Prostate Cancer Drug Research Articles

Falls and fractures in men with prostate cancer taking second-generation androgen receptor antagonists: A retrospective chart review.

Second-generation androgen receptor antagonists, including enzalutamide, apalutamide, and darolutamide, are commonly used to treat metastatic and non-metastatic prostate cancer. Although these medications are typically well-tolerated, falls were reported in 4.2-15.6% of patients and fractures in 4.2-11.7% of patients enrolled in the phase III clinical trials evaluating these drugs in prostate cancer. However, post-marketing studies have reported a lower incidence than reported in clinical trials. The objective of this study is to determine the prevalence of falls and fractures in patients with prostate cancer receiving second-generation androgen receptor antagonists at UConn Health and identify potential risk factors associated with falls and fractures in these patients. A retrospective chart review involving patients with prostate cancer treated with darolutamide, enzalutamide, or apalutamide from March 1, 2022, to March 31, 2023, at UConn Health Carole & Ray Neag Comprehensive Cancer Center. Data recorded includes basic demographics, history of fall or fracture, presence of metastases, fall risk, history of osteoporosis, prescribed second-generation androgen receptor antagonist, and other comorbidities. Data was evaluated using descriptive statistics. Twenty-six men were included, all of whom were receiving enzalutamide. At baseline, 96.1% of patients had bone metastases, 15.4% had osteoporosis, 15.4% had osteopenia, and 34.6% had neuropathy. The incidence of falls was 19.2% and the incidence of fractures was 26.9%. The mean length of therapy at time of a fall was 19.44 months (range, 6-31 months). The mean length of therapy at time of a fracture was 19 months (range, 1-33 months). In patients experiencing fall, 100% had arthralgia, 60% had neuropathy, 40% had a gait problem, 40% had hypertension, and 80% of them were at risk of fall. In patients experiencing fracture, 28.6% had osteoporosis, 42.9% had osteopenia, 100% had bone metastases, and 57.1% were on denosumab at time of fracture. The prevalence of falls and fractures in patients receiving enzalutamide were higher in this retrospective chart review than reported in clinical trials and post-marketing studies. This could be due to the small patient population or the patient's comorbidities such as osteoporosis, bone metastases, or neuropathy. Fall/fracture risk with enzalutamide and other risk factors for fall and fracture should be considered when discussing treatment and developing a monitoring plan.

Environmental impacts of drug products: The effect of the selection of production sites in the supply chain

The environmental impact of drug products is largely determined by activities beyond the direct control of pharmaceutical companies, such as outsourced production of pharmaceutical building blocks. Therefore, this study evaluates the environmental impacts of a prostate cancer drug packaged in one blister (declared unit), thereby analysing the whole value chain to gain insight into 1) the main contributors to the impact of drug product production and 2) the effect of the geographical location of production of solvents and pharmaceuticals. The carbon and resource footprints of the entire life cycle of the drug product are determined, using the IPCC GWP 100 and the Cumulative Exergy Extraction from the Natural Environment methods, respectively. Unlike many other studies, the impacts of building blocks, called intermediate pharmaceutical ingredients (IPIs), are modelled based on primary data, literature and similar processes. The carbon footprint per declared unit equals 34 kg CO2-eq, of which IPIs and active pharmaceutical ingredient (API) production account for 96 %. The resource footprint is 647 MJex/declared unit, with IPI and API production accounting for 93 %. The main impact contributors of these processes are solvents and electricity consumption. Four alternative scenarios for IPI and API production are developed to evaluate the geographical influence of different production locations of solvents and pharmaceuticals between Europe and China. European production of solvents and pharmaceuticals appears to have the lowest carbon and resource footprint. In contrast, Chinese production of solvents and pharmaceuticals increases the carbon footprint by 49 %, while the resource footprint increases by only 4 %, although the natural resource consumption shifts from abiotic renewable resources and nuclear energy to fossil fuels. The high contribution of IPI production and the influence of geography of the supply chain highlight the need for accurate data from external suppliers to fairly estimate the environmental footprint of drug products.

