Evidence mapPaperPMID 42169913Full record

ArticleJournal of gastrointestinal oncology2026

Targeting AKR1C1 overcomes lenvatinib resistance in hepatocellular carcinoma through the STAT3-ABC transporters pathway.

Yue Zhang, Lu Zheng, An-Qiang Feng, Cheng-Wen Zhao, Xin-Wei Xu, Han Wu, Yang Yu, Feng Gu, Yong-Qiang Chen

Abstract read
In one paragraph

Article in Journal of gastrointestinal oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing 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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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

9 authors.

Yue Zhang *Department of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Lu Zheng *Department of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
An-Qiang Feng *Department of Gastroenterology, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Cheng-Wen ZhaoDepartment of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Xin-Wei XuDepartment of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Han WuDepartment of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Yang YuDepartment of Oncology, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Feng GuDepartment of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.
Yong-Qiang ChenDepartment of Clinical Laboratory, Xuzhou Institute of Medical Science, Xuzhou Central Hospital, Southeast University, Xuzhou, China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Hepatocellular carcinoma (HCC) remains the leading cause of cancer-related deaths worldwide. Lenvatinib, a widely used treatment, often has its efficacy limited by acquired resistance. Accumulating evidence indicates that the aldo-keto reductase 1 (AKR1) family plays a key role in tumor treatment resistance. This study aims to explore the mechanism of AKR1 family regulating lenvatinib resistance and identify new drugs to overcome it. Methods: The establishment of lenvatinib-resistant HCC cells (HuH7/R and Hep3B/R) was achieved through long-term exposure to lenvatinib. The expression of the AKR1 family genes in these cells was identified by quantitative reverse transcription polymerase chain reaction (qRT-PCR). Plasma AKR1C1 was quantified by enzyme-linked immunosorbent assay (ELISA). The effect of AKR1C1 on lenvatinib-resistant HCC cells was assessed by transfecting small interfering RNA (siRNA) and the AKR1C1 inhibitor, flufenamic acid (FFA). The mechanism by which AKR1C1 regulates lenvatinib resistance in liver cancer cells was investigated through the application of co-immunoprecipitation and signaling pathway inhibitor assays. Results: AKR1C1, a member of the AKR1 family, was overexpressed in lenvatinib-resistant HCC cells and in the plasma of lenvatinib-resistant HCC patients. Bioinformatics studies revealed that high AKR1C1 mRNA expression was linked to a less favourable prognosis in HCC patients. The transfection of siRNA-AKR1C1 can overcome lenvatinib resistance. Mechanistically, AKR1C1 was demonstrated to interact with and activate STAT3, which in turn upregulated the expression of multidrug resistance protein 1 (MDR1), multidrug resistance-associated protein 2 (MRP2), and breast cancer resistance protein (BCRP), thereby conferring lenvatinib resistance. AKR1C1 inhibitor FFA, a non-steroidal anti-inflammatory drug, effectively reversed lenvatinib resistance, restricting the growth of lenvatinib-resistant HCC cells. Conclusions: AKR1C1 may drive lenvatinib resistance in HCC by activating the STAT3-ATP-binding cassette (ABC) transporters pathway, thereby providing both a potential predictive biomarker and a therapeutic target for intervention.

Indexed as

AKR1C1flufenamic acid (FFA)Hepatocellular carcinoma (HCC)lenvatinib resistance

Identifiers

PMID42169913
PMCPMC13188000

What Socratic holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

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 Socratic graph.