Combination of S-1 and the oral ATR inhibitor ceralasertib is effective against pancreatic cancer cells

Cancer Chemother Pharmacol. 2024 Dec;94(6):763-774. doi: 10.1007/s00280-024-04716-x. Epub 2024 Sep 14.

Abstract

Purpose: In our previous study, we found that the Chk1 inhibitor prexasertib enhances the antitumour effect of the oral anticancer drug S-1 against pancreatic cancer cells. In this study, we investigated the effect of combining S-1 and ceralasertib, an oral inhibitor of ATR, which is located upstream of Chk1. Ceralasertib is currently being investigated in multiple clinical trials for various cancers.

Methods: The cell-proliferation inhibitory effect was measured by MTT assay, using the pancreatic cancer cell lines BxPC-3, SUIT-2, PANC-1, and MIA PaCa-2, while apoptosis was measured by flow cytometry using PI/Annexin staining. The mechanism underlying the combined effect was analysed using western blotting, and the antitumor effect was analysed using a mouse xenograft model.

Results: MTT assay revealed that the combination of S-1 and ceralasertib had a synergistic effect, leading to the suppression of cell proliferation. Measurement with PI/Annexin staining revealed that the combination of S-1 and ceralasertib induced apoptosis more efficiently than either drug alone. Western blotting results showed that ceralasertib inhibited S-1-induced activation of ATR and Chk1. The average estimated tumour volume after 3 weeks of administration was 601 mm3 in the S-1 group, 580 mm3 in the ceralasertib group, and 298 mm3 in the combination group.

Conclusion: The combination of S-1 and ceralasertib demonstrated a high antiproliferative effect in inhibiting tumour growth in vitro.

Keywords: ATR; Ceralasertib; Chk1; Pancreatic cancer; S-1.

MeSH terms

  • Animals
  • Antineoplastic Combined Chemotherapy Protocols / pharmacology
  • Apoptosis* / drug effects
  • Ataxia Telangiectasia Mutated Proteins / antagonists & inhibitors
  • Cell Line, Tumor
  • Cell Proliferation* / drug effects
  • Checkpoint Kinase 1 / antagonists & inhibitors
  • Drug Combinations*
  • Drug Synergism*
  • Female
  • Humans
  • Indoles
  • Mice
  • Mice, Inbred BALB C
  • Mice, Nude
  • Morpholines
  • Oxonic Acid* / administration & dosage
  • Oxonic Acid* / pharmacology
  • Pancreatic Neoplasms* / drug therapy
  • Pancreatic Neoplasms* / pathology
  • Protein Kinase Inhibitors / administration & dosage
  • Protein Kinase Inhibitors / pharmacology
  • Pyrazines* / administration & dosage
  • Pyrazines* / pharmacology
  • Pyrazoles / pharmacology
  • Pyrimidines* / administration & dosage
  • Pyrimidines* / pharmacology
  • Sulfonamides
  • Tegafur* / administration & dosage
  • Tegafur* / pharmacology
  • Xenograft Model Antitumor Assays*

Substances

  • Pyrimidines
  • Oxonic Acid
  • Drug Combinations
  • S 1 (combination)
  • Tegafur
  • ceralasertib
  • Pyrazines
  • ATR protein, human
  • Ataxia Telangiectasia Mutated Proteins
  • Checkpoint Kinase 1
  • Protein Kinase Inhibitors
  • Pyrazoles
  • CHEK1 protein, human
  • Indoles
  • Morpholines
  • Sulfonamides