Pharmacologic inhibitor of DNA-PK, M3814, potentiates radiotherapy and regresses human tumors in mouse models

FT Zenke, A Zimmermann, C Sirrenberg… - Molecular cancer …, 2020 - AACR
FT Zenke, A Zimmermann, C Sirrenberg, H Dahmen, V Kirkin, U Pehl, T Grombacher…
Molecular cancer therapeutics, 2020AACR
Physical and chemical DNA-damaging agents are used widely in the treatment of cancer.
Double-strand break (DSB) lesions in DNA are the most deleterious form of damage and, if
left unrepaired, can effectively kill cancer cells. DNA-dependent protein kinase (DNA-PK) is
a critical component of nonhomologous end joining (NHEJ), one of the two major pathways
for DSB repair. Although DNA-PK has been considered an attractive target for cancer
therapy, the development of pharmacologic DNA-PK inhibitors for clinical use has been …
Abstract
Physical and chemical DNA-damaging agents are used widely in the treatment of cancer. Double-strand break (DSB) lesions in DNA are the most deleterious form of damage and, if left unrepaired, can effectively kill cancer cells. DNA-dependent protein kinase (DNA-PK) is a critical component of nonhomologous end joining (NHEJ), one of the two major pathways for DSB repair. Although DNA-PK has been considered an attractive target for cancer therapy, the development of pharmacologic DNA-PK inhibitors for clinical use has been lagging. Here, we report the discovery and characterization of a potent, selective, and orally bioavailable DNA-PK inhibitor, M3814 (peposertib), and provide in vivo proof of principle for DNA-PK inhibition as a novel approach to combination radiotherapy. M3814 potently inhibits DNA-PK catalytic activity and sensitizes multiple cancer cell lines to ionizing radiation (IR) and DSB-inducing agents. Inhibition of DNA-PK autophosphorylation in cancer cells or xenograft tumors led to an increased number of persistent DSBs. Oral administration of M3814 to two xenograft models of human cancer, using a clinically established 6-week fractionated radiation schedule, strongly potentiated the antitumor activity of IR and led to complete tumor regression at nontoxic doses. Our results strongly support DNA-PK inhibition as a novel approach for the combination radiotherapy of cancer. M3814 is currently under investigation in combination with radiotherapy in clinical trials.
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