Q2 · MEDICINE
Article
Author: Anderson, Robert F. ; Balbo, Silvia ; Theys, Jan ; Thiolloy, Sophie ; van der Wiel, Alexander M.A. ; Bull, Matthew R. ; Solivio, Morwena J. ; Marcus, Damiënne ; Patterson, Adam V. ; Guise, Christopher P. ; Lin, Xiaojing ; Ashoorzadeh, Amir ; Heyerick, Arne ; Dubois, Ludwig J. ; Mowday, Alexandra M. ; Jackson-Patel, Victoria ; Fu, Zhe ; Niemans, Raymon ; Liu, Emily ; Hicks, Kevin O. ; Lieuwes, Natasja G. ; Biemans, Rianne ; Yaromina, Ala ; Smaill, Jeff B. ; Kumara, Sisira ; Deschoemaeker, Sofie ; Abbattista, Maria R. ; Lambin, Philippe ; Jochems, Arthur
AbstractHypoxia-activated prodrugs (HAP) are a promising class of antineoplastic agents that can selectively eliminate hypoxic tumor cells. This study evaluates the hypoxia-selectivity and antitumor activity of CP-506, a DNA alkylating HAP with favorable pharmacologic properties. Stoichiometry of reduction, one-electron affinity, and back-oxidation rate of CP-506 were characterized by fast-reaction radiolytic methods with observed parameters fulfilling requirements for oxygen-sensitive bioactivation. Net reduction, metabolism, and cytotoxicity of CP-506 were maximally inhibited at oxygen concentrations above 1 μmol/L (0.1% O2). CP-506 demonstrated cytotoxicity selectively in hypoxic 2D and 3D cell cultures with normoxic/anoxic IC50 ratios up to 203. Complete resistance to aerobic (two-electron) metabolism by aldo-keto reductase 1C3 was confirmed through gain-of-function studies while retention of hypoxic (one-electron) bioactivation by various diflavin oxidoreductases was also demonstrated. In vivo, the antitumor effects of CP-506 were selective for hypoxic tumor cells and causally related to tumor oxygenation. CP-506 effectively decreased the hypoxic fraction and inhibited growth of a wide range of hypoxic xenografts. A multivariate regression analysis revealed baseline tumor hypoxia and in vitro sensitivity to CP-506 were significantly correlated with treatment response. Our results demonstrate that CP-506 selectively targets hypoxic tumor cells and has broad antitumor activity. Our data indicate that tumor hypoxia and cellular sensitivity to CP-506 are strong determinants of the antitumor effects of CP-506.