Modelling the tumor microenvironment in vitro in prostate cancer: current and future perspectives

AbstractProstate cancer is the most common cancer in over 50% of countries and the third most common malignancy worldwide. The tumor microenvironment includes the non‐cancerous cells and components present in the tumor, including the molecules they produce and release. Prostate cancer proliferation, angiogenesis, metastasis, and drug resistance are closely associated with the tumor microenvironment. With the continuous development of in vitro tumor models, they have gradually become important tools for recapitulating in vivo parental tumors and studying the reciprocal interactions between tumors and their microenvironment. In this perspective, we describe the significant in vitro models of prostate cancer, analyze the research results on incorporating the tumor microenvironment into these models, and compare their advantages and disadvantages. Furthermore, we highlight the future developmental direction of in vitro prostate cancer model research according to the hotspots of in vitro model research in other cancer types to facilitate precision medicine in prostate cancer.

Design, Synthesis, and Anti-Prostate Cancer Potential of 2-(4-Nitrobenzyl) Malonates In Vitro and DAL Acute Oral Toxicity Assessment In Vivo.

New 4-nitrobenzyl derivatives were designed and synthesised by nucleophilic substitution reactions of 4-nitrobenzyl bromide with malonic acid and its derivatives. The synthesised molecules were characterised using mass analysis and spectroscopic techniques and tested for their antioxidant properties using various methods, such as nitric oxide, DPPH, and hydrogen peroxide radical scavenging methods. The anti-inflammatory activities of the molecules were assessed using RBC membrane stabilisation and albumin denaturation methods. We evaluated the compounds' potential anti-prostate cancer activity using the DU145 cell line. The MTT assay determined the cell viability, indicating good anti-proliferative activity. The molecule 3 c exhibited the highest potency, with a CTC50 of 11.83 μg/mL. Molecular dynamics simulations were performed to study the stability of the ligand within the protein after docking and the resulting protein-ligand complex. The in vivo analysis of molecule 3 c in the DAL xenograft model demonstrated promising results. The increase in life span, reduction in tumor volume, and comparable effects to standard drugs are encouraging features that suggest that molecule 3 c may possess significant potential as an anti-cancer agent. The research also implies that these molecules might be potential lead compounds for developing new prostate cancer drugs.

Терапевтически индуцированная нейроэндокринная дифференцировка рака предстательной железы.

Introduction. The use of selective highly effective antiandrogen drugs in castration-resistant prostate cancer (CRPC) gradually leads to cellular transformation. Objective. To study current concepts of the prevalence of neuroendocrine differentiation (NED) in patients with CRPC, as well as the treatment of this aggressive variant of PCa. Materials and methods. The results of a search in the scientific databases PubMed, in the scientific electronic library eLibrary.ru were analyzed for the following queries - keywords: treatment-induced neuroendocrine prostate cancer, treatment-emergent neuroendocrine prostate cancer, androgen receptor resistance PCa therapy, neuroendocrine prostate cancer treatment. More than 100 scientific papers published in the last 10 years were found, of which 38 were selected for this review based on the objective of the review. Results. In a number of publications, the linear plasticity of prostate adenocarcinoma (PG) in NE tumor was designated as therapy-induced prostate carcinoma (t-NEPCs). The number of observations of NED PCa is growing, including due to the widespread use of powerful aromatase inhibitors. According to a number of studies, NED PCa is observed in 10-20% of patients with metastatic CRPCa, detected after androgen deprivation therapy and therapy with newgeneration antiandrogens, and the condition is characterized by a highly aggressive course and is accompanied by low survival rates. Conclusion. The high prevalence of NED in patients with CRPC, as well as the lack of effective treatment methods, indicate the need to concentrate efforts on studying this clinically relevant, but insufficiently studied condition. The search for new treatment options for NED PCa based on a patho- genetic complex approach is promising and in demand.

