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The Capital Region of Denmark - a part of Copenhagen University Hospital
E-pub ahead of print

MTH1 inhibitor TH1579 induces oxidative DNA damage and mitotic arrest in acute myeloid leukemia

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  • Kumar Sanjiv
  • José Manuel Calderón-Montaño
  • Therese M Pham
  • Tom Erkers
  • Viktoriia Tsuber
  • Ingrid Almlöf
  • Andreas Höglund
  • Yaser Heshmati
  • Brinton Seashore-Ludlow
  • Akhilesh Nagesh Danda
  • Helge Gad
  • Elisee Wiita
  • Camilla Göktürk
  • Azita Rasti
  • Stefanie Friedrich
  • Anders Centio
  • Montserrat Estruch
  • Thea Kristin Våtsveen
  • Nona Struyf
  • Torkild Visnes
  • Martin Scobie
  • Tobias Koolmeister
  • Martin Henriksson
  • Olov Wallner
  • Teresa Sandvall
  • Sören Lehmann
  • Kim Theilgaard-Mönch
  • Mathew J Garnett
  • Päivi Östling
  • Julian Walfridsson
  • Thomas Helleday
  • Ulrika Warpman Berglund
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Acute myeloid leukemia (AML) is an aggressive hematological malignancy, exhibiting high levels of reactive oxygen species (ROS). ROS levels have been suggested to drive leukemogenesis and is thus a potential novel target for treating AML. MTH1 prevents incorporation of oxidized nucleotides into the DNA to maintain genome integrity and is upregulated in many cancers. Here we demonstrate that hematological cancers are highly sensitive to MTH1 inhibitor TH1579 (karonudib). A functional precision medicine ex vivo screen in primary AML bone marrow samples demonstrated a broad response profile of TH1579, independent of the genomic alteration of AML, resembling the response profile of the standard-of-care treatments cytarabine and doxorubicin. Furthermore, TH1579 killed primary human AML blast cells (CD45+) as well as chemotherapy resistance leukemic stem cells (CD45+Lin-CD34+CD38-),which are often responsible for AML progression. TH1579 killed AML cells by causing mitotic arrest, elevating intracellular ROS levels, and enhancing oxidative DNA damage. TH1579 showed a significant therapeutic window, was well tolerated in animals, and could be combined with standard-of-care treatments to further improve efficacy. TH1579 significantly improved survival in two different AML disease models in vivo. In conclusion, the pre-clinical data presented here support that TH1579 is a promising novel anticancer agent for AML, providing a rational to investigate the clinical usefulness of TH1579 in AML in an on-going clinical phase 1 trial.

Original languageEnglish
JournalCancer Research
ISSN0008-5472
DOIs
Publication statusE-pub ahead of print - 30 Sep 2021

ID: 68208182