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01-02-2019 | Preclinical study

Rationally derived drug combinations with the novel Mcl-1 inhibitor EU-5346 in breast cancer

Authors: Sonia Vallet, Fengjuan Fan, Stefano Malvestiti, Martin Pecherstorfer, Martin Sattler, Andreas Schneeweiss, Henning Schulze-Bergkamen, Joseph T. Opferman, Michael H. Cardone, Dirk Jäger, Klaus Podar

Published in: Breast Cancer Research and Treatment | Issue 3/2019

Abstract

Purpose

Recent studies have emphasized a key role for the anti-apoptotic Bcl-2 family member Mcl-1 in conferring tumor cell survival and drug resistance in breast cancer (BC). Mcl-1 inhibitors, such as the BH3-mimetic EU-5346, therefore represent an exciting new class of targeting agents and are a current focus of widespread cancer-drug development efforts.

Methods

ONCOMINE analysis was utilized to compare expression profiles of Bcl-2 family members across all major BC subgroups. Potential toxicities of EU-5346 were evaluated using iPS-generated cardiomyocytes, blood cells and astrocytes. The anti-BC cell activity of EU-5346-based therapies was evaluated using [³H]-thymidine uptake and spheroid-forming assays as well as immunoblotting and the Chou-Talalay method. Protein level-based activity of EU-5346, the specific anti-Bcl-2 inhibitor ABT-199 and the specific anti-Bcl-x_L inhibitor WEHI-539 was verified in Mcl-1^Δ/null versus Mcl-1^wt/wt MEFs.

Results

We previously demonstrated significant anti-tumor activity of EU-5346 in all BC subtypes. Our present results go further and suggest that EU-5346 may induce limited adverse events such as cardiotoxicity, hematotoxicity, and neurotoxicity, frequently observed with other BH3 mimetics. As demonstrated by our mathematical scoring model, the prediction of EU-5643-induced IC₅₀ not only relies on the protein level of Mcl-1 but also on Bak, Bim, and Noxa. Synergistic anti-BC activity of low-dose EU-5346 with the BH3 mimetics ABT-199 or WEHI-539 was observed only in those BC cells expressing Bcl-2 or Bcl-x_L, respectively. Similarly, when combined with tamoxifen or trastuzumab, low-dose EU-5346 induced significant anti-BC activity in hormone receptor positive or Her2-positive BC cells, respectively. Finally, EU-5346 in combination with paclitaxel induced synergistic anti-BC activity in both paclitaxel-sensitive and paclitaxel-resistant TNBC cells.

Conclusion

These data strongly support the further clinical development of EU-5346 to improve BC patient survival.

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Title: Rationally derived drug combinations with the novel Mcl-1 inhibitor EU-5346 in breast cancer
Authors: Sonia Vallet
Fengjuan Fan
Stefano Malvestiti
Martin Pecherstorfer
Martin Sattler
Andreas Schneeweiss
Henning Schulze-Bergkamen
Joseph T. Opferman
Michael H. Cardone
Dirk Jäger
Klaus Podar
Publication date: 01-02-2019
Publisher: Springer US
Published in: Breast Cancer Research and Treatment / Issue 3/2019
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-018-5022-5

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