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Arbon D, Mach J, Čadková A, Sipkova A, Stursa J, Klanicová K, Machado M, Ganter M, Levytska V, Sojka D, Truksa J, Werner L, Sutak R. Chelation of Mitochondrial Iron as an Antiparasitic Strategy. ACS Infect Dis 2024; 10:676-687. [PMID: 38287902 PMCID: PMC10862539 DOI: 10.1021/acsinfecdis.3c00529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/02/2024] [Accepted: 01/09/2024] [Indexed: 01/31/2024]
Abstract
Iron, as an essential micronutrient, plays a crucial role in host-pathogen interactions. In order to limit the growth of the pathogen, a common strategy of innate immunity includes withdrawing available iron to interfere with the cellular processes of the microorganism. Against that, unicellular parasites have developed powerful strategies to scavenge iron, despite the effort of the host. Iron-sequestering compounds, such as the approved and potent chelator deferoxamine (DFO), are considered a viable option for therapeutic intervention. Since iron is heavily utilized in the mitochondrion, targeting iron chelators in this organelle could constitute an effective therapeutic strategy. This work presents mitochondrially targeted DFO, mitoDFO, as a candidate against a range of unicellular parasites with promising in vitro efficiency. Intracellular Leishmania infection can be cleared by this compound, and experimentation with Trypanosoma brucei 427 elucidates its possible mode of action. The compound not only affects iron homeostasis but also alters the physiochemical properties of the inner mitochondrial membrane, resulting in a loss of function. Furthermore, investigating the virulence factors of pathogenic yeasts confirms that mitoDFO is a viable candidate for therapeutic intervention against a wide spectrum of microbe-associated diseases.
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Affiliation(s)
- Dominik Arbon
- Department of Parasitology, Faculty
of Science, Charles University, BIOCEV, Vestec 25250, Czech Republic
| | - Jan Mach
- Department of Parasitology, Faculty
of Science, Charles University, BIOCEV, Vestec 25250, Czech Republic
| | - Aneta Čadková
- Department of Parasitology, Faculty
of Science, Charles University, BIOCEV, Vestec 25250, Czech Republic
| | - Anna Sipkova
- Department of Parasitology, Faculty
of Science, Charles University, BIOCEV, Vestec 25250, Czech Republic
| | - Jan Stursa
- Institute
of Biotechnology, Czech Academy of Sciences, BIOCEV, Vestec 25250, Czech Republic
- Laboratory
of Clinical Pathophysiology, Diabetes Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech
Republic
| | - Kristýna Klanicová
- Institute
of Biotechnology, Czech Academy of Sciences, BIOCEV, Vestec 25250, Czech Republic
- Department
of Organic Chemistry, Faculty of Science, Charles University, Prague 128 00, Czech Republic
| | - Marta Machado
- Graduate
Program in Areas of Basic and Applied Biology, Instituto de Ciências
Biomédicas Abel Salazar, Universidade
do Porto, Porto 4050-313, Portugal
- Centre for
Infectious Diseases, Parasitology, Heidelberg
University Hospital, Heidelberg 69120, Germany
| | - Markus Ganter
- Centre for
Infectious Diseases, Parasitology, Heidelberg
University Hospital, Heidelberg 69120, Germany
| | - Viktoriya Levytska
- Institute
of Parasitology, Biology Centre, Academy
of Sciences of the Czech Republic, Branišovská 1160/31, České Budějovice 37005, Czech Republic
| | - Daniel Sojka
- Institute
of Parasitology, Biology Centre, Academy
of Sciences of the Czech Republic, Branišovská 1160/31, České Budějovice 37005, Czech Republic
| | - Jaroslav Truksa
- Institute
of Biotechnology, Czech Academy of Sciences, BIOCEV, Vestec 25250, Czech Republic
| | - Lukáš Werner
- Institute
of Biotechnology, Czech Academy of Sciences, BIOCEV, Vestec 25250, Czech Republic
- Laboratory
of Clinical Pathophysiology, Diabetes Centre, Institute for Clinical and Experimental Medicine, Videnska 1958/9, 140 21 Prague, Czech
Republic
| | - Robert Sutak
- Department of Parasitology, Faculty
of Science, Charles University, BIOCEV, Vestec 25250, Czech Republic
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Vonka P, Rarova L, Bazgier V, Tichy V, Kolarova T, Holcakova J, Berka K, Kvasnica M, Oklestkova J, Kudova E, Strnad M, Hrstka R. Small change - big consequence: The impact of C15-C16 double bond in a D‑ring of estrone on estrogen receptor activity. J Steroid Biochem Mol Biol 2023; 233:106365. [PMID: 37468002 DOI: 10.1016/j.jsbmb.2023.106365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Revised: 07/13/2023] [Accepted: 07/16/2023] [Indexed: 07/21/2023]
