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Targeting SREBP-2-Regulated Mevalonate Metabolism for Cancer Therapy

Linyuan Xue, Hongyu Qi, He Zhang and 5 more

Frontiers in Oncology · 2020 · Review · CC BY

doi:10.3389/fonc.2020.01510

Abstract

Recently, targeting metabolic reprogramming has emerged as a potential therapeutic approach for fighting cancer. Sterol regulatory element binding protein-2 (SREBP-2), a basic helix-loop-helix leucine zipper transcription factor, mainly regulates genes involved in cholesterol biosynthesis and homeostasis. SREBP-2 binds to the sterol regulatory elements (SREs) in the promoters of its target genes and activates the transcription of mevalonate pathway genes, such as HMG-CoA reductase (HMGCR), mevalonate kinase and other key enzymes. In this review, we first summarized the structure of SREBP-2 and its activation and regulation by multiple signaling pathways. We then found that SREBP-2 and its regulated enzymes, including HMGCR, FPPS, SQS, and DHCR4 from the mevalonate pathway, participate in the progression of various cancers, including prostate, breast, lung, and hepatocellular cancer, as potential targets. Importantly, preclinical and clinical research demonstrated that fatostatin, statins, and N-BPs targeting SREBP-2, HMGCR, and FPPS, respectively, alone or in combination with other drugs, have been used for the treatment of different cancers. This review summarizes new insights into the critical role of the SREBP-2-regulated mevalonate pathway for cancer and its potential for targeted cancer therapy.

Full text

From PubMed Central, U.S. National Library of Medicine, as current on Oct 22, 2026. Paragraph numbers are ours, so an answer can point at one.

Introduction

Sterol regulatory-element binding proteins (SREBPs) were first identified as a subclass of membrane-bound, basic helix-loop-helix leucine zipper (bHLH-LZ) transcription factors which regulate the promoters of genes involved in lipid synthesis and uptake pathways. In mammals, two genes, SREBF1 and SREBF2, express three major SREBP proteins (SREBP-1a, SREBP-1c, and SREBP-2) with distinct but overlapping lipogenic transcriptional programs. Most studies report that SREBP-1a and SREBP-1c primarily regulate fatty acid metabolism and that SREBP-2 is a main regulator of cholesterol metabolism. Over the past 30 years, the functions of SREBPs have been identified to participate in numerous crucial physiologic processes, highlighting metabolic integrators in cellular homeostasis. Accumulating evidence has revealed that SREBPs integrate multiple cell signals to control lipogenesis as well as unexpected pathways in type II diabetes, atherosclerosis, and a series of cancers.

In particular, multiple SREBP-2-mediated pathways have been extensively studied as attractive potential targets for cancer therapy. As reported, SREBP-2 binds to the sterol regulatory elements (SREs) in the promoters of its target genes and activates the transcription of mevalonate pathway genes, such as 3-hydroxy-3-methyl-glutaryl-CoA (HMG-CoA) reductase (HMGCR), mevalonate kinase (MVK), and other key enzymes. Recent reports found that the mevalonate pathway and its metabolites are essential for cancer growth and malignant progression in a series of cancers, including prostate, breast, lung, and liver cancer. Moreover, multiple key pathways, such as the p53 and phosphatidylinositol-3-kinase (PI3K)/Akt signaling pathways, lead to the activation of SREBP-2 to promote tumorigenesis. Based on the findings above, targeting SREBP-2 and mevalonate pathways has emerged as an encouraging strategy for cancer therapy.

In this review, we first summarized recent advances in the study of SREBP-2 structure, activation, and regulation, followed by SREBP-2, key enzymes of mevalonate pathway, their regulation by various signal pathways or metabolites, and their roles in different cancers. Finally, we focused on the inhibition of the SREBP-2-regulated mevalonate pathway by fatostatin, natural products, statins, or amino-bisphosphonates (N-BPs), alone or in combination with other drugs, as potential therapeutic strategies for various cancers. This review provides new insights into the critical role of SREBP-2-regulated mevalonate metabolism in cancer and its potential as a target for cancer therapy.

SREBP-2 Structure

Human SREBP-2, identified by cDNA cloning in 1993, is produced from one gene, SREBF-2, 72kb, human chromosome 22q13, as the result of alternative promoter usage and transcription start sites. Similar to SREBP-1 structure, SREBP-2 contains 1,141 amino acids and includes an NH2-terminal transcription factor domain, a middle hydrophobic region and a COOH-terminal regulatory domain. The NH2-terminal domain with ~480 amino acids contains the bHLH-Zip motif (DNA binding) and an acidic transcriptional motif (transcriptional activity), which binds co-activator specificity protein 1 (SP1) or nuclear transcription factor Y (NF-Y) to regulate gene expression. A middle hydrophobic region of SREBP-2 with approximately 80 amino acids, a membrane-binding region, consists of two hydrophobic membrane-spanning segments separated by a hydrophilic loop, which extends into the lumen of the endoplasmic reticulum (ER). The COOH-terminal regulatory domain contains approximately 590 amino acids responsible for SREBP-2 subcellular localization and translocation (Figure 1A).

SREBP-2 Activation

Generally, SREBP-2 is synthesized as 125kDa inactive precursors in the ER. The COOH-terminal domain of SREBP-2 binds to the WD-repeat domain of SREBP cleavage-activation protein (SCAP), while the NH2-terminal domain of SCAP binds to the ER-resident insulin-induced gene proteins (INSIG), including INSIG1 and INSIG2, to form a complex of INSIG/SCAP/SREBP-2 for maintaining SREBP-2 in the ER. When sterol level decreases, SCAP dissociates from INSIGs and facilitates the incorporation of SCAP/SREBP into coatomer protein II (COPII)-coated vesicles, which then transports the complex from the ER to the Golgi apparatus. In the Golgi, SREBP-2 is sequentially cleaved by two membrane-bound proteases, site-1 protease (S1P) and site-2 protease (S2P) to release the NH2-terminal form of this transcription factor (nuclear SREBP-2, nSREBP-2). This form translocates to the nucleus and binds to the sterol regulatory element (SRE) of target genes, including key enzymes of cholesterol biosynthesis and uptake.

Many studies have shown that the INSIG/SCAP/SREBP-2 complex and the transport of SREBP-2 from ER to Golgi are regulated by multiple signaling proteins. When sterols in the ER membrane are high, they bind to loop 1 of SCAP and switch the conformation of SCAP to interact with INSIG protein, which blocks COPII binding and causes the maintenance of the SCAP/SREBP-2 complex in the ER (Figure 1B, upper). Three different mutants within the sterol-sensing domain of SCAP (L315F, Y298C, and D443N) disrupt the interaction of SCAP/INSIG to abolish the sterol-mediated feedback regulation of SREBP processing. A recent report showed that heat shock protein 90 (HSP90) stabilized the SCAP/SREBP complex to facilitate SREBP activation. Another intrinsic protein encoding an E3 ubiquitin ligase in ER, TRC8 (translocation in renal cancer from chromosome 8), is capable of binding both SREP-2 and SCAP to form a TRC8/SREBP-2/SCAP complex, which hampers the interaction between SCAP and Sec24, a COPII protein, to reduce the cleavage of SREBP-2. Meanwhile, INSIG-1 binds to GP78, a membrane-bound ubiquitin ligase with high affinity, and is then ubiquitinated and rapidly degraded in sterol-depleted cells. However, INSIG-2 lacks interaction with Gp78, which may be related to its slower degradation than INSIG-1. In addition, oxysterols such as 25-hydroxycholesterol bind directly to INSIGs to trigger ER retention of the SCAP/SREBP-2 complex. Mutations at F115A and T136A of the transmembrane helices of INSIG-2 are important for binding to oxysterols and SCAP.

For the transporting process, the mutant SCAP with aspartic acid replacement by alanine at 428 (D428A) fails to dissociate from INSIGs and impairs the transportation of SREBP-2 to the Golgi. Similar to INSIG-1, INSIG-2 binds SCAP to block the export of SREBPs in the absence of exogenous sterols, which is inhibited by microRNA-96 to increase the abundance of active SREBP-2. Furthermore, several signaling proteins were reported to control the transport of SREBP-2. One study showed that Golgi-localized transmembrane protein progestin and adipoQ receptor 3 (PAQR3) interacted with the SCAP/SREBP-2 complex to remain in the Golgi, which was disrupted to reduce cholesterol biosynthesis. Another report demonstrated that a RING-finger ubiquitin ligase, RNF finger protein 145, triggered the ubiquitination of SCAP on lysine residues within a cytoplasmic loop, potentially inhibiting the transport of SREBP-2 to Golgi and subsequent SREBP-2 processing. Additionally, the PI3K/Akt/mTORC1 pathway is involved in SREBP-2 transport to the Golgi, contributing to SREBP-2 activation, which can be activated by neuregulin-activated ERBB4 and melanoma antigen ganglioside GD3. Collectively, the INSIG/SCAP/SREBP-2 complex and SREBP-2 transportation from ER to Golgi are regulated by multiple signaling molecules, as summarized in Figure 1B.

SREBP-2 Regulation at Different Levels

After the cleavage of full-length SREBP-2 by S1P and S2P in the Golgi, nSREBP-2 can translocate to the nucleus and be regulated at protein expression and transcription levels. The nutrient and growth factor-responsive kinase mTOR complex 1 (mTORC1) causes Lipin-1, a phosphatidic acid phosphatase, to reside in the cytoplasm, which increases the expression of nSREBP-2 protein. mTORC1 can also suppress cholesterol delivery to lysosomes through the inhibition of autophagy and the maintenance of endosomal recycling, which reduces the level of cholesterol in ER to activate SREBP-2. A nuclear receptor protein, peroxisome proliferator-activated receptor (PPAR) α in in rat liver cells, leads to a decrease of nSREBP-2 to lower cholesterol concentration. In addition, the stability and function of nuclear SREBP-2 are negatively regulated by a substrate receptor of the SCF ubiquitin ligase complex, Fbw7, through ubiquitination and proteasome-mediated degradation in a phosphorylation-dependent manner.

Importantly, the transcriptional activity of nSREBP-2 is also modulated by various post-translational modifications, including phosphorylation, acetylation, and sumoylation. For the phosphorylated regulation, insulin-activated Erk-mitogen-activated protein kinase (MAPK) increases SREBP-2 activity by phosphorylation at serine 432 and 455. Glycogen synthase kinase 3 directly phosphorylates Ser443 on SREBP-2 to mediate Fbw7-induced ubiquitination and degradation of nSREBP-2. A synthetic polyphenol, S17834, can promote AMP-activated protein kinase (AMPK) activation to decrease SREBP-2 transcription via its phosphorylation site on SREBP-2. Aside from phosphorylation, histone acetyltransferase p300/CREB-binding protein (CBP) can bind and acetylate the N-terminus of SREBP-2 to enhance its expression and transcriptional activity, while sirtuin-1 (SIRT1) deacetylates SREBP-2 to decrease the abundance of SREBP-2 in the nucleus. Additionally, nSREBP-2 at Lys464 is also modified by sumoylation to decrease transcriptional activity. Taken together, SREBP-2 stability and activation are regulated by a series of key molecules and signaling pathways, which hold promise for understanding the role of SREBP-2 in physiological and pathological procedures.

