Abstract Ras pathway mutations are very common in cancer, with the highest prevalence for RAS itself, found in about 30% of tumors. Despite multiple efforts, targeting the RAS pathway has not yet been amenable to therapeutic intervention. Taking a different approach, our laboratory has focused on combination treatment with romidepsin, an HDAC inhibitor approved by the FDA to treat T-cell lymphoma. Our group indeed demonstrated perturbation of RAS downstream pathways after romidepsin treatment, by analyzing gene expression in samples obtained from patients treated with romidepsin for T-cell lymphoma (Chakraborty et al, Blood 2013, 121: 4115). The NCI-60 panel was screened with romidepsin plus or minus RAS pathway downstream inhibitors (MEK and/or Akt inhibitors). We found that mutations in RTK/RAS/BRAF correlated with romidepsin sensitivity (R = 0.472), with cell death ranging from 40% to 95% after 48h (assayed by annexin V labeling). Three KRAS mutant and three KRAS WT cell lines were then chosen to investigate the mechanism of this selectivity. Romidepsin induced histone acetylation and DNA damage from 30min treatment, and an increase in reactive oxygen species (ROS) after 10h exposure, independent of KRAS status. Only KRAS mutant cells showed mitochondrial membrane depolarization, cytochrome c release, and apoptosis, all starting about 24h after the beginning of treatment. Interestingly, cytoplasmic - but not mitochondrial - ROS scavengers rescued KRAS mutant cells from death, suggesting that ROS is required but not sufficient for romidepsin-induced apoptosis. Since Son et al (Nature 2013, 496: 101) reported that glutamine metabolism was reprogrammed by oncogenic KRAS to maintain redox balance, we explored this pathway using the Seahorse XF96 analyzer. We observed that, while all cell lines utilized glutamine for oxidative phosphorylation (OXPHOS) before drug exposure, romidepsin impaired the ability of only KRAS mutant cells to use glutamine for OXPHOS. Metabolomic analysis confirmed reduced glutamine use in KRAS mutant cells after drug treatment, as well as an inability to replenish their reduced glutathione stock. Moreover, this analysis also highlighted a romidepsin-induced drop in nucleotide synthesis in KRAS mutant cells, potentially leading to impaired DNA repair. Accordingly, adding back nucleosides to media blunted the effect of romidepsin on cell growth in KRAS mutant, but not in KRAS WT cells. From these results, we conclude that romidepsin causes cell damage through DNA damage and subsequent ROS release. And while KRAS WT cells are able to scavenge ROS and repair DNA breaks, KRAS mutant cells cannot. We hypothesize that the reprogramming of glutamine metabolism, which supports redox maintenance and may support nucleoside synthesis, makes KRAS mutant cells particularly sensitive to romidepsin treatment. Citation Format: Agnes Basseville, Carole Sourbier, Robert W. Robey, Dan L. Sackett, W. Marston Linehan, Susan E. Bates. Metabolic reprogramming in KRAS mutant cancer cells may cause sensitivity to the histone deacetylase (HDAC) inhibitor romidepsin. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1771. doi:10.1158/1538-7445.AM2015-1771
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