Abstract
Estrogen receptor alpha (ER) is a key biomarker for breast cancer, and the presence or absence of ER in breast and other hormone-dependent cancers decides treatment regimens and patient prognosis. ER is activated after ligand binding - typically by steroid. 2682 steroid compounds were used in a molecular docking study to identify novel ligands for ER and to predict compounds that may show anticancer activity. The effect of the most promising compounds was determined by a novel luciferase reporter assay. Two compounds, 7 and 12, showing ER inhibitory activity comparable to clinical inhibitors such as tamoxifen or fulvestrant were selected. We propose that the inhibitory effect of compounds 7 and 12 on ER is related to the presence of a double bond in their D-ring, which may protect against ER activation by reducing the electron density of the keto group, or may undergo metabolism leading to an active compound. Western blotting revealed that compound 12 decreased the level of ER in the breast cancer cell line MCF7, which was associated with reduced expression of both isoforms of the progesterone receptor, a well-known downstream target of ER. However, compound 12 has a different mechanism of action from fulvestrant. Furthermore, we found that compound 12 interferes with mitochondrial functions, probably by disrupting the electron transport chain, leading to induction of the intrinsic apoptotic pathway even in ER-negative breast cancer cells. In conclusion, the combination of computational and experimental methods shown here represents a rapid approach to determine the activity of compounds towards ER. Our data will not only contribute to research focused on the regulation of ER activity but may also be useful for the further development of novel steroid receptor-targeted drugs applicable in clinical practice.
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Affiliation(s)
- Petr Vonka
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Žlutý kopec 7, 656 53 Brno, Czech Republic; Laboratory of Growth Regulators, Faculty of Science of Palacký University & Institute of Experimental Botany of the Czech Academy of Sciences, Šlechtitelů 27, 783 71 Olomouc, Czech Republic
| | - Lucie Rarova
- Department of Experimental Biology, Faculty of Science, Palacký University Olomouc, Šlechtitelů 27, 78371 Olomouc, Czech Republic
| | - Vaclav Bazgier
- Department of Physical Chemistry, Faculty of Science, Palacký University Olomouc, třída 17. listopadu 12, 771 46 Olomouc, Czech Republic
| | - Vlastimil Tichy
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Žlutý kopec 7, 656 53 Brno, Czech Republic
| | - Tamara Kolarova
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Žlutý kopec 7, 656 53 Brno, Czech Republic
| | - Jitka Holcakova
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Žlutý kopec 7, 656 53 Brno, Czech Republic
| | - Karel Berka
- Department of Physical Chemistry, Faculty of Science, Palacký University Olomouc, třída 17. listopadu 12, 771 46 Olomouc, Czech Republic
| | - Miroslav Kvasnica
- Laboratory of Growth Regulators, Faculty of Science of Palacký University & Institute of Experimental Botany of the Czech Academy of Sciences, Šlechtitelů 27, 783 71 Olomouc, Czech Republic
| | - Jana Oklestkova
- Laboratory of Growth Regulators, Faculty of Science of Palacký University & Institute of Experimental Botany of the Czech Academy of Sciences, Šlechtitelů 27, 783 71 Olomouc, Czech Republic
| | - Eva Kudova
- Institute of Organic Chemistry and Biochemistry AS CR, Flemingovo náměstí 2, 166 10, Praha 6, Czech Republic
| | - Miroslav Strnad
- Laboratory of Growth Regulators, Faculty of Science of Palacký University & Institute of Experimental Botany of the Czech Academy of Sciences, Šlechtitelů 27, 783 71 Olomouc, Czech Republic
| | - Roman Hrstka
- Research Centre for Applied Molecular Oncology, Masaryk Memorial Cancer Institute, Žlutý kopec 7, 656 53 Brno, Czech Republic; Laboratory of Growth Regulators, Faculty of Science of Palacký University & Institute of Experimental Botany of the Czech Academy of Sciences, Šlechtitelů 27, 783 71 Olomouc, Czech Republic.
