Abstract 438: Inhibition of de novo lipogenesis with PUFA supplementation induces ferroptosis in advanced prostate cancer

Abstract Background: Metabolic alterations are recognized as a hallmark of cancer progression. In prostate cancer (PCa), in particular, a notable lipid reprogramming occurs with increased expression levels of multiple enzymes involved in the fatty acid synthesis pathway to fulfill the metabolic and structural demands of cancer cells. Fatty acids are vital for membrane building, ATP production through B-oxidation, and storage in lipid droplets for high-energy demands. In castration-resistant prostate cancer (CRPC), the aberrant overexpression of Fatty Acid Synthase (FASN), the rate-limiting enzyme in de novo lipogenesis (DNL), results in synthesis of saturated (palmitate) and monounsaturated fatty acids (SFA and MUFA). If DNL is inhibited, polyunsaturated fatty acids (PUFAs) are taken up from the environment. These could undergo lipid peroxidation generating reactive oxygen species (ROS) and contribute to ferroptosis. We hypothesize that combining the inhibition of DNL with the addition of exogenous PUFAs could increase cell death by ferroptosis. Methods: PCa cells (LNCaP, 22Rv1 and C4-2) and human organoids were exposed to pharmacologic FASN inhibition and PUFAs for 6 days. Cell viability, lipid peroxidation, superoxide production and, protein carbonylation as a measure of intracellular ROS as well as lipidomic profiling, were assessed. Results: FASN inhibition significantly increased lipid peroxidation and intracellular ROS, with subsequent membrane potential hyperpolarization in prostate cancer cells. These effects were partially rescued by palmitate, while FASNi supplemented with PUFA potentiated protein carbonylation. Expression levels of GPX4, the main regulator of ferroptosis, were reduced after DNL inhibition and rescued with palmitate addition. Suppression of DNL combined with supplemental addition of PUFAs resulted in significant cell growth inhibition in prostate cancer cells and organoids. Finally, lipid profiling demonstrated that the suppression of DNL triggers increased acyl chain length in phospholipid and several other lipid classes. Again, this effect was significantly potentiated when combining FASN inhibition with PUFA supplementation. Conclusion: FASN inhibition produces a cascade of intracellular events, including lipid remodeling, increased ROS production and ferroptosis, all potentiated by PUFAs. These findings provide compelling evidence for the use a combined approach involving DNL inhibition and PUFA supplementation as a novel therapeutic avenue to treat advanced prostate cancer. Citation Format: Silvia Daniele Rodrigues, Isadora Ferrari Teixeira, Pier Vitale Nuzzo, Hubert Pakula, David Nanus, Massimo Loda. Inhibition of de novo lipogenesis with PUFA supplementation induces ferroptosis in advanced prostate cancer 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 (6Suppl): Abstract nr 438.