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Diclofenac Potentiates Sorafenib-Based Treatments of Hepatocellular Carcinoma by Enhancing Oxidative Stress.
Cancers (Basel) 2019; 11(10)C

Abstract

Sorafenib is the first developed systemic treatment for advanced forms of hepatocellular carcinoma, which constitutes the most frequent form of primary liver cancers and is a major global health burden. Although statistically significant, the positive effect of sorafenib on median survival remains modest, highlighting the need to develop novel therapeutic approaches. In this report, we introduce diclofenac, a nonsteroidal anti-inflammatory drug, as a potent catalyzer of sorafenib anticancer efficacy. Treatment of three different hepatocellular cancer cells (Huh-7, HepG2, and PLC-PRF-5) with sorafenib (5 µM, 24 h) and diclofenac (100 µM, 24 h) significantly increased cancer cell death compared to sorafenib or diclofenac alone. Anti-oxidant compounds, including N-acetyl-cysteine and ascorbic acid, reversed the deleterious effects of diclofenac/sorafenib co-therapy, suggesting that the generation of toxic levels of oxidative stress was responsible for cell death. Accordingly, whereas diclofenac increased production of mitochondrial oxygen reactive species, sorafenib decreased concentrations of glutathione. We further show that tumor burden was significantly diminished in mice bearing tumor xenografts following sorafenib/diclofenac co-therapy when compared to sorafenib or diclofenac alone. Taken together, these results highlight the anticancer benefits of sorafenib/diclofenac co-therapy in hepatocellular carcinoma. They further indicate that combining sorafenib with compounds that increase oxidative stress represents a valuable treatment strategy in hepatocellular carcinoma.

Authors+Show Affiliations

Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Av de Beaumont, 1011 Lausanne, Switzerland. adrian.duval@chuv.ch.Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Av de Beaumont, 1011 Lausanne, Switzerland. laetitia.troquier@chuv.ch.Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Av de Beaumont, 1011 Lausanne, Switzerland. olga.de-souza-silva@chuv.ch.Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Av de Beaumont, 1011 Lausanne, Switzerland. demartines@chuv.ch.Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, Av de Beaumont, 1011 Lausanne, Switzerland. olivier.dormond@chuv.ch.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31569821

Citation

Duval, Adrian Paul, et al. "Diclofenac Potentiates Sorafenib-Based Treatments of Hepatocellular Carcinoma By Enhancing Oxidative Stress." Cancers, vol. 11, no. 10, 2019.
Duval AP, Troquier L, de Souza Silva O, et al. Diclofenac Potentiates Sorafenib-Based Treatments of Hepatocellular Carcinoma by Enhancing Oxidative Stress. Cancers (Basel). 2019;11(10).
Duval, A. P., Troquier, L., de Souza Silva, O., Demartines, N., & Dormond, O. (2019). Diclofenac Potentiates Sorafenib-Based Treatments of Hepatocellular Carcinoma by Enhancing Oxidative Stress. Cancers, 11(10), doi:10.3390/cancers11101453.
Duval AP, et al. Diclofenac Potentiates Sorafenib-Based Treatments of Hepatocellular Carcinoma By Enhancing Oxidative Stress. Cancers (Basel). 2019 Sep 27;11(10) PubMed PMID: 31569821.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Diclofenac Potentiates Sorafenib-Based Treatments of Hepatocellular Carcinoma by Enhancing Oxidative Stress. AU - Duval,Adrian Paul, AU - Troquier,Laetitia, AU - de Souza Silva,Olga, AU - Demartines,Nicolas, AU - Dormond,Olivier, Y1 - 2019/09/27/ PY - 2019/08/23/received PY - 2019/09/24/revised PY - 2019/09/25/accepted PY - 2019/10/2/entrez PY - 2019/10/2/pubmed PY - 2019/10/2/medline KW - cell death KW - co-therapy KW - diclofenac KW - hepatocellular carcinoma KW - oxidative stress KW - sorafenib JF - Cancers JO - Cancers (Basel) VL - 11 IS - 10 N2 - Sorafenib is the first developed systemic treatment for advanced forms of hepatocellular carcinoma, which constitutes the most frequent form of primary liver cancers and is a major global health burden. Although statistically significant, the positive effect of sorafenib on median survival remains modest, highlighting the need to develop novel therapeutic approaches. In this report, we introduce diclofenac, a nonsteroidal anti-inflammatory drug, as a potent catalyzer of sorafenib anticancer efficacy. Treatment of three different hepatocellular cancer cells (Huh-7, HepG2, and PLC-PRF-5) with sorafenib (5 µM, 24 h) and diclofenac (100 µM, 24 h) significantly increased cancer cell death compared to sorafenib or diclofenac alone. Anti-oxidant compounds, including N-acetyl-cysteine and ascorbic acid, reversed the deleterious effects of diclofenac/sorafenib co-therapy, suggesting that the generation of toxic levels of oxidative stress was responsible for cell death. Accordingly, whereas diclofenac increased production of mitochondrial oxygen reactive species, sorafenib decreased concentrations of glutathione. We further show that tumor burden was significantly diminished in mice bearing tumor xenografts following sorafenib/diclofenac co-therapy when compared to sorafenib or diclofenac alone. Taken together, these results highlight the anticancer benefits of sorafenib/diclofenac co-therapy in hepatocellular carcinoma. They further indicate that combining sorafenib with compounds that increase oxidative stress represents a valuable treatment strategy in hepatocellular carcinoma. SN - 2072-6694 UR - https://www.unboundmedicine.com/medline/citation/31569821/Diclofenac_Potentiates_Sorafenib-Based_Treatments_of_Hepatocellular_Carcinoma_by_Enhancing_Oxidative_Stress L2 - http://www.mdpi.com/resolver?pii=cancers11101453 DB - PRIME DP - Unbound Medicine ER -