From the Department of Pathology, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
Division of Pediatric Oncology, Johns Hopkins University, School of Medicine, Baltimore, Maryland, USA.
J Neuropathol Exp Neurol. 2021 Mar 22;80(4):336-344. doi: 10.1093/jnen/nlab018.
Medulloblastoma is the most common malignant pediatric brain tumor. Amplification of c-MYC is a hallmark of a subset of poor-prognosis medulloblastoma. MYC upregulates glutamine metabolism across many types of cancer. We modified the naturally occurring glutamine antagonist 6-diazo-5-oxo-l-norleucine (DON) by adding 2 promoeities to increase its lipophilicity and brain penetration creating the prodrug isopropyl 6-diazo-5-oxo-2-(((phenyl (pivaloyloxy) methoxy) - carbonyl) amino) hexanoate, termed JHU395. This prodrug was shown to have a 10-fold improved CSF-to-plasma ratio and brain-to-plasma ratio relative to DON. We hypothesized that JHU395 would have superior cell penetration compared with DON and would effectively and more potently kill MYC-expressing medulloblastoma. JHU395 treatment caused decreased growth and increased apoptosis in multiple human high-MYC medulloblastoma cell lines at lower concentrations than DON. Parenteral administration of JHU395 in Nu/Nu mice led to the accumulation of micromolar concentrations of DON in brain. Treatment of mice bearing orthotopic xenografts of human MYC-amplified medulloblastoma with JHU395 increased median survival from 26 to 45 days compared with vehicle control mice (p < 0.001 by log-rank test). These data provide preclinical justification for the ongoing development and testing of brain-targeted DON prodrugs for use in medulloblastoma.
髓母细胞瘤是最常见的儿童脑恶性肿瘤。c-MYC 扩增是预后不良髓母细胞瘤亚群的标志。MYC 上调多种癌症的谷氨酰胺代谢。我们通过添加 2 个促进剂来修饰天然存在的谷氨酰胺拮抗剂 6-叠氮-5-氧代-l-正亮氨酸 (DON),以增加其亲脂性和脑穿透性,从而产生前药异丙基 6-叠氮-5-氧代-2-(((苯 ( 特戊酰氧基) 甲氧基) - 羰基) 氨基) 己酸酯,称为 JHU395。与 DON 相比,该前药显示出 CSF 与血浆比和脑与血浆比提高了 10 倍。我们假设 JHU395 与 DON 相比具有更好的细胞穿透性,并能有效且更有效地杀死表达 MYC 的髓母细胞瘤。与 DON 相比,JHU395 处理在更低的浓度下导致多种高 MYC 髓母细胞瘤细胞系的生长减少和凋亡增加。在 Nu/Nu 小鼠中,JHU395 的静脉内给药导致 DON 在脑中积累到微摩尔浓度。与载体对照小鼠相比,用 JHU395 治疗携带人 MYC 扩增髓母细胞瘤的原位异种移植小鼠可将中位生存期从 26 天延长至 45 天(对数秩检验,p<0.001)。这些数据为正在进行的脑靶向 DON 前药的开发和测试提供了临床前依据,以用于髓母细胞瘤的治疗。