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Clofoctol and sorafenib inhibit prostate cancer growth via synergistic induction of endoplasmic reticulum stress and UPR pathways

Authors Fan L, He Z, Head SA, Zhou Y, Lu T, Feng X, Zhang X, Zhang M, Dang Y, Jiang X, Wang M

Received 24 May 2018

Accepted for publication 31 July 2018

Published 23 October 2018 Volume 2018:10 Pages 4817—4829

DOI https://doi.org/10.2147/CMAR.S175256

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Antonella D'Anneo


Lixia Fan,1,* Zhenglei He,1,* Sarah A Head,2 Yinghui Zhou,1 Ting Lu,1 Xulong Feng,1 Xueqing Zhang,1 Meng Zhang,1 Yongjun Dang,3 Xinghong Jiang,4 Minghua Wang1

1Department of Biochemistry and Molecular Biology, Medical College, Soochow University, Suzhou, Jiangsu, China; 2Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA; 3Department of Biochemistry and Molecular Biology, School of Basic Medical Sciences, Fudan University Shanghai Medical College, Shanghai, China; 4Department of Neurobiology, Medical College, Soochow University, Suzhou, China

*These authors contributed equally to this work

Background/Purpose:
Prostate cancer is a major burden on public health and a major cause of morbidity and mortality among men worldwide. Drug combination therapy is known as a powerful tool for the treatment of cancer. The aim of this study is to evaluate the synergistic inhibitory mechanisms of clofoctol and sorafenib in the treatment of prostate cancer. However, the molecular mechanisms of this phenomenon have not been illuminated clearly. In this study, we investigated the anti-tumor effects of clofoctol in combination with sorafenib in vitro and in vivo.
Methods: The activity and mechanism of clofoctol in combination with sorafenib were examined in PC-3cells. mRNA and protein expression of key players in the ER stress pathway were detected with RT-PCR and Western blotting. Cell viability was estimated by CCK-8 assay or Alamar blue assay, and apoptosis and cell cycle were monitored and measured by flow cytometry. PC-3 cells were inoculated subcutaneously in male BALB/c nude mice. The therapeutic regimen was initiated when the tumor began showing signs of growth and treatment continued for 5 weeks.
Results: Our data indicate that clofototol and sorafenib induce cell death through synergistic induction of endoplasmic reticulum (ER) stress, resulting in activation of the unfolded protein response (UPR). Combination therapy with clofoctol and sorafenib induced an upregulation of markers of all three ER stress pathways: PERK, IRE1 and ATF6. In addition, combination therapy with clofoctol and sorafenib markedly inhibited the growth of prostate cancer xenograft tumors, compared with clofoctol or sorafenib alone.
Conclusion: The combination of clofoctol and sorafenib can serve as a novel clinical treatment regimen, potentially enhancing antitumor efficacy in prostate cancer and decreasing the dose and adverse effects of either clofoctol or sorafenib alone. These results lay the foundation for subsequent research on this novel therapeutic regimen in human prostate cancer.

Keywords: drug combination, endoplasmic reticulum stress, unfolded protein response, prostate cancer, clofoctol

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