Lapachol / PKM2 Cancer Research Results

LapC, Lapachol: Click to Expand ⟱
Features:
Lapachol is a natural naphthoquinone originally derived from the heartwood of the lapacho tree (Tabebuia species).
-lapachol is an analog of shikonin

Pathways:

Oxidative Stress and ROS Generation
–Like many quinones, lapachol can undergo redox cycling that generates reactive oxygen species (ROS).
-Oxidative damage to DNA, proteins, and lipids, thereby promoting cancer cell death.
-cell cycle at specific checkpoints (commonly at G0/G1 or G2/M phases)
-Inhibition of the NF‑κB signaling pathway
–MAPK Pathways

-ic50 cancer cells 10-50uM, normal cells higher (existence of a therapeutic window)

Lapachol — a naturally occurring prenylated 1,4-naphthoquinone, chemically 2-hydroxy-3-(3-methyl-2-butenyl)-1,4-naphthoquinone, found principally in the heartwood of Tabebuia/Handroanthus species such as pau d’arco/lapacho. It is a natural-product small molecule and experimental pharmacologic agent rather than an approved anticancer drug. Lapachol has several experimentally supported molecular targets, notably RSK2, PKM2 and DHODH, with additional evidence for topoisomerase inhibition and quinone-associated redox effects.

Primary mechanisms (ranked):

  1. RSK2 inhibition with suppression of downstream proliferative signaling and induction of mitochondrial intrinsic apoptosis.
  2. PKM2 inhibition with suppression of aerobic glycolysis, reduced ATP generation and increased metabolic vulnerability.
  3. DHODH inhibition with suppression of de novo pyrimidine synthesis and proliferation.
  4. Mitochondrial intrinsic apoptosis involving BAX, cytochrome c and caspase-3/7 activation.
  5. Topoisomerase I and II inhibition with impaired DNA topology, DNA damage and antiproliferative effects in selected models.
  6. Quinone redox cycling and ROS generation (secondary/context-dependent), potentially enhanced in cells capable of efficient quinone reduction.
  7. Cell-cycle arrest and suppression of clonogenic growth and migration, varying substantially by tumor model.

Bioavailability / PK relevance: Lapachol is orally absorbable in animal models, with reported oral bioavailability approximately 55–77% for lapachol in one preclinical PK study; this should not be assumed to represent human exposure. It binds strongly to human serum albumin and is relatively hydrophobic, affecting distribution and free-drug exposure. Historical human studies found that plasma concentrations believed necessary for anticancer activity required very large oral doses, creating a major dose-limiting translational problem.

In-vitro vs systemic exposure relevance: Most modern anticancer studies use micromolar lapachol concentrations, frequently in the approximately 10–100 μM range depending on model and endpoint. Historical clinical work indicates that maintaining sufficiently high systemic concentrations is difficult without substantial toxicity; therefore many in-vitro anticancer exposures may exceed realistically sustainable human free-drug exposure. Derivatives and metal complexes of lapachol can be considerably more potent but should not be interpreted as evidence for parent lapachol itself.

Clinical evidence status: Preclinical with limited historical human exposure. A small early cancer clinical study was performed in the 1970s, but development was discontinued because high drug concentrations were required and dose-limiting toxicity, particularly anticoagulant effects and prolonged prothrombin time, emerged. No validated modern RCT evidence supports lapachol as an anticancer treatment, and it is not an approved cancer therapy.

