Oncogenic transformation by epidermal growth factor receptor (EGFR) increases the demand for cholesterol, suggesting a possibility for metabolic interference.

To test this idea in vivo, scientists ablated Nsdhl in adult keratinocytes expressing KRAS^G12D. Strikingly, Nsdhl inactivation antagonized the growth of skin tumors while having little effect on normal skin.

Loss of Nsdhl induced the expression of ATP-binding cassette (ABC) transporters ABCA1 and ABCG1, reduced the expression of low-density lipoprotein receptor (LDLR), decreased intracellular cholesterol, and was dependent on the liver X receptor (LXR) α.

Importantly, EGFR signaling opposed LXRα effects on cholesterol homeostasis, whereas an EGFR inhibitor synergized with LXRα agonists in killing cancer cells.

Inhibition of SC4MOL or NSDHL, or activation of LXRα by sterol metabolites, can be an effective strategy against carcinomas with activated EGFR-KRAS signaling.