Monika Raab, Balázs Győrffy, Samuel Peña-Llopis, Daniela Fietz, Monika Kressin, Margareta Kolaric, Matthias Ebert, Khayal Gasimli, Sven Becker, Mourad Sanhaji, Klaus Strebhardt
<p>Ovarian cancer, particularly high-grade serous ovarian cancer (HGSOC), remains the most lethal gynecological malignancy, with a 5-year survival rate of around 40% due to late diagnosis, recurrence, and the development of chemoresistance [<span>1, 2</span>]. Mutations in tumor protein 53 (<i>TP53</i>) occur in over 96% of HGSOC cases, impairing its tumor-suppressive functions, including cell cycle control, DNA repair, and apoptosis. Mutant <i>TP53</i> promotes tumor progression, genomic instability, and resistance to standard therapies, thereby worsening patient outcomes [<span>3, 4</span>]. Death-associated protein kinase 1 (<i>DAPK1</i>) is a key regulator of apoptosis and autophagy [<span>5, 6</span>]. While p53 can upregulate <i>DAPK1</i> expression, DAPK1 in turn stabilizes p53 by inhibiting its negative regulator, murine double minute 2 (MDM2). This reciprocal regulation forms a feedback loop that reinforces p53's tumor-suppressive function. We identified aberrant DAPK1 expression in ovarian cancer and sought to investigate whether restoring DAPK1 function could serve as a potential therapeutic strategy. Recent advancements in mRNA-based therapies offer a promising approach to gene restoration. Thus, we investigated whether in vitro-transcribed (IVT)-mRNA encoding DAPK1 could serve as an effective therapeutic strategy for HGSOC. Here, we explore the potential of mRNA-based reactivation of DAPK1 to regulate cell survival and apoptosis in HGSOC.</p><p>In studies using mammalian vectors to deliver functional proteins for replacement therapy, reducing the length of recombinant DNA vectors has been shown to enhance transfection efficiency, translation, and persistence in cells [<span>7-9</span>]. Given the relatively long open reading frame of <i>DAPK1</i> (4,290 base pairs), we generated a series of constructs containing different functional domains of DAPK1 and assessed their anti-tumor efficacy in ovarian cancer cells. We found that a truncated <i>DAPK1</i> variant, containing the kinase domain, ankyrin repeats, and death domain (KD-AR-DD), retained potent tumor-suppressive activity despite being approximately 50% shorter than the wild-type protein. Compared to other truncated constructs, mammalian vector-based expression of KD-AR-DD strongly activated Caspase-3/7 and significantly sensitized OVCAR-3 cells to paclitaxel treatment (Supplementary Figure S1A-C). Based on these findings, we selected KD-AR-DD as the basis for designing an IVT-mRNA construct, referred to as ∆DAPK1-mRNA (Figure 1A), optimized to induce cell death in ovarian cancer cells. For IVT-mRNA synthesis, we employed a bacterial vector containing a T7 RNA polymerase promoter to drive transcription of human truncated <i>DAPK1</i>, focusing on optimizing translational efficacy and mRNA stability [<span>9</span>]. To deliver ∆DAPK1-mRNA to HGSOC cells, we utilized a liposomal system with Lipofectamine MessengerMAX Transfection Reagent. Treatment of OVCAR-8 cells with increasing
{"title":"Targeted reactivation of the novel tumor suppressor DAPK1, an upstream regulator of p53, in high-grade serous ovarian cancer by mRNA liposomes reduces viability and enhances drug sensitivity in preclinical models","authors":"Monika Raab, Balázs Győrffy, Samuel Peña-Llopis, Daniela Fietz, Monika Kressin, Margareta Kolaric, Matthias Ebert, Khayal Gasimli, Sven Becker, Mourad Sanhaji, Klaus Strebhardt","doi":"10.1002/cac2.70029","DOIUrl":"10.1002/cac2.70029","url":null,"abstract":"<p>Ovarian cancer, particularly high-grade serous ovarian cancer (HGSOC), remains the most lethal gynecological malignancy, with a 5-year survival rate of around 40% due to late diagnosis, recurrence, and the development of chemoresistance [<span>1, 2</span>]. Mutations in tumor protein 53 (<i>TP53</i>) occur in over 96% of HGSOC cases, impairing its tumor-suppressive functions, including cell cycle control, DNA repair, and apoptosis. Mutant <i>TP53</i> promotes tumor progression, genomic instability, and resistance to standard therapies, thereby worsening patient outcomes [<span>3, 4</span>]. Death-associated protein kinase 1 (<i>DAPK1</i>) is a key regulator of apoptosis and autophagy [<span>5, 