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Figure 2B). SCC-9 dose-response curves for each inhibitor, alone or in combination, were analyzed while using the SynergyFinder software [46] with the Bliss independence model [47,48] showing high synergy between PI3Ki Bub or Omi and CQ (Figure 2C). Bliss synergy analysis for the other HNSCC cell lines of the panel (Figure S1B) demonstrated a high synergy between PI3Ki and CQ, as summarized in Figure 2D, with similar trends in cell line sensitivity for Bup and Omi and appeared Cancers 2020, 12, 2371 6 of 14 independent of PIK3CA mutation/amplification status. Our results advocate for the use of a combination therapy in HNSCC, which would include CQ in addition to PI3Ki. Figure 2. PI3Ki and chloroquine (CQ) work in synergy to decrease proliferation of HNSCC cell lines. (A) Figure 2. PI3Ki and chloroquine (CQ) work in synergy to decrease proliferation of HNSCC cell lines. Real-time cell proliferation of SCC-9 captured by IncuCyte S3 (Essen Bioscience, Ann Arbor, MI, USA) for 3 (A) Real-time cell proliferation of SCC-9 captured by IncuCyte S3 (Essen Bioscience, Ann Arbor, MI, days with vehicle (CTL), 0.5 μM Bup or 1 nM Omi and ± 10 μM CQ. Data are the mean of triplicates ± SEM. USA) for 3 days with vehicle (CTL), 0.5 μM Bup or 1 nM Omi and ± 10 μM CQ. Data are the mean of and atrreiprelipcaretessen±taStiEvMe o. fafnodurainrederpepenredsentaetxivperoimf efonutsr. (iBnd) eEpveanludaentitonexopfeproimpuenlatsti.on(Bd) oEuvbalilnugatiaofntero3f days in culptuorpeuflaotriofinvedoHuNblSinCgCafctelrl 3lindeasyswinithcu/wltiutrheofuotr PfiIv3eKHi aNnSdCCQceallt l0in.5esμwMitBhu/wpi,th1onuMt POI3mKi and C10QμaMt CQ (except for Detroit 562: 1 μM Bup, 10 nM Omi, and 30 μM CQ). Data are the mean ± SD; n = 4 independent experiments in triplicates for SCC-9, UM22A, and Detroit 562, and n = 5 in triplicates for FaDu and SCC-25. Data were analyzed with ANOVA test, * p < 0.05, ** p < 0.01, *** p < 0.001, and **** p < 0.0001. * p without underscore bar represents significant difference compared with CTL (vehicle). (C) Three-dimensional (3D) diagrams representing Bliss score (z) versus PI3Ki concentration (y) and autophagy inhibitor concentration (x). SCC-9 cell line was incubated with different concentrations of the inhibitors alone or in combination (1, 10, 30 μM CQ; 0.1 or 0.5 μM Bup; 0.1 or 1 nM Omi). Real-time proliferation was recorded for four days with IncuCyte S3 (Essen Bioscience, Ann Arbor, MI, USA) before AUC determination and Bliss score evaluation. Top: Bup. Bottom: Omi. (D) Bliss synergy scores for treatment combinations and PIK3CA status of six HNSCC cell lines. Bliss synergy scores over 1 indicate synergy. Cell lines were incubated in IncuCyte S3 (Essen Bioscience, Ann Arbor, MI, USA), as described with different concentrations of the inhibitors alone or in combination (1, 10, 30 μM CQ; 0.1 or 0.5 μM Bup; 0.1 or 1 nM Omi with the exception of FaDu with 1 or 5 nM Omi, and of Detroit 562 with 0.2 or 1 μM Bup and 2 or 10 nM Omi). Real-time proliferation was recorded for 3-4 days with IncuCyte S3 (Essen Bioscience, Ann Arbor, MI, USA).PDF Image | Dual Inhibition of Autophagy Pathway as a Therapeutic Strategy
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