FMO4 drives lung adenocarcinoma by stabilizing the MAT2A/MAT2B complex and hindering ferroptosis

Abstract

Lung cancer is the leading cause of death by cancer in the world and finding new targets is a major medical need to tackle this disease. Here, upon proteomic analysis to identify common players in oncogenic EGFR- and KRAS-driven lung adenocarcinoma mouse models, we uncovered a largely unknown protein in cancer, flavin-containing monooxygenase 4 (FMO4), whose expression was increased in lung tumors compared with adjacent lung tissue. FMO4 expression was strongly increased also in lung cancer samples from patients compared with healthy lung, and its expression level was inversely correlated with overall survival. Remarkably, in vivo deletion of FMO4 greatly decreased tumor burden and increased survival in oncogenic KRAS-driven lung adenocarcinoma mice unveiling its crucial role in tumor biology. Mechanistically, we found that FMO4 loss of function promotes ferroptosis and cooperates with ferroptosis inducers in vitro and in vivo. Moreover, FMO4 facilitates the interaction between MAT2A and MAT2B, promoting the generation of cysteine from methionine, which in turn boosts the generation of glutathione, thus protecting lung adenocarcinoma against ferroptosis. In summary we identified a new target in lung adenocarcinoma with important implications in cancer biology.