bims-meract Biomed News
on Metabolic reprogramming and anti-cancer therapy
Issue of 2026–07–05
thirteen papers selected by
Andrea Morandi, Università degli Studi di Firenze



  1. Cell Death Dis. 2026 Jun 29.
      ONC201 is a first-in-class, FDA-approved small molecule activator of the mitochondrial ATP-dependent caseinolytic peptidase P (ClpP). This and other related small molecules referred to as ClpP agonists, exert antiproliferative effects in several cancer cell types. We report that ONC201 and highly potent second generation ClpP agonists (TR-57, TR-107), promote induction of senescence in triple-negative breast cancer (TNBC) cell lines. Senescence was determined by increased β-galactosidase (β-gal) activity, downregulation of phosphorylated Rb, c-Myc (Myc), and lamin B1, upregulation of senescent-associated secretory phenotype (SASP), and extended cell proliferation assays. These responses were not observed in ClpP knockout cell lines, demonstrating ClpP-dependence. Proteomics analyses identified multiple events related to the development of senescence including cell cycle arrest and mitochondrial dysfunction. Flow cytometry confirmed an S-phase arrest and DNA damage was detected by Comet assay, 53BP1, phospho-S*Q, and γH2A.X immunostaining. In parallel with this, activation of the ATM pathway and phosphorylation of Chk2 was observed. We determined that ClpP agonist-induced senescence was irreversible in both in vitro and in vivo studies. Following TR-57 treatment and drug washout, cells remained growth arrested which coincided with loss of mitochondrial membrane potential and ability to produce ATP by oxidative phosphorylation. β-gal staining after TR-57 treatment and drug washout demonstrated a sustained increase in β-gal activity, indicating cells are senescent after drug washout. This response was reproduced in vivo wherein senescent 4T1-Luc cells did not develop tumors following injection into mice. Finally, the combination of a ClpP agonist with a known senolytic (venetoclax), synergistically increased the amount of cell death observed. In summary, we show that ClpP agonists stably induce an irreversible senescence in a ClpP-dependent manner that synergizes with venetoclax in TNBC cells.
    DOI:  https://doi.org/10.1038/s41419-026-09061-w
  2. NPJ Precis Oncol. 2026 Jun 29.
      Glucagon-like peptide-1 receptor agonists (GLP-1RAs), widely used for diabetes and obesity, have recently attracted attention for potential anti-tumor effects, although their mechanisms remain unclear. Given their role in metabolic regulation, we hypothesized that GLP-1RAs may target cancer-specific metabolic vulnerabilities. Hepatocellular carcinoma (HCC) is characterized by metabolic reprogramming and enhanced glycolysis, which contribute to therapeutic resistance. Here, we investigated the anti-tumor effects of a GLP-1RA in HCC, focusing on its ability to modulate glycolytic pathways and enhance sensitivity to Lenvatinib. Lenvatinib-resistant HCC cells exhibited suppressed AMPKα1 and increased HIF-1α and PFKFB3 expression, promoting glycolytic adaptation. GLP-1RA treatment restored AMPKα1 activity while suppressing HIF-1α/PFKFB3 signaling, thereby reducing glycolytic activity and enhancing apoptosis. Combination treatment with GLP-1RA and Lenvatinib significantly inhibited tumor cell growth in resistant models. These findings suggest that the AMPKα1/HIF-1α/PFKFB3 axis represents a metabolic vulnerability in Lenvatinib-resistant HCC and support GLP-1RA-based combination strategies.
    DOI:  https://doi.org/10.1038/s41698-026-01584-x
  3. Immunity. 2026 Jul 03. pii: S1074-7613(26)00253-0. [Epub ahead of print]
      Recurrence after tumor resection and liver transplantation remains a major clinical challenge in hepatocellular carcinoma (HCC). We examined tumor samples from HCC liver transplant patients to identify drivers of disease recurrence. Integration of proteomic profiling of human HCC samples with or without recurrence and T cell killing assays linked the cholesterol esterification enzyme SOAT1 to immune evasion and cancer recurrence. Genetic or pharmacological inhibition of SOAT1 sensitized liver cancer cells to CD8+ T cell-mediated immunosurveillance, anti-programmed cell death 1 (anti-PD-1) therapy, and chimeric antigen receptor (CAR)-T cell therapy and increased intratumoral CD8+ T cell infiltration. Mechanistically, the inhibition of SOAT1-mediated cholesterol esterification disrupted intratumoral cholesterol and lipid metabolism and reduced unsaturated fatty acids and prostaglandin E2 production; this impaired the antioxidant capacity and metabolic resilience of cancer cells under immune attack. Accordingly, SOAT1 inhibition enhanced immunotherapy efficacy in obesity-associated tumors and under immunosuppressant-induced conditions. Thus, cholesterol esterification supports redox fitness and cancer cell resilience upon immune attack, suggesting a strategy to prevent recurrence and improve immunotherapy outcomes.
