2023
DOI: 10.1038/s41416-023-02394-9
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Targeting mitochondrial oxidative phosphorylation: lessons, advantages, and opportunities

Nicole D. Machado,
Lisa C. Heather,
Adrian L. Harris
et al.

Abstract: In light of the disappointing termination of clinical trials with potent complex I inhibitors, such as IACS-010759, justification for oxidative phosphorylation inhibitors and mitochondrial targeting strategies has been called into question. Consideration of these agents’ potency, tissue selectivity and toxicity demonstrate what lessons can be learned from this failure and where new opportunities lie.

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Cited by 11 publications
(2 citation statements)
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“…This finding is also supported by a previous report pointing to increased sensitivity of PTEN-deficient fibroblasts to inhibition of mitochondrial complex I in comparison with PTEN-wildtype cells 45 . These observations may be especially significant given the narrow therapeutic index of recently developed complex I inhibitors such as IACS-010759 in clinical trials 46,47 , and highlight the importance of identifying specific subsets of patients that may actually benefit from such therapies despite the side effects. Importantly, loss of PTEN mutations are prevalent and predict poor survival in multiple cancers, including gliomas 39 .…”
Section: Discussionmentioning
confidence: 99%
“…This finding is also supported by a previous report pointing to increased sensitivity of PTEN-deficient fibroblasts to inhibition of mitochondrial complex I in comparison with PTEN-wildtype cells 45 . These observations may be especially significant given the narrow therapeutic index of recently developed complex I inhibitors such as IACS-010759 in clinical trials 46,47 , and highlight the importance of identifying specific subsets of patients that may actually benefit from such therapies despite the side effects. Importantly, loss of PTEN mutations are prevalent and predict poor survival in multiple cancers, including gliomas 39 .…”
Section: Discussionmentioning
confidence: 99%
“…Usually compounds that disrupt mitochondrial function result in toxic consequences like uncontrolled production of reactive oxygen species, which can induce cell death and lead to serious consequences including drug-induced liver injury and cardiotoxicity in humans (Barbier-Torres et al 2017; Karamanlidis et al 2013). Alternatively, there are several mitochondrial inhibitors such as metformin, nitric oxide, and arsenic trioxide, that are commonly studied in the clinic for potentially beneficial effects (Machado et al 2023). Atovaquone, a specific inhibitor for ETC complex III also showed very promising anti-cancer activity in patients (Xiang et al 2016).…”
Section: Discussionmentioning
confidence: 99%