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Bielcikova Z, Werner L, Stursa J, Cerny V, Krizova L, Spacek J, Hlousek S, Vocka M, Bartosova O, Pesta M, Kolostova K, Klezl P, Bobek V, Truksa J, Stemberkova-Hubackova S, Petruzelka L, Michalek P, Neuzil J. Mitochondrially targeted tamoxifen as anticancer therapy: case series of patients with renal cell carcinoma treated in a phase I/Ib clinical trial. Ther Adv Med Oncol 2023; 15:17588359231197957. [PMID: 37786538 PMCID: PMC10541747 DOI: 10.1177/17588359231197957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 08/03/2023] [Indexed: 10/04/2023] Open
Abstract
Mitochondrially targeted anticancer drugs (mitocans) that disrupt the energy-producing systems of cancer are emerging as new potential therapeutics. Mitochondrially targeted tamoxifen (MitoTam), an inhibitor of mitochondrial respiration respiratory complex I, is a first-in-class mitocan that was tested in the phase I/Ib MitoTam-01 trial of patients with metastatic cancer. MitoTam exhibited a manageable safety profile and efficacy; among 37% (14/38) of responders, the efficacy was greatest in patients with metastatic renal cell carcinoma (RCC) with a clinical benefit rate of 83% (5/6) of patients. This can be explained by the preferential accumulation of MitoTam in the kidney tissue in preclinical studies. Here we report the mechanism of action and safety profile of MitoTam in a case series of RCC patients. All six patients were males with a median age of 69 years, who had previously received at least three lines of palliative systemic therapy and suffered progressive disease before starting MitoTam. We recorded stable disease in four, partial response in one, and progressive disease (PD) in one patient. The histological subtype matched clear cell RCC (ccRCC) in the five responders and claro-cellular carcinoma with sarcomatoid features in the non-responder. The number of circulating tumor cells (CTCs) was evaluated longitudinally to monitor disease dynamics. Beside the decreased number of CTCs after MitoTam administration, we observed a significant decrease of the mitochondrial network mass in enriched CTCs. Two patients had long-term clinical responses to MitoTam, of 50 and 36 weeks. Both patients discontinued treatment due to adverse events, not PD. Two patients who completed the trial in November 2019 and May 2020 are still alive without subsequent anticancer therapy. The toxicity of MitoTam increased with the dosage but was manageable. The efficacy of MitoTam in pretreated ccRCC patients is linked to the novel mechanism of action of this first-in-class mitochondrially targeted drug.
