Metformin combined with cisplatin reduces anticancer activity via ATM/CHK2-dependent upregulation of Rad51 pathway in ovarian cancer

Neoplasia. 2024 Nov:57:101037. doi: 10.1016/j.neo.2024.101037. Epub 2024 Aug 13.

Abstract

Ovarian cancer (OC) is the deadliest malignancy of the female reproductive system. The standard first-line therapy for OC involves cytoreductive surgical debulking followed by chemotherapy based on platinum and paclitaxel. Despite these treatments, there remains a high rate of tumor recurrence and resistance to platinum. Recent studies have highlighted the potential anti-tumor properties of metformin (met), a traditional diabetes drug. In our study, we investigated the impact of met on the anticancer activities of cisplatin (cDDP) both in vitro and in vivo. Our findings revealed that combining met with cisplatin significantly reduced apoptosis in OC cells, decreased DNA damage, and induced resistance to cDDP. Furthermore, our mechanistic study indicated that the resistance induced by met is primarily driven by the inhibition of the ATM/CHK2 pathway and the upregulation of the Rad51 protein. Using an ATM inhibitor, KU55933, effectively reversed the cisplatin resistance phenotype. In conclusion, our results suggest that met can antagonize the effects of cDDP in specific types of OC cells, leading to a reduction in the chemotherapeutic efficacy of cDDP.

Keywords: ATM/CHK2; Cisplatin resistance; Metformin; Ovarian cancer; Rad51.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Apoptosis* / drug effects
  • Ataxia Telangiectasia Mutated Proteins* / metabolism
  • Cell Line, Tumor
  • Checkpoint Kinase 2* / genetics
  • Checkpoint Kinase 2* / metabolism
  • Cisplatin* / pharmacology
  • DNA Damage / drug effects
  • Drug Resistance, Neoplasm
  • Female
  • Gene Expression Regulation, Neoplastic / drug effects
  • Humans
  • Metformin* / pharmacology
  • Mice
  • Ovarian Neoplasms* / drug therapy
  • Ovarian Neoplasms* / genetics
  • Ovarian Neoplasms* / metabolism
  • Ovarian Neoplasms* / pathology
  • Rad51 Recombinase* / genetics
  • Rad51 Recombinase* / metabolism
  • Signal Transduction / drug effects
  • Up-Regulation / drug effects
  • Xenograft Model Antitumor Assays*

Substances

  • Cisplatin
  • Ataxia Telangiectasia Mutated Proteins
  • Metformin
  • Rad51 Recombinase
  • ATM protein, human
  • RAD51 protein, human
  • Checkpoint Kinase 2
  • CHEK2 protein, human
  • Antineoplastic Agents