Propofol attenuates prostate cancer progression by upregulating TRHDE-AS1 expression, and METTL14 could mediate its m6A modification.

Propofol has become a microtubule-stabilizing drug for prostate cancer (PC) therapy, but propofol resistance impairs the therapeutic effect. This study aimed to explore the regulatory mechanism of propofol in the pathogenesis of PC through mechanisms involving N6-methyladenosine (m6A) modification. The changes in PC cell malignancy were evaluated by means of transwell, cell counting kit 8 (CCK-8), western blotting and tumour xenograft model assays. Long noncoding RNA TRHDE-AS1 and m6A methyltransferase METTL14 expression levels were determined via reverse transcription quantitative polymerase chain reaction (RT-qPCR). The m6A modification of TRHDE-AS1 which was mediated by METTL14 was confirmed by conducting methylated RNA immunoprecipitation (MeRIP) assay. We observed that propofol (200 μM) inhibited PC cell malignancy in vivo and in vitro, elucidating that it impaired cell proliferation, migration and tumour growth but induced apoptosis. TRHDE-AS1 expression was observed to be lower in PC cells and tissues, and propofol induced TRHDE-AS1 upregulation in PC cells. Propofol was capable of reversing the tumour-promoting effect of TRHDE-AS1 knockdown in PC cells. Additionally, METTL14 was upstream of TRHDE-AS1 to induce m6A modification of TRHDE-AS1 in PC cells. Collectively, our results show that propofol prevents PC progression by upregulating TRHDE-AS1 expression and METTL14 is involved in the m6A modification of TRHDE-AS1. These findings suggest that TRHDE-AS1 may be a potential therapeutic target for the improvement of propofol's therapeutic effect.

Synergistic combination effect of the PCA-1/ALKBH3 inhibitor HUHS015 on prostate cancer drugs in vitro and in vivo.

Prostate cancer antigen-1/ALKBH3, a DNA/RNA demethylase of 3-methylcytosine, 1-methyladenine (1-meA), and 6-meA, was found in prostate cancer as an important prognostic factor. Additionally, 1-meA has been associated with other cancers. The ALKBH3 inhibitor HUHS015 was found to be effective against prostate cancer both in vitro and in vivo. Herein, we investigated the effect of HUHS015 in combination with drugs for prostate cancer approved in Japan (including bicalutamide, cisplatin, mitoxantrone, prednisolone, ifosfamide, tegafur/uracil, docetaxel, dacarbazine, and estramustine) by treating DU145 cells with around IC50 value concentrations of these drugs for 3 days. Additionally, the cells were observed for additional 9 days after drug removal. Combination treatment with dacarbazine, estramustine, tegafur/uracil, and HUHS015 showed a slight additive effect after 3 days. After drug washout of them and mitoxantrone, the combined effects and levels were enhanced and sustained, although the effects of each treatment alone declined. HUHS015 combined with cisplatin or docetaxel elicited synergistic and sustained effects. In vivo, combining HUHS015 and docetaxel, the first chemotherapeutic agent for castration-resistant prostate cancer, showed notable effects in the DU145 xenograft model. In conclusion, HUHS015 exhibited a synergistic effect with docetaxel and drugs acting on DNA in vitro, even after drug removal. Since cancer chemotherapy is typically administered during rest periods due to its high toxicity, combining it with an ALKBH3 inhibitor could be a promising strategy for enhancing cancer treatment, as it can elicit an additive effect during treatment, allowing dosage reduction, and synergistically sustain the effect after drug washout during rest periods.

Research Progress on the Bone Metastasis Mechanism of Prostate Cancer and Bone-Targeted Drugs

Research Progress on the Bone Metastasis Mechanism of Prostate Cancer and Bone-Targeted Drugs

An Inherited Allele Confers Prostate Cancer Progression and Drug Resistance via RFX6/HOXA10-Orchestrated TGFβ Signaling.

