HIV-protease inhibitors potentiate the activity of carfilzomib in triple-negative breast cancer

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Authors

BEŠŠE Andrej SEDLAŘÍKOVÁ Lenka BUECHLER Lorina KRAUS Marianne YANG Chieh-Hsiang STRAKOVA Nicol SOUCEK Karel NAVRÁTIL Jiří SVOBODA Marek WELM Alana L JOERGER Markus DRIESSEN Christoph BEŠŠE Lenka

Year of publication 2024
Type Article in Periodical
Magazine / Source British journal of cancer
MU Faculty or unit

Faculty of Medicine

Citation
Web https://www.nature.com/articles/s41416-024-02774-9
Doi http://dx.doi.org/10.1038/s41416-024-02774-9
Keywords triple-negative breast cancer; HIV-protease inhibitors
Attached files
Description BackgroundResistance to chemotherapy is a major problem in the treatment of patients with triple-negative breast cancer (TNBC). Preclinical data suggest that TNBC is dependent on proteasomes; however, clinical observations indicate that the efficacy of proteasome inhibitors in TNBC may be limited, suggesting the need for combination therapies.MethodsWe compared bortezomib and carfilzomib and their combinations with nelfinavir and lopinavir in TNBC cell lines and primary cells with regard to their cytotoxic activity, functional proteasome inhibition, and induction of the unfolded protein response (UPR). Furthermore, we evaluated the involvement of sXBP1, ABCB1, and ABCG2 in the cytotoxic activity of drug combinations.ResultsCarfilzomib, via proteasome beta 5 + beta 2 inhibition, is more cytotoxic in TNBC than bortezomib, which inhibits beta 5 + beta 1 proteasome subunits. The cytotoxicity of carfilzomib was significantly potentiated by nelfinavir or lopinavir. Carfilzomib with lopinavir induced endoplasmic reticulum stress and pro-apoptotic UPR through the accumulation of excess proteasomal substrate protein in TNBC in vitro. Moreover, lopinavir increased the intracellular availability of carfilzomib by inhibiting carfilzomib export from cells that express high levels and activity of ABCB1, but not ABCG2.ConclusionProteasome inhibition by carfilzomib combined with nelfinavir/lopinavir represents a potential treatment option for TNBC, warranting further investigation.
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