Significant Differences in the Development of Acquired Resistance to the MDM2 Inhibitor SAR405838 between In Vitro and In Vivo Drug Treatment.

SAR405838 is a potent and specific MDM2 inhibitor currently being evaluated in Phase I clinical trials for the treatment of human cancer. Using the SJSA-1 osteosarcoma cell line which harbors an amplified MDM2 gene and wild-type p53, we have investigated the acquired resistance mechanisms both in vitro and in vivo to SAR405838. Treatment of SJSA-1 cells with SAR405838 in vitro leads to dose-dependent cell growth inhibition, cell cycle arrest and robust apoptosis. However, prolonged treatment of SJSA-1 cells in vitro with SAR405838 results in profound acquired resistance to the drug. Analysis of in vitro-derived resistant cell lines showed that p53 is mutated in the DNA binding domain and can no longer be activated by SAR405838. Treatment of the parental SJSA-1 xenograft tumors with SAR405838 in mice yields rapid tumor regression but the tumors eventually regrow. Culturing the regrown tumors established a number of sublines, which showed only modest (3-5 times) loss of sensitivity to SAR405838 in vitro. Sequencing of the p53 showed that it retains its wild-type status in these in vivo sublines, with the exception of one subline, which harbors a single heterozygous C176F p53 mutation. Using xenograft models of two in vivo derived sublines, which has either wild-type p53 or p53 containing a single heterozygous C176F mutation, we showed that while SAR405838 effectively achieves partial tumor regression in these models, it no longer induces complete tumor regression and tumors resume growth once the treatment is stopped. Harvesting and culturing tumors obtained from a prolonged treatment with SAR405838 in mice established additional in vivo sublines, which all contain a single heterozygous C176F mutation with no additional p53 mutation detected. Interestingly, SAR405838 can still effectively activate p53 in all sublines containing a single heterozygous C176F mutation, with a moderately reduced potency as compared to that in the parental cell line. Consistently, SAR405838 is 3-5 times less effective in all the in vivo derived sublines containing a single heterozygous C176F p53 mutation than in the SJSA-1 parental cell line in assays of cell growth and apoptosis. Computational modeling suggested that a p53 tetramer containing two wild-type p53 molecules and two C176F mutated molecules can maintain the structural stability and interactions with DNA by formation of additional hydrophobic and cation-π interactions which compensate for the loss of sulphur-zinc coordination. Our data thus show that SJSA-1 tumor cells acquire very different levels of resistance in vitro and in vivo to the MDM2 inhibitor SAR405838. Our present study may have a significant implication for the investigation of resistant mechanisms for other classes of anticancer drugs.

Elucidation of Acquired Resistance to Bcl-2 and MDM2 Inhibitors in Acute Leukemia In Vitro and In Vivo.

PURPOSE: Two clinical-stage anticancer drugs, the Bcl-2 inhibitor ABT-263, and the MDM2 inhibitor SAR405838 achieve complete tumor regression in animal models of leukemia but also induce acquired resistance. Elucidation of acquired resistance mechanisms and development of strategies to overcome the resistance are critical for their successful clinical development. EXPERIMENTAL DESIGN: We employed RS4;11 and MV4;11 cell lines, two acute leukemia models, to investigate acquired resistance mechanisms for both drugs in vitro and in vivo and evaluated several treatment regimens in xenograft mouse models to improve long-term, complete tumor regression. RESULTS: Resistance to either SAR405838 or ABT-263 (or its analogue ABT-737) develops in acute leukemia models in vitro and in vivo. RS4;11 and MV4;11 tumors treated with SAR405838 acquire resistance to the drug by mutation of the TP53 gene or compromise of p53 protein function. RS4;11 tumors treated with either ABT-263 or ABT-737 acquire resistance primarily through downregulation of BAX but not BAK. When acute leukemia cells become highly resistant to the MDM2 inhibitor, they retain their sensitivity to the Bcl-2 inhibitors, or vice versa. Certain sequential or combination treatment of SAR405838 and ABT-263 can achieve longer-term tumor regression than treatment with either agent alone. CONCLUSIONS: Our study provides new insights into the mechanisms of acquired resistance of Bcl-2 and MDM2 inhibitors in acute leukemia models and suggests that certain sequential or combination treatment of these two distinct classes of apoptosis-inducing agents should be tested as new treatment strategies for acute leukemia in the clinic.

Formation of a triply bridged mu-oxo diiron(III) core stabilized by two deprotonated carboxamide groups upon photorelease of NO from a [Fe-NO]6 iron nitrosyl.

The iron nitrosyl [(PaPy2Q)Fe(NO)](ClO4)2 (2), derived from the quinoline-based ligand PaPy2QH (N,N-bis(2-pyridylmethyl)amine-N-ethyl-2-quinoline-2-carboxamide, where H is dissociable proton) has been characterized by spectroscopy and X-ray diffraction techniques. The 1H NMR spectrum (S = 0 ground state) and v(NO) value of 1885 cm(-1) indicate that 2 is a [Fe-NO]6 nitrosyl. Although 2 is stable in the dark, exposure of an acetonitrile solution of 2 (lambdamax = 510 nm) to light in the visible range causes rapid release of NO and formation of the solvato species [(PaPy2Q)Fe(MeCN)](ClO4)2 (6). Quantum yield (Phi) measurements indicate that 2 is a more efficient NO donor (Phi = 0.258) than [(PaPy3)Fe(NO)](ClO4)2 (1, Phi = 0.185), a complex derived from a similar but pyridine-based ligand. Interestingly, when the photoproduct 6 is exposed to water or a small amount of base, the triply bridged diiron(III) species [(PaPy2Q)FeOFe(PaPy2Q)](ClO4)2 (3) forms in good yield. This species can be independently synthesized from aerobic oxidation of the Fe(II) species [(PaPy2Q)Fe(MeCN)](ClO4) in acetonitrile. The structure of 3 reveals a unique Fe(III)-O-Fe(III) link supported by two (eta2,mu2)mu-NCO bridges derived from the carboxamido groups of the two (PaPy2Q)Fe(III) moieties.