Genetic and epigenetic alterations are cancer hallmark characteristics. However, the role of inherited cancer predisposition alleles in co-opting lineage factor epigenetic reprogramming and tumor progression remains elusive. Here the FinnGen cohort phenome-wide analysis, along with multiple genome-wide association studies, has consistently identified the rs339331-RFX6/6q22 locus associated with prostate cancer (PCa) risk across diverse populations. It is uncovered that rs339331 resides in a reprogrammed androgen receptor (AR) binding site in PCa tumors, with the T risk allele enhancing AR chromatin occupancy. RFX6, an AR-regulated gene linked to rs339331, exhibits synergistic prognostic value for PCa recurrence and metastasis. This comprehensive in vitro and in vivo studies demonstrate the oncogenic functions of RFX6 in promoting PCa cell proliferation and metastasis. Mechanistically, RFX6 upregulates HOXA10 that profoundly correlates with adverse PCa outcomes and is pivotal in RFX6-mediated PCa progression, facilitating the epithelial-mesenchymal transition (EMT) and modulating the TGFβ/SMAD signaling axis. Clinically, HOXA10 elevation is associated with increased EMT scores, tumor advancement and PCa recurrence. Remarkably, reducing RFX6 expression restores enzalutamide sensitivity in resistant PCa cells and tumors. This findings reveal a complex interplay of genetic and epigenetic mechanisms in PCa pathogenesis and drug resistance, centered around disrupted prostate lineage AR signaling and abnormal RFX6 expression.

Real-life Data on First- and Second-Line Treatment of Metastatic Castration-Resistant Prostate Cancer With Abiraterone, Enzalutamide and Cabazitaxel – A multicentric Study From Portugal

Introduction and objectivesNew drugs for metastatic castrate resistant prostate cancer (mCRPC) were approved, first in the pos-docetaxel and then in the pre-docetaxel setting. We aim to assess the real daily practice benefit of abiraterone (Abi), enzalutamide (Enz) and cabazitaxel (Cab) in patients with mCRPC, compare it with RCT results and compare Abi vs Enz. Materials and methodsWe retrospectively collected the data of all consecutive mCRPC patients treated with Abi, Enz or Cab in the six major oncological hospitals in the north of Portugal until December 2020. ResultsA total of 470 treatments pre-docetaxel (163 Abi and 307 Enz) and 373 pos-docetaxel (160 Abi, 148 Enz and 59 Cab) were included, with median follow-up time of 35 months. Mean age was 73.1, 84.4% had ECOG status < 2, ISUP grade was ≥ 4 in 59% and 28.0% had oligometastatic disease. In first line, for Abi and for Enz respectively, the proportion of patients with PSA reduction > 50% was 64.4% and 80.4% (P < .001), the mean duration of treatment (DT) was 10 and 14 months (P = .037) and the median overall survival (OS) was 25 months and 30 months (P = .17). In second line the results for Abi, Enz and Cab were respectively: proportion of patients with PSA reduction > 50% was 40.4%, 57.4% and 24.6% (p for Abi vs Enz=0.004); DT was 7, 8, and 3 months (p for Abi vs Enz = 0.27); OS was 17, 22 and 10 months (p for Abi vs. Enz = 0,07). ConclusionThese drugs have good efficacy in real-world evidence, similar to those reported in randomized clinical trials, with the expected exception of lower OS due to the inclusion of a broader sample of patients. Our results add to the evidence that Enz might have better efficacy in this setting compared with Abi.

