Metabolic cell death of labile iron deficiency as a vulnerability of head and neck squamous cell carcinoma evaded by BACH1

Head and neck squamous cell carcinoma (HNSCC) remains difficult to treat due to the lack of molecularly targeted drugs with high anti-tumor efficacy and safety. To investigate the involvement of the transcription factor BACH1, which is known to promote the metastasis of various cancers, in the malignant properties of HNSCC cells, we examined the effects of BACH1 depletion with short interfering RNAs in human HNSCC cell lines. We found that knockdown of BACH1 induced cell death due to depletion of intracellular labile iron which is not tightly bound to protein. Mitochodrial electron transfer chain activity was severely reduced but efficiently resuced with supplementation of iron in the medium. By combining chromatin immunoprecipitation-sequence and RNA-sequence analyses, we found that BACH1 represses ferritin genes in HNSCC cells. BACH1 knockdown was found to enhance the effect of tipifarnib, a selective inhibitor of farnesyltransferase required for HRAS activation, resulting in efficient inhibition of proliferation of HNSCC cell lines in vitro. These results indicate that BACH1 is essential for maintaining the amount of labile iron in HNSCC cells to evade metabolic cell death of iron deficiency and to proliferate. BACH1 can be a target for conferring Tipifarnib sensitivity to HNSCC cells.