Gemcitabine is the first-line
chemotherapy for
pancreatic cancer. To overcome the often-acquired
gemcitabine resistance, other drugs are used in combination with
gemcitabine. It is well-known that
cancer cells reprogram cellular metabolism, coupled with the up-regulation of selective nutrient transporters to feed into the altered metabolic pathways. Our previous studies have demonstrated that the
amino acid transporter SLC6A14 is markedly up-regulated in
pancreatic cancer and that it is a viable therapeutic target. α-Methyltryptophan (α-MT) is a blocker of SLC6A14 and is effective against
pancreatic cancer in vitro and in vivo. In the present study, we tested the hypothesis that α-MT could synergize with
gemcitabine in the treatment of
pancreatic cancer. We investigated the effects of combination of α-MT and
gemcitabine on proliferation, migration, and apoptosis in a human
pancreatic cancer cell line, and examined the underlying mechanisms using 1H-NMR-based metabolomic analysis. These studies examined the intracellular metabolite profile and the extracellular metabolite profile separately. Combination of α-MT with
gemcitabine elicited marked changes in a wide variety of metabolic pathways, particularly
amino acid metabolism with notable alterations in pathways involving
tryptophan,
branched-chain amino acids,
ketone bodies, and membrane
phospholipids. The metabolomic profiles of untreated control cells and cells treated with
gemcitabine or α-MT were distinctly separable, and the combination regimen showed a certain extent of overlap with the individual α-MT and
gemcitabine groups. This represents the first study detailing the metabolomic basis of the anticancer efficacy of
gemcitabine, α-MT and their combination.