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Lomitapide enhances cytotoxic effects of temozolomide in chemotherapy-resistant glioblastoma
Alyona Ivanova, Taylor M. Wilson, Kimia Ghannad-Zadeh, Esmond Tse, Robert Flick, Megan Wu, Sunit Das
Alyona Ivanova, Taylor M. Wilson, Kimia Ghannad-Zadeh, Esmond Tse, Robert Flick, Megan Wu, Sunit Das
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Research Article Cell biology Oncology

Lomitapide enhances cytotoxic effects of temozolomide in chemotherapy-resistant glioblastoma

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Abstract

More than a third of patients with glioblastoma experience tumor progression during adjuvant therapy. In this study, we performed a high-throughput drug repurposing screen of FDA-approved agents capable of crossing the blood-brain barrier in order to find agents to counteract acquired or inherent glioma cell resistance to temozolomide-associated cytotoxicity. We identified the cholesterol processing inhibitor, lomitapide, as a potential chemosensitizer in glioblastoma. In vitro treatment of temozolomide-resistant glioblastoma cells with lomitapide resulted in decreased intracellular ubiquinone levels and sensitized cells to temozolomide-induced ferroptosis. Concomitant treatment with lomitapide and temozolomide (TMZ) prolonged survival and delayed tumor recurrence in a mouse glioblastoma model, compared with treatment xwith TMZ alone. Our data identified lomitapide as a potential adjunct for treatment of temozolomide-resistant glioblastoma.

Authors

Alyona Ivanova, Taylor M. Wilson, Kimia Ghannad-Zadeh, Esmond Tse, Robert Flick, Megan Wu, Sunit Das

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Figure 4

Lomitapide cytotoxicity in vitro is attributed to inhibition of de novo cholesterol synthesis.

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Lomitapide cytotoxicity in vitro is attributed to inhibition of de novo ...
Lomitapide (2 μM) treatment has no effect on the expression of microsomal triglyceride transport protein (MTTP) in CTL-U251 (A and B) and TR-U251 (C and D) cells as confirmed by Western blot analysis after 24 and 48 hours of drug treatment. (E) Proposed mechanism of action of lomitapide. Lomitapide inhibits the critical rate-limiting step of mevalonate pathway by binding to HMGCR. While normally, cholesterol production acts through a negative feedback loop to control HMGCR synthesis, reduction in cholesterol production causes accumulation of HMGCR. (F) Targeted LC-MS results showing relative concentration of mevalonic acid in CTL-U251 cells treated with 2 μM lomitapide for 72 hours (n = 3). The data is normalized to untreated control. Inhibition of mevalonate pathway in CTL-U251 (G and H) and TR-U251 (I and J) cells at 24 and 48 hours following lomitapide treatment (0 μM, 1 μM, or 2 μM) is verified by accumulation of HMGCR. The data are normalized to untreated control. Lomitapide treatment does not lead to accumulation of HMGCR in normal HEK293 cells (K). (L) Cholesterol uptake by CTL-U251 cells following a 72-hour incubation in serum-free media at various lomitapide concentrations. U-18666A represents positive uptake control. The data are normalized to untreated control. All data is represented as individual measurements with mean ± SD. Two-tailed Student’s t tests were used for statistical comparisons between 2 groups, 1-way ANOVA, followed by a post-hoc Tukey’s HSD test, was used for multiple group comparisons. *P < 0.05; **P < 0.01; ***P < 0.001; ****P < 0.0001.

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