LAUSR

Background: Treatment of colorectal cancer (CRC) presents a major challenge due to chemotherapeutic resistance and recurrence, which are attributed to the presence of cancer stem cells (CSCs). Cholesterol metabolism is a critical regulator of CSCs. Lipid Rafts are cholesterol-rich microdomains in the plasma membrane (PM) that anchor various growth receptors tyrosine kinases (RTKs). STARD5 is a novel protein that helps transport cholesterol from the endoplasmic reticulum to the PM. We have identified specific small molecule inhibitors of the STARD5 which disrupt the lipid rafts, resulting in the inhibition of growth signaling pathways. Methods and Results: In-silico modeling studies using STARD5 crystal structure revealed 8 putative inhibitors (SD5i (A-H)). In vitro binding studies to determine secondary structural changes using circular dichroism spectroscopy revealed SD5iA and SD5iB as excellent STARD5 ligands. Both SD5iA and SD5iB caused a potent inhibition (IC50 0.3 -18 µM) of CSC-enriched 3D spheroids in 9 CRC cell lines representative of 3 consensus molecular subtypes. However, SD5iA but not SD5iB showed toxicity towards normal murine intestinal organoids at effective doses against CRC CSCs. Also, SD5iB enhanced cytotoxicity by oxaliplatin and panitumumab against CRC CSCs in HT-29 spheroids. Hence, SD5iB was advanced into in vivo studies. SD5iB caused no discernible toxicity in doses as high as 100 mg/kg in NCr nude mice at gross, serum chemistry, organ viability, or intestinal stem cell level (organoid formation). Subsequently, we generated s.c. xenograft using dual CSC marker sorted HT-29 cells and enriched them further with chemotherapy (5-fluorouracil and oxaliplatin weekly x 3) treatment followed by randomization to vehicle or SD5iB (100mg/kg i.p. 3/wk x 3 wks.). We observed xenograft growth inhibition and LGR5 expression in SD5iB-treated animals compared to vehicle controls. Mechanistically, we observed a decrease in free accessible PM cholesterol by SD5i measured by fluorescently tagged cholesterol-binding bacterial protein fALOD4 in HT-29 cells. Moreover, lipid raft staining (cholera toxin B staining) was significantly reduced in SD5iB-treated HT-29 cells compared to vehicle control using immunofluorescence. Further, lipid raft isolation was done by sucrose gradient ultracentrifugation to study the changes in the phosphorylation of RTKs SD5iB treatment in HT-29 spheroids resulted in decreased phosphorylation of EGFR, IGF1Rβ, and FGFR1 in isolated lipid rafts. Consequently, we observed a robust inhibition of ERK1/2 activation following SD5iB treatment compared to vehicle control. Conclusion: SD5i shows anti-CSC activity by targeting lipid-raft-driven growth factor signaling. Hence, STARD5 inhibitors represent a novel class of targeted therapy that will enhance the efficacy of FDA-approved therapies in CRC. Citation Format: Shoja Hajira, Chetna Sharon, Daniel RodriguezAgudo, Rio Boothelllo, Glenn Kellogg, Gregorio Gil, William Pandak, Bhaumik B. Patel. Novel inhibitors of StAR related lipid transfer protein 5 inhibitors target plasma membrane lipid raft growth signaling [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 6259.