Suppressing protein damage response to overcome multidrug resistance in cancer therapy
Fangyuan Shao1,2,3, Zongjie Li1,2, Hao Xiao4
1Cancer Center, Faculty of Health Sciences, University of Macau, Macau SAR, China.
Abstract:
Multidrug resistance is a significant barrier in cancer therapy largely due to poorly understood regulatory mechanisms. Here we reveal that certain anticancer drugs can bind to newly synthesized proteins prior to reaching their canonical targets, resulting in various forms of protein damage. This binding disrupts protein functions, particularly those of mitochondrial proteins, resulting in substantial cytotoxicity. The protein damage is further exacerbated by mitochondrial reactive oxygen species generated as a consequence of the initial damage, creating a positive feedback loop. In response, cancer cells rapidly initiate a chain of events, which we term the Protein Damage Response (PDR). This includes damage recognition primarily mediated by protein ubiquitination and subsequent damage clearance via the proteasome system. Notably, patients with advanced, drug-resistant metastatic breast or colon cancers exhibit elevated proteasome activity. In an effort to predict drug resistance, we developed a sensitive kit for detecting proteasome levels, enabling the identification and subtyping of patients with high proteasome activity to support tailored therapeutic strategies. Using a three-dimensional tumor slice culture-based drug sensitivity assay and an investigator-initiated clinical trial, we demonstrate that three clinically approved proteasome inhibitors effectively overcome multidrug resistance in colon and breast cancer patients with elevated proteasome activity.
Insights
Anticancer drugs damage proteins, triggering a cellular response. Targeting proteasome activity can overcome multidrug resistance in cancer therapy.
Area of Science:
- Oncology
- Molecular Biology
- Biochemistry
Background:
- Multidrug resistance (MDR) is a major challenge in cancer therapy.
- The regulatory mechanisms underlying MDR are not fully understood.
- Anticancer drugs can cause off-target protein damage, contributing to cytotoxicity.
Purpose of the Study:
- To investigate the mechanisms of anticancer drug-induced protein damage.
- To identify cellular responses to protein damage, termed the Protein Damage Response (PDR).
- To explore the role of proteasome activity in MDR and develop strategies to overcome it.
Main Methods:
- Analysis of drug-induced protein binding and subsequent cellular damage.
- Characterization of the Protein Damage Response (PDR) pathway, including ubiquitination and proteasome degradation.
- Development of a kit to detect proteasome levels in patient samples.
- Validation of proteasome inhibitors in 3D tumor slice cultures and a clinical trial.
Main Results:
- Anticancer drugs bind to newly synthesized proteins, causing damage, particularly to mitochondrial proteins.
- This initial damage triggers a positive feedback loop involving reactive oxygen species and leads to the PDR.
- Elevated proteasome activity is observed in drug-resistant metastatic breast and colon cancers.
- A proteasome detection kit identified patients with high proteasome activity.
- Proteasome inhibitors reversed MDR in patients with high proteasome activity.
Conclusions:
- Drug-induced protein damage and the subsequent PDR are key mechanisms in cancer therapy resistance.
- Proteasome activity is a predictive biomarker for MDR.
- Targeting proteasome activity with inhibitors offers a promising strategy to overcome MDR in specific cancer patient populations.
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