Medizinische Universität Graz - Research portal

Selected Publication:

SHR Neuro Cancer Cardio Lipid Metab Microb

Krstic, J; Reinisch, I; Schindlmaier, K; Galhuber, M; Riahi, Z; Berger, N; Kupper, N; Moyschewitz, E; Auer, M; Michenthaler, H; Nössing, C; Depaoli, MR; Ramadani-Muja, J; Usluer, S; Stryeck, S; Pichler, M; Rinner, B; Deutsch, AJA; Reinisch, A; Madl, T; Chiozzi, RZ; Heck, AJR; Huch, M; Malli, R; Prokesch, A.
Fasting improves therapeutic response in hepatocellular carcinoma through p53-dependent metabolic synergism.
Sci Adv. 2022; 8(3):eabh2635 Doi: 10.1126/sciadv.abh2635 [OPEN ACCESS]
Web of Science PubMed PUBMED Central FullText FullText_MUG


Leading authors Med Uni Graz
Krstic Jelena
Prokesch Andreas
Co-authors Med Uni Graz
Auer Martina
Berger Natascha
Depaoli Maria Rosa
Deutsch Alexander
Galhuber Markus
Kupper Nadja Julia
Madl Tobias
Malli Roland
Michenthaler Helene
Moyschewitz Elisabeth
Pichler Martin
Ramadani-Muja Jeta
Reinisch Andreas
Reinisch Isabel Nadine
Riahi Zina
Rinner Beate
Schindlmaier Katharina
Stryeck Sarah
Usluer Sinem

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Cancer cells voraciously consume nutrients to support their growth, exposing metabolic vulnerabilities that can be therapeutically exploited. Here, we show in hepatocellular carcinoma (HCC) cells, xenografts, and patient-derived organoids that fasting improves sorafenib efficacy and acts synergistically to sensitize sorafenib-resistant HCC. Mechanistically, sorafenib acts noncanonically as an inhibitor of mitochondrial respiration, causing resistant cells to depend on glycolysis for survival. Fasting, through reduction in glucose and impeded AKT/mTOR signaling, prevents this Warburg shift. Regulating glucose transporter and proapoptotic protein expression, p53 is necessary and sufficient for the sorafenib-sensitizing effect of fasting. p53 is also crucial for fasting-mediated improvement of sorafenib efficacy in an orthotopic HCC mouse model. Together, our data suggest fasting and sorafenib as rational combination therapy for HCC with intact p53 signaling. As HCC therapy is currently severely limited by resistance, these results should instigate clinical studies aimed at improving therapy response in advanced-stage HCC.

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