Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma

Neuroblastoma (NB) is a predominantly pediatric cancer with greater than 90% of cases arising in children under the age of five. More than half of patients have metastases detected at diagnosis, and high-risk disease is associated with five-year survival rates of only 50–60 %. Standard therapy invol...

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Main Authors: Seema Chugh, Jean C. Tien, Jennifer Hon, Carson Kenum, Rahul Mannan, Yunhui Cheng, Chi Chiang Li, Zainab I. Taher, Andrew D. Delekta, Pushpinder Singh Bawa, Ingrid J. Apel, Stephanie J. Miner, Xuhong Cao, Rohit Mehra, Saravana M. Dhanasekaran, Yuanyuan Qiao, Rajen Mody, Arul M. Chinnaiyan
Format: Article
Language:English
Published: Elsevier 2025-02-01
Series:Neoplasia: An International Journal for Oncology Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S1476558624000010
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author Seema Chugh
Jean C. Tien
Jennifer Hon
Carson Kenum
Rahul Mannan
Yunhui Cheng
Chi Chiang Li
Zainab I. Taher
Andrew D. Delekta
Pushpinder Singh Bawa
Ingrid J. Apel
Stephanie J. Miner
Xuhong Cao
Rohit Mehra
Saravana M. Dhanasekaran
Yuanyuan Qiao
Rajen Mody
Arul M. Chinnaiyan
author_facet Seema Chugh
Jean C. Tien
Jennifer Hon
Carson Kenum
Rahul Mannan
Yunhui Cheng
Chi Chiang Li
Zainab I. Taher
Andrew D. Delekta
Pushpinder Singh Bawa
Ingrid J. Apel
Stephanie J. Miner
Xuhong Cao
Rohit Mehra
Saravana M. Dhanasekaran
Yuanyuan Qiao
Rajen Mody
Arul M. Chinnaiyan
author_sort Seema Chugh
collection DOAJ
description Neuroblastoma (NB) is a predominantly pediatric cancer with greater than 90% of cases arising in children under the age of five. More than half of patients have metastases detected at diagnosis, and high-risk disease is associated with five-year survival rates of only 50–60 %. Standard therapy involves highly toxic chemotherapy, surgery, radiation, and immunotherapy, and less toxic, more specific targeted therapies are urgently needed. Genomic studies have identified common driver aberrations in high-risk NB, such as MYCN amplification. In addition, a proportion of high-risk patients harbor amplification or activating mutations in anaplastic lymphoma kinase (ALK), and co-occurrence of ALK mutations and MYCN amplification have been associated with aggressive disease. In this study, we analyzed the efficacy of a Phase Ia-cleared, orally bioavailable dual ALK and focal adhesion kinase (FAK) inhibitor, ESK440, in multiple preclinical NB models. ESK440 potently inhibited proliferation of NB cell lines, with increased sensitivity in cell lines harboring ALK aberrations. ALK, FAK, and downstream target activation were rapidly decreased upon ESK440 treatment, and this was associated with impaired cellular migration and invasion. Importantly, ESK440 treatment also decreased MYCN levels. NB cell line and patient-derived xenograft studies showed significant reduction in tumor growth in ESK440-treated mice with no signs of toxicity. In certain NB models, ESK440 showed comparable or enhanced efficacy to lorlatinib, another clinical ALK inhibitor, and a lorlatinib-resistant cell line (COG-N-561 LR) retained sensitivity to ESK440. These preclinical results indicate that ESK440 is a promising targeted agent for ALK-driven NB and support future clinical studies to evaluate its efficacy in NB patients.
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spelling doaj-art-1de47ba01c52412a829c6520b8c2fc472025-02-03T04:16:31ZengElsevierNeoplasia: An International Journal for Oncology Research1476-55862025-02-0160100964Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastomaSeema Chugh0Jean C. Tien1Jennifer Hon2Carson Kenum3Rahul Mannan4Yunhui Cheng5Chi Chiang Li6Zainab I. Taher7Andrew D. Delekta8Pushpinder Singh Bawa9Ingrid J. Apel10Stephanie J. Miner11Xuhong Cao12Rohit Mehra13Saravana M. Dhanasekaran14Yuanyuan Qiao15Rajen Mody16Arul M. Chinnaiyan17Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pediatrics, University of Michigan, Ann Arbor, MI 48109, USAMichigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Department of Pathology, University of Michigan, Ann Arbor, MI 48109, USA; Howard Hughes Medical Institute, University of Michigan, Ann Arbor, MI 48109, USA; Department of Urology, University of Michigan, Ann Arbor, MI 48109, USA; Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA; Corresponding author at: Michigan Center for Translational Pathology, 1500 East Medical Center Drive, 5316 Rogel Cancer Center, Ann Arbor, MI 48109, USA.Neuroblastoma (NB) is a predominantly pediatric cancer with greater than 90% of cases arising in children under the age of five. More than half of patients have metastases detected at diagnosis, and high-risk disease is associated with five-year survival rates of only 50–60 %. Standard therapy involves highly toxic chemotherapy, surgery, radiation, and immunotherapy, and less toxic, more specific targeted therapies are urgently needed. Genomic studies have identified common driver aberrations in high-risk NB, such as MYCN amplification. In addition, a proportion of high-risk patients harbor amplification or activating mutations in anaplastic lymphoma kinase (ALK), and co-occurrence of ALK mutations and MYCN amplification have been associated with aggressive disease. In this study, we analyzed the efficacy of a Phase Ia-cleared, orally bioavailable dual ALK and focal adhesion kinase (FAK) inhibitor, ESK440, in multiple preclinical NB models. ESK440 potently inhibited proliferation of NB cell lines, with increased sensitivity in cell lines harboring ALK aberrations. ALK, FAK, and downstream target activation were rapidly decreased upon ESK440 treatment, and this was associated with impaired cellular migration and invasion. Importantly, ESK440 treatment also decreased MYCN levels. NB cell line and patient-derived xenograft studies showed significant reduction in tumor growth in ESK440-treated mice with no signs of toxicity. In certain NB models, ESK440 showed comparable or enhanced efficacy to lorlatinib, another clinical ALK inhibitor, and a lorlatinib-resistant cell line (COG-N-561 LR) retained sensitivity to ESK440. These preclinical results indicate that ESK440 is a promising targeted agent for ALK-driven NB and support future clinical studies to evaluate its efficacy in NB patients.http://www.sciencedirect.com/science/article/pii/S1476558624000010NeuroblastomaALKFAKESK440MYCN
spellingShingle Seema Chugh
Jean C. Tien
Jennifer Hon
Carson Kenum
Rahul Mannan
Yunhui Cheng
Chi Chiang Li
Zainab I. Taher
Andrew D. Delekta
Pushpinder Singh Bawa
Ingrid J. Apel
Stephanie J. Miner
Xuhong Cao
Rohit Mehra
Saravana M. Dhanasekaran
Yuanyuan Qiao
Rajen Mody
Arul M. Chinnaiyan
Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma
Neoplasia: An International Journal for Oncology Research
Neuroblastoma
ALK
FAK
ESK440
MYCN
title Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma
title_full Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma
title_fullStr Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma
title_full_unstemmed Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma
title_short Therapeutic benefit of the dual ALK/FAK inhibitor ESK440 in ALK-driven neuroblastoma
title_sort therapeutic benefit of the dual alk fak inhibitor esk440 in alk driven neuroblastoma
topic Neuroblastoma
ALK
FAK
ESK440
MYCN
url http://www.sciencedirect.com/science/article/pii/S1476558624000010
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