Lidocaine kills cancer cells by activating bitter taste receptor, preclinical study shows

Lidocaine—typically used as a numbing agent for outpatient medical procedures—prompts sure bitter style receptors via two distinctive mechanisms that lead to most cancers cell loss of life, in response to researchers from the Perelman Faculty of Medication on the College of Pennsylvania.

Their findings, revealed at the moment in Cell Reports, pave the best way for a scientific trial to check the addition of lidocaine to the usual of care remedy for sufferers with head and neck cancers. The native anesthetic drug has lengthy been urged to have useful results in cancer patients, nevertheless it wasn’t identified how or why.

The preclinical study was led by Robert Lee, Ph.D., and Ryan Carey, MD, each assistant professors of Otorhinolaryngology—Head & Neck Surgical procedure, and Zoey Miller, a Pharmacology graduate pupil at Penn and member of Lee’s lab. The crew discovered that lidocaine prompts the bitter style receptor T2R14, which is elevated in varied cancer cells.

When this receptor is activated, it begins a course of known as apoptosis, inflicting the most cancers cells to die. The precise mechanisms that enable lidocaine to activate T2R14 are mitochondrial calcium ion overload, which produces reactive oxygen species that may harm biomolecules, and proteasome inhibition, collectively leading to cell loss of life.

Previous work by the crew confirmed that bitter taste receptors are discovered in lots of oral and throat most cancers cells, the place they set off apoptosis and that elevated expression of those bitter receptors is correlated with improved survival outcomes in sufferers with head and neck most cancers.

In April 2023, a multi-institutional randomized scientific trial revealed within the Journal of Clinical Oncology discovered that breast most cancers survival elevated when lidocaine was administered earlier than surgical procedure.

“We have been following this line of analysis for years however have been stunned to search out that lidocaine targets the one receptor that occurred to be most extremely expressed throughout cancers,” Lee mentioned. “T2R14 is present in cells all through the physique. What’s extremely thrilling is that lots of current medicine activate it, so there could possibly be extra alternatives to consider repurposing different medicine that might safely goal this receptor.”

Whereas T2R14 helps the physique understand bitter style within the mouth, the operate of the receptor in different cells all through the physique is unclear. Lidocaine is usually injected into the pores and skin or different tissues to forestall ache by blocking nerve indicators and will simply be immediately injected close to or round accessible oral tumors.

“Talking as a head and neck surgeon, we use lidocaine on a regular basis,” Carey mentioned. “We all know lidocaine is protected, we’re snug utilizing it, and it is available, which suggests it could possibly be integrated into different points of head and neck most cancers care pretty seamlessly.”

The examine, which was finished primarily in cell traces of head and neck squamous cell carcinomas (HNSCCs), additionally discovered that T2R14 is especially elevated in HNSCCs related to the human papillomavirus (HPV), which is now the dominant type of HNSCC. On account of these findings, Carey is planning to develop a scientific trial at Penn Medication’s Abramson Most cancers Heart to check the addition of lidocaine to plain look after HPV-associated HNSCCs.

“Whereas we’re not suggesting the lidocaine may remedy most cancers, we’re galvanized by the chance that it may get an edge on head and neck cancer therapy and transfer the dial ahead when it comes to enhancing therapy choices for sufferers with this difficult type of most cancers,” Carey mentioned.