Astragaloside IV enhances the sensibility of lung adenocarcinoma cells to bevacizumab by inhibiting autophagy

Abstract Bevacizumab (BV) has an inhibitory effect on tumor growth including lung adenocarcinoma. However, its efficacy is greatly affected by drug resistance. Astragaloside IV (AST‐IV) is effective in combination with other drugs is effective to treat cancer. This study aimed to investigate the effect of AST‐IV on enhancing the sensibility of lung adenocarcinoma cells to BV. A549 cells were treated by different concentrations of BV and AST‐IV. Cell viability, cell cycle, and apoptosis were detected by thiazolyl blue tetrazolium bromide (MTT) and flow cytometry, respectively. Quantitative reverse transcription‐polymerase chain reaction (qRT‐PCR) and western blotting were performed to detect the expression levels of autophagy‐ and apoptosis‐related proteins, protein kinase B (AKT), and mammalian target of rapamycin (mTOR). The results showed that BV or AST‐IV could inhibit the viability and promote the apoptosis of A549 cells in a concentration‐dependent manner. Moreover, BV or AST‐IV inhibited Bcl‐2 expression and increased the expressions of Bax and Cleaved caspase‐3, and promoted apoptosis. BV and AST‐IV in combination acted synergistically on viability and apoptosis of A549 cells. However, BV alone down‐regulated P62 expression, LC3I/LC3II level, the number of cells arrested at S phase and the phosphorylation levels of AKT and mTOR, but upregulated the number of cells arrested at G0/G1 phase and Beclin1 expression, whereas AST‐IV alone could reverse the effect of BV on autophagy‐related proteins, the phosphorylation levels of AKT and mTOR. This paper demonstrates that AST‐IV enhances the effect of BV on inhibiting proliferation and promoting apoptosis of lung adenocarcinoma cells through inhibiting autophagy pathway.