REPURPOSING ORLISTAT AS A FATTY ACID SYNTHASE INHIBITOR IN BREAST CANCER: IN VITRO EFFICACY, MECHANISMS, AND SYNERGY WITH DOXORUBICIN
Downloads
Objective: This study investigates the therapeutic potential of repurposing Orlistat, a potent irreversible inhibitor of fatty acid synthase (FASN), to enhance cytotoxic efficacy against breast cancer cells, both independently and in combination with doxorubicin. Method: Estrogen receptor-positive MCF-7 and triple-negative MDA-MB-231 cells were treated with Orlistat and doxorubicin individually and jointly, followed by assessments of cell viability (MTT), FASN expression (qRT-PCR and Western blot), apoptosis (Annexin V-FITC/PI flow cytometry and cleaved caspase-3), and drug interactions using the Chou–Talalay combination index. Results: Orlistat monotherapy significantly reduced cell viability in a dose-dependent manner, induced G1 arrest and apoptosis, and suppressed FASN expression and lipid accumulation, confirming metabolic targeting. Doxorubicin alone produced expected cytotoxicity, whereas the Orlistat–doxorubicin combination yielded synergistic inhibition (CI < 1) with markedly enhanced apoptotic signaling. Novelty: This work demonstrates, for the first time, a robust synergistic interaction between Orlistat and doxorubicin through coordinated disruption of lipid metabolism and heightened apoptotic induction, highlighting Orlistat’s promise as a metabolic adjuvant to improve breast cancer chemotherapeutic responses.
Z. Zakaria, Z. A. Othman, J. Bagi Suleiman, N. A. C. Jalil, W. S. W. Ghazali, and M. Mohamed, “Protective and Therapeutic Effects of Orlistat on Metabolic Syndrome and Oxidative Stress in High-Fat Diet-Induced Metabolic Dysfunction-Associated Fatty Liver Disease (MAFLD) in Rats: Role on Nrf2 Activation,” Vet Sci, vol. 8, no. 11, p. 274, Nov. 2021, doi: 10.3390/vetsci8110274.
B.-J. You, L.-Y. Chen, P.-H. Hsu, P.-H. Sung, Y.-C. Hung, and H.-Z. Lee, “Orlistat Displays Antitumor Activity and Enhances the Efficacy of Paclitaxel in Human Hepatoma Hep3B Cells,” Chem Res Toxicol, vol. 32, no. 2, pp. 255–264, Jan. 2019, doi: 10.1021/acs.chemrestox.8b00269.
C. John et al., “Orlistat exerts anti-obesity and anti-tumorigenic effects in a transgenic mouse model of endometrial cancer (189),” Gynecol Oncol, vol. 176, pp. S76–S77, Sep. 2023, doi: 10.1016/j.ygyno.2023.06.575.
P. Wigner, K. Zielinski, M. Labieniec-Watala, A. Marczak, and M. Szwed, “Doxorubicin–transferrin conjugate alters mitochondrial homeostasis and energy metabolism in human breast cancer cells,” Sci Rep, vol. 11, no. 1, Feb. 2021, doi: 10.1038/s41598-021-84146-4.
B. Schroeder et al., “Fatty acid synthase (FASN) regulates the mitochondrial priming of cancer cells,” Cell Death & Disease, vol. 12, no. 11, Oct. 2021, doi: 10.1038/s41419-021-04262-x.
K. N. Timm and D. J. Tyler, “The Role of AMPK Activation for Cardioprotection in Doxorubicin-Induced Cardiotoxicity,” Cardiovasc Drugs Ther, vol. 34, no. 2, pp. 255–269, Feb. 2020, doi: 10.1007/s10557-020-06941-x.
Z. Qian et al., “FASN inhibits ferroptosis in breast cancer via USP5 palmitoylation-dependent regulation of GPX4 deubiquitination,” Journal of Experimental & Clinical Cancer Research, vol. 44, no. 1, Oct. 2025, doi: 10.1186/s13046-025-03548-8.
A. M. A. Rasool and I. H. Mahmood, “Metformin’s antioxidant activity and protective nature,” in 2ND INTERNATIONAL CONFERENCE OF MATHEMATICS, APPLIED SCIENCES, INFORMATION AND COMMUNICATION TECHNOLOGY, AIP Publishing, 2023, p. 30022. doi: 10.1063/5.0164411.
P. Mishra, U. Singh, C. M. Pandey, P. Mishra, and G. Pandey, “Application of Student’s t-test, Analysis of Variance, and Covariance,” Ann Card Anaesth, vol. 22, no. 4, pp. 407–411, Oct. 2019, doi: 10.4103/aca.aca_94_19.
M. Oancea, S. Mazumder, M. E. Crosby, and A. Almasan, “Apoptosis Assays,” in Cardiovascular Disease, Volume 2: Molecular Medicine, Humana Press, pp. 279–290. doi: 10.1385/1-59745-213-0:279.
J. A. Menendez et al., “Fatty acid synthase (FASN) signalome: A molecular guide for precision oncology,” Mol Oncol, vol. 18, no. 3, pp. 479–516, Jan. 2024, doi: 10.1002/1878-0261.13582.
