EF24 (a Curcumin Analog) and ZSTK474 Emphasize the Effect of Cabozantinib in Medullary Thyroid Cancer

Endocrinology. 2018 Jun 1;159(6):2348-2360. doi: 10.1210/en.2018-00124.

Abstract

XL184 is a small-molecule kinase inhibitor recently included in first-line systemic therapy for patients with advanced, progressive medullary thyroid cancer (MTC). EF24 is a curcumin analog with a high bioavailability, and ZSTK474 is an inhibitor of the phosphatidylinositol 3-kinase signaling pathway. We investigated the effect of these compounds, alone and in combination, in two rearranged during transfection (RET)-mutated TT and MZ-CRC-1 MTC cell lines and in six mostly RET wild-type human MTC primary cultures. Low IC50 values demonstrated the efficacy of the drugs, whereas the combination index revealed an important synergistic effect of combinations of XL184 + ZSTK474 and XL184 + EF24. Cell-cycle changes and the induction of apoptosis or necrosis were modulated by single compounds or combinations thereof. Both XL184 and EF24, alone or combined, were effective in reducing calcitonin secretion. Western blot and in-cell Western analysis showed that the compounds prompted a decrease in general reactivity to phosphorylated antibodies. Our data confirm XL184 alone as the reference drug for RET-mutated MTC, but we also demonstrated that EF24 alone is effective in inhibiting MTC cell viability. We tested the combinations XL184 + ZSTK474 and XL184 + EF24 too, finding that they act synergistically, irrespective of RET mutation status.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Anilides / pharmacology*
  • Antineoplastic Agents / pharmacology*
  • Benzylidene Compounds / pharmacology*
  • Carcinoma, Neuroendocrine / pathology*
  • Cell Proliferation / drug effects
  • Drug Synergism
  • Female
  • Humans
  • Male
  • Middle Aged
  • Piperidones / pharmacology*
  • Pyridines / pharmacology*
  • Thyroid Neoplasms / pathology*
  • Triazines / pharmacology*
  • Tumor Cells, Cultured

Substances

  • 3,5-bis(2-fluorobenzylidene)piperidin-4-one
  • Anilides
  • Antineoplastic Agents
  • Benzylidene Compounds
  • Piperidones
  • Pyridines
  • Triazines
  • ZSTK474
  • cabozantinib

Supplementary concepts

  • Thyroid cancer, medullary