Evidence map›Paper›PMID 41554703›Full record

ArticleCell death discovery2026

Targeting metabolic vulnerabilities: REV-ERB agonist SR9009 potentiates sorafenib efficacy in liver cancer.

Silvia Sabbioni, Paola Guerriero, Ram C Shankaraiah, Laura Masatti, Angelo Michilli, Cristian Bassi, Lucilla D'Abundo, Farzaneh Moshiri, Bruno De Siena, Edi Simoni and 9 more

Abstract read
In one paragraph

Article in Cell death discovery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Silvia Sabbioni *Department of Life Sciences and Biotechnology, University of Ferrara, 44121, Ferrara, Italy. silvia.sabbioni@unife.it.
Paola Guerriero *Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Ram C Shankaraiah *Department of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Laura MasattiDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Angelo MichilliDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Cristian BassiLaboratorio Per Le Tecnologie Delle Terapie Avanzate (LTTA), University of Ferrara, 44121, Ferrara, Italy.
Lucilla D'AbundoDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Farzaneh MoshiriDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Bruno De SienaDepartment of Life Sciences and Biotechnology, University of Ferrara, 44121, Ferrara, Italy.
Edi SimoniDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Laura AstolfiBioacoustics Research Laboratory, Department of Neurosciences, University of Padova, 35129, Padova, Italy.
Laura GramantieriDivision of Internal Medicine, Hepatobiliary and Immunoallergic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138, Bologna, Italy.
Roberta RoncaratiDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy.
Bahaeldin K ElaminDepartment of Microbiology and Clinical Parasitology, College of Medicine, University of Bisha, Bisha, 61922, Saudi Arabia.
Massimo BonoraDepartment of Medical Sciences, Section of Experimental Medicine, University of Ferrara, 44121, Ferrara, Italy.ORCID http://orcid.org/0000-0002-5752-3318
Paolo PintonDepartment of Medical Sciences, Section of Experimental Medicine, University of Ferrara, 44121, Ferrara, Italy.ORCID http://orcid.org/0000-0001-7108-6508
Carlo M CroceDepartment of Cancer Biology and Genetics, The Ohio State University, Columbus, OH, USA.ORCID http://orcid.org/0000-0003-3788-1457
Massimo NegriniLaboratorio Per Le Tecnologie Delle Terapie Avanzate (LTTA), University of Ferrara, 44121, Ferrara, Italy. massimo.negrini@unife.it.
Elisa CallegariDepartment of Translational Medicine, University of Ferrara, 44121, Ferrara, Italy. elisa.callegari@unife.it.ORCID http://orcid.org/0000-0002-4969-5400

Funding

Ministero dell'Istruzione, dell'Università e della Ricerca (Ministry of Education, University and Research) PRIN2022- n. 2022F8NS75Università degli Studi di Ferrara (University of Ferrara) FAR 2019-24 and FIRD 2022-24Università degli Studi di Ferrara (University of Ferrara) FAR.L-CE 2019-2022; FAR.L_medtras_CE, 2023-FAR.L-FIRD_medtras
6 · The paper itself

Abstract

Hepatocellular carcinoma (HCC) is one of the most common cancers and the third leading cause of cancer-related death worldwide. The prognosis is poor, with a median survival of 12-15 months in patients with advanced-stage disease. Early diagnosis and the development of new, more effective therapeutic strategies are needed to address the challenges posed by this malignancy. Although immune checkpoint inhibitors have replaced multikinase inhibitors as first-line therapy, sorafenib continues to represent a valuable option for patients with contraindications to newer treatments. Based on genome-wide RNA-seq analysis, which identified mitochondrial oxidative phosphorylation (OxPhos) and Hmox1 upregulation as potential pro-survival mechanisms in sorafenib-resistant cells, we investigated whether SR9009, a synthetic agonist of the nuclear receptor REV-ERBα/β, heme competitor, and inhibitor of mitochondrial respiration, could enhance the antitumor efficacy of sorafenib in liver cancer models. Co-treatment with SR9009 and sorafenib significantly enhanced cytotoxic effects in both mouse and human liver cancer cells. This synergistic activity was associated with increased levels of free heme and a complete inhibition of mitochondrial OxPhos. In vivo xenograft studies confirmed that the combination was effective even in sorafenib-resistant tumors. Furthermore, in a N-Nitrosodiethylamine (DEN)-induced HCC model, the combination therapy led to a reduction in size in over 90% of tumor nodules, representing a significant improvement over sorafenib alone. The combination was well tolerated, with no evident signs of acute toxicity. These findings support the concept that the efficacy of anticancer therapies can be enhanced by targeting the metabolic adaptations that tumor cells rely on for survival. Combining sorafenib with agents like SR9009, that disrupt metabolic homeostasis, may offer a promising strategy for treating advanced HCC.

Identifiers

PMID41554703
PMCPMC12877144

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.