M. Jabbarzadeh, P. Zaboli, F. Chekin, and N. Saleh, “Anticancer effects of doxorubicin-conjugated magnetite MXene/Callicarpa extract on MCF-7 breast cancer cell line,” Talanta, vol. 295, p. 128380, Dec. 2025, doi: 10.1016/j.talanta.2025.128380.
J. Wen and R. G. Kerr, “Purification and characterization of the fatty acid synthase from Bugula neritina,” Comp Biochem Physiol B Biochem Mol Biol, vol. 128, no. 3, pp. 445–450, Mar. 2001, doi: 10.1016/s1096-4959(00)00343-2.
J. V Jovankić et al., “Potential of Orlistat to induce apoptotic and antiangiogenic effects as well as inhibition of fatty acid synthesis in breast cancer cells,” Eur J Pharmacol, vol. 939, p. 175456, Jan. 2023, doi: 10.1016/j.ejphar.2022.175456.
Z. Idrees, I. Cancarevic, and L. Huang, “FDA-Approved Pharmacotherapy for Weight Loss Over the Last Decade,” Cureus, Sep. 2022, doi: 10.7759/cureus.29262.
X. Hao et al., “Pharmacological effect and mechanism of orlistat in anti-tumor therapy: A review,” Medicine, vol. 102, no. 36, p. e34671, Sep. 2023, doi: 10.1097/md.0000000000034671.
R. Z. Hamza and K. Alsolami, “Ameliorative effects of Orlistat and metformin either alone or in combination on liver functions, structure, immunoreactivity and antioxidant enzymes in experimentally induced obesity in male rats,” Heliyon, vol. 9, no. 8, p. e18724, Aug. 2023, doi: 10.1016/j.heliyon.2023.e18724.
V. Foglizzo and S. Marchiò, “Nanoparticles as Physically- and Biochemically-Tuned Drug Formulations for Cancers Therapy,” Cancers (Basel), vol. 14, no. 10, p. 2473, May 2022, doi: 10.3390/cancers14102473.
R. Flavin, S. Peluso, P. L. Nguyen, and M. Loda, “Fatty Acid Synthase As a Potential Therapeutic Target in Cancer,” Future Oncology, vol. 6, no. 4, pp. 551–562, Apr. 2010, doi: 10.2217/fon.10.11.
J. P. Dewulf, I. Gerin, M. H. Rider, M. Veiga-da-Cunha, E. Van Schaftingen, and G. T. Bommer, “The synthesis of branched-chain fatty acids is limited by enzymatic decarboxylation of ethyl- and methylmalonyl-CoA,” Biochemical Journal, vol. 476, no. 16, pp. 2427–2447, Aug. 2019, doi: 10.1042/bcj20190500.
T.-C. Chou, “Drug Combination Studies and Their Synergy Quantification Using the Chou-Talalay Method,” Cancer Res, vol. 70, no. 2, pp. 440–446, Jan. 2010, doi: 10.1158/0008-5472.can-09-1947.
Z. Chenxi, A. Hemmat, N. H. Thi, and M. Afrand, “Nanoparticle-enhanced drug delivery systems: An up-to-date review,” J Mol Liq, vol. 424, p. 126999, Apr. 2025, doi: 10.1016/j.molliq.2025.126999.
U. Anand et al., “Corrigendum to ‘Cancer chemotherapy and beyond: Current status, drug candidates, associated risks and progress in targeted therapeutics’ [Genes & Diseases 10 (2023) 1367–1401],” Genes & Diseases, vol. 11, no. 4, p. 101211, Jul. 2024, doi: 10.1016/j.gendis.2024.101211.
F. Armutcu and B. Adam, “The Effect of Nano-Encapsulated Orlistat on Prostate Cancer: An In vitro Study,” Journal of Nanotechnology and Nanomaterials, vol. 5, no. 1, pp. 7–14, 2024, doi: 10.33696/nanotechnol.5.048.
alyaa Al-Safo, S. Yahya, and A. Abdel Rasool, “Protective Effects of Baobab Plant Extract on Doxorubicin-induced Histological and Biological Changes on Liver and Kidney of Albino Rats,” Al- Anbar Medical Journal, vol. 21, no. 2, pp. 110–116, Apr. 2025, doi: 10.33091/amj.2025.154901.1981.
M. Alsunbul, T. A. El-Masry, E. I. El Zahaby, M. M. S. Gaballa, and M. M. F. El-Nagar, “Potential Protective Effect of Orlistat: A Formulation of Nanocrystals Targeting Inflammation, Oxidative Stress, and Apoptosis in an Experimental Model of Doxorubicin-Induced Cardiotoxicity,” Pharmaceutics, vol. 16, no. 11, p. 1356, Oct. 2024, doi: 10.3390/pharmaceutics16111356.
D. Kuchkarova, D. Achilova, B. Ismatov, and S. Suyunov, “Algorithms for selecting a hydraulic structure design based on expert assessments,” Рroblems of engineering and professional education, vol. 73, no. 2, pp. 15–28, Jun. 2024, doi: 10.32523/2220-685x-2024-73-2-15-28.
Copyright (c) 2025 Abeer Mansour Abdel Rasool, Ammar M. Sheet Rashid, Emad Hussein Ahmad Hassan , Abdulhameed Subhi

This work is licensed under a Creative Commons Attribution 4.0 International License.














