Abstract 2018: Therapeutic benefit of dual ALK and FAK inhibition in neuroblastoma

Abstract Neuroblastoma (NB) is the most common extracranial pediatric tumor, and accounts for approximately 12% of cancer-related deaths in children. Though several genomic drivers have been identified, the development of targeted therapy for treating this aggressive pediatric malignancy has yet to be realized. Thus, there exists an urgent need to develop alternative therapeutic strategies for treating aggressive and metastatic NB. One novel approach is to therapeutically target anaplastic lymphoma kinase (ALK) and focal adhesion kinase (FAK), which are multi-functional tyrosine kinases implicated in neural development and play an important role in growth and metastasis of several cancers. Genomic aberrations of ALK such as overexpression, amplifications, and mutations, have been reported in NB. The role of FAK has also been delineated in NB as well as associated with disease metastasis. Using in silico analysis of sequencing data from NB patients procured from Pediatric MI-ONCOSEQ (precision oncology program), we found a cohort of patients that express high ALK and FAK expression. Given the potential roles of ALK and FAK in NB, we evaluated the efficacy of a novel compound ESK440, which is a dual ALK and FAK inhibitor. ESK440 has passed Phase 1 clinical trials in adult patients with solid tumors. It is capable of crossing the blood brain barrier and binds to several mutated forms of ALK, thus making ESK440 an attractive therapeutic candidate for treating NB. A wide panel of NB cancer cell lines were screened with ESK440, and a CellTiter-Glo® Luminescent Cell Viability Assay was used to determine the IC-50s. Our results revealed that NB cells with ALK genomic aberrations (mutations and amplifications) showed low IC-50 values. Further, treatment with ESK440 inhibited ALK and FAK associated signaling pathways. We also observed decreased expression of MYCN. Intriguingly, ESK440 studies in NB xenograft model (NB-1) resulted in tumor regression in treated animals. Altogether, our study has discovered the therapeutic potential of dual ALK and FAK inhibitor in NB, and our findings may provide the foundation for initiating clinical trials targeting this disease in pediatric patients. Citation Format: Seema Chugh, Jean C. Tien, Jennifer Hon, Pushpinder Singh Bawa, Carson Kenum, Chi Chiang Li, Yunhui Cheng, Andrew D. Delekta, Jae Eun Choi, Rahul Mannan, Yuanyuan Qiao, Rajen Mody, Arul Chinnaiyan. Therapeutic benefit of dual ALK and FAK inhibition in neuroblastoma [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 2018.