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Publication : Activation of the NRF2 antioxidant program sensitizes tumors to G6PD inhibition.

First Author  Ding H Year  2021
Journal  Sci Adv Volume  7
Issue  47 Pages  eabk1023
PubMed ID  34788087 Mgi Jnum  J:315125
Mgi Id  MGI:6830822 Doi  10.1126/sciadv.abk1023
Citation  Ding H, et al. (2021) Activation of the NRF2 antioxidant program sensitizes tumors to G6PD inhibition. Sci Adv 7(47):eabk1023
abstractText  The KEAP1/NRF2 pathway promotes metabolic rewiring to support redox homeostasis. Activation of NRF2 occurs in many cancers, often due to KEAP1 mutations, and is associated with more aggressive disease and treatment resistance. To identify metabolic dependencies in cancers with NRF2 activation, we performed a metabolism-focused CRISPR screen. Glucose-6-phosphate dehydrogenase (G6PD), which was recently shown to be dispensable in Ras-driven tumors, was a top dependency. G6PD catalyzes the committed step of the oxidative pentose phosphate pathway that produces NADPH and nucleotide precursors, but neither antioxidants nor nucleosides rescued. Instead, G6PD loss triggered tricarboxylic acid (TCA) intermediate depletion because of up-regulation of the alternative NADPH-producing enzymes malic enzyme and isocitrate dehydrogenase. In vivo, G6PD impairment markedly suppressed KEAP1 mutant tumor growth, and this suppression was further augmented by TCA depletion by glutaminase inhibition. Thus, G6PD inhibition–induced TCA depletion is a therapeutic vulnerability of NRF2-activated cancer.
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