    Keywords:  CAR-T cell therapy; SOAT1; anti-PD-1; cholesterol metabolism; hepatocellular carcinoma; immune evasion; immunotherapy; lipid metabolism; oxidative stress; tumor recurrence
    DOI:  https://doi.org/10.1016/j.immuni.2026.06.002
  4. Gut. 2026 Jul 02. pii: gutjnl-2026-338277. [Epub ahead of print]
       BACKGROUND: The application of the novel KRASG12D inhibitor in pancreatic ductal adenocarcinoma (PDAC) is currently hindered by adaptive resistance. Metabolic reprogramming is a hallmark of KRASG12D signalling, yet the mechanisms linking these alterations to immunosuppression and low therapeutic response are poorly defined.
    OBJECTIVE: To identify the key regulatory nodes connecting KRASG12D-driven metabolic adaptations to tumour microenvironment and develop a mechanistic-based combinatorial strategy.
    DESIGN: We integrated whole-exome sequencing, untargeted metabolomics and single-cell RNA sequencing of human PDAC specimens to analyse the metabolic-immune landscape. We evaluated therapeutic efficacy using the autochthonous mouse and patient-derived xenograft models.
    RESULTS: We found that KRASG12D enhanced cholesterol metabolism and promoted CD8+ T cell exhaustion, whereas KRASG12D inhibition or cholesterol synthesis blockade induced compensatory ULK1-associated autophagy. Cotargeting cholesterol metabolism and autophagy potentiated the antitumour efficacy of the KRASG12D inhibitor MRTX1133 and alleviated CD8+ T cell exhaustion. Mechanistically, KRASG12D transcriptionally upregulated USP20 via EGR1, which simultaneously deubiquitinated and stabilised 3-hydroxy-3-methylglutaryl-CoA reductase and ULK1, thereby orchestrating cholesterol metabolism and autophagy-associated survival. Genetic depletion or pharmacological inhibition of USP20 with GSK2643943A suppressed these pathways and restored CD8+ T cell function, improving responses to MRTX1133 and anti-programmed cell death protein-1 (anti-PD-1). In preclinical PDAC models, triple therapy with GSK2643943A, MRTX1133 and anti-PD-1 elicited a robust therapeutic response and induced significant tumour regression.
    CONCLUSION: USP20 acts as a critical metabolic checkpoint that orchestrates CD8+ T cell exhaustion and therapeutic response. Targeting the USP20-cholesterol-autophagy axis represents a promising strategy to reverse immune suppression and unlock the full potential of KRASG12D inhibitors in PDAC.
    Keywords:  IMMUNE RESPONSE; MOLECULAR TARGETED THERAPY; PANCREATIC CANCER
    DOI:  https://doi.org/10.1136/gutjnl-2026-338277
  5. Cancer Res. 2026 Jun 30.
      Immune checkpoint blockade (ICB) represents an important therapeutic approach for hepatocellular carcinoma (HCC). However, resistance to ICB treatment remains challenging. Here, we identified protein phosphatase magnesium-dependent 1δ (PPM1D) as a driver of HCC immunotherapy resistance. PPM1D expression was significantly upregulated in tumor tissues, and tumor cells elevated PPM1D expression in response to effector CD8+ T lymphocyte activation via TNFα-NF-κB signaling. Genetic or pharmacological inhibition of PPM1D inhibited HCC progression by enhancing CD8+ T-cell cytotoxicity. Mechanistically, PPM1D maintained tumor cell mitochondrial homeostasis and limited mitochondrial DNA leakage-triggered cGAS-STING-IFN activity by directly dephosphorylating mitochondrial outer membrane component VDAC2 at Ser 115, preventing VDAC2 oligomerization. Inhibiting PPM1D synergized with PD-1 inhibition in preclinical HCC models with minimal toxicity. Together, this study provides insights into targeting PPM1D to improve immunotherapy efficacy in HCC.
