GLUT6-facilitated noncanonical glucose metabolic rewiring enables resistance to targeted cancer therapy

Nat Commun. 2026 May 7;17(1):6166. doi: 10.1038/s41467-026-72922-7.

Abstract

Targeting glucose metabolism has long been pursued as an anticancer strategy, yet its clinical translation remains challenging. Achieving therapeutic selectivity requires identifying actionable metabolic distinctions between different malignant traits. Here, we uncover a noncanonical, lactate-independent glucose metabolic pathway facilitated by the glucose transporter 6 (GLUT6), which confers targeted therapy resistance in lung cancer. Downstream, GLUT6 promotes glucose influx and diversion toward methylglyoxal production, leading to kelch-like ECH-associated protein 1 (KEAP1) dimerization and nuclear factor erythroid 2-related factor 2 (NRF2) pathway activation, driving resistance. Upstream, GLUT6 expression is transcriptionally upregulated by therapy-induced MYC associated zinc finger protein (MAZ) activation. Targeting GLUT6 prevents and overcomes EGFR and KRAS inhibitors resistance. Moreover, the MAZ-GLUT6-NRF2 axis correlates with clinical treatment response and relapse. The preferential reliance on GLUT6-a noncanonical transporter with minimal systemic homeostasis perturbation-highlights its promise as a target for overcoming resistance and revitalizing glucose metabolism-based anticancer strategies.

MeSH terms

  • Animals
  • Antineoplastic Agents / pharmacology
  • Antineoplastic Agents / therapeutic use
  • Cell Line, Tumor
  • DNA-Binding Proteins / metabolism
  • Drug Resistance, Neoplasm* / drug effects
  • Drug Resistance, Neoplasm* / genetics
  • ErbB Receptors / antagonists & inhibitors
  • ErbB Receptors / metabolism
  • Gene Expression Regulation, Neoplastic
  • Glucose Transport Proteins, Facilitative* / genetics
  • Glucose Transport Proteins, Facilitative* / metabolism
  • Glucose* / metabolism
  • Humans
  • Lung Neoplasms* / drug therapy
  • Lung Neoplasms* / genetics
  • Lung Neoplasms* / metabolism
  • Lung Neoplasms* / pathology
  • Metabolic Reprogramming
  • Mice
  • NF-E2-Related Factor 2 / metabolism
  • Proto-Oncogene Proteins p21(ras) / antagonists & inhibitors
  • Proto-Oncogene Proteins p21(ras) / metabolism
  • Pyruvaldehyde / metabolism
  • Signal Transduction
  • Transcription Factors / metabolism

Substances

  • Glucose
  • NF-E2-Related Factor 2
  • Glucose Transport Proteins, Facilitative
  • Transcription Factors
  • Proto-Oncogene Proteins p21(ras)
  • Pyruvaldehyde
  • Antineoplastic Agents
  • DNA-Binding Proteins
  • ErbB Receptors