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Affiliation(s)
- Zuzana Bielcikova
- Department of Oncology, General Faculty Hospital, U Nemocnice 499/2, Prague 2, 128 08, Czech Republic
| | - Lukas Werner
- Institute of Biotechnology, Czech Academy of Sciences, Prumyslova 595, Prague-West 252 50, Czech Republic Diabetes Centre, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic
| | - Jan Stursa
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West, Czech RepublicDiabetes Centre, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic
| | - Vladimir Cerny
- Department of Radiodiagnostics, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Ludmila Krizova
- Department of Oncology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jan Spacek
- Department of Oncology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Stanislav Hlousek
- Department of Oncology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Vocka
- Department of Oncology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Olga Bartosova
- Institute of Pharmacology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Michal Pesta
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague, Czech Republic
| | - Katarina Kolostova
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Petr Klezl
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic Urology Clinic, Third Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Vladimir Bobek
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Jaroslav Truksa
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West, Czech Republic
| | - Sona Stemberkova-Hubackova
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West, Czech RepublicDiabetes Centre, Institute for Clinical and Experimental Medicine, Prague 4, Czech Republic
| | - Lubos Petruzelka
- Department of Oncology, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavel Michalek
- Department of Anesthesiology and Intensive Care, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiri Neuzil
- School of Pharmacy and Medical Science, Griffith University, Southport, Qld 4222, Australia Department of Pediatrics and Inherited Metabolic Diseases, General University Hospital and First Faculty of Medicine, Charles University, Prague, Czech Republic Department of Physiology, Faculty of Science, Charles University, and General University Hospital, Prague, Czech Republic Institute of Biotechnology, Czech Academy of Sciences, Prumyslova 595, Prague-West 252 50, Czech Republic
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4
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Neuzil J, Rohlena J, Werner L, Bielcikova Z. MitoTam-01 Trial: Mitochondrial Targeting as Plausible Approach to Cancer Therapy. Comment on Yap et al. Complex I Inhibitor of Oxidative Phosphorylation in Advanced Solid Tumors and Acute Myeloid Leukemia: Phase I Trials. Nat. Med. 2023, 29, 115-126. Cancers (Basel) 2023; 15:4476. [PMID: 37760446 PMCID: PMC10526283 DOI: 10.3390/cancers15184476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 08/25/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
A recent paper published in Nature Medicine reported on the Phase I clinical trial of a mitochondria-targeting anti-cancer agent IACS-01059 in patients with acute myeloid leukemia (AML) and solid tumors [...].
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Affiliation(s)
- Jiri Neuzil
- School of Pharmacy and Medical Science, Griffith University, Southport, Qld 4222, Australia
- Institute of Biotechnology, Czech Academy of Sciences, 252 50 Prague, Czech Republic; (J.R.); (L.W.)
- Faculty of Science, Charles University, 128 00 Prague, Czech Republic
- First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic;
| | - Jakub Rohlena
- Institute of Biotechnology, Czech Academy of Sciences, 252 50 Prague, Czech Republic; (J.R.); (L.W.)
| | - Lukas Werner
- Institute of Biotechnology, Czech Academy of Sciences, 252 50 Prague, Czech Republic; (J.R.); (L.W.)
| | - Zuzana Bielcikova
- First Faculty of Medicine, Charles University, 121 08 Prague, Czech Republic;
- General University Hospital, Charles University, 128 08 Prague, Czech Republic
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Kalyanaraman B, Cheng G, Hardy M, You M. OXPHOS-targeting drugs in oncology: new perspectives. Expert Opin Ther Targets 2023; 27:939-952. [PMID: 37736880 PMCID: PMC11034819 DOI: 10.1080/14728222.2023.2261631] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/18/2023] [Indexed: 09/23/2023]
Abstract
INTRODUCTION Drugs targeting mitochondria are emerging as promising antitumor therapeutics in preclinical models. However, a few of these drugs have shown clinical toxicity. Developing mitochondria-targeted modified natural compounds and US FDA-approved drugs with increased therapeutic index in cancer is discussed as an alternative strategy. AREAS COVERED Triphenylphosphonium cation (TPP+)-based drugs selectively accumulate in the mitochondria of cancer cells due to their increased negative membrane potential, target the oxidative phosphorylation proteins, inhibit mitochondrial respiration, and inhibit tumor proliferation. TPP+-based drugs exert minimal toxic side effects in rodents and humans. These drugs can sensitize radiation and immunotherapies. EXPERT OPINION TPP+-based drugs targeting the tumor mitochondrial electron transport chain are a new class of oxidative phosphorylation inhibitors with varying antiproliferative and antimetastatic potencies. Some of these TPP+-based agents, which are synthesized from naturally occurring molecules and FDA-approved drugs, have been tested in mice and did not show notable toxicity, including neurotoxicity, when used at doses under the maximally tolerated dose. Thus, more effort should be directed toward the clinical translation of TPP+-based OXPHOS-inhibiting drugs in cancer prevention and treatment.
