Department of Systems Medicine and Bioengineering, Houston Methodist Research Institute and Cancer Center, Weill Cornell Medicine, Houston, TX 77030, USA.
Preclinical Neuro-Oncology Research Program, Baylor College of Medicine, Houston, TX 77030, USA.
Sci Transl Med. 2018 Oct 24;10(464). doi: 10.1126/scitranslmed.aat0150.
Medulloblastoma (MB) is the most common malignant brain tumor of childhood. Although outcomes have improved in recent decades, new treatments are still needed to improve survival and reduce treatment-related complications. The MB subtypes groups 3 and 4 represent a particular challenge due to their intragroup heterogeneity, which limits the options for "rational" targeted therapies. Here, we report a systems biology approach to drug repositioning that integrates a nonparametric, bootstrapping-based simulated annealing algorithm and a 3D drug functional network to characterize dysregulated driver signaling networks, thereby identifying potential drug candidates. From more than 1300 drug candidates studied, we identified five members of the cardiac glycoside family as potentially inhibiting the growth of groups 3 and 4 MB and subsequently confirmed this in vitro. Systemic in vivo treatment of orthotopic patient-derived xenograft (PDX) models of groups 3 and 4 MB with digoxin, a member of the cardiac glycoside family approved for the treatment of heart failure, prolonged animal survival at plasma concentrations known to be tolerated in humans. These results demonstrate the power of a systematic drug repositioning method in identifying a potential treatment for MB. Our strategy could potentially be used to accelerate the repositioning of treatments for other human cancers that lack clearly defined rational targets.
髓母细胞瘤(MB)是儿童中最常见的恶性脑肿瘤。尽管近几十年来治疗效果有所提高,但仍需要新的治疗方法来提高生存率并减少与治疗相关的并发症。MB 亚型 3 和 4 组由于其组内异质性,代表了一个特别的挑战,这限制了“合理”靶向治疗的选择。在这里,我们报告了一种药物重定位的系统生物学方法,该方法集成了一种非参数、基于引导的模拟退火算法和一个 3D 药物功能网络,以表征失调的驱动信号网络,从而确定潜在的药物候选物。在研究的 1300 多种候选药物中,我们发现了心脏糖苷家族的五个成员可能抑制 3 组和 4 组 MB 的生长,并随后在体外证实了这一点。地高辛是一种心脏糖苷类药物,已被批准用于治疗心力衰竭,用其对 3 组和 4 组 MB 的原位患者来源异种移植(PDX)模型进行全身体内治疗,延长了动物的存活时间,其血浆浓度在已知可耐受的人类范围内。这些结果证明了系统药物重定位方法在确定 MB 潜在治疗方法方面的强大功能。我们的策略有可能被用于加速缺乏明确合理靶点的其他人类癌症的治疗方法的重新定位。