Abstract While ferroptosis induction offers promising avenue for cancer therapeutics, its clinical utility in colorectal cancer (CRC) is limited by pervasive intrinsic resistance mechanisms. Here, we identify Aurora kinase A (AURKA) as a central suppressor of ferroptosis by rewiring cholesterol metabolism. Mechanistically, AURKA phosphorylates and destabilizes its negative regulator SAPS3 at Ser523/524, relieving AMPK suppression. Activated AMPK subsequently inhibits SREBP2 nuclear translocation and DHCR7 transcription, resulting in the accumulation of 7-dehydrocholesterol (7-DHC), a lipid antioxidant that confers ferroptosis resistance. Both genetic and pharmacologic inhibition of AURKA restore ferroptosis sensitivity and enhance chemotherapy efficacy in vitro and in patient-derived xenograft models. Clinically, elevated AURKA expression correlates with poor prognosis and reduced chemotherapy response in CRC patients. These findings delineate a novel AURKA-SAPS3-AMPK-SREBP2 axis that bridges cholesterol homeostasis and ferroptosis evasion, positioning AURKA as a promising therapeutic target for chemosensitization in CRC.
Gao et al. (Mon,) studied this question.