Ferroptosis as a mechanism to mediate p53 function in tumor radiosensitivity

Oncogene. 2021 May;40(20):3533-3547. doi: 10.1038/s41388-021-01790-w. Epub 2021 Apr 29.

Abstract

Ferroptosis, a form of regulated cell death triggered by lipid peroxidation, was recently identified as an important mechanism in radiotherapy (RT)-mediated tumor suppression and radioresistance, although the exact genetic contexts in which to target ferroptosis in RT remains to be defined. p53 is the most commonly mutated gene in human cancers and a major effector to RT. Here, we identify ferroptosis as a critical mechanism to mediate p53 function in tumor radiosensitivity. Mechanistically, RT-mediated p53 activation antagonizes RT-induced SLC7A11 expression and represses glutathione synthesis, thereby promoting RT-induced lipid peroxidation and ferroptosis. p53 deficiency promotes radioresistance in cancer cells or tumors at least partly through SLC7A11-mediated ferroptosis inhibition. Ferroptosis inducers (FINs) that inhibit SLC7A11 exert significant radiosensitizing effects in tumor organoids and patient-derived xenografts with p53 mutation or deficiency. Finally, we show that RT-induced ferroptosis correlates with p53 activation and better clinical outcomes to RT in cancer patients. Together, our study uncovers a previously unappreciated role of ferroptosis in p53-mediated radiosensitization and suggest using FINs in combination with RT to treat p53-mutant cancers.

Publication types

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

MeSH terms

  • Amino Acid Transport System y+ / metabolism
  • Animals
  • Cell Line, Tumor
  • Female
  • Ferroptosis
  • Humans
  • Lipid Peroxidation
  • Mice
  • Mice, Inbred NOD
  • Mice, SCID
  • Neoplasms / metabolism*
  • Neoplasms / pathology
  • Neoplasms / radiotherapy*
  • Radiation Tolerance
  • Tumor Suppressor Protein p53 / metabolism*
  • Xenograft Model Antitumor Assays

Substances

  • Amino Acid Transport System y+
  • SLC7A11 protein, human
  • TP53 protein, human
  • Tumor Suppressor Protein p53