American Association for Cancer Research
00085472can190644-sup-217823_3_supp_5781798_pxzg5h.pdf (2.74 MB)

Supplementary Data from Targeting the Metabolic Response to Statin-Mediated Oxidative Stress Produces a Synergistic Antitumor Response

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journal contribution
posted on 2023-03-31, 03:25 authored by Grace H. McGregor, Andrew D. Campbell, Sigrid K. Fey, Sergey Tumanov, David Sumpton, Giovanny Rodriguez Blanco, Gillian Mackay, Colin Nixon, Alexei Vazquez, Owen J. Sansom, Jurre J. Kamphorst

Figure S1 shows the effect of statins on cholesterol and coenzyme Q levels and synthesis. Figure S2 shows statins reduce oxidative phosphorylation and hence increase glucose uptake and lactate secretion. Figure S3 shows the metabolic rewiring that occurs as a consequence of statin-mediated ROS production. Figure S4 shows simvastatin treatment in vivo does not alter cholesterol or dolichol synthesis or systemic coenzyme Q synthesis. Figure S5 shows simvastatin and AZD6244 are synergistic.


Cancer Research UK

Rosetrees Trust



Statins are widely prescribed inhibitors of the mevalonate pathway, acting to lower systemic cholesterol levels. The mevalonate pathway is critical for tumorigenesis and is frequently upregulated in cancer. Nonetheless, reported effects of statins on tumor progression are ambiguous, making it unclear whether statins, alone or in combination, can be used for chemotherapy. Here, using advanced mass spectrometry and isotope tracing, we showed that statins only modestly affected cancer cholesterol homeostasis. Instead, they significantly reduced synthesis and levels of another downstream product, the mitochondrial electron carrier coenzyme Q, both in cultured cancer cells and tumors. This compromised oxidative phosphorylation, causing severe oxidative stress. To compensate, cancer cells upregulated antioxidant metabolic pathways, including reductive carboxylation, proline synthesis, and cystine import. Targeting cystine import with an xCT transporter–lowering MEK inhibitor, in combination with statins, caused profound tumor cell death. Thus, statin-induced ROS production in cancer cells can be exploited in a combinatorial regimen. Cancer cells induce specific metabolic pathways to alleviate the increased oxidative stress caused by statin treatment, and targeting one of these pathways synergizes with statins to produce a robust antitumor response.See related commentary by Cordes and Metallo, p. 151