Lumefantrine, an antimalarial drug, reverses radiation and temozolomide resistance in glioblastoma

Proc Natl Acad Sci U S A. 2020 Jun 2;117(22):12324-12331. doi: 10.1073/pnas.1921531117. Epub 2020 May 14.

Abstract

Glioblastoma multiforme (GBM) is an aggressive cancer without currently effective therapies. Radiation and temozolomide (radio/TMZ) resistance are major contributors to cancer recurrence and failed GBM therapy. Heat shock proteins (HSPs), through regulation of extracellular matrix (ECM) remodeling and epithelial mesenchymal transition (EMT), provide mechanistic pathways contributing to the development of GBM and radio/TMZ-resistant GBM. The Friend leukemia integration 1 (Fli-1) signaling network has been implicated in oncogenesis in GBM, making it an appealing target for advancing novel therapeutics. Fli-1 is linked to oncogenic transformation with up-regulation in radio/TMZ-resistant GBM, transcriptionally regulating HSPB1. This link led us to search for targeted molecules that inhibit Fli-1. Expression screening for Fli-1 inhibitors identified lumefantrine, an antimalarial drug, as a probable Fli-1 inhibitor. Docking and isothermal calorimetry titration confirmed interaction between lumefantrine and Fli-1. Lumefantrine promoted growth suppression and apoptosis in vitro in parental and radio/TMZ-resistant GBM and inhibited tumor growth without toxicity in vivo in U87MG GBM and radio/TMZ-resistant GBM orthotopic tumor models. These data reveal that lumefantrine, an FDA-approved drug, represents a potential GBM therapeutic that functions through inhibition of the Fli-1/HSPB1/EMT/ECM remodeling protein networks.

Keywords: Fli-1; HSPB1; TMZ resistance; glioblastoma; radioresistance.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Antimalarials / administration & dosage*
  • Antineoplastic Agents, Alkylating / administration & dosage*
  • Brain Neoplasms / drug therapy*
  • Brain Neoplasms / radiotherapy
  • Cell Line, Tumor
  • Drug Resistance, Neoplasm
  • Epithelial-Mesenchymal Transition / drug effects
  • Gene Expression Regulation, Neoplastic / drug effects
  • Glioblastoma / drug therapy*
  • Glioblastoma / genetics
  • Glioblastoma / metabolism
  • Glioblastoma / radiotherapy
  • Heat-Shock Proteins / genetics
  • Heat-Shock Proteins / metabolism
  • Humans
  • Lumefantrine / administration & dosage*
  • Microfilament Proteins / genetics
  • Microfilament Proteins / metabolism
  • Molecular Chaperones / genetics
  • Molecular Chaperones / metabolism
  • Temozolomide / administration & dosage*
  • Trans-Activators / genetics
  • Trans-Activators / metabolism

Substances

  • Antimalarials
  • Antineoplastic Agents, Alkylating
  • FLII protein, human
  • HSPB1 protein, human
  • Heat-Shock Proteins
  • Microfilament Proteins
  • Molecular Chaperones
  • Trans-Activators
  • Lumefantrine
  • Temozolomide