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01-06-2020 | Cholangiocarcinoma | Original Article

Evaluation of NUC-1031: a first-in-class ProTide in biliary tract cancer

Authors: Mansi Arora, James M. Bogenberger, Amro Abdelrahman, Jennifer L. Leiting, Xianfeng Chen, Jan B. Egan, Aradhana Kasimsetty, Elzbieta Lenkiewicz, Smriti Malasi, Pedro Luiz Serrano Uson, Bolni Marius Nagalo, Yumei Zhou, Marcela A. Salomao, Heidi E. Kosiorek, Esteban Braggio, Michael T. Barrett, Mark J. Truty, Mitesh J. Borad

Published in: Cancer Chemotherapy and Pharmacology | Issue 6/2020

Abstract

Purpose

NUC1031 is a first-in-class ProTide, that is a gemcitabine pro-drug designed to overcome putative mechanisms of resistance, including decreased expression of hENT/hCNT transporters, absence of activating enzymes such as deoxycytidine kinase (dCK) and presence of degrading enzymes such as cytidine deaminase (CDA). We undertook comprehensive pre-clinical evaluation of NUC1031 in biliary tract cancer (BTC) models, given that gemcitabine/cisplatin is a standard first-line therapy in advanced BTC.

Methods

Here, we compared the in vitro activity of NUC1031 in comparison to gemcitabine, validate putative mechanism(s) of action, assessed potential biomarkers of sensitivity or resistance, and performed combination studies with cisplatin. We also evaluated the in vivo efficacy of NUC1031 and gemcitabine using a CDA-high cholangiocarcinoma patient-derived xenograft (PDX) model.

Results

In a panel of BTC cell lines (N = 10), NUC1031 had less potency than gemcitabine in multiple cellular assays. NUC1031 did not demonstrate evidence of greater synergy over gemcitabine in combination with cisplatin. Surprisingly, efficacy of both gemcitabine and NUC1031 was not found to be correlated with hENT/hCTN, dCK or CDA transcript levels. Gemcitabine and NUC1031 showed equivalent efficacy in a CDA-high PDX model in vivo contradicting the primary rationale of NUC1031 design.

Conclusion

NUC1031 did not exhibit evidence of superior activity over gemcitabine, as a single-agent, or in combination with cisplatin, in either our in vivo or in vitro BTC models. Given that the largest Phase 3 study (ClinicalTrials.gov: NCT0314666) to date in BTC is underway (N = 828) comparing NUC1031/cisplatin to gemcitabine/cisplatin, our results suggest that a more conservative clinical evaluation path would be more appropriate.

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Title: Evaluation of NUC-1031: a first-in-class ProTide in biliary tract cancer
Authors: Mansi Arora
James M. Bogenberger
Amro Abdelrahman
Jennifer L. Leiting
Xianfeng Chen
Jan B. Egan
Aradhana Kasimsetty
Elzbieta Lenkiewicz
Smriti Malasi
Pedro Luiz Serrano Uson
Bolni Marius Nagalo
Yumei Zhou
Marcela A. Salomao
Heidi E. Kosiorek
Esteban Braggio
Michael T. Barrett
Mark J. Truty
Mitesh J. Borad
Publication date: 01-06-2020
Publisher: Springer Berlin Heidelberg
Keywords: Cholangiocarcinoma
Cholangiocarcinoma
Published in: Cancer Chemotherapy and Pharmacology / Issue 6/2020
Print ISSN: 0344-5704
Electronic ISSN: 1432-0843
DOI: https://doi.org/10.1007/s00280-020-04079-z

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