Article

CCS facilitates the progression of ovarian cancer by suppressing ferroptotic cell death via the modulation of p53- mediated expression of SLC7A11 and GPX4

Qi Yan1, Ming-ming Sun1, Xin-ru Zhai1, Hong-kai Chang1, Xin-yue Geng1, Xiao-bo Zhai1, Chen-xin Yang2, Yan-ping Li3, Tao Wang4, Jian-guo Zhao4, Tao He5, Chang-liang Shan1, Shuai Zhang2,6,7
1 State Key Laboratory of Medicinal Chemical Biology, College of Pharmacy and Tianjin Key Laboratory of Molecular Drug Research, Nankai University, Tianjin 300350, China
2 School of Integrative Medicine, State Key Laboratory of Chinese Medicine Modernization, Tianjin University of Traditional Chinese Medicine, Tianjin 301617, China
3 Precision Medicine Laboratory for Chronic Non-communicable Diseases of Shandong Province, Institute of Precision Medicine, Jining Medical University, Jining 272067, China
4 Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300110, China
5 Department of Pathology, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin 300162, China
6 Haihe Laboratory of Modern Chinese Medicine, Tianjin 301617, China
7 Tianjin Cancer Institute of Traditional Chinese Medicine, Tianjin 300381, China
Correspondence to: Jian-guo Zhao: killingyousoft@126.com, Tao He: hetao_1981@163.com, Chang-liang Shan: changliangshan@nankai.edu.cn, Shuai Zhang: shuaizhang@tjutcm.edu.cn,
DOI: 10.1038/s41401-026-01816-7
Received: 8 October 2025
Accepted: 29 March 2026
Advance online: 18 May 2026

Abstract

Ovarian cancer is the most prevalent and deadly gynecological malignancy worldwide, with a 5-year overall survival rate of only 10%–40% for patients with advanced disease. Copper chaperone for superoxide dismutase 1 (CCS) is a metallochaperone that plays a multifaceted role in the maturation of copper and displays aberrant expression levels and functions in cancer. Ferroptosis, a new form of cell death resulting from iron-dependent lipid peroxidation, is closely related to cancer. However, whether CCS regulates ferroptosis in ovarian cancer is unknown, and its underlying mechanisms have not been reported. Here, we report that highly expressed CCS contributes to ovarian cancer tumor growth. Moreover, suppressing CCS induced ferroptosis in ovarian cancer cells and increased their sensitivity to ferroptosis inducers. Mechanistically, high CCS expression was found to reduce intracellular copper ion levels and increase Solute Carrier Family 7 Member 11 (SLC7A11) or Glutathione Peroxidase 4 (GPX4) expression by increasing p53 ubiquitination, thus affecting ferroptosis. Additionally, DC_AC50, a small-molecule inhibitor of CCS that targets its copper transport interface, regulates ferroptosis and ovarian cancer growth. Analysis of clinical data revealed a positive correlation between high CCS expression and high SLC7A11 and GPX4 expression in ovarian cancer patients. In summary, our study reveals that CCS protects ovarian cancer cells from ferroptosis by promoting SLC7A11 and GPX4 expression in a p53-dependent manner.
Keywords: ovarian cancer; ferroptosis; CCS; p53; SLC7A11; GPX4

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