Benzothiazole‐Piperazine Hybrids Effectively Target C4‐2 Castration‐Resistant Prostate Cancer Cells in vitro Implicated through Computational Studies

AbstractA series of new analogs based on benzothiazole‐piperazine conjugates were synthesized and assessed to investigate their anticancer properties using in vitro and in silico techniques. The compounds 3 a–3 h were tested against prostate (C4‐2) cancer cells, and the results revealed that all the compounds showed significant inhibitory activity against C4‐2 cells (&gt;50 % inhibition at 20 μM). Among all, 2‐(4‐(pyrimidin‐2‐yl) piperazin‐1‐yl) benzo[d]thiazole demonstrated the most prominent activity in the cell viability assay conducted displaying an IC50 value of 19.98 μM. In vitro studies have demonstrated that the compound can selectively target the androgen receptor (AR) and reduce the expression of several androgen‐responsive genes, including EAF2, ELL2, PSA and CALR genes, in castration‐resistant prostate cancer cells. Molecular docking results also revealed that all the compounds exhibited good energy binding scores against the androgen receptor target (PB ID: 2PNU) particularly compound 3 g which showed a maximum binding energy of −9.87 kcal/mol followed by other compounds as well as the established prostate cancer drug, enzalutamide, with a binding energy of −5.66 kcal/mol. Docking results were further supported by MD simulation studies, which confirmed that the ligand+protein complex was in stable conformation throughout the simulation time of 100 nanoseconds. Collectively, the present results, stemming from a combination of in vitro and in silico examinations, demonstrate that compound 3 g displays notable anti‐cancer characteristics, implying its viability as a prospective anti‐cancer pharmaceutical subject to clinical validation and subsequent development.

Self-Assembled Micelles Based on Ginsenoside Rg5 for the Targeted Treatment of PTX-Resistant Tumors.

Paclitaxel (PTX) is one of the first-line drugs for prostate cancer (PC) treatment. However, the poor water solubility, inadequate specific targeting ability, multidrug resistance, and severe neurotoxicity are far from being fully resolved, despite diverse PTX formulations in the market, such as the gold-standard PTX albumin nanoparticle (Abraxane) and polymer micelles (Genexol-PM). Some studies attempting to solve the multiple problems of chemotherapy delivery fall into the trap of an extremely complicated formulation design and sacrifice druggability. To better address these issues, this study designed an efficient, toxicity-reduced paclitaxel-ginsenoside polymeric micelle (RPM). With the aid of the inherent amphiphilic molecular structure and pharmacological effects of ginsenoside Rg5, the prepared RPM enhances the water solubility and active targeting of PTX, inhibiting chemotherapy resistance in cancer cells. Moreover, the polymeric micelles demonstrated favorable anti-inflammatory and neuroprotective effects, providing ideas for the development of new clinical anti-PC preparations.

Improved detection of homologous recombination deficiency using WES sequencing: Insights into a Chinese pan-cancer cohort.

e17503 Background: Homologous recombination (HR) deficiency has emerged as a novel biomarker for the clinical use of PARP inhibitors in advanced ovarian cancer, and may also be of value in guiding the clinical use of PARP inhibitors and platinum-based drugs in breast cancer, prostate cancer, and other tumors. This significant finding assists in precision medication and prognosis judgments for patients. Methods: This research incorporated a Chinese pan-cancer cohort comprising 1033 patients diagnosed across thirteen cancer types. All matched tumor tissues and peripheral blood samples were processed for the whole exome sequencing. The HRD scoring was conducted with ScarHRD R package with defined parameters for the heterozygosity (LOH), telomeric allelic imbalance (TAI), and large-scale state transitions (LST) status. HR deficiency were defined as an HRD-score ≥50 or BRCA1/2 deficient, while HR proficiency were defined as an HRD-score &lt;50 and BRCA1/2 intact. Results: Ovarian cancer demonstrates the highest HRD prevalence at 51.85%, surpassing the BRCA1/2 mutation rate of 20.37%. Breast cancer follows with an HRD rate of 45.45%, yet no BRCA1/2 mutations are detected. Other cancers like pancreatic, gastric, and sarcomas also present notable HRD rates (29.41%, 36.84%, and 29.79%, respectively) without corresponding BRCA1/2 mutations. In contrast, cancers such as urological, lung, intestinal, and neurological tumors exhibit a mismatch between HRD rates and BRCA1/2 mutation presence, few patients with notable BRCA1/2 mutations did not have consisted HR-deficient rate, and vice versa. Conclusions: Analysis HRD-score can help to screen a larger population of PARP inhibitor beneficiaries and provide hope to more patients. In the future we will do more dimensional data analysis statistics on this cohort. [Table: see text]

