Abstract 641: SCD1 upregulation due to STK11/KEAP1 loss upregulates SLC7A11 and causes deregulation of fatty acid metabolism leading to ferroptosis evasion
Authors: Sen Utsav , Coleman Charles , Hasson Dan , Sen Triparna 
Published: March 2024

Abstract
Introduction: Non-small cell lung cancer (NSCLC) with co-occurring loss-of-function (LOF) mutations in serine/threonine kinase 11 (STK11) and Kelch-like ECH-associated protein1 (KEAP1) (SK) are notably aggressive and unresponsive to chemo and immunotherapy, in current care standards. Novel therapeutic strategies are in demand to improve the outcomes for SK co-mutant NSCLC patients. We reported earlier that SK LOF mutations enhance cell proliferation and tumor growth in xenograft lung cancer models. We also found the ferroptosis evasion genes are enriched, and targeting ferroptosis regulators is a therapeutic opportunity in SK co-mutant NSCLC.
Methods: We used CRISPR/Cas9 gene editing to create stable knockouts of STK11 (SKO), KEAP1 (KKO) or both (DKO), non-targeting control (NTC) in two NSCLC lines. We performed an in vitro druggable genome library CRISPR screening in the same NSCLC lines. We performed kinase profiling and RNA-seq in the cell lines to depict the transcriptomic and proteomic landscape, followed by western blotting and qRT-PCR validation. We also performed BODIPY/C11 assay and lipidomics to explore the ferroptosis and metabolic landscape of SK co-mutant NSCLC models.
Results: Stearoyl CoA desaturase-1 (SCD1) was the top CRISPR screen hit, a critical modulator of fatty acid metabolism and ferroptosis evasion. SCD1 expression is significantly higher in NSCLC tissue than adjacent normal tissue (p&lt;0.0001), and high SCD1 expression correlates with poorer prognosis in patients with NSCLC (p=0.027). GSEA from the bulk RNA sequencing in SK co-mutant cells pre-and post-SCD1 inhibitor treatment showed SCD1 inhibition leads to upregulation of the glutathione and glutamic acid pathways compared to NTC cells. Moreover, SK co-mutant cells have a significantly higher expression of SLC7A11, enabling cystine uptake and subsequent conversion to cysteine, essential for maintaining redox balance and cell survival. Hence, SK co-mutant cells are more resistant to cysteine depletion than NTC cells. SCD1 inhibition causes a decrease in SLC7A11 expression exclusively in DKO cells. Eventually, SCD1 inhibition leads to global metabolomic changes in SK co-mutant cells, including key pathways involved in lipid and glucose metabolism. Finally, genetic and pharmacological inhibition of SCD1 prevents tumor growth and sensitizes DKO cells to ferroptosis inducers like erastin.
Conclusions: Our findings highlight the importance of the SCD1-SLC7A11 axis in regulating ferroptosis in SK co-mutant models. Current data impact our understanding of ferroptosis in NSCLC and its ability to target SCD1 or ferroptosis in cancer treatment. Compounds such as inhibitors of SLC7A11 (Erastin/IKE) are safe to use with acceptable toxicity and established doses. Hence, our study will facilitate the translation of ferroptosis inducers or SCD1 inhibitors in clinical trials.
Citation Format: Utsav Sen, Charles Coleman, Dan Hasson, Triparna Sen. SCD1 upregulation due to STK11/KEAP1 loss upregulates SLC7A11 and causes deregulation of fatty acid metabolism leading to ferroptosis evasion [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 641.