The SREBP-2-Regulated Mevalonate Pathway

In the nucleus, nSREBP-2 binds to SREs in the promoter of target genes to activate the gene expression of most of the enzymes involved in the mevalonate pathway, including HMGCR, MVK, squalene synthase (SQS), and 24-dihydrocholesterol reductase (DHCR24), as well as increasing the expression of low-density lipoprotein receptors (LDLR) for exogenous cholesterol uptake. For the mevalonate pathway, two molecules of acetyl-CoA from glucose metabolism or fatty acid degradation form acetoacetyl-CoA by acetoacetyl-CoA thiolase. In the presence of HMG-CoA synthase (HMGCS), acetyl-CoA and acetoacetyl-CoA form HMG-CoA, which is converted to mevalonate by HMGCR. Then, the mevalonate is phosphorylated sequentially to 5-phosphomevalonate by mevalonate kinase (MK) and to 5-pyrophosphomevalonate by phosphomevalonate kinase (PMK), which is further synthesized to isopentenylpyrophosphate (IPP) by mevalonate diphosphate decarboxylase. Furthermore, IPP and its isomer, dimethylallyl pyrophosphate (DMPP), can form geranyl pyrophosphate (GPP) by farnesylpyrophosphate synthase (FPPS, FDPS), which is condensed with another IPP to yield farnesylpyrophosphate (FPP). By the action of SQS, FPP is converted to squalene, which is converted sequentially to monooxidaosqualene (MOS) and lanosterol by squalene monooxygenase (SM) and lanosterol synthase, respectively. Lastly, lanosterol is further metabolized to cholesterol by 19 enzymes, including CYP51A (lanosterol-14α demethylase), TM7SF2 (steroid 14 reductase), SC4MOL (4 methyl sterol oxidase), NSDHL (C3 sterol dehydrogenase), HSD17B7 (3-ketoreductase), EBP (phenylalkylamine Ca2+ antagonist binding protein), SC5D (sterol-C5-desaturase), 7-dehydrocholesterol reductase (DHCR7), and DHCR24. As reported, cholesterol plays a crucial role in maintaining the structure and function of cellular membranes and is also a precursor of steroid hormones and vitamin D. Collectively, SREBP-2 controls cholesterol biosynthesis by regulating mevalonate metabolism enzymes (Figure 2).

As many studies reported, SREBP-2 activation and pathways are regulated by multiple signals. A major tumor suppressor, p53, can block activation of SREBP-2 to decrease the transcription of mevalonate pathway genes through transcriptional up-regulation of the ATP-binding cassette (ABC) transporter A1 (ABCA1) gene, which mediates tumor suppression. On the other hand, SREBP-2 can increase the generation of oxysterol ligands for liver X receptors (LXRs) to positively regulate ABCA1 gene transcription. LXRs play a potential role in maintaining cholesterol homeostasis through promoting cholesterol efflux and suppressing de novo synthesis and uptake. Mutant p53 is recruited to the promoters of genes encoding mevalonate pathway enzymes by binding to the SREBP-2, which subsequently increases the activities of oncogenic pathways such as Ras, RhoA, and YAP/TAZ to promote cancer progression. Apart from p53, protein kinase B (Akt) acutely activates SREBP-2 to induce the expression of genes involved in cholesterol synthesis, which contributes to tumor development. In addition, tumor microenvironments such hypoxia, extracellular pH, and nutrient levels also play critical roles in the regulation of SREBP-2 activation. Hypoxia inducible factor-1α is able to increase the activity of HMGCR by the translocation of SREBP-2 to the nucleus. Acidic extracellular pH (pH 6.8) triggers nuclear translocation of SREBP-2 to target acyl-CoA synthase short-chain family member 2 for maintaining overall survival of cancer patients. As a kind of nutrient, glucose promotes SCAP/SREBP complex trafficking from the ER to the Golgi and subsequent SREBP activation via N-glycosylation of SCAP. When cholesterol in the ER falls below 5% of total ER lipids, the cleavage of SREBP-2 is activated. A steroid hormone, androgen, can induce SREBP-2 activation in normal physiological or pathological conditions, such as prostate cancer. Taken together, either multiple signaling pathways or cellular nutrient levels can regulate SREBP-2 activation to control the mevalonate pathway (Figure 2).

Meanwhile, the enzymes participating in the mevalonate pathway, such as HMGCR, MVK, SQS, and DHCR24, are regulated by various molecules or the metabolites from mevalonate metabolism. Both the phosphorylation by AMP-activated protein kinase (AMPK) and dephosphorylation by protein phosphatase 2A regulate HMGCR activity. The binding of INSIG on the sterol-sensing domain can lead to the ubiquitination and degradation of HMGCR. Interestingly, PPARγ can regulate multiple pathways, including decreasing the expressions of SREBP-2 and HMGCR and increasing the expression of LXRα to reduce cholesterol levels. Considering the role of LXRα on cholesterol efflux, the expression of ABC transporter G5 or G8 is increased by the PPARγ-LXRα pathway or their individual dependence, which needs to be further clarified. Two key enzymes of the post-squalene pathway, SQS and CYP51A are directly repressed by LXRα via negative binding with LXR DNA response elements. Moreover, DHCR24 as a final enzyme for cholesterol biosynthesis is regulated by RE1-silencing transcription factor, REST and LXRα through the binding of its promoter at the transcriptional level. These findings suggest that LXRα plays an important role in regulating several enzymes of the mevalonate pathway, such as SQS, CYP51A, and DHCR24.

Additionally, key metabolites also can modulate metabolic enzymes of the SREBP-2-reguated mevalonate pathway. Cholesterol and 25-hydroxycholesterol can regulate HMGCR by increasing its alternative splicing. Mevalonate and certain of its derivatives such as dioxidolanosterol and geraniol regulate HMGCR mRNA translation or polysome distribution to reduce its synthesis and translation. Lanosterol and other C4-dimethylated sterol intermediates may regulate both HMGCR degradation and SREBP-2 cleavage. For geranylgeranyle diphosphate (GGPP), FPP and IPP, these intermediates post-transcriptionally inhibit MVK activity by negative feedback responses. Other metabolites, such as phytosterols, 24(S), 25-epoxycholesterol (24,25-EC) and steroid hormones (progesterone) can directly inhibit DHCR24 activity at the post-translational level. Overall, SREBP-2 and the enzymes for cholesterol biosynthesis, such as HMGCR, MVK, SQS, and DHCR24, can be regulated by various signaling pathways and mevalonate pathway metabolites at the transcriptional and post-translational levels (Figure 2).

SREBP-2 Signaling and the Enzymes From the Mevalonate Pathway in the Cancer Context

Reprogramming of lipid metabolism occurs in a variety of cancers and contributes to rapid tumor growth, which is regulated by SREBPs. SREBP-2 is markedly upregulated in various cancers, including prostate, breast, and hepatocellular cancer. Moreover, SREBP-2-mediated mevalonate metabolism drives epithelial to mesenchymal transition (EMT) and supports cancer stemness, and has been suggested as a potential target for cancer treatment.

Prostate Cancer

Lipid synthesis and uptake are significantly elevated in prostate cancer (PCa) as important energy resources to support tumor growth and progression. As is well-known, androgens bind to and activate the androgen receptor (AR) to maintain the survival and proliferation of PCa. Androgen-induced activation of SREBPs occurs not only under normal physiological conditions but also in the setting of steroid-regulated cancers. Androgens markedly stimulate the expression of SCAP and cause a switch in the isoform expression of INSIG, which play a pivotal role in the lipogenic effects of androgen in PCa. Meanwhile, dihydrotestosterone or R1881 marginally up-regulates the mRNA and protein levels of SREBP-2, which induces the expression of multiple genes encoding enzymes involved in cholesterol biosynthesis, including HMGCS, HMGCR, FPPS in PCa cells. A recent report shows that an aberrant SREBP-dependent lipogenic program promotes PCa metastasis with double-null PML and PTEN. During the progression to androgen independence, nuclear SREBP-2 protein expression underwent a 3-fold increase in a PCa xenograft model. In addition, SREBP-2 expression is elevated in advanced pathologic grade and metastatic PCa and significantly associated with poor clinical outcomes. SREBP-2 promotes PCa cell growth, stemness and metastasis through transcriptional c-Myc activation mediated by direct interaction with a SREBP-2-binding element in the 5′-flanking c-Myc promoter region.

Key enzymes for mevalonate pathway such as HMGCS1, HMGCR, FPPS, and SQS also play important roles in PCa malignant progression. HMGCS1 and HMGCR are overexpressed in stroma of early stage PCa. Moreover, enzalutamide-resistant PCa cell lines express elevated HMGCR, and are more sensitive to statins, HMGCR inhibitors. FPPS is associated with increasing Gleason scores, PTEN functionally deficient status, and poor survival in PCa through modulation of the small GTPases/Akt axis. SQS at rs2645429 is significantly associated with PCa risk and aggressive phenotypes. Taken together, SREBP-2 and key enzymes for the mevalonate pathway are potential targets for PCa treatment.

Breast Cancer

In breast cancer, CtBP expression negatively correlates with SREBP-2 and HMGCR expressions. CtBP can form a complex with ZEB1 to transcriptionally repress SREBP-2 expression and activate TGF-β signaling, which maintains intracellular cholesterol homeostasis in breast cancer. TP53 mutation correlates with elevated expression of a subset of mevalonate pathway genes in breast cancer patients. The levels of genes such as HMGCR, FPPS, SQS, and DHCR7 are positively associated with the risk of breast cancer. The functional interaction with SREBP-2 is critical for mutant p53-mediated up-regulation of the mevalonate pathway genes. Oncogenic PI3K (H1047R) or K-Ras (G12V) can induce de novo lipogenesis through convergent activation of mTORC1 to promote aberrant growth and proliferation of breast cancer, which is mediated by the activation of SREBP-2 or SREBP-1. In addition, SREBP-2 is highly expressed in breast cancer tissues and correlated with a poor prognosis. SREBP-2 expression is increased during the early stages of osteoclast formation under the control of the RANKL/cAMP-CREB signaling cascade, which induces the expressions of NFATc1 and matrix metalloproteinase, thus contributing to breast cancer-induced osteolysis.

For patients with HER2+ metastatic breast cancer, dual targeted therapy with a tyrosine kinase inhibitor, lapatinib or its combination with an anti-HER2 monoclonal antibody, trastuzumab can significantly improve pathological complete response and overall survival. However, lapatinib and its combination with trastuzumab lead to the resistance of breast cancer cells to HER2-targeted therapy, which has been a clinical challenge. The mevalonate pathway has been considered as a new potential target for overcoming this acquired anti-HER2 treatment resistance, which may be mediated by activating the mTORC1-mediated YAP/TAZ pathway. Rate-limiting enzyme studies found that high levels of HMGCR are correlated with breast cancer risk and poor survival. Cholesterol is also implicated as a breast cancer risk factor and promotes breast tumor growth and metastasis. Another metabolite, 27-hydroxycholesterol, can increase the proliferation of estrogen receptor (ER)-positive breast cancer through the activation of ER and LXR. Therefore, inhibition of the SREBP-2-mediated mevalonate pathway has been recognized as a potential therapeutic approach for breast cancer.

