Breast Cancer Research and Treatment

, Volume 147, Issue 3, pp 539–550 | Cite as

Dichloroacetate enhances apoptotic cell death via oxidative damage and attenuates lactate production in metformin-treated breast cancer cells

  • Allison B. HaugrudEmail author
  • Yongxian Zhuang
  • Joseph D. Coppock
  • W. Keith Miskimins
Preclinical study


The unique metabolism of breast cancer cells provides interest in exploiting this phenomenon therapeutically. Metformin, a promising breast cancer therapeutic, targets complex I of the electron transport chain leading to an accumulation of reactive oxygen species (ROS) that eventually lead to cell death. Inhibition of complex I leads to lactate production, a metabolic byproduct already highly produced by reprogrammed cancer cells and associated with a poor prognosis. While metformin remains a promising cancer therapeutic, we sought a complementary agent to increase apoptotic promoting effects of metformin while attenuating lactate production possibly leading to greatly improved efficacy. Dichloroacetate (DCA) is a well-established drug used in the treatment of lactic acidosis which functions through inhibition of pyruvate dehydrogenase kinase (PDK) promoting mitochondrial metabolism. Our purpose was to examine the synergy and mechanisms by which these two drugs kill breast cancer cells. Cell lines were subjected to the indicated treatments and analyzed for cell death and various aspects of metabolism. Cell death and ROS production were analyzed using flow cytometry, Western blot analysis, and cell counting methods. Images of cells were taken with phase contrast microscopy or confocal microscopy. Metabolism of cells was analyzed using the Seahorse XF24 analyzer, lactate assays, and pH analysis. We show that when DCA and metformin are used in combination, synergistic induction of apoptosis of breast cancer cells occurs. Metformin-induced oxidative damage is enhanced by DCA through PDK1 inhibition which also diminishes metformin promoted lactate production. We demonstrate that DCA and metformin combine to synergistically induce caspase-dependent apoptosis involving oxidative damage with simultaneous attenuation of metformin promoted lactate production. Innovative combinations such as metformin and DCA show promise in expanding breast cancer therapies.


Metformin Dichloroacetate Breast cancer Lactate Apoptosis 



This article was supported by grants from Susan G. Komen for the Cure (KG100497) and the National Cancer Institute of the National Institutes of Health (1R01CA180033). Flow Cytometry and Imaging Cores were supported by COBRE Grants P20GM103548 and P20GM103620 from the National Institute of General Medical Sciences at the National Institutes of Health.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical standards

The authors declare that the experiments comply with the current laws of the country in which they were performed.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Allison B. Haugrud
    • 1
    Email author
  • Yongxian Zhuang
    • 1
  • Joseph D. Coppock
    • 1
  • W. Keith Miskimins
    • 1
  1. 1.Cancer Biology Research CenterSanford ResearchSioux FallsUSA

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