1. Drug prioritization identifies panobinostat as a tailored treatment element for patients with metastatic hepatoblastoma.
- Author
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Demir, Salih, Hotes, Alina, Schmid, Tanja, Cairo, Stefano, Indersie, Emilie, Pisano, Claudio, Hiyama, Eiso, Hishiki, Tomoro, Vokuhl, Christian, Branchereau, Sophie, Brock, Penelope, Schmid, Irene, Zsiros, József, and Kappler, Roland
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DUAL specificity phosphatase 1 , *CELL death inhibition , *APOPTOSIS , *HISTONE deacetylase inhibitors , *NEOADJUVANT chemotherapy - Abstract
Background: Patients with metastatic hepatoblastoma are treated with severely toxic first-line chemotherapies in combination with surgery. Yet, inadequate response of lung metastases to neo-adjuvant chemotherapy still compromises patient outcomes making new treatment strategies, tailored to more efficient lung clearance, mandatory. Methods: We harnessed a comprehensive patient-derived xenograft platform and a variety of in vitro and in vivo assays to establish the preclinical and biological rationale for a new drug for patients with metastatic hepatoblastoma. Results: The testing of a library of established drugs on patient-derived xenografts identified histone deacetylase inhibitors, most notably panobinostat, to be highly efficacious on hepatoblastoma cells, as compared to non-cancerous cells. Molecularly, the anti-tumor effect of panobinostat is mediated by posttranslational obstruction of the MYC oncoprotein as a result of dual specificity phosphatase 1 upregulation, thereby leading to growth inhibition and programmed cell death. Of clinical importance, upregulation of the MYC target gene nucleophosmin 1 is indicative of response to panobinostat and associated with metastatic disease in patients with hepatoblastoma. The combination of panobinostat with the current SIOPEL 4 induction protocol, consisting of cisplatin and doxorubicin, revealed high synergies already at low nanomolar levels. The simulation of a clinical trial, with this combination therapy, in patient-derived xenograft models, and ultimately heterotypic lung metastasis mimics clearly underscored the potency of this approach. Conclusion: Integrated studies define MYC inhibition by panobinostat as a novel treatment element to be introduced into the therapeutic strategy for patients with metastatic hepatoblastoma. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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