Lung Cancer

The single-nucleotide polymorphism of HMGCR, rs12916, is associated with the subgroups of attained age for lung cancer and the C allele of the SQS rs2645429 polymorphism gene can be a risk factor for non-small cell lung cancer (NSCLC). Three key enzymes of the mevalonate pathway, FPPS, SQS and GGPPS, are also associated with stage and metastasis of NSCLC. Of these enzymes, SQS is increased in invasive lung cancer cells and in the tumor regions of lung cancer specimens, and significantly associated with metastasis and poor prognosis by enhancing NF-κB-mediated up-regulation of matrix metallopeptidase-1 or modulating extracellular signal-regulated kinase (ERK) signaling. FPPS plays an important role in promoting cell invasion and EMT through the RhoA/ROCK1 pathway. Although GGPPS knockdown has no effect on lung adenocarcinoma cell proliferation and apoptosis, it significantly inhibits invasion and migration by regulating EMT. Overall, several enzymes from the mevalonate pathway as mentioned above have been identified as potential targets for treating lung cancer.

Hepatocellular Carcinoma

New studies reveal that several key molecules, such as p53 and fatty acid synthase (FASN), can activate SREBP-2 to promote cholesterol accumulation for maintaining the progression of hepatocellular carcinoma (HCC). In HCC, p53 tumor suppressor can induce the expression of MVA pathway enzymes through the accumulation and stabilization of mature SREBP-2 by transcriptionally inducing ABCA1, a cholesterol transporter gene. Like p53 loss, the ablation of ABCA1 promotes murine liver tumorigenesis and is associated with increased SREBP-2 maturation. In contrast to p53, a p53 activator, haplo-insufficient tumor suppressor ASPP2, can interact with SREBP-2 in the nucleus and negatively regulates the mevalonate pathway to mediate the inhibition of HCC tumor growth. Moreover, overexpression of Staphylococcal nuclease and tudor domain containing-1 (SND-1) in HCC results in the accumulation of cellular cholesteryl esters due to the altered activation of SREBP-2. Interestingly, SREBP-2 also binds to specific sites in SND-1 promoter to induce its transcription, which contributes to lipid metabolism reprogramming in HCC. This suggests that there is a complex for the interaction of SND-1and SREBP-2 in the lipid reprogramming of HCC, which needs to be clarified. Another molecule, FASN, contributes to de novo fatty acid synthesis in a murine HCC model induced by Pten loss and c-Met overexpression. Compared with the control group, genes such as HMGCR involved in cholesterol biosynthesis were obviously upregulated in HCC in FASN knockout mice, related to the promotion of nuclear SREBP-2. Reportedly, the inhibition of FASN ubiquitination and disruption of the SREBP-1/SREBP-2 degradation complexes may be potential molecular mechanisms of Akt-induced lipogenesis and HCC tumor development in mice. In addition, Forkhead Box M1 has a positive correlation with SREBP-2 or HMGCR in HCC tissues, which links the mevalonate pathway through protein geranylgeranylation as novel targets. Based on the findings above, targeting the SREBP-2-mediated mevalonate pathway seems to have potential as a strategy for HCC treatment.

Other Cancers

Similarly, SREBP-2 and its regulated mevalonate pathways also participate in other cancers. In esophageal squamous cell carcinoma, SREBP-2 is upregulated in clinical samples and promotes cell growth, migration and colony formation, which may be mediated by interaction with c-Myc to increase HMGCR expression. In renal carcinoma, kruppel-like factor 6 (KLF6) activates mTOR signaling and its downstream lipid metabolism regulator, SREBP-2 to enhance tumor growth. In pancreatic cancer, the novel small nucleolar RNA host gene 16 directly regulates the miR-195/SREBP-2 axis to promote lipogenesis and accelerate tumor progression. Furthermore, increasing cellular cholesterol can drive intestinal stem cell proliferation and tumorigenesis through the activation of nuclear SREBP-2. Also, SQS is frequently mutated and dysregulated in the liver metastatic cohort of colorectal cancer. The final enzyme of the cholesterol pathway, DHCR24, is significantly elevated and associated with advanced clinical stage and overall survival in bladder and endometrial cancer, which is mediated by several oncogenesis-associated biological processes. Collectively, these findings in different cancers indicate that the SREBP-2-regulated mevalonate pathway significantly participates in tumor growth and metastasis and may be an attractive target in a variety of malignancies (Table 1).

Targeting the SREBP-2-Regulated Mevalonate Pathway For Cancer Therapy

Based on the above reports, we choose SREBP-2, HMGCR, and FPPS as potential targets for cancer therapy and summarized the findings so far regarding several inhibitors or miRNAs used to address these targets in preclinical and clinical studies.

Targeting SREBP-2 for Cancer Therapy

As reported, SREBPs inhibition by small molecules such as fatostatin, natural products, and microRNAs such as miR-185, miR-342, and miR-33a have been extensively found to exert multiple anti-tumor effects in various cancers by reducing mevalonate metabolic dysfunction. Fatostatin, a non-sterol diarylthazole derivative, was first reported to inhibit insulin-induced adipogenesis and reduce body weight by blocking nuclear translocation of SREBPs in obese mice. Fatostatin has been used for treating prostate, breast, and endometrial cancers. Mechanistically, fatostatin directly binds SCAP and blocks its transport from ER to Golgi apparatus, then inhibits the activation of SREBPs. A recent study also showed that fatostatin inhibits cell proliferation through a SCAP-independent mechanism. In PCa, in vitro and in vivo studies reveal that fatostatin suppresses cell proliferation and induces apoptosis through blockade of SREBP-regulated metabolic pathways, similar to the findings in endometrial carcinoma. The combination of fatostatin with docetaxel significantly increases proliferation inhibition and apoptosis induction in metastatic PCa harboring p53 mutations, compared with fatostatin alone. Moreover, fatostatin also inhibits mitotic microtubule spindle assembly and cell division in aggressive cancers in addition to the inhibition of SREBP activity. Fatostatin also causes lipid accumulation as a response to endoplasmic reticulum stress rather than the inhibition of SREBP-mediated lipogenesis in ER+ breast cancer cells. These studies suggest that the antitumor effects of fatostation are multiple and dependent on cancer type.

Recent studies indicate that natural products can directly target SREBP-2 to inhibit the expression of key enzymes for the mevalonate pathway, to reduce tumor growth. Tocotrienol, a minor form of vitamin E, can degrade mature SREBP-2 without affecting LXR activity to maintain cholesterol homoeostasis in PCa. In glioma, artesunate, initially developed as an anti-malaria drug, effectively inhibits cancer cell growth and distant metastasis, and further induces cell senescence by regulating the nuclear localization of SREBP-2 and the expression of HMGCR. As an anthraquinone derived from many plants, emodin inhibits SREBP-2 transcriptional activity to suppress cholesterol metabolism and Akt signaling, which sensitizes HCC cells to the anti-cancer effect of sorafenib in vitro and in xenograft models. Surprisingly, ursolic acid as a natural pentacyclic terpenoid activates SREBP-2 and increases the expression of cholesterol biosynthesis-related enzymes to induce cell cycle arrest and apoptosis in HCC cells. Additionally, archazolid B leads to the accumulation of free cholesterol and drastic disturbance in cholesterol homeostasis, which can activate nuclear SREBP-2 expression and up-regulate HMGCR for killing bladder cancer cells.

Some miRNAs, such as miR-98 and miR-33a, have been found to play critical roles in cholesterol metabolism by targeting SREBP-2. Our previous study shows that miR-185 and miR-342 not only significantly block SREBP-2-mediated cholesterogenesis, but also inhibit SREBP-1-mediated lipogenesis in PCa. Another miRNA, miR-33a, an intronic miRNA located within the SREBP-2 gene, inhibits EMT targeting of Twist1 to block invasion and metastasis in NSCLC. According to present studies, searching for miRNAs directly and specifically targeting SREBP-2 could be a future direction for new cancer treatment strategies. Table 2 summarizes current SREBP-2 targeting by small molecules or miRNAs.

Targeting HMGCR in Preclinical Cancer Therapy

Altered cholesterol metabolism is considered as a risk factor and driver of tumor growth, and is also associated with worse prognosis in a variety of cancers including breast, prostate, brain, and colorectal cancer. Targeting HMGCR, a rate-limiting specific enzyme of cholesterol synthesis, has been identified as a potential therapeutic strategy for cancer treatment. Originally for treating cardiovascular diseases, statins like HMGCR inhibitors have become a standard of care for treating cancer patients with high cholesterol levels and also reduce the incidence and recurrence of various cancers, including colon, liver, and lung cancer. Statins can be divided mainly into two groups, depending on their origin by fungi fermentation or chemical syntheses, including type-1, mevastatin, lovastatin, simvastatin and type-2, fluvastatin, and atorvastatin. A number of studies have indicated that statins can inhibit cell proliferation, invasion and colony formation, and induce apoptosis to suppress tumorigenesis, tumor survival, angiogenesis and metastasis by regulating multiple signaling pathways.

In PCa xenograft mice models, simvastatin treatment at 25 μM inhibited serum-induced Akt activity, cell migration and colony formation. Both simvastatin and fluvastatin inhibit cell proliferation and induce apoptosis in a dose- and time-dependent manner via the downregulation of Akt/Foxo1 phosphorylation in PCa. Simvastatin treatment also overcomes enzalutamide-induced resistance through the inhibition of mTOR-mediated AR degradation.

In breast cancer, both statins and HMGCR transcriptional regulation can overcome statin resistance through the regulation of SREBP-2 cleavage. The findings in a 2D co-culture and a splenic mouse model demonstrate that atorvastatin suppresses breast cancer proliferation, EMT and distant metastasis and also induces autophagy, which is related to regulating PTEN/Akt and Ras homolog family member B pathways. In breast cancer stem-like cells, statins at non-toxic doses significantly alter a shared cluster of 37 genes, including the Hippo, Notch, and Wnt pathways, to hold back EMT processes. Simvastatin induces breast cancer cell death through the deactivation of PI3K/Akt and MAPK/Erk signals and also prevents triple-negative breast cancer proliferation and metastasis through Foxo3a phosphorylation or HSP90 acetylation. Another statin, pitavastatin, can slow breast cancer-induced bone metastasis and reduce urine-derived volatile organic compounds through the mevalonate pathway.

Increasing evidence demonstrates the anticancer effects of statins including atorvastatin, lovastatin, and fluvastatin against lung cancer by decreasing proliferative and migratory capacity and inducing apoptosis, which is mediated by SphK1, COX-2/PPARγ, TGF-β RII/Erk, and other key pathways. Lung cancer cells metastasize to the bone and release RANKL, IL-6, and other factors to stimulate osteoclasts, which can be inhibited by fluvastatin through autophagy induction and osteoclastogenesis.