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Affiliation(s)
- Balaraman Kalyanaraman
- Department of Biophysics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
| | - Gang Cheng
- Department of Biophysics, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, United States
| | - Micael Hardy
- Aix Marseille Univ, CNRS, ICR, UMR 7273, Marseille 13013, France
| | - Ming You
- Center for Cancer Prevention, Houston Methodist Research Institute, 6670 Bertner Avenue, Houston, TX 77030, United States
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Raudenská M, Petrláková K, Juriňáková T, Leischner Fialová J, Fojtů M, Jakubek M, Rösel D, Brábek J, Masařík M. Engine shutdown: migrastatic strategies and prevention of metastases. Trends Cancer 2023; 9:293-308. [PMID: 36804341 DOI: 10.1016/j.trecan.2023.01.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 12/29/2022] [Accepted: 01/03/2023] [Indexed: 02/17/2023]
Abstract
Most cancer-related deaths among patients with solid tumors are caused by metastases. Migrastatic strategies represent a unique therapeutic approach to prevent all forms of cancer cell migration and invasion. Because the migration machinery has been shown to promote metastatic dissemination, successful migrastatic therapy may reduce the need for high-dose cytotoxic therapies that are currently used to prevent the risk of metastatic dissemination. In this review we focus on anti-invasive and antimetastatic strategies that hold promise for the treatment of solid tumors. The best targets for migrastatic therapy would be those that are required by all forms of motility, such as ATP availability, mitochondrial metabolism, and cytoskeletal dynamics and cell contractility.
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Affiliation(s)
- Martina Raudenská
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic
| | - Kateřina Petrláková
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic
| | - Tamara Juriňáková
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic
| | - Jindřiška Leischner Fialová
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic
| | - Michaela Fojtů
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic
| | - Milan Jakubek
- BIOCEV (Biotechnology and Biomedicine Center in Vestec), First Faculty of Medicine, Charles University, Prumyslova 595, CZ-252 50 Vestec, Czech Republic
| | - Daniel Rösel
- Department of Cell Biology, BIOCEV, Faculty of Science, Charles University, CZ-252 50, Vestec, Prague-West, Czech Republic
| | - Jan Brábek
- Department of Cell Biology, BIOCEV, Faculty of Science, Charles University, CZ-252 50, Vestec, Prague-West, Czech Republic
| | - Michal Masařík
- Department of Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; Department of Pathological Physiology, Faculty of Medicine, Masaryk University, Kamenice 5, CZ-625 00 Brno, Czech Republic; BIOCEV (Biotechnology and Biomedicine Center in Vestec), First Faculty of Medicine, Charles University, Prumyslova 595, CZ-252 50 Vestec, Czech Republic.
