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AG-1024 Sensitizes Sorafenib-Resistant Hepatocellular Carcinoma Cells to Sorafenib via Enhancing G1/S Arrest

Authors Zhou W, Lou W, Chen J, Ding B, Chen B, Xie H, Zhou L, Zheng S, Jiang D

Received 29 October 2020

Accepted for publication 15 January 2021

Published 15 February 2021 Volume 2021:14 Pages 1049—1059


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 3

Editor who approved publication: Dr Alberto Bongiovanni

Wei Zhou,1– 3 Weiyang Lou,4 Junru Chen,1– 3 Bisha Ding,4 Binjie Chen,2,3,5 Haiyang Xie,1– 3 Lin Zhou,1– 3 Shusen Zheng,1– 3 Donghai Jiang2,3,5

1Department of Surgery, Division of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 2NHFPC Key Laboratory of Combined Multi-Organ Transplantation, Hangzhou, People’s Republic of China; 3Key Laboratory of the Diagnosis and Treatment of Organ Transplantation, Hangzhou, People’s Republic of China; 4Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, People’s Republic of China; 5Key Laboratory of Organ Transplantation, Hangzhou, People’s Republic of China

Correspondence: Shusen Zheng Tel +86-571-87236567
Fax +86-571-87236466
Donghai Jiang Tel +86-571-87236570
Fax +86-571-87236466

Purpose: The frequency in resistance to sorafenib accounts for the grim prognosis of advanced hepatocellular carcinoma (HCC). In the present study, we explore the anti-cancer efficacy of co-administration of sub-toxic AG-1024 with sorafenib in HCC cells to enhance the sensitivity of these cells to sorafenib.
Materials and Methods: Two acquired sorafenib-resistant HCC cells, SNU-sora-5 and SK-sora-5, were established and verified. The MTT assay, colony formation assay, cell morphology detection and flow cytometric analysis were then used to determine the anti-tumor effects of the co-administration of sub-toxic AG-1024 and sorafenib. Finally, the potential molecular mechanism was preliminarily examined.
Results: Compared to parental cell lines, the acquired sorafenib-resistant cell lines, SNU-sora-5 and SK-sora-5, were more resistant to sorafenib. Sub-toxic AG-1024 markedly enhanced sorafenib-mediated cell inhibition in acquired sorafenib-resistant HCC strains, with a reversal index (RI) of 4.64 in SNU-sora-5 and 4.58 in SK-sora-5 cell lines. Moreover, co-administration of sub-toxic AG-1024 and sorafenib exerted dramatic cytotoxicity compared with sorafenib alone in the intrinsic sorafenib-resistant HCC-LM3 cells. In contrast to high-dose sorafenib, sub-toxic AG-1024 combined with sorafenib had less impact on apoptosis while significantly enhancing G1/S arrest via activation of the mTOR/p21 signaling pathway. The more, pharmacological inhibition of mTOR activity by inhibitor Palomid 529 significantly antagonized the synergistic anti-cancer effects of AG-1024 and sorafenib in HCC cells.
Conclusion: The current findings indicate that sub-toxic AG-1024 may be a promising therapeutic agent in enhancing the sensitivity in HCC cells to sorafenib, bringing hope to HCC patients refractory to sorafenib treatment.

Keywords: hepatocellular carcinoma, sorafenib resistance, AG-1024, mTOR, G1/S arrest

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