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Abstract Aggressive cancer cells must overcome diverse stress forms in the tumor microenvironment and circulation, such as oxidative stress, to survive and metastasize. One adaptive process to counter oxidative stress is to upregulate glutathione (GSH), a tripeptide consisting of glutamate, cysteine, and glycine, which is a powerful antioxidant in cells, including in tumor cells. A rate-liming step in GSH production is the availability of the amino acid, cysteine. Tumor cells can either import cystine, a dimer of cysteine, through the xCT antiporter system, for conversion to the reduced cysteine monomer, or in some tumor types, they can synthesize cysteine de novo from methionine and serine through the transsulfuration pathway. GSH is not only critical for redox homeostasis, but is taken up into mitochondria where is acts as a source of sulphur to generate iron-sulphur (Fe-S) clusters that are essential for many mitochondrial enzymes including electron transport complexes. We wished to determine if Ewing sarcoma cells could tolerate reduced levels of GSH, using either xCT genetic or pharmacologic inhibition, or by blocking downstream enzymes in the GSH synthesis pathway, including GCLC using buthionine sulfoximine (BSO), or glutaminase using CB-839. To our surprise, we were able to generate BSO and CB-839 resistant cells with vanishingly low levels of GSH. These cells somehow maintained not only redox homeostasis, but also showed functional mitochondrial respiration (oxidative phosphorylation). We then performed CRISPR dropout screens to identify how these cells might be surviving in the absence of GSH, and to tease out specific dependencies of these BSO and CB-839 resistant cells. These studies revealed unexpected dependencies, and opportunities for synthetic lethal interventions, as will be discussed. Citation Format: Poul H. Sorensen, Hai-Feng Zhang, Christopher Hughes, Alberto Delaidelli, Samuel Aparicio. Identification of metabolic adaptation mechanisms that confer resistance to glutathione depletion in Ewing sarcoma abstract. In: Proceedings of the AACR Special Conference in Cancer Research: Expanding and Translating Cancer Synthetic Vulnerabilities; 2024 Jun 10-13; Montreal, Quebec, Canada. Philadelphia (PA): AACR; Mol Cancer Ther 2024;23(6 Suppl):Abstract nr IA019.
Sorensen et al. (Mon,) studied this question.