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Ferroptosis is evolving as a highly promising approach to combat difficult-to-treat tumour entities including therapy-refractory and dedifferentiating cancers1-3. Recently, ferroptosis suppressor protein-1 (FSP1), along with extramitochondrial ubiquinone or exogenous vitamin K and NAD(P)H/H+ as an electron donor, has been identified as the second ferroptosis-suppressing system, which efficiently prevents lipid peroxidation independently ofthe cyst(e)ine-glutathione (GSH)-glutathione peroxidase 4 (GPX4) axis4-6. To develop FSP1 inhibitors as next-generation therapeutic ferroptosis inducers, here we performed a small molecule library screen and identified the compound class of 3-phenylquinazolinones (represented by icFSPl) as potent FSP1 inhibitors. We show that icFSPl, unlike iFSPl, the first described on-target FSP1 inhibitor5, does not competitively inhibit FSP1 enzyme activity, but instead triggers subcellular relocalization of FSP1 from the membrane and FSP1 condensation before ferroptosis induction, in synergism with GPX4 inhibition. icFSPl-induced FSP1 condensates show droplet-like properties consistent with phase separation, an emerging and widespread mechanism to modulate biological activity7. N-terminal myristoylation, distinct amino acid residues and intrinsically disordered, lowcomplexity regions in FSP1 were identified to be essential for FSPl-dependent phase separation in cells and in vitro. We further demonstrate that icFSPl impairs tumour growth and induces FSP1 condensates in tumours in vivo. Hence, our results suggest that icFSPl exhibits a unique mechanism of action and synergizes with ferroptosisinducing agents to potentiate the ferroptotic cell death response, thus providing a rationale for targeting FSPl-dependent phase separation as an efficient anti-cancer therapy.
Ferroptosis, a metabolic form of non-apoptotic cell death characterized by iron-dependent lipid peroxidation, has been defined only recently1,8. Ferroptosis has attracted tremendous interest because of its high relevance to human diseases such as neurodegenerative disorders, tissue damage during cold exposure, ischaemia-reperfusion injury and cancer9-12. In particular, triggering ferroptosis in the context of malignancies has emerged as a highly promising approach that shows synergistic effects with cancer immunotherapy and even kills therapy-resistant and metastatic cancers2'3'13-15. We recently showed that FSP1 represents a powerful backup system for the guardian of ferroptosis, known as GPX4, rendering tumours resistant to inhibition of this node5,6. However, because the first described FSP1-specific inhibitor iFSP1 (ref. 5) does not qualify to be further developed as an anti-cancer drug, owing to its limited potential for medicinal chemistry development in terms of an unfavourable structure and substitution pattern16, next-generation, efficacious in vivo FSP1 inhibitors...