新しい薬剤クラスによる難治がんへの併用療法の有効性(Hard-to-Treat Cancers Respond to Combination Therapy Using a New Class of Drugs)

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2025-07-25 バージニア工科大学(VirginiaTech)

バージニア工科大学の研究チームが、CDKN2A/MTAP欠損がんに有効な新たな薬物併用療法を発見した。がん細胞の生存に不可欠な酵素PRMT5を標的とし、CRISPRスクリーニングで最適な併用薬を同定。単剤療法よりも効果が高く、一部腫瘍では完全消失が見られた。肺・脳・膵臓がんなど難治性がんの約5%に有効とされ、今後の臨床応用が期待されている。

<関連情報>

CRISPR-薬物組み合わせスクリーニングにより、MTAP欠失がんに対する有効な組み合わせ治療法が同定された CRISPR-Drug Combinatorial Screening Identifies Effective Combination Treatments for MTAP-deleted Cancer

Nikola Knoll;Sarah Masser;Blanka Bordas;Richard Y. Ebright;Guangyan Li;Devishi Kesar;Eliana Destefanis;Nicholas Kania;Diego J. Rodriguez;Jayu Jen;Sydney E. Zagar;Caleb Mensah;Zixin Chen;Samuel J. Moffitt;Erhumuoghene M. Enakireru;Yao He;Baomou Feng;Mira K. Chokshi;Cyrus Y. Jin;Srivatsan Raghavan;William R. Sellers;Kathleen M. Mulvaney
Cancer Research  Published:July 22 2025
DOI:https://doi.org/10.1158/0008-5472.CAN-25-1464

Abstract

CDKN2A/MTAP co-deletion occurs frequently in non-small cell lung cancer and other solid tumors, including glioblastoma and pancreatic ductal adenocarcinoma. Lung cancer remains the leading cause of cancer-related mortality, and fewer than 15% of glioblastoma or pancreatic cancer patients survive 5 years, underscoring the need for more effective therapies. PRMT5 is a synthetic-lethal dependency in MTAP-null tumors and an attractive therapeutic target for CDKN2A/MTAP-deleted cancers. A new revolutionary class of inhibitors, referred to as MTA-cooperative PRMT5 inhibitors, has shown promising results in ongoing early phase clinical trials. Nonetheless, effective cancer treatment typically requires therapeutic combinations to improve response rates and defeat emergent resistant clones. Thus, we sought to determine whether perturbation of other pathways could improve the efficacy of MTA-cooperative PRMT5 inhibitors. A paralog and single gene targeting CRISPR library was used to screen MTAP-deleted cancers in the presence or absence of MTA-cooperative PRMT5 inhibitors. Loss of several genes sensitized to PRMT5 inhibition, including members of the MAPK pathway. Chemical inhibition of MAPK pathway members using KRAS, MEK, ERK, and RAF inhibitors synergized with PRMT5 inhibition to kill CDKN2A/MTAP-null, RAS-active tumors. Further, MTA-cooperative PRMT5 inhibitors combined with either KRAS or RAF inhibitors led to complete responses in vivo, emphasizing the potential benefit for patients. Lastly, cell lines resistant to KRAS inhibition were not resistant to MTA-cooperative PRMT5 inhibitors and vice versa, suggesting non-cross-reactive mechanisms of resistance. Overall, this study identifies therapeutic combinations with MTA-cooperative PRMT5 inhibitors that may offer significant benefit to patients.

有機化学・薬学
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