Enhancing the cytotoxicity of chemoradiation with radiation-guided delivery of anti-MGMT morpholino oligonucleotides in non-methylated solid tumors

Cancer Gene Ther. 2017 Aug;24(8):348-357. doi: 10.1038/cgt.2017.27. Epub 2017 Jul 28.

Abstract

The DNA repair enzyme O6-methylguanine DNA methyltransferase (MGMT) is epigenetically silenced in some tumors by MGMT gene promoter methylation. MGMT-hypermethylated solid tumors have enhanced susceptibility to the cytotoxic effects of alkylating chemotherapy such as temozolomide, compared with non-methylated tumors. In glioblastoma, subjects with MGMT hypermethylation have significantly longer survival rates after chemoradiotherapy. We report the first successful use of a non-ablative dose of ionizing radiation to prime human cancer cells to enhance the uptake of unmodified anti-MGMT morpholino oligonucleotide (AMON) sequences. We demonstrate >40% reduction in the in vitro proliferation index and cell viability in radiation-primed MGMT-expressing human solid tumor cells treated with a single dose of AMONs and temozolomide. We further demonstrate the feasibility of using a non-ablative dose of radiation in vivo to guide and enhance the delivery of intravenously administered AMONs to achieve 50% MGMT knockdown only at radiation-primed tumor sites in a subcutaneous tumor model. Local upregulation of physiological endocytosis after radiation may have a role in radiation-guided uptake of AMONs. This approach holds direct translational significance in glioblastoma and brain metastases where radiation is part of the standard of care; our approach to silence MGMT could overcome the significant problem of MGMT-mediated chemoresistance.

MeSH terms

  • A549 Cells
  • Animals
  • Apoptosis / drug effects
  • Apoptosis / genetics
  • Apoptosis / radiation effects
  • Cell Line, Tumor
  • Chemoradiotherapy
  • DNA Modification Methylases / biosynthesis
  • DNA Modification Methylases / genetics*
  • DNA Repair Enzymes / biosynthesis
  • DNA Repair Enzymes / genetics*
  • Female
  • Humans
  • Immunohistochemistry
  • Morpholinos / administration & dosage
  • Morpholinos / genetics
  • Morpholinos / pharmacokinetics
  • Neoplasms / genetics
  • Neoplasms / metabolism
  • Neoplasms / radiotherapy
  • Neoplasms / therapy*
  • Oligonucleotides, Antisense / administration & dosage*
  • Oligonucleotides, Antisense / genetics
  • Oligonucleotides, Antisense / pharmacokinetics
  • Rats
  • Rats, Nude
  • Transfection
  • Tumor Suppressor Proteins / biosynthesis
  • Tumor Suppressor Proteins / genetics*

Substances

  • Morpholinos
  • Oligonucleotides, Antisense
  • Tumor Suppressor Proteins
  • DNA Modification Methylases
  • MGMT protein, human
  • DNA Repair Enzymes