Lapachol Mechanistic Profile

Rank Pathway / Axis Cancer Cells Normal Cells TSF Primary Effect Notes / Interpretation
1 RSK2 signaling ↓ ↔ / ↓ (context-dependent) R/G Suppression of proliferative signaling Direct RSK2 inhibition demonstrated in ESCC models; growth inhibition was strongly dependent on RSK2 expression and was associated with intrinsic apoptosis.
2 PKM2 and glycolysis ↓ ↔ / ↓ (context-dependent) R/G Reduced glycolytic ATP production Lapachol inhibits purified PKM2 and tumor-cell PKM2 activity, decreases glycolytic flux and ATP, and increases reliance on mitochondrial oxidative metabolism.
3 DHODH and pyrimidine synthesis ↓ ↓ proliferating cells R/G Reduced de novo pyrimidine synthesis Direct DHODH binding and inhibition are supported by biochemical studies and a human DHODH–lapachol crystal structure. The mechanism is not cancer-specific and may also suppress proliferating lymphocytes.
4 Mitochondrial intrinsic apoptosis ↑ ↔ / ↑ (dose-dependent) R/G Caspase-dependent apoptosis Associated with ↑ BAX, ↑ cytochrome c release, ↑ caspase-3/7 activity and PARP cleavage in responsive cancer models.
5 Topoisomerase I and II ↓ ↓ (high concentration) R/G DNA damage and impaired DNA topology Inhibition of TOP1 and TOP2 has been demonstrated in glioma models. Evidence is less extensive than for RSK2, PKM2 and DHODH.
6 ATP and metabolic fitness ↓ ↔ / ↓ (dose-dependent) R/G Energetic stress Primarily downstream of PKM2 inhibition and metabolic rewiring rather than a discrete molecular target.
7 Mitochondrial respiration ↑ (context-dependent) ↔ R Compensatory oxidative metabolism PKM2 inhibition can shift melanoma cells away from glycolysis toward increased oxygen consumption, creating vulnerability to mitochondrial perturbation.
8 ROS and quinone redox cycling ↑ (context-dependent) ↑ (dose-dependent) P/R Oxidative stress and macromolecular damage Mechanistically plausible for reducible naphthoquinones and supported by naphthoquinone redox biology, but ROS should be treated as a secondary mechanism for parent lapachol rather than its best-established primary anticancer target.
9 DNA damage ↑ ↑ (high concentration) R/G Genotoxic stress Can arise downstream of topoisomerase inhibition and oxidative stress.
10 Cell-cycle progression ↓ ↓ (dose-dependent) G Cell-cycle arrest Sub-G1 accumulation and other checkpoint effects have been reported; the specific checkpoint varies by cell type and experimental system.
11 Clonogenic survival ↓ Not established G Reduced long-term proliferative capacity Demonstrated in ESCC and more recent bladder cancer models.
12 Migration ↓ Not established G Reduced tumor-cell motility Reported in bladder cancer and other experimental models; molecular basis remains less well established than the core metabolic targets.
13 Vitamin K recycling ↓ ↓ R/G Anticoagulant effect Lapachol inhibits vitamin K epoxide reductase and vitamin K quinone reductase. This provides a mechanistic explanation for prolonged prothrombin time observed at high exposure and represents an important safety limitation.
14 Clinical Translation Constraint ↓ therapeutic feasibility ↑ toxicity risk G Exposure-limited clinical utility Anticancer activity generally requires substantial micromolar exposure. Historical clinical studies encountered difficulty achieving effective plasma levels without anticoagulant toxicity; no modern clinical anticancer efficacy has been established.
P: 0–30 min    R: 30 min–3 hr    G: >3 hr

PKM2, Pyruvate Kinase, Muscle 2: Click to Expand ⟱
Source:
Type: enzyme
PKM2 (Pyruvate Kinase, Muscle 2) is an enzyme that plays a crucial role in glycolysis, the process by which cells convert glucose into energy. PKM2 is a key regulatory enzyme in the glycolytic pathway, and it is primarily expressed in various tissues, including muscle, brain, and cancer cells.
-C-myc is a common oncogene that enhances aerobic glycolysis in the cancer cells by transcriptionally activating GLUT1, HK2, PKM2 and LDH-A
-PKM2 has been shown to be overexpressed in many types of tumors, including breast, lung, and colon cancer. This overexpression may contribute to the development and progression of cancer by promoting glycolysis and energy production in cancer cells.
-inhibition of PKM2 may cause ATP depletion and inhibiting glycolysis.
-PK exists in four isoforms: PKM1, PKM2, PKR, and PKL
-PKM2 plays a role in the regulation of glucose metabolism in diabetes.
-PKM2 is involved in the regulation of cell proliferation, apoptosis, and autophagy.
– Pyruvate kinase catalyzes the final, rate-limiting step of glycolysis, converting phosphoenolpyruvate (PEP) to pyruvate with the production of ATP.
– The PKM2 isoform is uniquely regulated and can exist in both highly active tetrameric and less active dimeric forms.
– Cancer cells often favor the dimeric form of PKM2 to slow pyruvate production, thereby accumulating upstream glycolytic intermediates that can be diverted into anabolic pathways to support cell growth and proliferation.
– Under low oxygen conditions, cancer cells rely on altered metabolic pathways in which PKM2 is a key player. – The shift to aerobic glycolysis (Warburg effect) orchestrated in part by PKM2 helps tumor cells survive and grow in hypoxic conditions.