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7
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Bielcikova Z, Stursa J, Krizova L, Dong L, Spacek J, Hlousek S, Vocka M, Rohlenova K, Bartosova O, Cerny V, Padrta T, Pesta M, Michalek P, Hubackova SS, Kolostova K, Pospisilova E, Bobek V, Klezl P, Zobalova R, Endaya B, Rohlena J, Petruzelka L, Werner L, Neuzil J. Mitochondrially targeted tamoxifen in patients with metastatic solid tumours: an open-label, phase I/Ib single-centre trial. EClinicalMedicine 2023; 57:101873. [PMID: 37064512 PMCID: PMC10102891 DOI: 10.1016/j.eclinm.2023.101873] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 01/10/2023] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
Background Mitochondria present an emerging target for cancer treatment. We have investigated the effect of mitochondrially targeted tamoxifen (MitoTam), a first-in-class anti-cancer agent, in patients with solid metastatic tumours. Methods MitoTam was tested in an open-label, single-centre (Department of Oncology, General Faculty Hospital, Charles University, Czech Republic), phase I/Ib trial in metastatic patients with various malignancies and terminated oncological therapies. In total, 75 patients were enrolled between May 23, 2018 and July 22, 2020. Phase I evaluated escalating doses of MitoTam in two therapeutic regimens using the 3 + 3 design to establish drug safety and maximum tolerated dose (MTD). In phase Ib, three dosing regimens were applied over 8 and 6 weeks to evaluate long-term toxicity of MitoTam as the primary objective and its anti-cancer effect as a secondary objective. This trial was registered with the European Medicines Agency under EudraCT 2017-004441-25. Findings In total, 37 patients were enrolled into phase I and 38 into phase Ib. In phase I, the initial application of MitoTam via peripheral vein indicated high risk of thrombophlebitis, which was avoided by central vein administration. The highest dose with acceptable side effects was 5.0 mg/kg. The prevailing adverse effects (AEs) in phase I were neutropenia (30%), anaemia (30%) and fever/hyperthermia (30%), and in phase Ib fever/hyperthermia (58%) together with anaemia (26%) and neutropenia (16%). Serious AEs were mostly related to thromboembolic (TE) complications that affected 5% and 13% of patients in phase I and Ib, respectively. The only statistically significant AE related to MitoTam treatment was anaemia in phase Ib (p = 0.004). Of the tested regimens weekly dosing with 3.0 mg/kg for 6 weeks afforded the best safety profile with almost all being grade 1 (G1) AEs. Altogether, five fatalities occurred during the study, two of them meeting criteria for Suspected Unexpected Serious Adverse Events Reporting (SUSAR) (G4 thrombocytopenia and G5 stroke). MitoTam showed benefit evaluated as clinical benefit rate (CBR) in 37% patients with the largest effect in renal cell carcinoma (RCC) where four out of six patients reached disease stabilisation (SD), one reached partial response (PR) so that in total, five out of six (83%) patients showed CBR. Interpretation In this study, the MTD was established as 5.0 mg/kg and the recommended dose of MitoTam as 3.0 mg/kg given once per week via central vein with recommended preventive anti-coagulation therapy. The prevailing toxicity included haematological AEs, hyperthermia/fever and TE complications. One fatal stroke and non-fatal G4 thrombocytopenia were recorded. MitoTam showed high efficacy against RCC. Funding Smart Brain Ltd. Translation For the Czech translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Zuzana Bielcikova
- Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
- Corresponding author. Department of Oncology, General Faculty Hospital and 1st Faculty of Medicine, Charles University, U Nemocnice 499/2, Prague 2 128 08, Czech Republic.
| | - Jan Stursa
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
| | - Ludmila Krizova
- Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Lanfeng Dong
- School of Pharmacy and Medical Science, Griffith University, Southport, Qld 4222, Australia
| | - Jan Spacek
- Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Stanislav Hlousek
- Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Michal Vocka
- Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Katerina Rohlenova
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
| | - Olga Bartosova
- Institute of Pharmacology, First Faculty of Medicine, Charles University and General University Hospital, Prague 128 08, Czech Republic
| | - Vladimir Cerny
- Department of Radiodiagnostics, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Tomas Padrta
- Department of Radiodiagnostics, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Michal Pesta
- Department of Probability and Mathematical Statistics, Faculty of Mathematics and Physics, Charles University, Prague 121 06, Czech Republic
| | - Pavel Michalek
- Department of Anesthesiology and Intensive Care, First Faculty of Medicine, Charles University and General University Hospital, Prague 128 08, Czech Republic
| | - Sona Stemberkova Hubackova
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
- Centre for Experimental Medicine, Institute for Clinical and Experimental Medicine, Prague 4 140 21, Czech Republic
| | - Katarina Kolostova
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague 10 100 34, Czech Republic
| | - Eliska Pospisilova
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague 10 100 34, Czech Republic
| | - Vladimir Bobek
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague 10 100 34, Czech Republic
| | - Peter Klezl
- Laboratory of Personalized Medicine, Oncology Clinic, Faculty Hospital Kralovske Vinohrady, Prague 10 100 34, Czech Republic
- Urology Clinic, Third Faculty of Medicine, Charles University and Faculty Hospital Kralovske Vinohrady, Prague 10 100 34, Czech Republic
| | - Renata Zobalova
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
| | - Berwini Endaya
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
- Department of Pediatrics and Inherited Metabolic Diseases, First Faculty of Medicine, Charles University, Prague 2 128 08, Czech Republic
| | - Jakub Rohlena
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
| | - Lubos Petruzelka
- Department of Oncology, First Faculty of Medicine, Charles University, and General University Hospital, Prague 128 08, Czech Republic
| | - Lukas Werner
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
- Corresponding author. Institute of Biotechnology, Czech Academy of Sciences, Prumyslova 595, Prague-West 252 50, Czech Republic.