    DOI:  https://doi.org/10.1158/0008-5472.CAN-25-5286
  6. Nat Commun. 2026 Jun 30.
      Genetic heterogeneity contributes to the variable therapeutic responses in cancers. Frequent SPOP mutations and recurrent CHD1 deletions define distinct molecular subtypes of prostate cancer (PCa) with differential responses to anti-androgen therapy. Ferroptosis, an iron-dependent cell death mechanism driven by lipid peroxidation, has emerged as a promising anticancer strategy. Here, we identify SPOP mutations and CHD1 deletion as key genetic determinants of ferroptosis susceptibility in PCa. Using genetically engineered human and murine models, we show that SPOP mutations enhance, whereas CHD1 deletion impairs, the efficacy of ferroptosis inducers targeting GPX4. Mechanistically, SPOP and CHD1 exert opposing effects on ferroptosis by antagonistically regulating the MYC-ACSL4 axis. Furthermore, we demonstrate that targeting cholesterol metabolism with cholesterol-lowering agents restores ACSL4 expression and re-sensitizes SPOP/CHD1 co-deficient tumors to ferroptosis-inducing therapy. Our findings establish SPOP/CHD1 as upstream genetic regulators of ferroptosis and provide biomarker-driven combinatorial strategies to enhance ferroptosis-based therapy in men with advanced PCa.
    DOI:  https://doi.org/10.1038/s41467-026-75010-y
  7. Trends Mol Med. 2026 Jul 02. pii: S1471-4914(26)00138-3. [Epub ahead of print]
      Hepatocellular carcinoma (HCC) remains lethal due to its high refractoriness to standard treatment, which is contributed to by factors including adaptive metabolic reprogramming of HCC cells and pre-existing liver diseases that compromise liver function. Abnormal tumor vasculature creates a nutrient-deprived microenvironment, intensifying competition between HCC cells and immune cells and impairing antitumor immunity. Among the complex metabolic network, amino acid (AA) metabolism emerges as a critical player and an attractive therapeutic target. This review first examines how dysregulated AA metabolism supports HCC hallmarks, including metabolic reprogramming and immune evasion. We discuss the translational potential of therapies targeting AA metabolism in HCC, ranging from pharmacologic inhibition to dietary AA intervention, which can be further integrated with existing HCC treatments to improve clinical outcomes.
    Keywords:  amino acid metabolism; amino acid-targeted therapy; hepatocellular carcinoma; tumor microenvironment
    DOI:  https://doi.org/10.1016/j.molmed.2026.06.002
  8. Pancreas. 2026 Jul 02.
       BACKGROUND: Integrinβ4 (ITGB4), a transmembrane adhesion molecule, is closely associated with chemotherapy resistance in tumor cells. The pentose phosphate pathway (PPP) is a critical metabolic pathway that enables tumor cells to cope with chemotherapeutic stress and maintain survival. However, the specific mechanisms of ITGB4 regulating the PPP to influence the sensitivity of pancreatic adenocarcinoma (PAAD) to gemcitabine (GEM) remain unclear.
    METHODS: Data from the TCGA-PAAD dataset were utilized to assess ITGB4 expression level and its correlation with patient prognosis. The correlation between ITGB4 and the expression of key PPP genes was assessed. RT-qPCR and Western blot were employed to measure levels of ITGB4 and G6PD. The half-maximal inhibitory concentration (IC50) of GEM in cells and cell vitality were determined using the CCK-8 assay. Cell proliferation capacity was examined via the EdU assay. Glucose consumption, lactate production, and intracellular levels of NADP⁺ and NADPH were measured using specific kits to evaluate PPP metabolic activity. Intracellular reactive oxygen species (ROS) levels were detected by flow cytometry to analyze changes in the redox state.
    RESULTS: The high expression status of ITGB4 in PAAD was significantly linked with poor prognosis in patients, and its expression level was also positively correlated with the expression of PPP key genes. Based on functional experiment, knocking down the expression of ITGB4 significantly enhanced the sensitivity of PAAD cells to GEM. At the same time, knocking down ITGB4 resulted in significantly elevated intracellular NADPH levels and ROS levels, suggesting that the PPP pathway may be suppressed. In addition, upon 6-AN treatment, the increase in IC50 value and cell proliferation enhancement caused by overexpression of ITGB4 in GEM were reversed.