Estimating physico-chemical properties of drugs for prostate cancer using degree-based and neighbourhood degree-based topological descriptors

Prostate cancer is one of the most alarming diseases among men and leads to various illnesses. The main flaw in this disease is that there is not a single test that can find it. Prostate-specific antigens and prostate biopsies are used to identify this type of cancer. Many pharmaceutical industries do active research to identify non-steroidal drugs that can be used to treat prostate cancer effectively. QSPR analysis is one of the best practices that aid scientists in getting a deep insight into the physico-chemical properties of drugs without actually performing experiments in a wet lab, thereby cutting down on the cost of manufacturing such drugs. In this article, we perform a QSPR analysis of nineteen drugs primarily used to treat prostate cancer by using a set of ten degree-based indices and another set of ten novel neighbourhood-degree-based indices. In addition, we have done a comparative study of the findings obtained through these two different sets of indices over thirteen physico-chemical properties of prostate cancer drugs.

Design of a pebbles-like erbium stannate integrated with graphene nanoribbons for the anti-cancer drug nilutamide detection in water and biological samples

The invention of antibiotics revolutionized modern medicine, yet their unchecked usage poses risks to the environment and human health. Nilutamide (NLT), an anti-androgen drug for prostate cancer, undergoes hepatic metabolism, producing harmful by-products. Recent studies have detected elevated NLT levels in ecosystems, demanding comprehensive monitoring. Electrochemical sensors have evolved, offering compact, sensitive, and selective detection. Integration of nanotechnology has further enhanced these sensors, particularly graphene nanoribbons (GNRs) and pyrochlore oxides like erbium stannate (Er2Sn2O7). This study focuses on fabricating a GNR/Er2Sn2O7 nanocomposite-modified electrode and proposing its application for NLT detection in water and human samples. The nanocomposite's hierarchical arrangement, facilitated by synergistic effects and quantum confinement within the hybrid heterojunction, enhances the electrode modifier's activation, enabling the detection of NLT with an outstanding limit of detection (LOD) as well as a wide linear range and appreciable recoveries in real samples.

Au/Doc/Quer@PDA/A10-3.2 Nanoparticles for targeted treatment of docetaxel-resistant prostate cancer

Docetaxel (Doc), as a first-line chemotherapy drug for prostate cancer (PC), often loses its therapeutic efficacy due to acquired resistance and lack of targeting specificity. Therefore, there is a need to develop a novel drug that can overcome Doc resistance and enhance its targeting ability to inhibit PC progression. In this study, we prepared Au/Doc/Quer@PDA/A10-3.2 nanoparticles (NPs) composite drug by encapsulating Doc and quercetin (Quer) within polydopamine (PDA)-coated Au NPs and further modifying them with RNA oligonucleotide aptamer A10-3.2. A10-3.2 was used for specific targeting of prostate-specific membrane antigen (PSMA)-positive PC cells (LNCaP). Quer was employed to reverse the resistance of Doc-resistant cell line (LNCaP/R) to Doc. Physical characterization using ultraviolet-visible spectroscopy (UV-vis), transmission electron microscopy (TEM), dynamic light scattering (DLS), X-ray photoelectron spectroscopy (XPS), and Fourier-transform infrared spectroscopy (FTIR) confirmed the successful preparation of Au/Doc/Quer@PDA/A10-3.2 NPs. Fluorescence imaging and flow cytometry experiments demonstrated the targeting ability of Au/Doc/Quer@PDA/A10-3.2 NPs towards PSMA-positive LNCaP/R cells. Cell proliferation, apoptosis, invasion, and migration experiments revealed that Quer reversed the resistance of LNCaP/R cells to Doc. Immunoblotting experiments further confirmed the mechanism behind sensitization of chemotherapy by Quer. Finally, we evaluated the therapeutic efficacy of Au/Doc/Quer@PDA/A10-3.2 NPs in a mouse model of PC. In conclusion, this study synthesized and validated a novel nano-composite drug (Au/Doc/Quer@PDA/A10-3.2 NPs) for combating Doc-resistant PC, which could potentially be applied in clinical treatment of PC.

