p63 and SOX2 Dictate Glucose Reliance and Metabolic Vulnerabilities in Squamous Cell Carcinomas

Meng Hsiung Hsieh, Joshua H. Choe, Jashkaran Gadhvi, Yoon Jung Kim, Marcus A. Arguez, Madison Palmer, Haleigh Gerold, Chance Nowak, Hung Do, Simbarashe Mazambani, Jordan K. Knighton, Matthew Cha, Justin Goodwin, Min Kyu Kang, Ji Yun Jeong, Shin Yup Lee, Brandon Faubert, Zhenyu Xuan, E. Dale Abel, Claudio ScafoglioDavid B. Shackelford, John D. Minna, Pankaj K. Singh, Vladimir Shulaev, Leonidas Bleris, Kenneth Hoyt, J. Kim, Masahiro Inoue, Ralph J. DeBerardinis, Tae Hoon Kim, Jung whan Kim

Research output: Contribution to journalArticlepeer-review

59 Scopus citations


Squamous cell carcinoma (SCC), a malignancy arising across multiple anatomical sites, is responsible for significant cancer mortality due to insufficient therapeutic options. Here, we identify exceptional glucose reliance among SCCs dictated by hyperactive GLUT1-mediated glucose influx. Mechanistically, squamous lineage transcription factors p63 and SOX2 transactivate the intronic enhancer cluster of SLC2A1. Elevated glucose influx fuels generation of NADPH and GSH, thereby heightening the anti-oxidative capacity in SCC tumors. Systemic glucose restriction by ketogenic diet and inhibiting renal glucose reabsorption with SGLT2 inhibitor precipitate intratumoral oxidative stress and tumor growth inhibition. Furthermore, reduction of blood glucose lowers blood insulin levels, which suppresses PI3K/AKT signaling in SCC cells. Clinically, we demonstrate a robust correlation between blood glucose concentration and worse survival among SCC patients. Collectively, this study identifies the exceptional glucose reliance of SCC and suggests its candidacy as a highly vulnerable cancer type to be targeted by systemic glucose restriction. Hsieh et al. show that p63 and SOX2 cooperate to induce enhanced GLUT1 expression, driving a critical reliance on glucose, in squamous cell carcinomas. Systemic glucose restriction by ketogenic diet or SGLT2 inhibition attenuates squamous tumor progression by disrupting redox homeostasis and insulin/AKT pathways in vivo.

Original languageEnglish (US)
Pages (from-to)1860-1878.e9
JournalCell Reports
Issue number7
StatePublished - Aug 13 2019


  • GLUT1
  • SGLT2
  • SOX2
  • glucose restriction
  • ketogenic diet
  • p63
  • squamous cell carcinoma

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology


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