Published online Feb 21, 2024. doi: 10.3748/wjg.v30.i7.714
Peer-review started: September 26, 2023
First decision: October 9, 2023
Revised: December 13, 2023
Accepted: January 17, 2024
Article in press: January 17, 2024
Published online: February 21, 2024
Processing time: 147 Days and 13.2 Hours
We previously showed that receptor tyrosine kinase inhibitors such as cabozantinib and vandetanib can increase mitochondrial membrane potential (Δψm) in tumor cells and, thus, facilitate mitochondrial enrichment of Δψm-sensitive agents in tumor cells. This effect can disrupt mitochondrial homeostasis and trigger tumor cell death.
Pancreatic cancer is one of the most lethal tumors, demanding highly effective molecular therapies. Although the epidermal growth factor receptor inhibitor erlotinib has been approved for pancreatic adenocarcinoma (PDAC), its efficacy is limited as monotherapy, and it is often used in combination with other drugs. We sought to determine whether erlotinib can be combined with a mitochondria-targeted agent for PDAC suppression.
We measured cell viability by performing cell death assays in 2D and 3D cultures of conventional and patient-derived primary PDAC cell lines. We determined how erlotinib affects Δψm in PDAC cells using Δψm-sensitive fluorescent dyes and by measuring protein adduct formation with mitochondria-targeted carboxy-proxyl (MitoCP) in mitochondria. We examined the effect of erlotinib and mitochondria-targeted ubiquinone (MitoQ) combination by measuring cell viability and analyzing synergy. We determined the preclinical efficacy and physiological relevance of the drug combination using immune-compromised nude mice bearing PDAC cell line xenografts.
Erlotinib elevated Δψm in PDAC cells and facilitated mitochondrial enrichment of the triphenyl-phosphonium (TPP)-conjugated agents. While MitoQ single treatment triggered caspase-dependent apoptosis in PDAC cells, its combination with erlotinib synergistically induced PDAC cell death. Consistent with these data, the drug combination suppressed human PDAC cell line xenografts in mice more effectively than a single treatment of each agent.
These data suggest that erlotinib elevated Δψm in PDAC cells and facilitated mitochondrial enrichment of the TPP-conjugated agents. The drug combination synergistically suppressed PDAC cells.
We aimed to determine whether erlotinib elevates Δψm in PDAC cells, increases tumor cell uptake of the TPP cation-conjugated ubiquinone MitoQ, and subsequently causes tumor cell death.
These data suggest that the erlotinib and MitoQ combination may have therapeutic potential for pancreatic cancer.