1. Academic Validation
  2. Drug Repurposing to Identify a Synergistic High-Order Drug Combination to Treat Sunitinib-Resistant Renal Cell Carcinoma

Drug Repurposing to Identify a Synergistic High-Order Drug Combination to Treat Sunitinib-Resistant Renal Cell Carcinoma

  • Cancers (Basel). 2021 Aug 6;13(16):3978. doi: 10.3390/cancers13163978.
Magdalena Rausch 1 2 3 Adriano Rutz 1 2 Pierre-Marie Allard 1 2 Céline Delucinge-Vivier 4 Mylène Docquier 4 5 Olivier Dormond 6 Paul J Dyson 7 Jean-Luc Wolfender 1 2 Patrycja Nowak-Sliwinska 1 2 3
Affiliations

Affiliations

  • 1 School of Pharmaceutical Sciences, University of Geneva, CMU-Rue Michel-Servet 1, CH-1211 Geneva, Switzerland.
  • 2 Institute of Pharmaceutical Sciences of Western Switzerland, University of Geneva, CMU-Rue Michel-Servet 1, CH-1211 Geneva, Switzerland.
  • 3 Translational Research Center in Oncohaematology, CH-1211 Geneva, Switzerland.
  • 4 GE3 Genomics Platform, University of Geneva, CH-1211 Geneva, Switzerland.
  • 5 Department of Genetics and Evolution, University of Geneva, CH-1211 Geneva, Switzerland.
  • 6 Department of Visceral Surgery, Lausanne University Hospital and University of Lausanne, 1015 Lausanne, Switzerland.
  • 7 Institute of Chemical Sciences and Engineering, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1015 Lausanne, Switzerland.
Abstract

Repurposed drugs have been evaluated for the management of clear cell renal cell carcinoma (ccRCC), but only a few have influenced the overall survival of patients with advanced disease. To combine repurposed non-oncology with oncological drugs, we applied our validated phenotypic method, which consisted of a reduced experimental part and data modeling. A synergistic optimized multidrug combination (ODC) was identified to significantly reduce the energy levels in Cancer remaining inactive in non-cancerous cells. The ODC consisted of Rapta-C, erlotinib, metformin and parthenolide and low doses. Molecular and functional analysis of ODC revealed a loss of adhesiveness and induction of Apoptosis. Gene-expression network analysis displayed significant alterations in the cellular metabolism, confirmed by LC-MS based metabolomic analysis, highlighting significant changes in the lipid classes. We used heterotypic in vitro 3D co-cultures and ex vivo organoids to validate the activity of the ODC, maintaining an efficacy of over 70%. Our results show that repurposed drugs can be combined to target Cancer cells selectively with prominent activity. The strong impact on cell adherence and metabolism indicates a favorable mechanism of action of the ODC to treat ccRCC.

Keywords

Rapta-C; drug combination; drug repurposing; drug-drug interaction; metabolism; metformin; synergistic.

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