Activation of the NRF2 antioxidant program sensitizes tumors to G6PD inhibition. Author Hongyu Ding, Zihong Chen, Katherine Wu, Shih Huang, Warren Wu, Sarah LeBoeuf, Ray Pillai, Joshua Rabinowitz, Thales Papagiannakopoulos Publication Year 2021 Type Journal Article Abstract The pathway promotes metabolic rewiring to support redox homeostasis. Activation of NRF2 occurs in many cancers, often due to mutations, and is associated with more aggressive disease and treatment resistance. To identify metabolic dependencies in cancers with NRF2 activation, we performed a metabolism-focused CRISPR screen. Glucose-6-phosphate dehydrogenase (G6PD), which was recently shown to be dispensable in Ras-driven tumors, was a top dependency. G6PD catalyzes the committed step of the oxidative pentose phosphate pathway that produces NADPH and nucleotide precursors, but neither antioxidants nor nucleosides rescued. Instead, G6PD loss triggered tricarboxylic acid (TCA) intermediate depletion because of up-regulation of the alternative NADPH-producing enzymes malic enzyme and isocitrate dehydrogenase. In vivo, G6PD impairment markedly suppressed mutant tumor growth, and this suppression was further augmented by TCA depletion by glutaminase inhibition. Thus, G6PD inhibition–induced TCA depletion is a therapeutic vulnerability of NRF2-activated cancer. Journal Sci Adv Volume 7 Issue 47 Pages eabk1023 Date Published 2021 Nov 19 ISSN Number 2375-2548 DOI 10.1126/sciadv.abk1023 Alternate Journal Sci Adv PMCID PMC8598006 PMID 34788087 PubMedPubMed CentralGoogle ScholarBibTeXEndNote X3 XML