Watanabe Tatsuro, Kidoguchi Keisuke, Kimura Shinya
Department of Drug Discovery and Biomedical Sciences, Faculty of Medicine, Saga University, Saga, Japan.
Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan.
Cancer Sci. 2025 Apr;116(4):853-861. doi: 10.1111/cas.16452. Epub 2025 Jan 21.
DNA methylation is an enzyme-driven epigenetic modification that must be precisely regulated to maintain cellular homeostasis. Aberrant methylation status, especially hypermethylation of the promoter sites of tumor-suppressor genes, is observed in human malignancies and is a proven target for cancer therapy. The first-generation DNA demethylating agents, azacitidine and decitabine, are widely used for treating several hematological malignancies. In addition, orally bioavailable prodrugs of azacitidine and decitabine have recently been approved by the FDA. We have developed a silylated derivative of decitabine, OR-2100, which is resistant to degradation by cytidine deaminase and orally bioavailable. It has efficacy against several human hematological malignancies in xenograft mouse models with less hematotoxicity than decitabine. Since DNA demethylating agents are combined with molecularly targeted drugs in clinical use and trials, we think that the less hematotoxic profile of OR-2100 makes it suitable for use as a combination therapy. In this article, we review the therapeutic approach in hematological malignancies with the DNA demethylating agent OR-2100.
DNA甲基化是一种由酶驱动的表观遗传修饰,必须进行精确调控以维持细胞内稳态。在人类恶性肿瘤中观察到异常的甲基化状态,尤其是肿瘤抑制基因启动子位点的高甲基化,这已被证实是癌症治疗的一个靶点。第一代DNA去甲基化剂阿扎胞苷和地西他滨被广泛用于治疗多种血液系统恶性肿瘤。此外,阿扎胞苷和地西他滨的口服生物利用型前药最近已获美国食品药品监督管理局批准。我们研发了一种地西他滨的硅烷化衍生物OR-2100,它对胞苷脱氨酶的降解具有抗性且口服具有生物利用性。在异种移植小鼠模型中,它对多种人类血液系统恶性肿瘤有效,且血液毒性比地西他滨小。由于DNA去甲基化剂在临床应用和试验中与分子靶向药物联合使用,我们认为OR-2100较低的血液毒性使其适合用作联合治疗药物。在本文中,我们综述了使用DNA去甲基化剂OR-2100治疗血液系统恶性肿瘤的方法。
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