Metabolic vulnerabilities in endometrial cancer

Women with metabolic disorders, including obesity and diabetes, have an increased risk of developing endometrial cancer. However, the metabolism of endometrial tumors themselves has been largely understudied. Comparing human endometrial tumors and cells to their non-malignant counterparts we found that up-regulation of the glucose transporter GLUT6 was more closely associated with the cancer phenotype than other hallmark cancer genes including hexokinase 2 and pyruvate kinase M2. Importantly, suppression of GLUT6 expression inhibited glycolysis and survival of endometrial cancer cells. Glycolysis and lipogenesis were also highly coupled with the cancer phenotype in patient samples and cells. To test whether targeting endometrial cancer metabolism could be exploited as a therapeutic strategy, we screened a panel of compounds known to target diverse metabolic pathways in endometrial cells. We identified that the glycolytic inhibitor, 3-bromopyruvate (BrPA), is a powerful antagonist of lipogenesis through pyruvylation of coenzyme A. We also provide evidence that BrPA promotes cell death via a necrotic mechanism that does not involve reactive oxygen species and that BrPA impaired the growth of endometrial cancer xenografts in vivo. Overall, this study identifies GLUT6 and glycolytic-lipogenic pathways as novel liabilities in endometrial cancer that may be exploited for therapeutic intervention.