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Dual targeting of EWS-FLI1 activity and the associated DNA damage response with trabectedin and SN38 synergistically inhibits Ewing sarcoma cell growth.
[werner syndrome]
The
goal
of
this
study
is
to
optimize
the
activity
of
trabectedin
for
Ewing
sarcoma
by
developing
a
molecularly
targeted
combination
therapy
.
We
have
recently
shown
that
trabectedin
interferes
with
the
activity
of
EWS-
FLI
1
in
Ewing
sarcoma
cells
.
In
this
report
,
we
build
on
this
work
to
develop
a
trabectedin-based
combination
therapy
with
improved
EWS-
FLI
1
suppression
that
also
targets
the
drug-associated
DNA
damage
to
Ewing
sarcoma
cells
.
We
demonstrate
by
siRNA
experiments
that
EWS-
FLI
1
drives
the
expression
of
the
Werner
syndrome
protein
(
WRN
)
in
Ewing
sarcoma
cells
.
Because
WRN
-
deficient
cells
are
known
to
be
hypersensitive
to
camptothecins
,
we
utilize
trabectedin
to
block
EWS-
FLI
1
activity
,
suppress
WRN
expression
,
and
selectively
sensitize
Ewing
sarcoma
cells
to
the
DNA-damaging
effects
of
SN
38
.
We
show
that
trabectedin
and
SN
38
are
synergistic
,
demonstrate
an
increase
in
DNA
double
-strand
breaks
,
an
accumulation
of
cells
in
S-
phase
and
a
low
picomolar
IC
50
.
In
addition
,
SN
38
cooperates
with
trabectedin
to
augment
the
suppression
of
EWS-
FLI
1
downstream
targets
,
leading
to
an
improved
therapeutic
index
in
vivo
.
These
effects
translate
into
the
marked
regression
of
two
Ewing
sarcoma
xenografts
at
a
fraction
of
the
dose
of
camptothecin
used
in
other
xenograft
studies
.
These
results
provide
the
basis
and
rationale
for
translating
this
drug
combination
to
the
clinic
.
In
addition
,
the
study
highlights
an
approach
that
utilizes
a
targeted
agent
to
interfere
with
an
oncogenic
transcription
factor
and
then
exploits
the
resulting
changes
in
gene
expression
to
develop
a
molecularly
targeted
combination
therapy
.
Diseases
Validation
Diseases presenting
"deficient cells"
symptom
child syndrome
esophageal adenocarcinoma
gm1 gangliosidosis
junctional epidermolysis bullosa
kindler syndrome
lymphangioleiomyomatosis
neonatal adrenoleukodystrophy
werner syndrome
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