Chemosensitizing Effects Of The Novel, Small Molecule Dna Methylation Inhibitor Sgi-110 In Ovarian Cancer

Deoxycytosine methylation of CpG islands in promoter regions of tumor suppressor genes (TSGs) plays a prominent role in the development and progression of drug-resistant epithelial ovarian cancer (OC). We previously demonstrated in a phase I/II trial that the DNA methylation inhibitor decitabine alters DNA methylation and restores platinum sensitivity in platinum-resistant OC patients, resulting in significant clinical activity. SGI-110 (Astex Pharmaceuticals) is a DNA hypomethylating agent with demonstrated activity in restoring silenced TSG expression in cancer cells by reversal of DNA methylation. As a decitabine-deoxyguanosine dinucleotide, SGI-110 has been shown to be less prone to deamination by cytidine deaminase and could have advantages over decitabine, such as better stability, less toxicity and a more convenient and less frequent SQ administration. We examined SGI-110 for its ability to inhibit OC cell proliferation and to demethylate and induce TSGs in vitro and in vivo. A 48 hour pretreatment with SGI-110 resensitized drug-resistant ovarian cancer cell lines to cisplatin (3-fold reduction in IC50 of cisplatin). In A2780 platinum sensitive OC cells, SGI-110 pre-treatment for 5 days reduced cisplatin IC50 by >2-fold. Prolonged (7 days) SGI-110 treatment reduced by 2-fold the number of ALDH1+ cells in SKOV3 and A2780 cells, suggesting an effect on the stem cell population, potentially involved in drug resistance. SGI-110 induced significant demethylation of TSGs ras-associated domain family 1A (RASSF1A) and human MutL homologue-1 (MLH1) and the differentiation-associated gene HOXA10; furthermore, RASSF1A, MLH1 and HOXA10 gene reexpression was also observed after 48 hour SGI-110 treatment. SGI-110 prevented TGF-β induced epithelial to mesenchymal transition of OC cells, as measured morphologically and by quantification of E-cadherin, Zeb1, Slug and miR200c expression levels. SGI-110 suppressed E-cadherin promoter methylation induced by TGF-β. We then examined the in vivo tolerability and efficacy of SGI-110, singly and in combination with cisplatin, in nude athymic mice. Mice were injected qd or bi-weekly with SGI-110 (sc) and/or cisplatin (ip) and body weights were measured twice weekly. In the qd regimen, SGI-110 2 mg/kg plus 4 mg/kg cisplatin was tolerated. The 10 mg/kg bi-weekly dose of SGI-110 was tolerated, either alone or in combination with 2 mg/kg cisplatin (5mg/kg SGI-110 plus 4 mg/kg cisplatin was similarly tolerated). SGI-110 induced significant global hypomethylation, as determined by pyrosequencing analysis of LINE1 demethylation in peripheral blood mononuclear cells. We are currently assessing the activity of SGI-110 in combination with cisplatin to retard the growth of platinum resistant human ovarian cancer xenografts. In summary, SGI-110 combined with platinum is a promising clinical combination for the therapy of ovarian cancer. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 103rd Annual Meeting of the American Association for Cancer Research; 2012 Mar 31-Apr 4; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2012;72(8 Suppl):Abstract nr 4077. doi:1538-7445.AM2012-4077