MUC1 and HIF-1alpha Signaling Crosstalk Induces Anabolic Glucose Metabolism to Impart Gemcitabine Resistance to Pancreatic Cancer

Cancer Cell. 2017 Jul 10;32(1):71-87.e7. doi: 10.1016/j.ccell.2017.06.004.

Abstract

Poor response to cancer therapy due to resistance remains a clinical challenge. The present study establishes a widely prevalent mechanism of resistance to gemcitabine in pancreatic cancer, whereby increased glycolytic flux leads to glucose addiction in cancer cells and a corresponding increase in pyrimidine biosynthesis to enhance the intrinsic levels of deoxycytidine triphosphate (dCTP). Increased levels of dCTP diminish the effective levels of gemcitabine through molecular competition. We also demonstrate that MUC1-regulated stabilization of hypoxia inducible factor-1α (HIF-1α) mediates such metabolic reprogramming. Targeting HIF-1α or de novo pyrimidine biosynthesis, in combination with gemcitabine, strongly diminishes tumor burden. Finally, reduced expression of TKT and CTPS, which regulate flux into pyrimidine biosynthesis, correlates with better prognosis in pancreatic cancer patients on fluoropyrimidine analogs.

Keywords: HIF-1α; MUC1; cancer metabolism; chemotherapy resistance; gemcitabine; mucin; non-oxidative pentose phosphate pathway; nucleotide synthesis; pancreatic cancer; pyrimidine biosynthesis.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, N.I.H., Extramural

MeSH terms

  • Carbon / metabolism
  • Deoxycytidine / analogs & derivatives*
  • Deoxycytidine / therapeutic use
  • Digoxin / pharmacology
  • Drug Resistance, Neoplasm*
  • Gemcitabine
  • Glucose / metabolism*
  • Humans
  • Hypoxia-Inducible Factor 1, alpha Subunit / antagonists & inhibitors
  • Hypoxia-Inducible Factor 1, alpha Subunit / metabolism*
  • Mucin-1 / metabolism*
  • Pancreatic Neoplasms / drug therapy*
  • Pancreatic Neoplasms / genetics
  • Pancreatic Neoplasms / metabolism
  • Pentose Phosphate Pathway
  • Prognosis
  • Pyrimidines / biosynthesis
  • Signal Transduction

Substances

  • HIF1A protein, human
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • MUC1 protein, human
  • Mucin-1
  • Pyrimidines
  • Deoxycytidine
  • Digoxin
  • Carbon
  • Glucose
  • pyrimidine
  • Gemcitabine