In hepatocellular carcinoma, in vitro and in vivo studies reveal that simvastatin induces G0/G1 arrest by upregulating p21 and p27, activating AMPK and inhibiting the STAT3-Skp2 axis in HCC. Other studies report that TAZ, Notch1 or ROCK expression are also involved in the anti-proliferative effects of statins against HCC.

Fluvastatin has potent anti-cancer effects against renal cell carcinoma through the suppression of the Akt/mTOR signaling cascade and induces lymphoma cell apoptosis by promoting ROS generation and regulating the Akt, Erk, and p38 signaling pathways via the inhibition of mevalonate metabolic products. Combination therapy studies demonstrated that statins combined with chemical molecules, including doxorubicin, celecoxib, venetoclax, metformin, or a MEK inhibitor, AZD6244, can synergistically suppress tumor growth in prostate, ovarian, endometrial, or pancreatic cancers, respectively. Overall, these findings suggest that statins alone or combined with other drugs inhibit the mevalonate pathway to achieve anti-cancer effects by a variety of molecular mechanisms (Table 2).

Targeting HMGCR in Clinical Cancer Therapy

Currently, statins are in use for preventing or treating cancer patients with prostate, breast, lung, liver, and other cancers. The safety, efficacy and mortality benefits of statins have been assessed both alone and in combination therapy in clinical cancer patients studies.

In a 7.5 year follow-up of patients with PCa, statin use was associated with a decreased risk of death and delays in cancer progression, dependent on the increasing intensity of usage. However, statin use before diagnosis is not associated with PCa death risk. A meta-analysis of breast cancer patients indicates that statin can lower cancer-specific and all-cause mortality, which appears to be related to statin type (lipophilic or hydrophilic statin) and follow-up time. Seventeen studies in 98,445 patients indicate that statins potentially decrease cancer-specific mortality and promote the overall survival of patients with lung cancer in observational studies, which does not affect progression-free survival. In liver cancer, numerous studies have demonstrate decreased liver cancer mortality by statin treatment after adjusting for cholesterol level and body mass index, which is a novel approach for the prevention and treatment of HCC. In addition, post-diagnostic statin use is associated with improved survival of patients with other cancers, such as esophageal cancer and ovarian cancer. Compared to statin alone, the combination of statins with therapeutic drugs such as thalidomide, idarubicin or tyrosine kinase inhibitor has synergistic effects for patients with refractory myeloma, acute myeloid leukemia or NSCLC, respectively.

However, some contradictory studies indicate that statins have no protective effect on skin, colon, or other cancers in numerous clinical trials, which might be related to chemical nature, tumor stage and type, dose, use duration and patient characteristics. Therefore, well-defined patient information and clinical trial design need careful consideration in future studies of statins in cancer patients. Table 3 summarizes the detailed information about tumor type, the number of patients, and main findings from clinical studies of statins alone or combined with other therapeutic agents in patients with various cancers.

Targeting FPPS in Preclinical Cancer Therapy

Amino-bisphosphonates (N-BPs), as FPPS inhibitors, represent another major class of inhibitors targeting the mevalonate pathway. Compared to original non-nitrogen containing bisphosphonates, N-BPs have an increased affinity to hydroxyapatite and interfere with FPPS in the mevalonate pathway, and are used for treating patients with osteoporosis or osteolytic bone metastases. Several studies reveal anti-tumor effects of N-BPs apart from the inhibition of osteoclasts. Third-generation N-BPs, zoledronic acid (ZOL) and minodronate (YM529), are more potent inhibitors of FPPS than the first-generation bisphosphonates, and have been found to exhibit anti-tumor effects through inhibition of cell growth, induction of apoptosis, inhibition of angiogenesis, decrease in tumor cell adhesion to bone and other possible mechanisms in various cancers.

In PCa, ZOL induces apoptosis through down-regulation of survivin, and inhibits RhoA-mediated amoeboid motility to impede metastatic lung colonization. In PCa stem cells, ZOL can facilitate the intrinsic apoptosis pathway to overcome chemoresistance. Moreover, ZOL exposure markedly induces autophagosome formation and inhibits protein prenylation for anti-prostate cancer activity. In breast cancer, ZOL can significantly reduce the expression of cancer cell factors such as CCL2 and IDO to suppress regulatory T-cell function. Especially, a formed ZOL-nanoparticle restores doxorubicin cytotoxic efficacy against chemo-immunoresistant tumors by reducing metabolic flux and also lowers Ras/Erk1/2/HIF-1α axis activity to maintain cell death and immunosuppression. In lung cancer, in vitro and in vivo experiments demonstrate that ZOL-treated cells typically arrest the at S/G2/M phase with increases of cyclins and cyclin-related regulatory proteins such as Ras. ZOL can also inhibit Ras and Rap1A prenylation to target lung cancer. Similar findings in HCC demonstrate that ZOL inhibits the translocation of Ras and RhoA to reduce cell growth and prevent progression to bone metastatic lesions. Additionally, ZOL treatment reverts M2 macrophages to M1 phenotype for producing IFN-γ or activating Vγ9Vδ2 T cells to suppress tumorigenesis through the immune modulation.

Another N-BP, YM529, also exerts anti-tumor effects against various types of cancer cells, including PCa, NSCLC, and bladder cancer, by various mechanisms such as CXCR-4-induced invasion, down-regulation of Erk1/2 phosphorylation, and inhibition of Rap1A prenylation. In addition, N-BPs have been used in combination with chemotherapy, statins or enzyme inhibitors to achieve additive or synergistic effects by diverse mechanisms, including a reduction in protein prenylation, impairment of geranylgeranylation or inhibition of STAT3 in prostate, breast, and lung cancers. The effects of FPPS inhibitors such as ZOL and YM529 alone and in combination with other drugs targeting multiple signaling pathways in cancer cell and xenograft models are summarized in Table 2.

Targeting FPPS in Clinical Cancer Therapy

Based on their strong inhibitory effect on osteoclasts, N-BPs are used to treat osteolytic bone metastases, which are frequent in advanced cancer, especially prostate and breast cancer. In PCa, ZOL has become an established first-line or adjunctive treatment in bone-targeted therapy for metastatic castration-resistant progression. Though ZOL delays skeletal-related events (SREs), it reportedly has no effect on overall survival, other disease-oriented parameters, or radiographic progression improvement. It remains an important adjunctive treatment strategy in the care of metastatic castrate-resistant PCa patients. Findings in clinical trials indicate that the beneficial effect of ZOL on bone metastasis from advanced prostate cancer might be related to long-term therapy, generally for more than 2 years. Similarly, ZOL can prevent the development of SREs in bone metastatic patients with breast cancer and improve quality of life, although with no effect on overall survival. However, long-term side effects of ZOL, such as impaired renal function and bone pain need to be taken into consideration for treatment decisions. Findings in clinical studies of ZOL treatment alone or in combination are summarized in Table 3.

Overall, the SREBP-2-regulated mevalonate pathway is a crucial regulator for tumor progression and a promising therapeutic target. Targeting SREBP-2, HMGCR or FPPS has become an attractive strategy for cancer therapy. Preclinical (Table 2) and clinical (Table 3) studies demonstrate that fatostatin, statins, ZOL, and YM529, alone or in combination with chemotherapy or other drugs, have anti-tumor effects through a variety of molecular mechanisms.

Conclusions

This review has summarized the structure, activation and regulation of SREBP-2 by multiple signaling pathways. SREBP-2 and its regulated enzymes from the mevalonate pathway, including HMGCR, FPPS, SQS, and DHCR4, participate in the progression of various cancers including prostate, breast, lung, and hepatocellular cancer, and thus are important potential therapeutic targets. Importantly, preclinical and clinical research has demonstrated that fatostatin, statins, and N-BPs targeting SREBP-2, HMGCR, and FPPS, respectively, alone or in combination with other drugs, are used for the treatment of different cancers. This review provides new insights into the critical role of the SREBP-2-regulated mevalonate pathway in cancer and its potential for targeted cancer therapy.

As a metabolic reprogramming process, the SREBP-2-regulated mevalonate pathway has a high-degree of similarity with glucose or glutamine metabolism and links them together to participate in cancer progression. Based on the function of SREBP-2 in cholesterol biosynthesis, it is necessary to develop new strategies specifically targeting SREBP-2 to treat various cancers with dysfunctional cholesterol metabolism. Combination treatments simultaneously targeting SREBP-2 and its regulated enzymes from the mevalonate pathway may achieve beneficial effects for cancer treatment and prevention, and represent important future directions in ongoing research.

Author Contributions

LX, XL, and BW: conceptualization. LX: writing—original draft preparation. HQ, HZ, LD, and QH: writing—review and editing of different sections. DZ, BW, and XL: supervision. All authors have read and agreed to the published version of the manuscript.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

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    Sever N Yang T Brown MS Goldstein JL DeBose-Boyd RA. Accelerated degradation of HMG CoA reductase mediated by binding of insig-1 to its sterol-sensing domain. Mol Cell. (2003 ) 11:25–33.

    Not in our library10.1016/s1097-2765(02)00822-5

  78. 78.

    Tsai YC Leichner GS Pearce MM Wilson GL Wojcikiewicz RJ Roitelman J. Differential regulation of HMG-CoA reductase and Insig-1 by enzymes of the ubiquitin-proteasome system. Mol Biol Cell. (2012 ) 23:4484–94.

    Not in our library10.1091/mbc.e12-08-0631

  79. 79.

    Han T Lv Y Wang S Hu T Hong H Fu Z. PPARgamma overexpression regulates cholesterol metabolism in human L02 hepatocytes. J Pharmacol Sci. (2019 ) 139:1–8.

    Not in our library10.1016/j.jphs.2018.09.013

  80. 80.

    Wang Y Rogers PM Su C Varga G Stayrook KR Burris TP. Regulation of cholesterologenesis by the oxysterol receptor, LXRalpha. J Biol Chem. (2008 ) 283:26332–9.

    Not in our library10.1074/jbc.m804808200

  81. 81.

    Tint GS Pan L Shang Q Sharpe LJ Brown AJ Li M. Desmosterol in brain is elevated because DHCR24 needs REST for Robust Expression but REST is poorly expressed. Dev Neurosci. (2014 ) 36:132–42.

    Not in our library10.1159/000362363

  82. 82.

    Medina MW Gao F Naidoo D Rudel LL Temel RE McDaniel AL. Coordinately regulated alternative splicing of genes involved in cholesterol biosynthesis and uptake. PLoS ONE. (2011 ) 6:e19420.

    Not in our library10.1371/journal.pone.0019420

  83. 83.

    Peffley DM Gayen AK. Mevalonate regulates polysome distribution and blocks translation-dependent suppression of 3-hydroxy-3-methylglutaryl coenzyme A reductase mRNA: relationship to translational control. Somat Cell Mol Genet. (1995 ) 21:189–204.

    Not in our library10.1007/bf02254770

  84. 84.