– Elevated expression of PKM2 is frequently observed in many cancer types, including lung, breast, colorectal, and pancreatic cancers.
– High levels of PKM2 are often correlated with enhanced tumor aggressiveness, poor differentiation, and advanced clinical stage.

PKM2 in carcinogenesis and oncotherapy

Inhibitors of PKM2:
-Shikonin, Resveratrol, Baicalein, EGCG, Apigenin, Curcumin, Ursolic Acid, Citrate (best known as an allosteric inhibitor of phosphofructokinase-1 (PFK-1), a key rate-limiting enzyme in glycolysis) potential to directly inhibit or modulate PKM2 is less well established

Full List of PKM2 inhibitors from Database
-key connected observations: Glycolysis↓, lactateProd↓, ROS↑ in cancer cell, while some result for opposite effect on normal cells.
Tumor pyruvate kinase M2 modulators

Flavonoids effect on PKM2
Compounds name IC50/AC50uM Effect
Flavonols
1. Fisetin 0.90uM Inhibition
2. Rutin 7.80uM Inhibition
3. Galangin 8.27uM Inhibition
4. Quercetin 9.24uM Inhibition
5. Kaempferol 9.88uM Inhibition
6. Morin hydrate 37.20uM Inhibition
7. Myricetin 0.51uM Activation
8. Quercetin 3-b- D-glucoside 1.34uM Activation
9. Quercetin 3-D -galactoside 27-107uM Ineffective
Flavanons
10. Neoeriocitrin 0.65uM Inhibition
11. Neohesperidin 14.20uM Inhibition
12. Naringin 16.60uM Inhibition
13. Hesperidin 17.30uM Inhibition
14. Hesperitin 29.10uM Inhibition
15. Naringenin 70.80uM Activation
Flavanonols
16. (-)-Catechin gallateuM 0.85 Inhibition
17. (±)-Taxifolin 1.16uM Inhibition
18. (-)-Epicatechin 1.33uM Inhibition
19. (+)-Gallocatechin 4-16uM Ineffective
Phenolic acids
20. Ferulic 11.4uM Inhibition
21. Syringic and 13.8uM Inhibition
22. Caffeic acid 36.3uM Inhibition
23. 3,4-Dihydroxybenzoic acid 78.7uM Inhibition
24. Gallic acid 332.6uM Inhibition
25. Shikimic acid 990uM Inhibition
26. p-Coumaric acid 22.2uM Activation
27. Sinapinic acids 26.2uM Activation
28. Vanillic 607.9uM Activation


Scientific Papers found: Click to Expand⟱
8162- LapC,    Lapachol inhibits glycolysis in cancer cells by targeting pyruvate kinase M2
- in-vitro, Melanoma, MEL526 - in-vitro, Melanoma, MEL697 - in-vitro, Melanoma, MEL103
Glycolysis↓, OCR↑, PKM2↓, ATP↓, TumCP↓, Apoptosis↑, OXPHOS↑, Dose↝,

Showing Research Papers: 1 to 1 of 1

* indicates research on normal cells as opposed to diseased cells
Total Research Paper Matches: 1

Pathway results for Effect on Cancer / Diseased Cells:


Redox & Oxidative Stress(tgid=1) ⓘ

OXPHOS↑, 1,  

Mitochondria & Bioenergetics(tgid=3) ⓘ

ATP↓, 1,   OCR↑, 1,  

Core Metabolism/Glycolysis(tgid=4) ⓘ

Glycolysis↓, 1,   PKM2↓, 1,  

Cell Death(tgid=5) ⓘ

Apoptosis↑, 1,  

Migration(tgid=13) ⓘ

TumCP↓, 1,  

Drug Metabolism & Resistance(tgid=21) ⓘ

Dose↝, 1,  
Total Targets: 8

Pathway results for Effect on Normal Cells:


Total Targets: 0

Scientific Paper Hit Count for: PKM2, Pyruvate Kinase, Muscle 2
Query results interpretion may depend on "conditions" listed in the research papers.
Such Conditions may include : 
  -low or high Dose
  -format for product, such as nano of lipid formations
  -different cell line effects
  -synergies with other products 
  -if effect was for normal or cancerous cells

Filter Conditions: Pro/AntiFlg:%  IllCat:%  CanType:%  Cells:%  prod#:300  Target#:772  State#:%  Dir#:%
  wNotes=0  sortOrder:rid,rpid

 

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