1. The third generation AKR1C3-activated prodrug, ACHM-025, eradicates disease in preclinical models of aggressive T-cell acute lymphoblastic leukemia
- Author
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Toscan, CE, McCalmont, H, Ashoorzadeh, A, Lin, X, Fu, Z, Doculara, L, Kosasih, HJ ; https://orcid.org/0000-0002-0428-6195, Cadiz, R, Zhou, A, Williams, S, Evans, K, Khalili, F, Cai, R, Yeats, KL, Gifford, AJ ; https://orcid.org/0000-0002-4092-2347, Pickford, R ; https://orcid.org/0000-0001-8982-7618, Mayoh, C ; https://orcid.org/0000-0002-6398-3046, Xie, J, Henderson, MJ ; https://orcid.org/0000-0003-2741-3852, Trahair, TN ; https://orcid.org/0000-0002-3295-228X, Patterson, AV, Smaill, JB, de Bock, CE ; https://orcid.org/0000-0001-5182-8535, Lock, RB ; https://orcid.org/0000-0002-3436-9071, Toscan, CE, McCalmont, H, Ashoorzadeh, A, Lin, X, Fu, Z, Doculara, L, Kosasih, HJ ; https://orcid.org/0000-0002-0428-6195, Cadiz, R, Zhou, A, Williams, S, Evans, K, Khalili, F, Cai, R, Yeats, KL, Gifford, AJ ; https://orcid.org/0000-0002-4092-2347, Pickford, R ; https://orcid.org/0000-0001-8982-7618, Mayoh, C ; https://orcid.org/0000-0002-6398-3046, Xie, J, Henderson, MJ ; https://orcid.org/0000-0003-2741-3852, Trahair, TN ; https://orcid.org/0000-0002-3295-228X, Patterson, AV, Smaill, JB, de Bock, CE ; https://orcid.org/0000-0001-5182-8535, and Lock, RB ; https://orcid.org/0000-0002-3436-9071
- Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematological malignancy that expresses high levels of the enzyme aldo-keto reductase family 1 member C3 (AKR1C3). To exploit this finding, we developed a novel prodrug, ACHM-025, which is selectively activated by AKR1C3 to a nitrogen mustard DNA alkylating agent. We show that ACHM-025 has potent in vivo efficacy against T-ALL patient-derived xenografts (PDXs) and eradicated the disease in 7 PDXs. ACHM-025 was significantly more effective than cyclophosphamide both as a single agent and when used in combination with cytarabine/6-mercaptopurine. Notably, ACHM-025 in combination with nelarabine was curative when used to treat a chemoresistant T-ALL PDX in vivo. The in vivo efficacy of ACHM-025 directly correlated with AKR1C3 expression levels, providing a predictive biomarker for response. Together, our work provides strong preclinical evidence highlighting the potential of ACHM-025 as a targeted and effective therapy for aggressive forms of T-ALL.
- Published
- 2024