Arvinas partners with Novartis for prostate cancer drugs

Arvinas partners with Novartis for prostate cancer drugs

Abstract 6205: Identify drugs for metastatic castration-resistance prostate cancer (mCRPC) patients with high glycolytic activity through in silico approach

Abstract Prostate cancer (PC) remains a prominent cause of cancer-related mortality among men in the United States. A significant factor contributing to the mortality of PC patients is the development of resistance to second-generation antiandrogen therapies, particularly androgen receptor-signaling inhibitors (ARSI), which is pronounced in patients with late-stage PC, metastatic castration-resistance prostate cancer (mCRPC). Therefore, there is an urgent need for novel therapeutics beyond AR signaling inhibition for patients with mCRPC. One of the key drivers of resistance to ARSI and a critical feature of CRPC is cancer metabolism reprogramming to elevated glycolysis. However, the current research on finding drugs to impede high-glycolytic tumor growth is hurdled by a resistance raised from metabolic plasticity. The aim of this research is to quickly repurpose existing drugs for inhibiting high-glycolytic mCRPC growth while proactively circumstancing resistance from metabolic plasticity through computational approaches. To do this, we imputed a large number of drug responses in patients with mCRPC using a computational algorithm (OncoPredict), identified drugs that were projected to show higher sensitivity in high-glycolytic tumors, and performed in vitro validation. Furthermore, to maximize drug efficacy, we identified biomarkers for drug candidates. By implementing this computational pipeline, we identified a number of drugs with various mechanisms of action that show higher efficacy in mCRPC with high glycolysis. Furthermore, we successfully validated the efficacy of these nominated drug candidates including an anti-parasitic agent, an HSP90 inhibitor, and a CDK inhibitor. These drug candidates exhibited superior tumor growth inhibition in in vitro models of high glycolysis-induced advanced PC. In conclusion, this study introduces an innovative in silico approach to unveil the existing drugs’ unknown potential for the treatment of patients with mCRPC. Our findings hold promise for development of effective therapeutics for combating this challenging disease. Citation Format: Mei-Chi Su, Adam M. Lee, R. Stephanie Huang. Identify drugs for metastatic castration-resistance prostate cancer (mCRPC) patients with high glycolytic activity through in silico approach [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6205.

Abstract 4563: Ferroptotic mechanism of drug induced toxicity of PARPi and AurKi in prostate cancer

