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Quisinostat is a brain-penetrant radiosensitizer in glioblastoma
Costanza Lo Cascio, Tigran Margaryan, Ernesto Luna-Melendez, James B. McNamara, Connor I. White, William Knight, Saisrinidhi Ganta, Zorana Opachich, Claudia Cantoni, Wonsuk Yoo, Nader Sanai, Artak Tovmasyan, Shwetal Mehta
Costanza Lo Cascio, Tigran Margaryan, Ernesto Luna-Melendez, James B. McNamara, Connor I. White, William Knight, Saisrinidhi Ganta, Zorana Opachich, Claudia Cantoni, Wonsuk Yoo, Nader Sanai, Artak Tovmasyan, Shwetal Mehta
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Research Article Oncology Therapeutics

Quisinostat is a brain-penetrant radiosensitizer in glioblastoma

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Abstract

Histone deacetylase (HDAC) inhibitors have garnered considerable interest for the treatment of adult and pediatric malignant brain tumors. However, owing to their broad-spectrum nature and inability to effectively penetrate the blood-brain barrier, HDAC inhibitors have failed to provide substantial clinical benefit to patients with glioblastoma (GBM) to date. Moreover, global inhibition of HDACs results in widespread toxicity, highlighting the need for selective isoform targeting. Although no isoform-specific HDAC inhibitors are currently available, the second-generation hydroxamic acid–based HDAC inhibitor quisinostat possesses subnanomolar specificity for class I HDAC isoforms, particularly HDAC1 and HDAC2. It has been shown that HDAC1 is the essential HDAC in GBM. This study analyzed the neuropharmacokinetic, pharmacodynamic, and radiation-sensitizing properties of quisinostat in preclinical models of GBM. It was found that quisinostat is a well-tolerated and brain-penetrant molecule that extended survival when administered in combination with radiation in vivo. The pharmacokinetic-pharmacodynamic-efficacy relationship was established by correlating free drug concentrations and evidence of target modulation in the brain with survival benefit. Together, these data provide a strong rationale for clinical development of quisinostat as a radiosensitizer for the treatment of GBM.

Authors

Costanza Lo Cascio, Tigran Margaryan, Ernesto Luna-Melendez, James B. McNamara, Connor I. White, William Knight, Saisrinidhi Ganta, Zorana Opachich, Claudia Cantoni, Wonsuk Yoo, Nader Sanai, Artak Tovmasyan, Shwetal Mehta

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Figure 5

QST is effective in slowing tumor growth in a flank model of human GBM.

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QST is effective in slowing tumor growth in a flank model of human GBM.
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(A) Schematic illustrating the experimental design. Athymic nude mice were treated with a single dose of QST (10 mg/kg) through IP injection, SC injection, or OG. Blood samples were collected at 0.5, 1, 2, 4, 6, 8, and 24 hours after dosing and analyzed by LC-MS/MS. (B) Total plasma concentration–time curve for QST administered through various routes. Values for AUClast were calculated for each route to illustrate plasma QST exposure (bottom). Error bars indicate SEM. (C) Schematic illustrating the treatment regimen for mice with flank tumors. When the tumors reached a mean volume of 100 mm3, mice were randomized into 4 groups: vehicle, 10 mg/kg QST, IR alone (6 Gy), or combination treatment (6 Gy IR and 10 mg/kg QST) (n = 10 mice in each cohort). IR was given in fractionated doses (2 Gy MWF) only during the first week of treatment, with or without QST. Following completion of IR, mice in the monotherapy and combination cohorts continued to receive QST alone on MWF until the tumors reached the indicated volume threshold. (D) Weekly mean volume measurements of U87 flank tumors from mice treated with vehicle, QST, IR, or a combination of QST and IR (QST+IR) (n = 10 mice in each cohort). Error bars indicate SEM. (E) Mean weights of mice from each cohort throughout the study duration. Error bars indicate SEM. (F) Total levels of QST in plasma and flank tumors of mice treated with QST and QST+IR (n = 3 or 4 mice per cohort). Error bars indicate SEM. (G) Immunoblotting of protein lysate–derived homogenized flank tumors from each cohort (n = 3 mice per group). Membranes were probed for H3K9/14ac, H3K27ac, γ-H2AX, and β-actin. Differences were assessed using ordinary 1-way ANOVA with Dunnett’s multiple-comparison test.

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