    CONCLUSION: ITGB4 reduces the sensitivity of PAAD cells to GEM by activating the PPP. This finding not only elucidates the mechanism of ITGB4 in PAAD chemo-resistance but also offers a theoretical basis for improving the efficacy of GEM treatment and developing targeted therapeutic strategies.
    Keywords:  GEM; ITGB4; pancreatic adenocarcinoma; pentose phosphate pathway
    DOI:  https://doi.org/10.1097/MPA.0000000000002690
  9. Nature. 2026 Jul 01.
      Patients with colorectal cancer (CRC) frequently develop liver metastases1-3. The prognosis of these patients is skewed by the histopathological heterogeneity of their liver metastases4,5. Patients with 'replacement' metastases have a 5-year overall survival of less than 44.2%, compared with 73.4% in patients with 'encapsulated' (previously known as desmoplastic) metastases5; yet there are currently no approved therapies targeting replacement liver metastases. Here we show that treatment-naive patients with CRC with liver steatosis have an increased occurrence of replacement metastases compared with patients without steatosis. Mechanistically, we find that steatosis-promoted fatty acid oxidation increases formation of replacement metastases by increasing MYC stability through acetylation. In turn, MYC activates proline synthesis, fuelling collagen production, enabling growth of replacement metastases. Targeting MYC, P5CS or COL1A1 suppresses the occurrence and growth of replacement metastases in patient-derived organoids, mouse or patient-derived xenograft models. Spatial metabolite and protein analyses of liver metastases from patients with CRC further support this mechanism. In conclusion, we provide a mechanistic understanding of the emergence of liver metastases with poor prognosis in treatment-naive patients with CRC, identifying potential targets for therapeutic intervention.
    DOI:  https://doi.org/10.1038/s41586-026-10686-2
  10. Adv Sci (Weinh). 2026 Jul 03. e76402
      Anaplastic thyroid carcinoma (ATC) is an exceptionally aggressive malignancy with dismal survival, largely due to intrinsic cisplatin resistance. This study identifies a novel mechanism by which small extracellular vesicles (sEVs) promote chemoresistance by enhancing DNA repair via protein lactylation. ATC cells secrete sEVs enriched with Annexin A2 (ANXA2). Upon delivery to recipient ATC cells, ANXA2 stabilizes the interaction between SRC kinase and lactate dehydrogenase A (LDHA), leading to increased LDHA phosphorylation (Y10), enzyme activity, and lactate production. The resulting lactate surge serves as a substrate for lysine lactylation. Ku80 (XRCC5) is identified as a key lactylation target at K265, catalyzed by the acyltransferase KAT5. This lactylation modification strengthens the interaction between Ku80 and its partner Ku70 (XRCC6), stabilizing the initial DNA-end binding complex in the non-homologous end-joining (NHEJ) repair pathway. Consequently, NHEJ efficiency is significantly enhanced, enabling ATC cells to rapidly repair cisplatin-induced DNA double-strand breaks and survive treatment. Genetic disruption of the XRCC5-K265 lactylation site or pharmacological inhibition of LDHA sensitizes ATC xenograft tumors to cisplatin, while in vitro, inhibition of the SRC/LDHA axis produces a similar chemosensitizing effect. This work unveils the ANXA2+ sEV/SRC/LDHA/lactate/XRCC5-lactylation axis as a critical driver of NHEJ-mediated chemoresistance in ATC, offering new potential therapeutic targets.
    Keywords:  XRCC5; anaplastic thyroid carcinoma; lactylation; non‐homologous end‐joining repair; small extracellular vesicle
