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Lomitapide enhances cytotoxic effects of temozolomide in chemotherapy-resistant glioblastoma
Alyona Ivanova, Taylor M. Wilson, Kimia Ghannad-Zadeh, Esmond Tse, Robert Flick, Megan Wu, Sunit Das
Alyona Ivanova, Taylor M. Wilson, Kimia Ghannad-Zadeh, Esmond Tse, Robert Flick, Megan Wu, Sunit Das
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Research Article Cell biology Oncology

Lomitapide enhances cytotoxic effects of temozolomide in chemotherapy-resistant glioblastoma

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Abstract

More than a third of patients with glioblastoma experience tumor progression during adjuvant therapy. In this study, we performed a high-throughput drug repurposing screen of FDA-approved agents capable of crossing the blood-brain barrier in order to find agents to counteract acquired or inherent glioma cell resistance to temozolomide-associated cytotoxicity. We identified the cholesterol processing inhibitor, lomitapide, as a potential chemosensitizer in glioblastoma. In vitro treatment of temozolomide-resistant glioblastoma cells with lomitapide resulted in decreased intracellular ubiquinone levels and sensitized cells to temozolomide-induced ferroptosis. Concomitant treatment with lomitapide and temozolomide (TMZ) prolonged survival and delayed tumor recurrence in a mouse glioblastoma model, compared with treatment xwith TMZ alone. Our data identified lomitapide as a potential adjunct for treatment of temozolomide-resistant glioblastoma.

Authors

Alyona Ivanova, Taylor M. Wilson, Kimia Ghannad-Zadeh, Esmond Tse, Robert Flick, Megan Wu, Sunit Das

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Figure 6

Lomitapide treatment causes accumulation of key mevalonate pathway enzyme HMGCR in vivo.

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Lomitapide treatment causes accumulation of key mevalonate pathway enzym...
Representative images from IHC analysis of U251 flank tumors stained for HMGCR collected from (A) control mice or mice treated with (B) TMZ, (C) Lomitapide, or a (D) combination of Lomitapide and TMZ. The boxes indicate the areas shown at higher magnification. Scale bars: 500 μm (left), 100 μm (middle), 50 μm (right). (E) Percentage of cells staining positive for HMGCR as determined through IHC analysis of U251 flank tumors (n = 16). All data are represented as individual measurements with mean ± SD. One-way ANOVA, followed by a post hoc Tukey’s HSD test, was used for multiple group comparisons. ****P < 0.0001.

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