Arginine, a semi-essential amino acid in humans, is critical for the growth of human cancers, particularly those marked by de novo chemoresistance and a poor clinical outcome. In addition to protein synthesis, arginine is involved in diverse aspects of tumour metabolism, including the synthesis of nitric oxide, polyamines, nucleotides, proline and glutamate. Tumoural downregulation of the enzyme argininosuccinate synthetase (ASS1), a recognised rate-limiting step in arginine synthesis, results in an intrinsic dependence on extracellular arginine due to an inability to synthesise arginine for growth. This dependence on extracellular arginine is known as arginine auxotrophy. Several tumours are arginine auxotrophic, due to variable loss of ASS1, including hepatocellular carcinoma, malignant melanoma, malignant pleural mesothelioma, prostate and renal cancer. Importantly, targeting extracellular arginine for degradation in the absence of ASS1 triggers apoptosis in arginine auxotrophs. Several phase I/II clinical trials of the arginine-lowering drug, pegylated arginine deiminase, have shown encouraging evidence of clinical benefit and low toxicity in patients with ASS1-negative tumours. In part, ASS1 loss is due to epigenetic silencing of the ASS1 promoter in various human cancer cell lines and tumours, and it is this silencing that confers arginine auxotrophy. In relapsed ovarian cancer, this is associated with platinum refractoriness. In contrast, several platinum sensitive tumours, including primary ovarian, stomach and colorectal cancer, are characterised by ASS1 overexpression, which is regulated by proinflammatory cytokines. This review examines the prospects for novel approaches in the prevention, diagnosis and treatment of malignant disease based on ASS1 pathophysiology and its rate-limiting product, arginine.Dysregulation of cellular metabolism is a key event in cancer development and progression and critical to many of the hallmarks of cancer. 1 This is exemplified by the high rate of aerobic glycolysis found in many tumours (the 'Warburg effect') and forms the basis of 18-FDG-PET in cancer imaging. 2 Research into various aspects of tumour metabolism currently is undergoing a renaissance, with the expectation that metabolic targeting will become a viable anti-cancer strategy. 3 The focus of this mini review is on arginine, a semi-essential amino acid with diverse roles in normal and malignant cells, and its biosynthetic enzyme, argininosuccinate synthetase or ASS1. Before discussing the potential for ASS1-tailored therapy in the oncology clinic, we will review the evidence implicating a critical role for arginine in tumourigenesis from a biological perspective.
Arginine in Tumour BiologyFollowing identification of arginine (L-2-amino-5-guanidinovaleric acid) from lupin seedlings and the determination of its structure in 1910, several discoveries over the course of the last century identified arginine as a precursor for initiation of a variety of metabolic pathways. 4 These include, in addition to protein ...