A Drug Repurposing Screen Identifies Fludarabine Phosphate as a Potential Therapeutic Agent for N-MYC Overexpressing Neuroendocrine Prostate Cancers.
Hussain ElhasasnaRaymond KhanKalpana K BhanumathyFrederick S VizeacoumarPrachi WalkeMaricris BautistaDinesh K DahiyaVincent MarandaHardikkumar PatelAmrutha BalagopalNezeka AlliAnand KrishnanAndrew FreywaldFranco J VizeacoumarPublished in: Cells (2022)
Neuroendocrine prostate cancer (NEPC) represents a highly aggressive form of prostate tumors. NEPC results from trans-differentiated castration-resistant prostate cancer (CRPC) with increasing evidence indicating that the incidence of NEPC often results from the adaptive response to androgen deprivation therapy. Recent studies have shown that a subset of NEPC exhibits overexpression of the MYCN oncogene along with the loss of tumor suppressing TP53 and RB1 activities. N-MYC is structurally disordered with no binding pockets available on its surface and so far, no clinically approved drug is available. We adopted a drug-repurposing strategy, screened ~1800 drug molecules, and identified fludarabine phosphate to preferentially inhibit the proliferation of N-MYC overexpressing NEPC cells by inducing reactive oxygen species (ROS). We also show that fludarabine phosphate affects N-MYC protein levels and N-MYC transcriptional targets in NEPC cells. Moreover, enhanced ROS production destabilizes N-MYC protein by inhibiting AKT signaling and is responsible for the reduced survival of NEPC cells and tumors. Our results indicate that increasing ROS production by the administration of fludarabine phosphate may represent an effective treatment option for patients with N-MYC overexpressing NEPC tumors.
Keyphrases
- prostate cancer
- transcription factor
- induced apoptosis
- reactive oxygen species
- signaling pathway
- cell cycle arrest
- cell death
- dna damage
- gene expression
- endoplasmic reticulum stress
- radical prostatectomy
- cell proliferation
- drug induced
- risk factors
- oxidative stress
- mesenchymal stem cells
- small molecule
- bone marrow
- amino acid
- heat shock
- replacement therapy