    Chen L Ma MY Sun M Jiang LY Zhao XT Fang XX. Endogenous sterol intermediates of the mevalonate pathway regulate HMGCR degradation and SREBP-2 processing. J Lipid Res. (2019 ) 60:1765–75.

    Not in our library10.1194/jlr.ra119000201

  85. 85.

    Hinson DD Chambliss KL Toth MJ Tanaka RD Gibson KM. Post-translational regulation of mevalonate kinase by intermediates of the cholesterol and nonsterol isoprene biosynthetic pathways. J Lipid Res. (1997 ) 38:2216–23.

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  86. 86.

    Metherall JE Waugh K Li H Progesterone inhibits cholesterol biosynthesis in cultured cells. Accumulation of cholesterol precursors. J Biol Chem. (1996 ) 271:2627–33.

    Not in our library10.1074/jbc.271.5.2627

  87. 87.

    Fernandez C Suarez Y Ferruelo AJ Gomez-Coronado D Lasuncion MA. Inhibition of cholesterol biosynthesis by Delta22-unsaturated phytosterols via competitive inhibition of sterol Delta24-reductase in mammalian cells. Biochem J. (2002 ) 366(Pt. 1):109–19.

    Not in our library10.1042/bj20011777

  88. 88.

    Zerenturk EJ Kristiana I Gill S Brown AJ. The endogenous regulator 24(S),25-epoxycholesterol inhibits cholesterol synthesis at DHCR24 (Seladin-1). Biochim Biophys Acta. (2012 ) 1821:1269–77.

    Not in our library10.1016/j.bbalip.2011.11.009

  89. 89.
    Lipid metabolism reprogramming and its potential targets in cancer · 2018
    No notice
  90. 90.

    Ettinger SL Sobel R Whitmore TG Akbari M Bradley DR Gleave ME. Dysregulation of sterol response element-binding proteins and downstream effectors in prostate cancer during progression to androgen independence. Cancer Res. (2004 ) 64:2212–21.

    Not in our library10.1158/0008-5472.can-2148-2

  91. 91.

    Armengol S Arretxe E Enzunza L Llorente I Mendibil U Navarro-Imaz H. SREBP-2-driven transcriptional activation of human SND1 oncogene. Oncotarget. (2017 ) 8:108181–94.

    Not in our library10.18632/oncotarget.22569

  92. 92.

    Gruenbacher G Thurnher M. Mevalonate metabolism in cancer stemness and trained immunity. Front Oncol. (2018 ) 8:394.

    Not in our library10.3389/fonc.2018.00394

  93. 93.

    Suburu J Chen YQ. Lipids and prostate cancer. Prostaglandins Other Lipid Mediat. (2012 ) 98:1–10.

    Not in our library10.1016/j.prostaglandins.2012.03.003

  94. 94.

    Bull CJ Bonilla C Holly JM Perks CM Davies N Haycock P. Blood lipids and prostate cancer: a Mendelian randomization analysis. Cancer Med. (2016 ) 5:1125–36.

    Not in our library10.1002/cam4.695

  95. 95.

    Fujita K Nonomura N. Role of androgen receptor in prostate cancer: a review. World J Mens Health. (2019 ) 37:288–95.

    Not in our library10.5534/wjmh.180040

  96. 96.

    Heemers HV Verhoeven G Swinnen JV. Androgen activation of the sterol regulatory element-binding protein pathway: current insights. Mol Endocrinol. (2006 ) 20:2265–77.

    Not in our library10.1210/me.2005-0479

  97. 97.

    Heemers H Verrijdt G Organe S Claessens F Heyns W Verhoeven G. Identification of an androgen response element in intron 8 of the sterol regulatory element-binding protein cleavage-activating protein gene allowing direct regulation by the androgen receptor. J Biol Chem. (2004 ) 279:30880–7.

    Not in our library10.1074/jbc.m401615200

  98. 98.

    Swinnen JV Van Veldhoven PP Esquenet M Heyns W Verhoeven G. Androgens markedly stimulate the accumulation of neutral lipids in the human prostatic adenocarcinoma cell line LNCaP. Endocrinology. (1996 ) 137:4468–74.

    Not in our library10.1210/endo.137.10.8828509

  99. 99.

    Swinnen JV Ulrix W Heyns W Verhoeven G. Coordinate regulation of lipogenic gene expression by androgens: evidence for a cascade mechanism involving sterol regulatory element binding proteins. Proc Natl Acad Sci USA. (1997 ) 94:12975–80.

    Not in our library10.1073/pnas.94.24.12975

  100. 100.

    Chen M Zhang J Sampieri K Clohessy JG Mendez L Gonzalez-Billalabeitia E. An aberrant SREBP-dependent lipogenic program promotes metastatic prostate cancer. Nat Genet. (2018 ) 50:206–18.

    Not in our library10.1038/s41588-017-0027-2

  101. 101.

    Ashida S Kawada C Inoue K. Stromal regulation of prostate cancer cell growth by mevalonate pathway enzymes HMGCS1 and HMGCR. Oncol Lett. (2017 ) 14:6533–42.

    Not in our library10.3892/ol.2017.7025

  102. 102.

    Kong Y Cheng L Mao F Zhang Z Zhang Y Farah E. Inhibition of cholesterol biosynthesis overcomes enzalutamide resistance in castration-resistant prostate cancer (CRPC). J Biol Chem. (2018 ) 293:14328–41.

    Not in our library10.1074/jbc.ra118.004442

  103. 103.

    Todenhofer T Hennenlotter J Kuhs U Gerber V Gakis G Vogel U. Altered expression of farnesyl pyrophosphate synthase in prostate cancer: evidence for a role of the mevalonate pathway in disease progression? World J Urol. (2013 ) 31:345–50.

    Not in our library10.1007/s00345-012-0844-y

  104. 104.

    Seshacharyulu P Rachagani S Muniyan S Siddiqui JA Cruz E Sharma S. FDPS cooperates with PTEN loss to promote prostate cancer progression through modulation of small GTPases/AKT axis. Oncogene. (2019 ) 38:5265–80.

    Not in our library10.1038/s41388-019-0791-9

  105. 105.

    Fukuma Y Matsui H Koike H Sekine Y Shechter I Ohtake N. Role of squalene synthase in prostate cancer risk and the biological aggressiveness of human prostate cancer. Prostate Cancer Prostatic Dis. (2012 ) 15:339–45.

    Not in our library10.1038/pcan.2012.14

  106. 106.

    Zhao Z Hao D Wang L Li J Meng Y Li P. CtBP promotes metastasis of breast cancer through repressing cholesterol and activating TGF-beta signaling. Oncogene. (2019 ) 38:2076–91.

    Not in our library10.1038/s41388-018-0570-z

  107. 107.

    Ricoult SJ Yecies JL Ben-Sahra I Manning BD. Oncogenic PI3K and K-Ras stimulate de novo lipid synthesis through mTORC1 and SREBP. Oncogene. (2016 ) 35:1250–60.

    Not in our library10.1038/onc.2015.179

  108. 108.

    Xu ZQ Zhang Y Li N Liu PJ Gao L Gao X. Efficacy and safety of lapatinib and trastuzumab for HER2-positive breast cancer: a systematic review and meta-analysis of randomised controlled trials. BMJ Open. (2017 ) 7:e013053.

    Not in our library10.1136/bmjopen-2016-013053

  109. 109.
    Different mechanisms for resistance to trastuzumab versus lapatinib in HER2- positive breast cancers - role of estrogen receptor and HER2 reactivation · 2011
    No notice
  110. 110.

    Sethunath V Hu H De Angelis C Veeraraghavan J Qin L Wang N. Targeting the mevalonate pathway to overcome acquired anti-HER2 treatment resistance in breast cancer. Mol Cancer Res. (2019 ) 17:2318–30.

    Not in our library10.1158/1541-7786.mcr-19-0756

  111. 111.

    Orho-Melander M Hindy G Borgquist S Schulz CA Manjer J Melander O. Blood lipid genetic scores, the HMGCR gene and cancer risk: a Mendelian randomization study. Int J Epidemiol. (2018 ) 47:495–505.

    Not in our library10.1093/ije/dyx237

  112. 112.

    Clendening JW Pandyra A Boutros PC El Ghamrasni S Khosravi F Trentin GA. Dysregulation of the mevalonate pathway promotes transformation. Proc Natl Acad Sci USA. (2010 ) 107:15051–6.

    Not in our library10.1073/pnas.0910258107

  113. 113.

    Di Benedetto A Mottolese M Sperati F Ercolani C Di Lauro L Pizzuti L. HMG-CoAR expression in male breast cancer: relationship with hormone receptors, Hippo transducers and survival outcomes. Sci Rep. (2016 ) 6:35121.

    Not in our library10.1038/srep35121

  114. 114.

    Baek AE Nelson ER. The contribution of cholesterol and its metabolites to the pathophysiology of breast cancer. Horm Cancer. (2016 ) 7:219–28.

    Not in our library10.1007/s12672-016-0262-5

  115. 115.

    Nelson ER Chang CY McDonnell DP. Cholesterol and breast cancer pathophysiology. Trends Endocrinol Metab. (2014 ) 25:649–55.

    Not in our library10.1016/j.tem.2014.10.001

  116. 116.

    Dehghani M Samani Z Abidi H Manzouri L Mahmoudi R Hosseini Teshnizi S. Relationship of SNP rs2645429 in farnesyl-diphosphate farnesyltransferase 1 gene promoter with susceptibility to lung cancer. Int J Genomics. (2018 ) 2018:4863757.

    Not in our library10.1155/2018/4863757

  117. 117.

    Yang YF Jan YH Liu YP Yang CJ Su CY Chang YC. Squalene synthase induces tumor necrosis factor receptor 1 enrichment in lipid rafts to promote lung cancer metastasis. Am J Respir Crit Care Med. (2014 ) 190:675–87.

    Not in our library10.1164/rccm.201404-0714oc

  118. 118.

    Lin L Li M Lin L Xu X Jiang G Wu L. FPPS mediates TGF-beta1-induced non-small cell lung cancer cell invasion and the EMT process via the RhoA/Rock1 pathway. Biochem Biophys Res Commun. (2018 ) 496:536–41.

    Not in our library10.1016/j.bbrc.2018.01.066

  119. 119.

    Wang X Xu W Zhan P Xu T Jin J Miu Y. Overexpression of geranylgeranyl diphosphate synthase contributes to tumour metastasis and correlates with poor prognosis of lung adenocarcinoma. J Cell Mol Med. (2018 ) 22:2177–89.

    Not in our library10.1111/jcmm.13493

  120. 120.

    Ge H Zhao Y Shi X Tan Z Chi X He M. Squalene epoxidase promotes the proliferation and metastasis of lung squamous cell carcinoma cells though extracellular signal-regulated kinase signaling. Thorac Cancer. (2019 ) 10:428–36.

    Not in our library10.1111/1759-7714.12944

  121. 121.

    Fatehi Hassanabad A Mina F. Targeting the mevalonate pathway for treating lung cancer. Am J Clin Oncol. (2020 ) 43:69–70.