6</span>]. While p53 can upregulate <i>DAPK1</i> expression, DAPK1 in turn stabilizes p53 by inhibiting its negative regulator, murine double minute 2 (MDM2). This reciprocal regulation forms a feedback loop that reinforces p53's tumor-suppressive function. We identified aberrant DAPK1 expression in ovarian cancer and sought to investigate whether restoring DAPK1 function could serve as a potential therapeutic strategy. Recent advancements in mRNA-based therapies offer a promising approach to gene restoration. Thus, we investigated whether in vitro-transcribed (IVT)-mRNA encoding DAPK1 could serve as an effective therapeutic strategy for HGSOC. Here, we explore the potential of mRNA-based reactivation of DAPK1 to regulate cell survival and apoptosis in HGSOC.</p><p>In studies using mammalian vectors to deliver functional proteins for replacement therapy, reducing the length of recombinant DNA vectors has been shown to enhance transfection efficiency, translation, and persistence in cells [<span>7-9</span>]. Given the relatively long open reading frame of <i>DAPK1</i> (4,290 base pairs), we generated a series of constructs containing different functional domains of DAPK1 and assessed their anti-tumor efficacy in ovarian cancer cells. We found that a truncated <i>DAPK1</i> variant, containing the kinase domain, ankyrin repeats, and death domain (KD-AR-DD), retained potent tumor-suppressive activity despite being approximately 50% shorter than the wild-type protein. Compared to other truncated constructs, mammalian vector-based expression of KD-AR-DD strongly activated Caspase-3/7 and significantly sensitized OVCAR-3 cells to paclitaxel treatment (Supplementary Figure S1A-C). Based on these findings, we selected KD-AR-DD as the basis for designing an IVT-mRNA construct, referred to as ∆DAPK1-mRNA (Figure 1A), optimized to induce cell death in ovarian cancer cells. For IVT-mRNA synthesis, we employed a bacterial vector containing a T7 RNA polymerase promoter to drive transcription of human truncated <i>DAPK1</i>, focusing on optimizing translational efficacy and mRNA stability [<span>9</span>]. To deliver ∆DAPK1-mRNA to HGSOC cells, we utilized a liposomal system with Lipofectamine MessengerMAX Transfection Reagent. Treatment of OVCAR-8 cells with increasing","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"45 8","pages":"966-970"},"PeriodicalIF":24.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.70029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Edmund Chiong, Ziteng Wang, Eleanor Jing Yi Cheong, Yi Chen Yao, Sin Mun Tham, Revathi Periaswami, Poh Choo Toh, Ziting Wang, Qing Hui Wu, Woon Chau Tsang, Arshvin Kesavan, Alvin Seng Cheong Wong, Patrick Thomas Wong, Felicia Lim, Shuaibing Liu, Eric Chun Yong Chan
Prostate cancer is a common cancer among men worldwide. Large-scale clinical studies of the 1,000 mg daily dosing of abiraterone acetate (AA) have confirmed its antitumor efficacy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) or metastatic castration-resistant prostate cancer (mCRPC), regardless of their cancer's response to androgen deprivation therapy (ADT) or treatment duration. However, this dosage was indirectly justified based on the absence of dose-limiting toxicities (DLTs) in prior phase I dose-escalation trials, where a plateau in the increase of upstream steroids relating to secondary mineralocorticoid excess was observed at doses greater than 750 mg and up to 2,000 mg daily [1, 2]. Notably, prostate specific antigen (PSA) levels declined at all investigated doses (250 to 1,000 mg) [1, 2].
Cytochrome P450 17A1 (CYP17A1) is involved in both adrenal and de novo intratumoural androgen biosynthesis. We previously identified that abiraterone targeted CYP17A1 via a two-step binding mechanism [3]. Our subsequent pharmacokinetic/pharmacodynamic (PK/PD) simulations found that both the 1,000 mg and 500 mg doses of AA achieved comparable > 80% apparent target CYP17A1 enzyme occupancy and equipotent reduction of downstream plasma dehydroepiandrostenedione-sulfate (DHEA-S) levels, despite the difference in systemic exposure of abiraterone [3]. In addition, we developed physiologically-based pharmacokinetic (PBPK) models for AA and abiraterone via a middle-out approach [4], which enabled the prospective prediction of abiraterone systemic exposure at different doses.