    DOI:  https://doi.org/10.1002/advs.76402
  11. NPJ Breast Cancer. 2026 Jun 27.
      Endocrine therapies targeting estrogen receptor alpha (ERα), expressed in ~70% of breast cancers, remain the standard of care for ER+ disease. However, 30-40% of patients experience recurrence and metastasis, with 5-year survival rates of only 31.9%. Using the Carle Foundation Hospital cohort and liver metastatic patient-derived xenograft models, we identified upregulated lipid metabolism and acetyl-CoA production as metabolic vulnerabilities. We demonstrate that combining Fulvestrant (Fulv) with an inhibitor of Acyl-CoA Synthetase Short Chain Family Member 2 (ACSS2) synergistically reduces metastatic breast cancer cell viability. Through isotope tracing, CUT&RUN sequencing, immunofluorescence, western blot, and RNA sequencing, we show that Fulv increases ACSS2 expression and acetate utilization, redirecting acetate flux from the TCA cycle toward fatty acid synthesis. Nuclear ACSS2 chromatin occupancy increases with Fulv treatment, expanding ERα/ACSS2/H3K27ac co-occupancy at tumor progression genes, an effect abolished by ACSS2 inhibition. RNA sequencing revealed that ACSS2 inhibition suppresses Fulv-induced metabolic and oncogenic transcriptional programs. In a therapy-resistant xenograft model, combination treatment reduced Fulv-dependent metastatic burden. These findings establish ACSS2 as a driver of endocrine resistance through nuclear acetyl-CoA provision for epigenetic reprogramming, representing a novel therapeutic target in metastatic breast cancer.
    DOI:  https://doi.org/10.1038/s41523-026-00987-0
  12. Cell Death Dis. 2026 Jun 30.
      Cetuximab resistance remains a major obstacle in the treatment of metastatic colorectal cancer (mCRC), highlighting the urgent need to identify synthetic lethal partners of EGFR. In this study, we observed glutamate dehydrogenase 1 (GDH1) accumulation in cetuximab-treated CRC samples. GDH1 depletion sensitized CRC cells to cetuximab and suppressed remodeling of the tumor immune microenvironment (TIME), as revealed by single-cell RNA sequencing. Mechanistically, cetuximab treatment induced substantial cytosolic accumulation of GDH1. Under normal conditions, EGFR directly phosphorylates cytosolic GDH1 at Y451, leading to HIP1R-mediated lysosomal degradation. Cetuximab, however, blocks GDH1-Y451 phosphorylation, thereby stabilizing GDH1 and increasing α-ketoglutarate (αKG) production. Elevated αKG enhances ALKBH5 activity to demethylate m6A modifications in the 3'UTR of NDUFA2, CXCL3, and SOS1 pre-mRNAs. This cascade coordinately rewires tumor cell metabolism and reprograms the TIME, while also amplifying KRAS-driven signaling to promote CRC liver metastasis. Importantly, combining cetuximab with the GDH1 activity inhibitor R162 curbed tumor metabolic adaptation, reversed TIME remodeling, and suppressed KRAS activation, thereby preventing immune escape and metastatic progression. Our findings unveil the EGFR/GDH1/αKG/ALKBH5 axis as a key modulator of cetuximab response and suggest that post-treatment monitoring of blood αKG may help identify patients who could benefit from GDH1 inhibition to augment immunotherapy and KRAS-targeted strategies.
    DOI:  https://doi.org/10.1038/s41419-026-09001-8
  13. Leukemia. 2026 Jun 30.
      Relapsed/refractory B-cell acute lymphoblastic leukemia (B-ALL) remains a leading cause of cancer-related death in children and young adults. While CD19-directed chimeric antigen receptor T cell (CAR-T) therapy offers promise, high rates of long-term failure underscore the need to understand resistance mechanisms. Our studies found p53 inactivation promotes CAR-T resistance in human pre-B-ALL cell lines. Through genome-wide CRISPR/Cas9 screening of CAR-sensitive TP53-wildtype and CAR-resistant TP53-mutated CD19 + B-ALL cell lines, we found the Fatty Acid Transport Protein 2 (FATP2, encoded by SLC27A2) is a leukemia-intrinsic mechanism of CAR-T resistance in TP53-mutant B-ALL. High SLC27A2 expression in pediatric B-ALL patients correlate with worse survival outcomes following conventional chemotherapy. Using B-ALL cell lines and patient-derived xenografts, we show that FATP2-expressing TP53-mutant B-ALL resistance to CAR-T is dependent on exogenous lipid uptake to fuel fatty acid oxidation (FAO) and cell survival, which can be pharmacologically targeted through inhibition of neutral lipolysis and CPT1. These findings identify FATP2-mediated fatty acid uptake and downstream FAO as a potential target to improve existing CAR-T efficacy in human B-ALL.
    DOI:  https://doi.org/10.1038/s41375-026-03030-0