    Not in our library10.1097/coc.0000000000000630

  122. 122.

    Liang B Chen R Song S Wang H Sun G Yang H. ASPP2 inhibits tumor growth by repressing the mevalonate pathway in hepatocellular carcinoma. Cell Death Dis. (2019 ) 10:830.

    Not in our library10.1038/s41419-019-2054-7

  123. 123.

    Navarro-Imaz H Chico Y Rueda Y Fresnedo O. Channeling of newly synthesized fatty acids to cholesterol esterification limits triglyceride synthesis in SND1-overexpressing hepatoma cells. Biochim Biophys Acta Mol Cell Biol Lipids. (2019 ) 1864:137–46.

    Not in our library10.1016/j.bbalip.2018.11.004

  124. 124.

    Che L Chi W Qiao Y Zhang J Song X Liu Y. Cholesterol biosynthesis supports the growth of hepatocarcinoma lesions depleted of fatty acid synthase in mice and humans. Gut. (2019 ) 69:177–86.

    Not in our library10.1136/gutjnl-2018-317581

  125. 125.

    Ogura S Yoshida Y Kurahashi T Egawa M Furuta K Kiso S. Targeting the mevalonate pathway is a novel therapeutic approach to inhibit oncogenic FoxM1 transcription factor in human hepatocellular carcinoma. Oncotarget. (2018 ) 9:21022–35.

    Not in our library10.18632/oncotarget.24781

  126. 126.

    Syafruddin SE Rodrigues P Vojtasova E Patel SA Zaini MN Burge J. A KLF6-driven transcriptional network links lipid homeostasis and tumour growth in renal carcinoma. Nat Commun. (2019 ) 10:1152.

    Not in our library10.1038/s41467-019-09116-x

  127. 127.

    Yu Y Dong JT He B Zou YF Li XS Xi CH. LncRNA SNHG16 induces the SREBP2 to promote lipogenesis and enhance the progression of pancreatic cancer. Future Oncol. (2019 ) 15:3831–44.

    Not in our library10.2217/fon-2019-0321

  128. 128.

    Wang B Rong X Palladino END Wang J Fogelman AM Martin MG. Phospholipid remodeling and cholesterol availability regulate intestinal stemness and tumorigenesis. Cell Stem Cell. (2018 ) 22:206–20. e204.

    Not in our library10.1016/j.stem.2017.12.017

  129. 129.

    Ma YS Wu ZJ Zhang HW Cai B Huang T Long HD. Dual regulatory mechanisms of expression and mutation involving metabolism-related genes FDFT1 and UQCR5 during CLM. Mol Ther Oncolytics. (2019 ) 14:172–8.

    Not in our library10.1016/j.omto.2019.04.008

  130. 130.

    Dai M Zhu XL Liu F Xu QY Ge QL Jiang SH. Cholesterol synthetase DHCR24 induced by insulin aggravates cancer invasion and progesterone resistance in endometrial carcinoma. Sci Rep. (2017 ) 7:41404.

    Not in our library10.1038/srep41404

  131. 131.

    Liu XP Yin XH Meng XY Yan XH Cao Y Zeng XT. DHCR24 predicts poor clinicopathological features of patients with bladder cancer: a STROBE-compliant study. Medicine. (2018 ) 97:e11830.

    Not in our library10.1097/md.0000000000011830

  132. 132.

    Li X Chen YT Josson S Mukhopadhyay NK Kim J Freeman MR. MicroRNA-185 and 342 inhibit tumorigenicity and induce apoptosis through blockade of the SREBP metabolic pathway in prostate cancer cells. PLoS ONE. (2013 ) 8:e70987.

    Not in our library10.1371/journal.pone.0070987

  133. 133.

    Li X Chen YT Hu P Huang WC. Fatostatin displays high antitumor activity in prostate cancer by blocking SREBP-regulated metabolic pathways and androgen receptor signaling. Mol Cancer Ther. (2014 ) 13:855–66.

    Not in our library10.1158/1535-7163.mct-13-0797

  134. 134.
    Identification of miR-185 as a regulator of de novo cholesterol biosynthesis and low density lipoprotein uptake · 2014
    Not checked
  135. 135.

    Yang L Yang J Li J Shen X Le Y Zhou C. MircoRNA-33a inhibits epithelial-to-mesenchymal transition and metastasis and could be a prognostic marker in non-small cell lung cancer. Sci Rep. (2015 ) 5:13677.

    Not in our library10.1038/srep13677

  136. 136.

    Gholkar AA Cheung K Williams KJ Lo YC Hamideh SA Nnebe C. Fatostatin inhibits cancer cell proliferation by affecting mitotic microtubule spindle assembly and cell division. J Biol Chem. (2016 ) 291:17001–8.

    Not in our library10.1074/jbc.c116.737346

  137. 137.

    Choi Y Kawazoe Y Murakami K Misawa H Uesugi M. Identification of bioactive molecules by adipogenesis profiling of organic compounds. J Biol Chem. (2003 ) 278:7320–4.

    Not in our library10.1074/jbc.m210283200

  138. 138.

    Kamisuki S Mao Q Abu-Elheiga L Gu Z Kugimiya A Kwon Y. A small molecule that blocks fat synthesis by inhibiting the activation of SREBP. Chem Biol. (2009 ) 16:882–92.

    Not in our library10.1016/j.chembiol.2009.07.007

  139. 139.

    Brovkovych V Izhar Y Danes JM Dubrovskyi O Sakallioglu IT Morrow LM. Fatostatin induces pro- and anti-apoptotic lipid accumulation in breast cancer. Oncogenesis. (2018 ) 7:66.

    Not in our library10.1038/s41389-018-0076-0

  140. 140.

    Gao S Shi Z Li X Li W Wang Y Liu Z. Fatostatin suppresses growth and enhances apoptosis by blocking SREBP-regulated metabolic pathways in endometrial carcinoma. Oncol Rep. (2018 ) 39:1919–29.

    Not in our library10.3892/or.2018.6265

  141. 141.

    Shao W Machamer CE Espenshade PJ. Fatostatin blocks ER exit of SCAP but inhibits cell growth in a SCAP-independent manner. J Lipid Res. (2016 ) 57:1564–73.

    Not in our library10.1194/jlr.m069583

  142. 142.

    Li X Wu JB Chung LW Huang WC. Anti-cancer efficacy of SREBP inhibitor, alone or in combination with docetaxel, in prostate cancer harboring p53 mutations. Oncotarget. (2015 ) 6:41018–32.

    Not in our library10.18632/oncotarget.5879

  143. 143.

    Krycer JR Phan L Brown AJ. A key regulator of cholesterol homoeostasis, SREBP-2, can be targeted in prostate cancer cells with natural products. Biochem J. (2012 ) 446:191–201.

    Not in our library10.1042/bj20120545

  144. 144.

    Wei S Liu L Chen Z Yin W Liu Y Ouyang Q. Artesunate inhibits the mevalonate pathway and promotes glioma cell senescence. J Cell Mol Med. (2019 ).

    Not in our library10.1111/jcmm.14717

  145. 145.

    Kim YS Lee YM Oh TI Shin DH Kim GH Kan SY. Emodin sensitizes hepatocellular carcinoma cells to the anti-cancer effect of sorafenib through suppression of cholesterol metabolism. Int J Mol Sci. (2018 ) 19:3127.

    Not in our library10.3390/ijms19103127

  146. 146.

    Kim GH Kan SY Kang H Lee S Ko HM Kim JH. Ursolic acid suppresses cholesterol biosynthesis and exerts anti-cancer effects in hepatocellular carcinoma cells. Int J Mol Sci. (2019 ) 20:4767.

    Not in our library10.3390/ijms20194767

  147. 147.

    Hamm R Chen YR Seo EJ Zeino M Wu CF Muller R. Induction of cholesterol biosynthesis by archazolid B in T24 bladder cancer cells. Biochem Pharmacol. (2014 ) 91:18–30.

    Not in our library10.1016/j.bcp.2014.06.018

  148. 148.

    Horie T Ono K Horiguchi M Nishi H Nakamura T Nagao K. MicroRNA-33 encoded by an intron of sterol regulatory element-binding protein 2 (Srebp2) regulates HDL in vivo. Proc Natl Acad Sci USA. (2010 ) 107:17321–6.

    Not in our library10.1073/pnas.1008499107

  149. 149.

    Geng C Dong T Jin W Yu B Yin F Peng F. MicroRNA-98 regulates hepatic cholesterol metabolism via targeting sterol regulatory element-binding protein 2. Biochem Biophys Res Commun. (2018 ) 504:422–6.

    Not in our library10.1016/j.bbrc.2018.08.205

  150. 150.

    Kochuparambil ST Al-Husein B Goc A Soliman S Somanath PR. Anticancer efficacy of simvastatin on prostate cancer cells and tumor xenografts is associated with inhibition of Akt and reduced prostate-specific antigen expression. J Pharmacol Exp Ther. (2011 ) 336:496–505.

    Not in our library10.1124/jpet.110.174870

  151. 151.

    Deng JL Zhang R Zeng Y Zhu YS Wang G. Statins induce cell apoptosis through a modulation of AKT/FOXO1 pathway in prostate cancer cells. Cancer Manag Res. (2019 ) 11:7231–42.

    Not in our library10.2147/cmar.s212643

  152. 152.

    Beckwitt CH Clark AM Ma B Whaley D Oltvai ZN Wells A. Statins attenuate outgrowth of breast cancer metastases. Br J Cancer. (2018 ) 119:1094–105.

    Not in our library10.1038/s41416-018-0267-7

  153. 153.

    Hu MB Zhang JW Gao JB Qi YW Gao Y Xu L. Atorvastatin induces autophagy in MDA-MB-231 breast cancer cells. Ultrastruct Pathol. (2018 ) 42:409–15.

    Not in our library10.1080/01913123.2018.1522406

  154. 154.

    Ma Q Gao Y Xu P Li K Xu X Gao J. Atorvastatin inhibits breast cancer cells by downregulating PTEN/AKT pathway via promoting ras homolog family member B (RhoB). Biomed Res Int. (2019 ) 2019:3235021.

    Not in our library10.1155/2019/3235021

  155. 155.

    Koohestanimobarhan S Salami S Imeni V Mohammadi Z Bayat O Lipophilic statins antagonistically alter the major epithelial-to-mesenchymal transition signaling pathways in breast cancer stem-like cells via inhibition of the mevalonate pathway. J Cell Biochem. (2018 ) 120:2515–31.

    Not in our library10.1002/jcb.27544

  156. 156.

    Wang T Seah S Loh X Chan CW Hartman M Goh BC. Simvastatin-induced breast cancer cell death and deactivation of PI3K/Akt and MAPK/ERK signalling are reversed by metabolic products of the mevalonate pathway. Oncotarget. (2016 ) 7:2532–44.

    Not in our library10.18632/oncotarget.6304

  157. 157.

