Our findings suggest that paclitaxel treatment combined with inhibition of autophagy might be a potentially more effective chemotherapeutic approach for FLCN-deficient renal cancer and BHD-related kidney tumors. Acknowledgements This study was funded by the Department of Urology, University of Rochester

Medical Center. GFP-LC3 Plasmid was supplied from Frederick W. Wortmannin in vitro Alt, and Toren Finkel through Addgene. Electronic supplementary material Additional file 1: Figure S1: Paclitaxel-induced autophagosomes in cells with or without FLCN expression were detected using MDC assay. Punctuated areas in cells represent autophagosomes. Cell scores were calculated by the intracellular punctuates. Scale bars = 10 μm (*: p < 0.05. UOK257 vs UOK257-2; ACHN-sc vs ACHN 5968; n = 60). (TIFF 3 MB) References 1. Gump JM, Thorburn A: Autophagy and apoptosis: what is the connection? Trends Cell Biol 2011, 21:387–392.PubMedCentralPubMedCrossRef 2. Maiuri MC, Zalckvar E, Kimchi eFT-508 concentration A, Kroemer G: Self-eating and self-killing: crosstalk between

autophagy and apoptosis. Nat Rev Mol Cell Biol 2007, 8:741–752.PubMedCrossRef 3. Mah LY, Ryan KM: Autophagy and cancer. Cold Spring Harb Perspect Biol 2012, 4:a008821.PubMedCrossRef 4. Katayama M, Kawaguchi T, Berger MS, Pieper RO: DNA damaging agent-induced autophagy produces a cytoprotective adenosine triphosphate surge in malignant glioma cells. Cell Death Differ 2007, 14:548–558.PubMedCrossRef 5. Chen N, Karantza-Wadsworth V: Role and regulation of autophagy in cancer. Biochim Biophys Acta 2009, 1793:1516–1523.PubMedCentralPubMedCrossRef

6. Scripture CD, Figg WD, Sparreboom A: Paclitaxel chemotherapy: from empiricism to a mechanism-based formulation strategy. Ther Clin Risk Manage 2005, 1:107–114.CrossRef 7. Liu F, Liu D, Yang BCKDHB Y, Zhao S: Effect of autophagy inhibition on chemotherapy-induced GSK2245840 in vivo apoptosis in A549 lung cancer cells. Oncol Lett 2013, 5:1261–1265.PubMedCentralPubMed 8. Kim HJ, Lee SG, Kim YJ, Park JE, Lee KY, Yoo YH, et al.: Cytoprotective role of autophagy during paclitaxel-induced apoptosis in Saos-2 osteosarcoma cells. Int J Oncol 2013, 42:1985–1992.PubMed 9. Veldhoen RA, Banman SL, Hemmerling DR, Odsen R, Simmen T, Simmonds AJ, et al.: The chemotherapeutic agent paclitaxel inhibits autophagy through two distinct mechanisms that regulate apoptosis. Oncogene 2013, 32:736–746.PubMedCrossRef 10. Lu X, Wei W, Fenton J, Nahorski MS, Rabai E, Reiman A, et al.: Therapeutic targeting the loss of the birt-hogg-dube suppressor gene. Mol Cancer Ther 2011, 10:80–89.PubMedCrossRef 11. Birt AR, Hogg GR, Dube WJ: Hereditary multiple fibrofolliculomas with trichodiscomas and acrochordons. Arch Derm 1977, 113:1674–1677.PubMedCrossRef 12. Baba M, Furihata M, Hong SB, Tessarollo L, Haines DC, Southon E, et al.: Kidney-targeted Birt-Hogg-Dube gene inactivation in a mouse model: Erk1/2 and Akt-mTOR activation, cell hyperproliferation, and polycystic kidneys.