| | - Jiri Neuzil
- Institute of Biotechnology, Czech Academy of Sciences, Prague-West 252 50, Czech Republic
- School of Pharmacy and Medical Science, Griffith University, Southport, Qld 4222, Australia
- Department of Pediatrics and Inherited Metabolic Diseases, First Faculty of Medicine, Charles University, Prague 2 128 08, Czech Republic
- Department of Physiology, Faculty of Science, Charles University, Prague 2 128 00, Czech Republic
- Corresponding author. School of Pharmacy and Medical Science, Griffith University, Parklands Avenue, 4222 Southport, Qld, Australia, or Institute of Biotechnology, Czech Academy of Sciences, Prumyslova 595, Prague-West 252 50, Czech Republic.
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Hyroššová P, Milošević M, Škoda J, Vachtenheim Jr J, Rohlena J, Rohlenová K. Effects of metabolic cancer therapy on tumor microenvironment. Front Oncol 2022; 12:1046630. [PMID: 36582801 PMCID: PMC9793001 DOI: 10.3389/fonc.2022.1046630] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 11/28/2022] [Indexed: 12/15/2022] Open
Abstract
Targeting tumor metabolism for cancer therapy is an old strategy. In fact, historically the first effective cancer therapeutics were directed at nucleotide metabolism. The spectrum of metabolic drugs considered in cancer increases rapidly - clinical trials are in progress for agents directed at glycolysis, oxidative phosphorylation, glutaminolysis and several others. These pathways are essential for cancer cell proliferation and redox homeostasis, but are also required, to various degrees, in other cell types present in the tumor microenvironment, including immune cells, endothelial cells and fibroblasts. How metabolism-targeted treatments impact these tumor-associated cell types is not fully understood, even though their response may co-determine the overall effectivity of therapy. Indeed, the metabolic dependencies of stromal cells have been overlooked for a long time. Therefore, it is important that metabolic therapy is considered in the context of tumor microenvironment, as understanding the metabolic vulnerabilities of both cancer and stromal cells can guide new treatment concepts and help better understand treatment resistance. In this review we discuss recent findings covering the impact of metabolic interventions on cellular components of the tumor microenvironment and their implications for metabolic cancer therapy.
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Affiliation(s)
- Petra Hyroššová
- Institute of Biotechnology of the Czech Academy of Sciences, Prague, Czechia
| | - Mirko Milošević
- Institute of Biotechnology of the Czech Academy of Sciences, Prague, Czechia,Faculty of Science, Charles University, Prague, Czechia
| | - Josef Škoda
- Institute of Biotechnology of the Czech Academy of Sciences, Prague, Czechia
| | - Jiří Vachtenheim Jr
- 3rd Department of Surgery, First Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - Jakub Rohlena
- Institute of Biotechnology of the Czech Academy of Sciences, Prague, Czechia,*Correspondence: Kateřina Rohlenová, ; Jakub Rohlena,
| | - Kateřina Rohlenová
- Institute of Biotechnology of the Czech Academy of Sciences, Prague, Czechia,*Correspondence: Kateřina Rohlenová, ; Jakub Rohlena,
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