    Wolfe AR Debeb BG Lacerda L Larson R Bambhroliya A Huang X. Simvastatin prevents triple-negative breast cancer metastasis in pre-clinical models through regulation of FOXO3a. Breast Cancer Res Treat. (2015 ) 154:495–508.

    Not in our library10.1007/s10549-015-3645-3

  158. 158.

    Kou X Jiang X Liu H Wang X Sun F Han J. Simvastatin functions as a heat shock protein 90 inhibitor against triple-negative breast cancer. Cancer Sci. (2018 ) 109:3272–84.

    Not in our library10.1111/cas.13748

  159. 159.

    Wang L Wang Y Chen A Teli M Kondo R Jalali A. Pitavastatin slows tumor progression and alters urine-derived volatile organic compounds through the mevalonate pathway. FASEB J. (2019 ) 33:13710–21.

    Not in our library10.1096/fj.201901388r

  160. 160.

    Fan Z Jiang H Wang Z Qu J. Atorvastatin partially inhibits the epithelial-mesenchymal transition in A549 cells induced by TGF-beta1 by attenuating the upregulation of SphK1. Oncol Rep. (2016 ) 36:1016–22.

    Not in our library10.3892/or.2016.4897

  161. 161.

    Walther U Emmrich K Ramer R Mittag N Hinz B. Lovastatin lactone elicits human lung cancer cell apoptosis via a COX-2/PPARgamma-dependent pathway. Oncotarget. (2016 ) 7:10345–62.

    Not in our library10.18632/oncotarget.7213

  162. 162.

    Shang L Jia SS Jiang HM Wang H Xu WH Lv CJ. Simvastatin downregulates expression of TGF-betaRII and inhibits proliferation of A549 cells via ERK. Tumour Biol. (2015 ) 36:4819–24.

    Not in our library10.1007/s13277-015-3134-7

  163. 163.

    Nakashima Y Haneji T. Stimulation of osteoclast formation by RANKL requires interferon regulatory factor-4 and is inhibited by simvastatin in a mouse model of bone loss. PLoS ONE. (2013 ) 8:e72033.

    Not in our library10.1371/journal.pone.0072033

  164. 164.

    Sarkar D. Statins as inhibitors of lung cancer bone metastasis. EBioMedicine. (2017 ) 19:6–7.

    Not in our library10.1016/j.ebiom.2017.04.028

  165. 165.

    Yang Z Su Z DeWitt JP Xie L Chen Y Li X. Fluvastatin prevents lung adenocarcinoma bone metastasis by triggering autophagy. EBioMedicine. (2017 ) 19:49–59.

    Not in our library10.1016/j.ebiom.2017.04.017

  166. 166.
    Simvastatin-induced cell cycle arrest through inhibition of STAT3/SKP2 axis and activation of AMPK to promote p27 and p21 accumulation in hepatocellular carcinoma cells · 2017
    No notice
  167. 167.

    Higashi T Hayashi H Kitano Y Yamamura K Kaida T Arima K. Statin attenuates cell proliferative ability via TAZ (WWTR1) in hepatocellular carcinoma. Med Oncol. (2016 ) 33:123.

    Not in our library10.1007/s12032-016-0845-6

  168. 168.

    Huang X Ma J Xu J Su Q Zhao J. Simvastatin induces growth inhibition and apoptosis in HepG2 and Huh7 hepatocellular carcinoma cells via upregulation of Notch1 expression. Mol Med Rep. (2015 ) 11:2334–40.

    Not in our library10.3892/mmr.2014.2976

  169. 169.

    Relja B Meder F Wang M Blaheta R Henrich D Marzi I. Simvastatin modulates the adhesion and growth of hepatocellular carcinoma cells via decrease of integrin expression and ROCK. Int J Oncol. (2011 ) 38:879–85.

    Not in our library10.3892/ijo.2010.892

  170. 170.

    Woodard J Sassano A Hay N Platanias LC. Statin-dependent suppression of the Akt/mammalian target of rapamycin signaling cascade and programmed cell death 4 up-regulation in renal cell carcinoma. Clin Cancer Res. (2008 ) 14:4640–9.

    Not in our library10.1158/1078-0432.ccr-07-5232

  171. 171.

    Qi XF Zheng L Lee KJ Kim DH Kim CS Cai DQ. HMG-CoA reductase inhibitors induce apoptosis of lymphoma cells by promoting ROS generation and regulating Akt, Erk and p38 signals via suppression of mevalonate pathway. Cell Death Dis. (2013 ) 4:e518.

    Not in our library10.1038/cddis.2013.44

  172. 172.

    Zheng X Cui XX Gao Z Zhao Y Lin Y Shih WJ. Atorvastatin and celecoxib in combination inhibits the progression of androgen-dependent LNCaP xenograft prostate tumors to androgen independence. Cancer Prev Res. (2010 ) 3:114–24.

    Not in our library10.1158/1940-6207.capr-09-0059

  173. 173.
    Lovastatin induces apoptosis of ovarian cancer cells and synergizes with doxorubicin: potential therapeutic relevance · 2010
    No notice
  174. 174.

    Lee JS Roberts A Juarez D Vo TT Bhatt S Herzog LO. Statins enhance efficacy of venetoclax in blood cancers. Sci Transl Med. (2018 ) 10:eaaq1240.

    Not in our library10.1126/scitranslmed.aaq1240

  175. 175.

    Kim JS Turbov J Rosales R Thaete LG Rodriguez GC. Combination simvastatin and metformin synergistically inhibits endometrial cancer cell growth. Gynecol Oncol. (2019 ) 154:432–40.

    Not in our library10.1016/j.ygyno.2019.05.022

  176. 176.

    McGregor GH Campbell AD Fey SK Tumanov S Sumpton D Blanco GR. Targeting the metabolic response to statin-mediated oxidative stress produces a synergistic antitumor response. Cancer Res. (2020 ) 80:175–88.

    Not in our library10.1158/0008-5472.can-19-0644

  177. 177.

    Fragni M Bonini SA Stabile A Bodei S Cristinelli L Simeone C. Inhibition of survivin is associated with zoledronic acid-induced apoptosis of prostate cancer cells. Anticancer Res. (2016 ) 36:913–20.

    Not in our library

  178. 178.

    Pietrovito L Comito G Parri M Giannoni E Chiarugi P Taddei ML. Zoledronic Acid inhibits the RhoA-mediated amoeboid motility of prostate cancer cells. Curr Cancer Drug Targets. (2019 ) 19:807–16.

    Not in our library10.2174/1568009619666190115142858

  179. 179.

    Rouhrazi H Turgan N Oktem G. Zoledronic acid overcomes chemoresistance by sensitizing cancer stem cells to apoptosis. Biotech Histochem. (2018 ) 93:77–88.

    Not in our library10.1080/10520295.2017.1387286

  180. 180.

    Lin JF Lin YC Lin YH Tsai TF Chou KY Chen HE. Zoledronic acid induces autophagic cell death in human prostate cancer cells. J Urol. (2011 ) 185:1490–6.

    Not in our library10.1016/j.juro.2010.11.045

  181. 181.

    Coxon JP Oades GM Kirby RS Colston KW. Zoledronic acid induces apoptosis and inhibits adhesion to mineralized matrix in prostate cancer cells via inhibition of protein prenylation. BJU Int. (2004 ) 94:164–70.

    Not in our library10.1111/j.1464-4096.2004.04831.x

  182. 182.

    Liu H Wang SH Chen SC Chen CY Lin TM. Zoledronic acid blocks the interaction between breast cancer cells and regulatory T-cells. BMC Cancer. (2019 ) 19:176.

    Not in our library10.1186/s12885-019-5379-9

  183. 183.

    Kopecka J Porto S Lusa S Gazzano E Salzano G Pinzon-Daza ML. Zoledronic acid-encapsulating self-assembling nanoparticles and doxorubicin: a combinatorial approach to overcome simultaneously chemoresistance and immunoresistance in breast tumors. Oncotarget. (2016 ) 7:20753–72.

    Not in our library10.18632/oncotarget.8012

  184. 184.

    Li YY Chang JW Liu YC Wang CH Chang HJ Tsai MC. Zoledronic acid induces cell-cycle prolongation in murine lung cancer cells by perturbing cyclin and Ras expression. Anticancer Drugs. (2011 ) 22:89–98.

    Not in our library10.1097/cad.0b013e3283400a05

  185. 185.

    Xie F Li P Gong J Zhang J Ma J. The bisphosphonate zoledronic acid effectively targets lung cancer cells by inhibition of protein prenylation. Biochem Biophys Res Commun. (2015 ) 467:664–9.

    Not in our library10.1016/j.bbrc.2015.10.089

  186. 186.

    Honda Y Takahashi S Zhang Y Ono A Murakami E Shi N. Effects of bisphosphonate zoledronic acid in hepatocellular carcinoma, depending on mevalonate pathway. J Gastroenterol Hepatol. (2015 ) 30:619–27.

    Not in our library10.1111/jgh.12715

  187. 187.

    Goto H Matsuda K Srikoon P Kariya R Hattori S Taura M. Potent antitumor activity of zoledronic acid-induced Vgamma9Vdelta2 T cells against primary effusion lymphoma. Cancer Lett. (2013 ) 331:174–82.

    Not in our library10.1016/j.canlet.2012.12.021

  188. 188.

    Comito G Pons Segura C Taddei ML Lanciotti M Serni S Morandi A. Zoledronic acid impairs stromal reactivity by inhibiting M2-macrophages polarization and prostate cancer-associated fibroblasts. Oncotarget. (2017 ) 8:118–32.

    Not in our library10.18632/oncotarget.9497

  189. 189.

    Miwa S Mizokami A Keller ET Taichman R Zhang J Namiki M. The bisphosphonate YM529 inhibits osteolytic and osteoblastic changes and CXCR-4-induced invasion in prostate cancer. Cancer Res. (2005 ) 65:8818–25.

    Not in our library10.1158/0008-5472.can-05-0540

  190. 190.

    Koshimune R Aoe M Toyooka S Hara F Ouchida M Tokumo M. Anti-tumor effect of bisphosphonate (YM529) on non-small cell lung cancer cell lines. BMC Cancer. (2007 ) 7:8.

    Not in our library10.1186/1471-2407-7-8

  191. 191.

    Sato K Yuasa T Nogawa M Kimura S Segawa H Yokota A. A third-generation bisphosphonate, minodronic acid (YM529), successfully prevented the growth of bladder cancer in vitro and in vivo. Br J Cancer. (2006 ) 95:1354–61.

    Not in our library10.1038/sj.bjc.6603423

  192. 192.

    Jones RM Morgan C Bertelli G. Effects of zoledronic acid and docetaxel on small GTP-binding proteins in prostate cancer. Tumour Biol. (2015 ) 36:4861–9.

    Not in our library10.1007/s13277-015-3140-9

  193. 193.

    Wilke M Gobel A Rauner M Benad-Mehner P Schutze N Fussel S. Zoledronic acid and atorvastatin inhibit alphavbeta3-mediated adhesion of breast cancer cells. J Bone Oncol. (2014 ) 3:10–7.

