High-Throughput Drug Screening Revealed That Ciclopirox Olamine Can Engender Gastric Cancer Stem-like Cells

Simple Summary Cancer stem cells (CSCs) are thought to be involved in tumor initiation and recurrence, which makes them pivotal therapeutic targets. However, the molecular circuits behind CSC characteristics are not fully understood and the low number of CSCs is an obstacle for conducting tests that explore their properties. Thus, increasing the number of these cells via small molecule-mediated cellular reprogramming seems a valid alternative tool. Using the SORE6-GFP reporter system, based on SOX2/OCT4 activity and incorporated in gastric non-CSCs, we performed a high-throughput drug screen to identify small molecules capable of converting non-CSCs into CSCs. Our results show that ciclopirox olamine (CPX) is able to reprogram gastric cancer cells to a stem-like phenotype via SOX2 expression, reprogram cell metabolism, and induce senescence. Furthermore, these results suggest that the CSC phenotype is a resistance mechanism to CPX treatment, which is being considered as a repurposing drug for cancer treatment.Abstract Cancer stem cells (CSCs) are relevant therapeutic targets for cancer treatment. Still, the molecular circuits behind CSC characteristics are not fully understood. The low number of CSCs can sometimes be an obstacle to carrying out assays that explore their properties. Thus, increasing CSC numbers via small molecule-mediated cellular reprogramming appears to be a valid alternative tool. Using the SORE6-GFP reporter system embedded in gastric non-CSCs (SORE6-), we performed a high-throughput image-based drug screen with 1200 small molecules to identify compounds capable of converting SORE6- to SORE6+ (CSCs). Here, we report that the antifungal agent ciclopirox olamine (CPX), a potential candidate for drug repurposing in cancer treatment, is able to reprogram gastric non-CSCs into cancer stem-like cells via activation of SOX2 expression and increased expression of C-MYC, HIF-1 & alpha;, KLF4, and HMGA1. This reprogramming depends on the CPX concentration and treatment duration. CPX can also induce cellular senescence and the metabolic shift from oxidative phosphorylation (OXPHOS) to glycolysis. We also disclose that the mechanism underlying the cellular reprogramming is similar to that of cobalt chloride (CoCl2), a hypoxia-mimetic agent.