Investigation of new treatment option for hepatocellular carcinoma: a combination of sorafenib with usnic acid

J Pharm Pharmacol. 2019 Jul;71(7):1119-1132. doi: 10.1111/jphp.13097. Epub 2019 Apr 25.

Abstract

Objectives: Sorafenib (SOR) is an orally administered molecular targeted agent in the systemic chemotherapy of hepatocellular carcinoma (HCC). However, the partial response of SOR is limited due to its adverse side effect and high heterogeneity and resistant phenotype of HCC. In the current study, we investigated synergistic effects of SOR and usnic acid (UA) on HCC cell lines including HepG2 and SNU-449, and a normal cell line, HUVEC.

Methods: The antiproliferative and apoptotic effects of combination therapy and SOR alone were analysed by WST-1 and Annexin V analysis, respectively. Furthermore, cell cycle, gene expression analysis of SOR-targeted kinases and acridine orange-ethidium bromide staining were also performed in combined treatments.

Key findings: Our results demonstrated that SOR and UA combination indicated a strong synergism in HCC cell lines and reduced SOR toxicity in HUVEC cells. Additionally, the combination treatment SOR and UA significantly induced much more apoptotic cell death and G0/G1 arrest through downregulation of SOR-targeted kinases.

Conclusions: Consequently, SOR and UA combination could be a new therapeutic strategy for HCC treatment.

Keywords: combination treatment; hepatocellular carcinoma; sorafenib; usnic acid.

MeSH terms

  • Annexin A5 / pharmacology
  • Antineoplastic Agents / pharmacology*
  • Apoptosis / drug effects
  • Benzofurans / pharmacology*
  • Carcinoma, Hepatocellular / drug therapy*
  • Carcinoma, Hepatocellular / pathology
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • Drug Synergism
  • Drug Therapy, Combination
  • Hep G2 Cells
  • Humans
  • Liver Neoplasms / drug therapy*
  • Liver Neoplasms / pathology
  • Protein-Tyrosine Kinases / metabolism
  • Sorafenib / pharmacology*

Substances

  • Annexin A5
  • Antineoplastic Agents
  • Benzofurans
  • usnic acid
  • Sorafenib
  • Protein-Tyrosine Kinases