title: Refractory testicular germ cell tumors are highly sensitive to the second generation DNA methylation inhibitor guadecitabine.
abstract: Testicular germ cell tumors (TGCTs) are the most common cancers of young males. A substantial portion of TGCT patients are refractory to cisplatin. There are no effective therapies for these patients, many of whom die from progressive disease. Embryonal carcinoma (EC) are the stem cells of TGCTs. In prior in vitro studies we found that EC cells were highly sensitive to the DNA methyltransferase inhibitor, 5-aza deoxycytidine (5-aza). Here, as an initial step in bringing demethylation therapy to the clinic for TGCT patients, we evaluated the effects of the clinically optimized, second generation demethylating agent guadecitabine (SGI-110) on EC cells in an animal model of cisplatin refractory testicular cancer. EC cells were exquisitely sensitive to guadecitabine and the hypersensitivity was dependent on high levels of DNA methyltransferase 3B. Guadecitabine mediated transcriptional reprogramming of EC cells included induction of p53 targets and repression of pluripotency genes. As a single agent, guadecitabine completely abolished progression and induced complete regression of cisplatin resistant EC xenografts even at doses well below those required to impact somatic solid tumors. Low dose guadecitabine also sensitized refractory EC cells to cisplatin in vivo. Genome-wide analysis indicated that in vivo antitumor activity was associated with activation of p53 and immune-related pathways and the antitumor effects of guadecitabine were dependent on p53, a gene rarely mutated in TGCTs. These preclinical findings suggest that guadecitabine alone or in combination with cisplatin is a promising strategy to treat refractory TGCT patients.
authors.affiliation: Division of Hematology/Oncology, Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Costantine
authors.initials: C
authors.lastname: Albany
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Mary P
authors.initials: MP
authors.lastname: Hever-Jardine
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Katherine M
authors.initials: KM
authors.lastname: von Herrmann
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Christina Y
authors.initials: CY
authors.lastname: Yim
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Janice
authors.initials: J
authors.lastname: Tam
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Joshua M
authors.initials: JM
authors.lastname: Warzecha
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Leah
authors.initials: L
authors.lastname: Shin
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Bock
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Curran
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Aneeq S
authors.initials: AS
authors.lastname: Chaudhry
authors.affiliation: Departments of Pharmacology and Toxicology and Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Fred
authors.initials: F
authors.lastname: Kim
authors.affiliation: Department of Pathology, Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: George E
authors.initials: GE
authors.lastname: Sandusky
authors.affiliation: Astex Pharmaceutical, Pleasanton, CA, USA.
authors.forename: Pietro
authors.initials: P
authors.lastname: Taverna
authors.affiliation: Department of Comparative Biosciences, The University of Illinois at Urbana-Champaign, Urbana, IL, USA.
authors.forename: Sarah J
authors.initials: SJ
authors.lastname: Freemantle
authors.affiliation: Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
authors.forename: Brock C
authors.initials: BC
authors.lastname: Christensen
authors.affiliation: Division of Hematology/Oncology, Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN, USA.
authors.forename: Lawrence H
authors.initials: LH
authors.lastname: Einhorn
authors.affiliation: Department of Comparative Biosciences, The University of Illinois at Urbana-Champaign, Urbana, IL, USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Spinella
mesh_terms: D000818:Animals; D000970:Antineoplastic Agents / Q000494:pharmacology*; D001374:Azacitidine / Q000031:analogs & derivatives* / Q000494:pharmacology; D045744:Cell Line, Tumor; D002945:Cisplatin / Q000494:pharmacology; D004248:DNA (Cytosine-5-)-Methyltransferases / Q000235:genetics / Q000378:metabolism; D019175:DNA Methylation / Q000187:drug effects*; D019008:Drug Resistance, Neoplasm / Q000235:genetics*; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic / Q000187:drug effects; D006801:Humans; D008297:Male; D051379:Mice; D009373:Neoplasms, Germ Cell and Embryonal / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D013736:Testicular Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000378:metabolism / Q000473:pathology; D016159:Tumor Suppressor Protein p53 / Q000235:genetics / Q000378:metabolism; D023041:Xenograft Model Antitumor Assays; D000097584:DNA Methyltransferase 3B
chemical_list: D000970:Antineoplastic Agents; D001374:Azacitidine; D002945:Cisplatin; D004248:DNA (Cytosine-5-)-Methyltransferases; D016159:Tumor Suppressor Protein p53; D000097584:DNA Methyltransferase 3B; C580831:guadecitabine
keywords: DNA methylation; SGI-110; embryonal carcinoma; in vivo; testicular cancer