ZYH005, a novel DNA intercalator, overcomes all-trans retinoic acid resistance in acute promyelocytic leukemia

Nucleic Acids Res. 2018 Apr 20;46(7):3284-3297. doi: 10.1093/nar/gky202.

Abstract

Despite All-trans retinoic acid (ATRA) has transformed acute promyelocytic leukemia (APL) from the most fatal to the most curable hematological cancer, there remains a clinical challenge that many high-risk APL patients who fail to achieve a complete molecular remission or relapse and become resistant to ATRA. Herein, we report that 5-(4-methoxyphenethyl)-[1, 3] dioxolo [4, 5-j] phenanthridin-6(5H)-one (ZYH005) exhibits specific anticancer effects on APL and ATRA-resistant APL in vitro and vivo, while shows negligible cytotoxic effect on non-cancerous cell lines and peripheral blood mononuclear cells from healthy donors. Using single-molecule magnetic tweezers and molecule docking, we demonstrate that ZYH005 is a DNA intercalator. Further mechanistic studies show that ZYH005 triggers DNA damage, and caspase-dependent degradation of the PML-RARa fusion protein. As a result, APL and ATRA-resistant APL cells underwent apoptosis upon ZYH005 treatment and this apoptosis-inducing effect is even stronger than that of arsenic trioxide and anticancer agents including 5-fluorouracil, cisplatin and doxorubicin. Moreover, ZYH005 represses leukemia development in vivo and prolongs the survival of both APL and ATRA-resistant APL mice. To our knowledge, ZYH005 is the first synthetic phenanthridinone derivative, which functions as a DNA intercalator and can serve as a potential candidate drug for APL, particularly for ATRA-resistant APL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis / drug effects
  • Arsenic Trioxide / administration & dosage
  • Arsenic Trioxide / chemistry
  • Caspases / genetics
  • Cell Line, Tumor
  • Cell Proliferation / drug effects
  • DNA Damage / drug effects
  • Drug Resistance, Neoplasm / drug effects
  • Drug Resistance, Neoplasm / genetics*
  • Humans
  • Intercalating Agents / administration & dosage*
  • Intercalating Agents / chemistry
  • Leukemia, Promyelocytic, Acute / drug therapy*
  • Leukemia, Promyelocytic, Acute / genetics
  • Leukemia, Promyelocytic, Acute / pathology
  • Mice
  • Molecular Docking Simulation
  • Oncogene Proteins, Fusion / antagonists & inhibitors
  • Oncogene Proteins, Fusion / genetics
  • Phenanthridines / administration & dosage*
  • Phenanthridines / chemistry
  • Promyelocytic Leukemia Protein / genetics
  • Proteolysis / drug effects
  • Retinoic Acid Receptor alpha / genetics
  • Tretinoin / administration & dosage
  • Tretinoin / chemistry
  • Xenograft Model Antitumor Assays

Substances

  • Intercalating Agents
  • Oncogene Proteins, Fusion
  • Phenanthridines
  • Promyelocytic Leukemia Protein
  • RARA protein, human
  • Retinoic Acid Receptor alpha
  • PML protein, human
  • Tretinoin
  • Caspases
  • Arsenic Trioxide