIC10, ONC206, and ONC212, are novel small-molecules that bind mitochondrial ClpP and induce activation of the integrated stress response (ISR), tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) signaling, and oxidative stress. Each has previously demonstrated antitumor effects in a variety of preclinical in vitro and in vivo cancer subtypes, including colorectal cancer, with limited toxicity. Reactive oxidation species (ROS) are natural biproducts of cellular oxidative metabolism and play important roles in the modulation of cell death pathways, differentiation, and immune response. Using varying doses of ONC201, ONC206, and ONC212, we observed increased lipid peroxidation in several colorectal and pancreatic cancer cell lines using the C-11 BODIPY assay which measures lipid-specific peroxides. Lipid peroxidation was reversed by the ferroptosis inhibitor liproxstatin-1, suggesting that in addition to inducing apoptosis, imipridones may be involved in ferroptosis induction. Future directions include mechanistic work, investigation of the effect of imipridone-induced lipid peroxidation on immune cell cytotoxicity, and understanding the relative importance of lipid peroxidation in the clinical efficacy of imipridones. Citation Format: Arielle De La Cruz, Praveen R. Srinivasan, Andrew George, Varun V. Prabhu, Maximilian P. Pinho-Schwermann, Wafik S. El-Deiry. Imipridones induce lipid peroxidation and oxidative stress in gastrointestinal malignancies. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4786.
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