Our research group participated in a global phase II study that demonstrated a 250 mg dose of AA taken with a low-fat meal achieved comparable PSA metrics to the standard 1,000 mg AA dose taken in a fasting state in patients with CRPC [5]. However, the fat content of food could significantly impact the relative bioavailability of abiraterone [4], and controlling food intake poses a challenge in outpatient settings and during the long-term use of abiraterone. By analyzing the PK data, we observed that the systemic exposure of a lower dose of 500 mg of AA (fasted) is comparable to that of a 250 mg dose of AA with a low-fat meal. Furthermore, our modeling studies revealed that 500 mg AA is promising in achieving optimal antitumor efficacy, and diminishing mineralocorticoid-related adverse outcomes simultaneously. In addition, patients will pay less with a half-reduced dose. Currently, data on the administration of 500 mg AA in prostate cancer patients remains insufficient. To address this gap, we conducted a proof-of-concept phase I study in mCRPC and mHSPC patients newly initiated on 500 mg once daily AA. Simultaneous PBPK/PD simulations of the low-dose AA were performed to further support the unique relationship between systemic exposure and pharmacological
{"title":"Evaluation of exposure-response-safety relationship of model-informed low-dose 500 mg abiraterone acetate in prostate cancer patients","authors":"Edmund Chiong, Ziteng Wang, Eleanor Jing Yi Cheong, Yi Chen Yao, Sin Mun Tham, Revathi Periaswami, Poh Choo Toh, Ziting Wang, Qing Hui Wu, Woon Chau Tsang, Arshvin Kesavan, Alvin Seng Cheong Wong, Patrick Thomas Wong, Felicia Lim, Shuaibing Liu, Eric Chun Yong Chan","doi":"10.1002/cac2.70035","DOIUrl":"10.1002/cac2.70035","url":null,"abstract":"<p>Prostate cancer is a common cancer among men worldwide. Large-scale clinical studies of the 1,000 mg daily dosing of abiraterone acetate (AA) have confirmed its antitumor efficacy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) or metastatic castration-resistant prostate cancer (mCRPC), regardless of their cancer's response to androgen deprivation therapy (ADT) or treatment duration. However, this dosage was indirectly justified based on the absence of dose-limiting toxicities (DLTs) in prior phase I dose-escalation trials, where a plateau in the increase of upstream steroids relating to secondary mineralocorticoid excess was observed at doses greater than 750 mg and up to 2,000 mg daily [<span>1, 2</span>]. Notably, prostate specific antigen (PSA) levels declined at all investigated doses (250 to 1,000 mg) [<span>1, 2</span>].</p><p>Cytochrome P450 17A1 (CYP17A1) is involved in both adrenal and de novo intratumoural androgen biosynthesis. We previously identified that abiraterone targeted CYP17A1 via a two-step binding mechanism [<span>3</span>]. Our subsequent pharmacokinetic/pharmacodynamic (PK/PD) simulations found that both the 1,000 mg and 500 mg doses of AA achieved comparable > 80% apparent target CYP17A1 enzyme occupancy and equipotent reduction of downstream plasma dehydroepiandrostenedione-sulfate (DHEA-S) levels, despite the difference in systemic exposure of abiraterone [<span>3</span>]. In addition, we developed physiologically-based pharmacokinetic (PBPK) models for AA and abiraterone via a middle-out approach [<span>4</span>], which enabled the prospective prediction of abiraterone systemic exposure at different doses.</p><p>Our research group participated in a global phase II study that demonstrated a 250 mg dose of AA taken with a low-fat meal achieved comparable PSA metrics to the standard 1,000 mg AA dose taken in a fasting state in patients with CRPC [<span>5</span>]. However, the fat content of food could significantly impact the relative bioavailability of abiraterone [<span>4</span>], and controlling food intake poses a challenge in outpatient settings and during the long-term use of abiraterone. By analyzing the PK data, we observed that the systemic exposure of a lower dose of 500 mg of AA (fasted) is comparable to that of a 250 mg dose of AA with a low-fat meal. Furthermore, our modeling studies revealed that 500 mg AA is promising in achieving optimal antitumor efficacy, and diminishing mineralocorticoid-related adverse outcomes simultaneously. In addition, patients will pay less with a half-reduced dose. Currently, data on the administration of 500 mg AA in prostate cancer patients remains insufficient. To address this gap, we conducted a proof-of-concept phase I study in mCRPC and mHSPC patients newly initiated on 500 mg once daily AA. Simultaneous PBPK/PD simulations of the low-dose AA were performed to further support the unique relationship between systemic exposure and pharmacological ","PeriodicalId":9495,"journal":{"name":"Cancer Communications","volume":"45 8","pages":"971-975"},"PeriodicalIF":24.9,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cac2.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}