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An SLC7A5-dependent nutrient-sensing circuit overcomes cisplatin tolerance via mTOR-autophagy signaling.

Cisplatin-based chemotherapy responses are highly heterogeneous across cancers, with the mechanisms governing drug sensitivity remaining incompletely understood. Using genome-wide CRISPR-Cas9 knockout screening, we systematically characterized regulators of cisplatin response and uncovered a counterintuitive finding: mTOR inhibition promotes cisplatin tolerance, contradicting the canonical view that PI3K-AKT-mTOR activation confers chemoresistance. Mechanistically, both mTOR suppression and cisplatin treatment converge to activate cytoprotective autophagy, which enhances cancer cell survival under therapeutic stress. The amino acid transporter SLC7A5 was identified and validated as a key integrator of the mTOR-autophagy axis that modulates cisplatin sensitivity. SLC7A5 expression positively correlates with cisplatin sensitivity across cancer cell lines, and its downregulation is associated with cisplatin resistance in multiple cancer types, supporting its potential as a mechanistically grounded predictive biomarker. Translationally, leucine supplementation sensitizes cancer cells to cisplatin in an SLC7A5-mTOR-autophagy-dependent manner. Collectively, our study defines a novel mTOR-autophagy adaptive loop governing cisplatin tolerance, positions SLC7A5 as a central regulatory node with both biomarker and therapeutic target value, and proposes leucine supplementation as a simple, translatable strategy to improve cisplatin efficacy in SLC7A5-expressing tumors.

Cisplatin

Baseline metabolomic profile as potential biomarker for weight change after Roux-en-Y gastric bypass (RYGB) surgery.

Metabolic and bariatric surgery (MBS) is the most effective intervention for sustained weight loss and cardiometabolic improvement in individuals with severe obesity. However, long-term outcomes vary, with many patients experiencing weight regain. The biological determinants of this variability remain incompletely understood. Given the integrative nature of the metabolome-capturing interactions among host genetics, diet, microbiota, and environmental exposures-we hypothesized that baseline circulating metabolites could stratify individuals into distinct long-term weight trajectory groups. We profiled untargeted fasting plasma metabolites in a nested case-control study within the Longitudinal Assessment of Bariatric Surgery (LABS-2) cohort. From these metabolites, a 13-metabolite risk score (MetRS) predictive of weight regain five years after Roux-en-Y gastric bypass was derived. The MetRS, which captures pathways including fatty acid oxidation, bile acid conjugation, and microbial-host co-metabolism, outperformed clinical variables in predicting long-term weight outcomes. Its performance was evaluated in two independent cohorts, including one assessed a median of seven years post-surgery. Genomic analyses identified common variants in loci including AGXT2 and SLC7A5 associated with key MetRS metabolites, suggesting a heritable component to the observed metabolic signature. Together, these findings lay the groundwork for a clinically actionable framework to identify individuals at risk for weight recidivism and support the integration of metabolic profiling into preoperative assessment for personalized obesity care.

Journal Article