Abstract BACKGROUND: Cancer is typically treated with a combination of drugs rather than monotherapy stratagems, but identification of synergistic drug combinations for the treatment of cancers is challenging. Here we present the combination of PARP and Aurora Kinase inhibitors synergize through induction of the ferroptosis pathway of cell death. METHODS: We identified these drugs through an unbiased screen of enriched drug class response correlations. We then validated a synergistic cell killing effect of multiple drugs of each class by in vitro drug screening. Next, we performed reversal experiments using a ferroptosis inhibitor and lipid peroxide staining to confirm ferroptosis is a relevant cell death pathway. We performed Western immunoblot analysis in cells overexpressing putative Aurora Kinase phospho-substrates in the relevant pathway of interest, and performed site directed mutagenesis experiments to show the relevant amino acid altered by kinase activity. We also performed a series of qPCR and co-IP experiments to show PARPi effect on the antioxidant signaling pathway. RESULTS: We validated and identified synergy in a prostate cancer specific context. Next, we found Talazoparib and Alisertib induced ferroptosis after synergy was reduced with a ferroptosis inhibitor and lipid peroxides increased accumulation. We found a novel mechanism action for Alisertib, wherein Aurora Kinase inhibitors can alter the phospho-status and activity of the iron reduction enzyme Steap3.We also found that PARP inhibitors can affect the Nrf2-driven antioxidant signaling pathway on a transcriptional level. CONCLUSION: Aurora Kinase inhibitors and PARP inhibitors for the treatment of prostate cancer was identified and was validated as synergistic, which revealed new functional roles of both drugs in the context of cell killing. These findings represent a new clinical combination of drugs in prostate cancer and reveal a novel role for this drug class in ferroptosis. Citation Format: August John, Kuntian Luo, Zhenkun Lou, Liewei Wang. Ferroptotic mechanism of drug induced toxicity of PARPi and AurKi in prostate cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4563.

Abstract 5651: Personalized transcriptomic profiling for advanced prostate cancer: Guiding second-generation hormonal drug selection

Abstract Introduction: Second-generation hormonal drugs have demonstrated significant efficacy in extending the survival of patients with advanced prostate cancer. These drugs operate through two distinct molecular mechanisms: inhibition of androgen biosynthesis and blockade of the androgen receptor. However, due to concerns of side effects, concurrent usage of multiple drugs is not recommended. A notable challenge is the eventual development of drug resistance, rendering all second-generation hormonal therapies ineffective. Currently, there is a lack of guidelines for helping patients choose the most suitable drug. In the context of pharmacogenomics, genetic differences can influence drug susceptibility and efficacy, with variations in genomic sequences and regulatory mechanisms impacting drug response at the transcriptional and translational levels. Considered the rapid processing capabilities of Affymetrix transcriptomic microarrays, we hypothesized that distinct gene signatures in patients who respond well or poorly to second-generation hormonal drugs could be identified and could act as a companion diagnostic tool. Methods: We enrolled 180 advanced prostate cancer patients, who fulfilled Taiwan national health insurance criteria of using second-generation hormonal drugs, from seven medical centers or regional hospitals in Taiwan at 3 time points: prior to drug administration, 3 months after treatment started and drug resistance developed. The RNA expression data and clinical parameters were analyzed, and classification models were built using IPA and R. Good or poor responders were defined by 3-month prostate-specific antigen (PSA) lowered by 90 percent. Results:: Differential expression and enrichment analyses post-treatment highlighted the activation of NF-kappa B signaling and various immune cell pathways. Notably, pathways related to primary immunodeficiency and IL-17 became prominent following the development of drug resistance. At the initial stages, distinct alterations in cell cycle pathways, particularly G1/S and G2/M, were observed between good and poor responders. This was elucidated through principal component analysis and subsequent dbscan clustering. To further distinguish between these responder groups, we utilized an integrative approach for feature selection, combining support vector machine, random forest classifier, and lasso regression. Despite the innovative approach, the model's error rate stood at approximately 15%, attributed mainly to the limited number of cases. Conclusion: Our study highlights the potential of using transcriptomic analysis to predict responses to second-generation hormonal drugs in advanced prostate cancer, paving the way for personalized treatment strategies. However, the need for larger cohort studies is evident to refine these predictive models and enhance their accuracy. Citation Format: Li-Hsin Chang, Hao-Han Chang, Xin-Yi Lin, Shu-Chi Wang, Chih-Pin Chuu, Deng-Neng Chen, Shu-Pin Huang, Chia-Yang Li. Personalized transcriptomic profiling for advanced prostate cancer: Guiding second-generation hormonal drug selection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 5651.