    Not in our library10.1016/j.jbo.2014.02.001

  194. 194.
    The bisphosphonate, zoledronic acid, induces apoptosis of breast cancer cells: evidence for synergy with paclitaxel · 2001
    No notice
  195. 195.

    Gobel A Thiele S Browne AJ Rauner M Zinna VM Hofbauer LC. Combined inhibition of the mevalonate pathway with statins and zoledronic acid potentiates their anti-tumor effects in human breast cancer cells. Cancer Lett. (2016 ) 375:162–71.

    Not in our library10.1016/j.canlet.2016.03.004

  196. 196.

    Feng C Liu X Li X Guo F Huang C Qin Q. Zoledronic acid increases the antitumor effect of gefitinib treatment for non-small cell lung cancer with EGFR mutations. Oncol Rep. (2016 ) 35:3460–70.

    Not in our library10.3892/or.2016.4741

  197. 197.

    Kuzu OF Noory MA Robertson GP. The role of cholesterol in cancer. Cancer Res. (2016 ) 76:2063–70.

    Not in our library10.1158/0008-5472.can-15-2613

  198. 198.

    Ding X Zhang W Li S Yang H. The role of cholesterol metabolism in cancer. Am J Cancer Res. (2019 ) 9:219–27.

    Not in our library

  199. 199.

    Corcos L Le Jossic-Corcos C. Statins: perspectives in cancer therapeutics. Dig Liver Dis. (2013 ) 45:795–802.

    Not in our library10.1016/j.dld.2013.02.002

  200. 200.

    Iannelli F Lombardi R Milone MR Pucci B De Rienzo S Budillon A. Targeting mevalonate pathway in cancer treatment: repurposing of statins. Recent Pat Anticancer Drug Discov. (2018 ) 13:184–200.

    Not in our library10.2174/1574892812666171129141211

  201. 201.

    Singh H Mahmud SM Turner D Xue L Demers AA Bernstein CN. Long-term use of statins and risk of colorectal cancer: a population-based study. Am J Gastroenterol. (2009 ) 104:3015–23.

    Not in our library10.1038/ajg.2009.574

  202. 202.

    Chiu HF Ho SC Chen CC Yang CY. Statin use and the risk of liver cancer: a population-based case-control study. Am J Gastroenterol. (2011 ) 106:894–8.

    Not in our library10.1038/ajg.2010.475

  203. 203.

    Khurana V Bejjanki HR Caldito G Owens MW. Statins reduce the risk of lung cancer in humans: a large case-control study of US veterans. Chest. (2007 ) 131:1282–8.

    Not in our library10.1378/chest.06-0931

  204. 204.

    Fatehi Hassanabad A McBride SA. Statins as potential therapeutics for lung cancer: molecular mechanisms and clinical outcomes. Am J Clin Oncol. (2019 ) 42:732–6.

    Not in our library10.1097/coc.0000000000000579

  205. 205.

    Gobel A Breining D Rauner M Hofbauer LC Rachner TD. Induction of 3-hydroxy-3-methylglutaryl-CoA reductase mediates statin resistance in breast cancer cells. Cell Death Dis. (2019 ) 10:91.

    Not in our library10.1038/s41419-019-1322-x

  206. 206.

    Murtola TJ Peltomaa AI Talala K Maattanen L Taari K Tammela TLJ. statin use and prostate cancer survival in the finnish randomized study of screening for prostate cancer. Eur Urol Focus. (2017 ) 3:212–20.

    Not in our library10.1016/j.euf.2016.05.004

  207. 207.

    Liu B Yi Z Guan X Zeng YX Ma F. The relationship between statins and breast cancer prognosis varies by statin type and exposure time: a meta-analysis. Breast Cancer Res Treat. (2017 ) 164:1–11.

    Not in our library10.1007/s10549-017-4246-0

  208. 208.

    Xia DK Hu ZG Tian YF Zeng FJ. Statin use and prognosis of lung cancer: a systematic review and meta-analysis of observational studies and randomized controlled trials. Drug Des Devel Ther. (2019 ) 13:405–22.

    Not in our library10.2147/dddt.s187690

  209. 209.

    Kim GA Shim JJ Lee JS Kim BH Kim JW Oh CH. Effect of statin use on liver cancer mortality considering hypercholesterolemia and obesity in patients with non-cirrhotic chronic hepatitis B. Yonsei Med J. (2019 ) 60:1203–8.

    Not in our library10.3349/ymj.2019.60.12.1203

  210. 210.

    Couttenier A Lacroix O Vaes E Cardwell CR De Schutter H Robert A. Statin use is associated with improved survival in ovarian cancer: a retrospective population-based study. PLoS ONE. (2017 ) 12:e0189233.

    Not in our library10.1371/journal.pone.0189233

  211. 211.

    Nguyen T Khan A Liu Y El-Serag HB Thrift AP. The association between statin use after diagnosis and mortality risk in patients with esophageal cancer: a retrospective cohort study of United States veterans. Am J Gastroenterol. (2018 ) 113:1310.

    Not in our library10.1038/s41395-018-0169-6

  212. 212.

    Mei Z Liang M Li L Zhang Y Wang Q Yang W. Effects of statins on cancer mortality and progression: a systematic review and meta-analysis of 95 cohorts including 1,111,407 individuals. Int J Cancer. (2017 ) 140:1068–81.

    Not in our library10.1002/ijc.30526

  213. 213.

    Farooqi MAM Malhotra N Mukherjee SD Sanger S Dhesy-Thind SK Ellis P. Statin therapy in the treatment of active cancer: a systematic review and meta-analysis of randomized controlled trials. PLoS ONE. (2018 ) 13:e0209486.

    Not in our library10.1371/journal.pone.0209486

  214. 214.

    Zaleska M Mozenska O Bil J. Statins use and cancer: an update. Future Oncol. (2018 ) 14:1497–509.

    Not in our library10.2217/fon-2017-0543

  215. 215.

    Lin JJ Ezer N Sigel K Mhango G Wisnivesky JP. The effect of statins on survival in patients with stage IV lung cancer. Lung Cancer. (2016 ) 99:137–42.

    Not in our library10.1016/j.lungcan.2016.07.006

  216. 216.

    Hus M Grzasko N Szostek M Pluta A Helbig G Woszczyk D. Thalidomide, dexamethasone and lovastatin with autologous stem cell transplantation as a salvage immunomodulatory therapy in patients with relapsed and refractory multiple myeloma. Ann Hematol. (2011 ) 90:1161–6.

    Not in our library10.1007/s00277-011-1276-2

  217. 217.

    Advani AS Li H Michaelis LC Medeiros BC Liedtke M List AF. Report of the relapsed/refractory cohort of SWOG S0919: A phase 2 study of idarubicin and cytarabine in combination with pravastatin for acute myelogenous leukemia (AML). Leuk Res. (2018 ) 67:17–20.

    Not in our library10.1016/j.leukres.2018.01.021

  218. 218.

    Hung MS Chen IC Lee CP Huang RJ Chen PC Tsai YH. Statin improves survival in patients with EGFR-TKI lung cancer: a nationwide population-based study. PLoS ONE. (2017 ) 12:e0171137.

    Not in our library10.1371/journal.pone.0171137

  219. 219.

    Li X Wu XB Chen Q Statin use is not associated with reduced risk of skin cancer: a meta-analysis. Br J Cancer. (2014 ) 110:802–7.

    Not in our library10.1038/bjc.2013.762

  220. 220.

    Gray RT Loughrey MB Bankhead P Cardwell CR McQuaid S O'Neill RF. Statin use, candidate mevalonate pathway biomarkers, and colon cancer survival in a population-based cohort study. Br J Cancer. (2017 ) 116:1652–9.

    Not in our library10.1038/bjc.2017.139

  221. 221.
    Lack of Effect of Lowering LDL Cholesterol on Cancer: Meta-Analysis of Individual Data from 175,000 People in 27 Randomised Trials of Statin Therapy · 2012
    No notice
  222. 222.

    Abdullah MI de Wolf E Jawad MJ Richardson A. The poor design of clinical trials of statins in oncology may explain their failure - lessons for drug repurposing. Cancer Treat Rev. (2018 ) 69:84–9.

    Not in our library10.1016/j.ctrv.2018.06.010

  223. 223.

    Finianos A Aragon-Ching JB. Zoledronic acid for the treatment of prostate cancer. Expert Opin Pharmacother. (2019 ) 20:657–66.

    Not in our library10.1080/14656566.2019.1574754

  224. 224.

    Lluch A Cueva J Ruiz-Borrego M Ponce J Perez-Fidalgo JA. Zoledronic acid in the treatment of metastatic breast cancer. Anticancer Drugs. (2014 ) 25:1–7.

    Not in our library10.1097/cad.0000000000000020

  225. 225.

    Seider MJ Pugh SL Langer C Wyatt G Demas W Rashtian A. Randomized phase III trial to evaluate radiopharmaceuticals and zoledronic acid in the palliation of osteoblastic metastases from lung, breast, and prostate cancer: report of the NRG Oncology RTOG 0517 trial. Ann Nucl Med. (2018 ) 32:553–60.

    Not in our library10.1007/s12149-018-1278-4

  226. 226.
    Addition of docetaxel or bisphosphonates to standard of care in men with localised or metastatic, hormone-sensitive prostate cancer: a systematic review and meta-analyses of aggregate data · 2016
    Corrected
  227. 227.

    van Beek E Pieterman E Cohen L Lowik C Papapoulos S. Farnesyl pyrophosphate synthase is the molecular target of nitrogen-containing bisphosphonates. Biochem Biophys Res Commun. (1999 ) 264:108–11.

    Not in our library10.1006/bbrc.1999.1499

  228. 228.

    Rakel A Boucher A Ste-Marie LG. Role of zoledronic acid in the prevention and treatment of osteoporosis. Clin Interv Aging. (2011 ) 6:89–99.

    Not in our library10.2147/cia.s7282

  229. 229.

    Van Acker HH Anguille S Willemen Y Smits EL Van Tendeloo VF. Bisphosphonates for cancer treatment: mechanisms of action and lessons from clinical trials. Pharmacol Ther. (2016 ) 158:24–40.

    Not in our library10.1016/j.pharmthera.2015.11.008

  230. 230.

    Green JR. Antitumor effects of bisphosphonates. Cancer. (2003 ) 97:840–7.

    Not in our library10.1002/cncr.11128

  231. 231.

    Zekri J Mansour M Karim SM. The anti-tumour effects of zoledronic acid. J Bone Oncol. (2014 ) 3:25–35.

    Not in our library10.1016/j.jbo.2013.12.001

  232. 232.

    Pinkawa M. Zoledronic acid in first-line treatment of prostate cancer. Int J Radiat Oncol Biol Phys. (2017 ) 97:6–8.

    Not in our library10.1016/j.ijrobp.2016.06.2453

  233. 233.

    Ressler S Mlineritsch B Greil R. Zoledronic acid for adjuvant use in patients with breast cancer. Expert Rev Anticancer Ther. (2011 ) 11:333–49.

    Not in our library10.1586/era.11.13

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