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We have recently shown that hydrophobic weak base anticancer drugs are highly sequestered in acidic lysosomes, inducing TFEB-mediated lysosomal biogenesis and markedly increased lysosome numbers per cell. This enhanced lysosomal sequestration of chemotherapeutics, away from their intracellular targets, provoked cancer multidrug resistance. However, little is known regarding the fate of lysosome-sequestered drugs. While we suggested that sequestered drugs might be expelled from cancer cells via lysosomal exocytosis, no actual drug-induced lysosomal exocytosis was demonstrated. By following the subcellular localization of lysosomes during exposure to lysosomotropic chemotherapeutics, we herein demonstrate that lysosomal drug accumulation results in translocation of lysosomes from the perinuclear zone towards the plasma membrane via movement on microtubule tracks. Furthermore, following translocation to the plasma membrane in drug-treated cells, lysosomes fused with the plasma membrane and released their cargo to the extracellular milieu, as also evidenced by increased levels of the lysosomal enzyme cathepsin D in the extracellular milieu. These findings suggest that lysosomal exocytosis of chemotherapeutic drug-loaded lysosomes is a crucial component of lysosome-mediated cancer multidrug resistance. We further argue that drug-induced lysosomal exocytosis bears important implications on tumor progression, as several lysosomal enzymes were found to play a key role in tumor cell invasion, angiogenesis and metastasis.

Lysosomal accumulation of anticancer drugs triggers lysosomal exocytosis