Abstract 1851: Selective targeting of aberrant ETS transcription factors using uniquely modified mithramycin analogs
Authors: Leggas Markos , Dudhate Ambika , Rohr Jurgen 
Published: June 2022

Abstract
Background: Recent studies demonstrated that the aberrant oncogenic activity of ETS transcription factor fusions such as EWS-FLI1 and EWS-ERG in Ewing sarcoma can be targeted with the natural product mithramycin (MTM), which is known to have poor pharmacology. We hypothesized that the pharmacological properties of MTM can be ameliorated by rational semisynthetic modifications that improve its pharmacokinetic (PK) liabilities and expand its efficacy toxicity window. Further, we reasoned that the MTM core of each analog can facilitate DNA docking while the substitutions may interact uniquely with oncogenic ETS transcriptional complexes in different cancers. Here we present the pharmacologic properties of two analogs and their unique transcriptome profiles in TC32 Ewing sarcoma and VCaP prostate cancer cells, both of which depend on the aberrant oncogenic activity of an ETS gene fusion.
Methods: MTM analogs were generated by semisynthetic conjugation to the 3-side chain of MTM. Cytotoxicity (GI50) was assessed using the resazurin assay following 72 hr incubation with test compounds (0.3nM-10uM). PK properties were assessed in athymic nu/nu mice after a bolus tail-vein injection and concentrations were assessed in plasma using LC/MS/MS methods. The maximum tolerated dose (MTD) was estimated based on weight loss and blood hematology. In vivo efficacy was assessed in subcutaneous xenografts established, which were dosed SIDx5 at the respective MTD or fractions of the MTD. Transcriptomic profiles were assessed in cells exposed to their respective 72 hr GI50 for 24 hr and in livers of mice that were dosed SIDx5.
Results: Here we demonstrate that select modifications displayed unique cytotoxicity and efficacy Ewing sarcoma (EWS-FLI1) and VCaP prostate (TMPRSS2-ERG) cancer cell lines. Analogues with bulky amino acid substitutions in the 3-side chain of MTM had significantly improved PK in mice, as compared to MTM. Select analogs displayed selective efficacy in xenograft models of Ewing sarcoma at doses ranging as low as 1/3 of the MTD. Significantly, analogues of MTM displayed significantly different transcriptomic profiles in each cell line, which suggests that these molecules have unique properties despite sharing a core DNA-binding structure with MTM.
Conclusions: MTM analogues with bulky hydrophobic amino acid substitutions on the 3-side chain showed the greatest improvement in PK properties and efficacy. Presumably PK are affected due to increased protein binding and an increase in the pKa, which leads to a lower ionized fraction and decreased uptake in the liver by organic anion transporters. This increase in plasma exposure may lead to increased drug partition in the tumor, as compared to MTM, and, therefore, improved efficacy. Transcriptomic data suggest that the analogs have unique transcriptional effects and therefore unlikely to manifest the same toxicity profile as MTM.
Citation Format: Markos Leggas, Ambika Dudhate, Jurgen Rohr. Selective targeting of aberrant ETS transcription factors using uniquely modified mithramycin analogs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 1851.