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Health & Medicine for Senior Citizens

Cancer Cells Eat Themselves When Treated with Drug Combination

Clinical trial to test safety of PI3K/AKT inhibitor combined with sorafenib and regorafenib, which dramatically increased cell death

Nov. 5, 2013 It is too early for celebration but the effective killing of colon, liver, lung, kidney, breast and brain cancer cells with little damage to noncancerous cells in a preclinical study at Virginia Commonwealth University Cancer Study has focused attention on the new drug combination therapy that caused the cancer cells to self-destruct.

The results are now the foundation for researchers to plan a phase 1 clinical trial to test the safety of the therapy in a small group of patients.

"It is still too premature to estimate when a clinical trial will open to further test this drug combination therapy, but we are now in the planning phase and encouraged by the results of these laboratory experiments," says Andrew Poklepovic, M.D., oncologist and member of the Developmental Therapeutics research program at VCU Massey Cancer Center and assistant professor in the Division of Hematology, Oncology and Palliative Care at VCU School of Medicine.

"We are also encouraged by the fact that the drugs used in this therapy are either already approved by the FDA to treat certain cancers or are currently being investigated in other clinical trials."

 

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Featured in the journal Molecular Pharmacology, the study led by Paul Dent, Ph.D., demonstrated that the drugs sorafenib and regorafenib synergize with a class of drugs known as PI3K/AKT inhibitors to kill a variety of cancers.

Sorafenib and regorafenib work by blocking the production of enzymes called kinases, which are vital to the growth and survival of cancer cells. Sorafenib is currently approved by the FDA to treat kidney and liver cancers, and regorafenib is currently approved for the treatment of colorectal cancer. However, sorafenib and regorafenib do not directly affect PI3K and AKT kinases, which are also very active in promoting cancer cell survival.

The addition of a PI3K/AKT inhibitor to the combination of sorafenib and regorafenib dramatically increased cell death and was even effective against cells with certain mutations that make one or the other drug less effective.

"We know that there are certain cellular processes that are frequently dysregulated in cancers and important to cell proliferation and survival, but if you shut down one, then cells can often compensate by relying on another," says Dent, Universal Corporation Distinguished Professor for Cancer Cell Signaling and member of the Developmental Therapeutics research program at VCU Massey Cancer Center as well as vice chair of the Department of Neurosurgery at VCU School of Medicine.

"We are blocking several of these survival pathways, and the cancer cells are literally digesting themselves in an effort to stay alive."

Results of the study showed that the combination therapy killed the cells by physically interacting with molecules to block the survival pathways and induce a toxic effect known as autophagy. Autophagy is a protective process where cells metabolize themselves when starved of the resources needed to survive.

"Many groups are trying the approach of inhibiting two survival signaling pathways, but our approach takes this further by blocking significantly more of these pathways," says Dent. "Our findings could benefit many different cancer patients based on the broad range of effects seen in multiple cancer types."

Notes:

In addition to Poklepovic, Dent collaborated on this research with Steven Grant, M.D., Shirley Carter Olsson and Sture Gordon Olsson Chair in Oncology Research, associate director for translational research, co-leader of the Developmental Therapeutics research program and member of the Cancer Cell Signaling research program at VCU Massey; Laurence Booth, Ph.D., Instructor in the Department of Neurosurgery at VCU School of Medicine; Gangadharan B. Sajithlal, Hossein A. Hamed, Ph.D., and Nichola Cruickshanks, Ph.D., all postdoctoral researchers in the Department of Neurosurgery at VCU School of Medicine; and Jahangir Syed, M.D./Ph.D. student in the Department of Biology at VCU.

This research was supported by National Cancer Institute grants R01-CA141704 and R01-CA150214, National Institute of Diabetes and Digestive and Kidney Diseases grant R01-DK52825, Department of Defense grant W81XWH-10-1-0009 and, in part, by VCU Massey Cancer Center's NIH-NCI Cancer Center Support Grant P30 CA016059.

 

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