Development of an orally bioavailable mSWI/SNF ATPase degrader and acquired mechanisms of resistance in prostate cancer
- Proc Natl Acad Sci U S A. 2024 Apr 9;121(15):e2322563121. doi: 10.1073/pnas.2322563121.
- 1. Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI 48109.
- 2. Department of Pathology, University of Michigan, Ann Arbor, MI 48109.
- 3. Department of Urology, Xiangya Hospital, Central South University, Changsha, Hunan 410008, China.
- 4. Medical Scientist Training Program, University of Michigan, Ann Arbor, MI 48109.
- 5. Cellular and Molecular Biology Program, University of Michigan, Ann Arbor, MI 48109.
- 6. Rogel Cancer Center, University of Michigan, Ann Arbor, MI 48109.
- 7. Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109.
- 8. HHMI, University of Michigan, Ann Arbor, MI 48109.
- 9. Aurigene Oncology Limited, Bangalore, Karnataka 560100, India.
- 10. Department of Internal Medicine, Division of Medical Oncology, University of Michigan, Ann Arbor, MI 48109.
- 11. Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI 48109.
- 12. Department of Internal Medicine, Division of Gastroenterology, University of Michigan, Ann Arbor, MI 48109.
- 13. Department of Urology, University of Michigan, Ann Arbor, MI 48109.
- # Contributed equally.
Mammalian switch/sucrose nonfermentable (mSWI/SNF) ATPase degraders have been shown to be effective in enhancer-driven cancers by functioning to impede oncogenic transcription factor chromatin accessibility. Here, we developed AU-24118, an orally bioavailable proteolysis-targeting chimera (PROTAC) degrader of mSWI/SNF ATPases (SMARCA2 and SMARCA4) and PBRM1. AU-24118 demonstrated tumor regression in a model of castration-resistant prostate Cancer (CRPC) which was further enhanced with combination enzalutamide treatment, a standard of care Androgen Receptor (AR) antagonist used in CRPC patients. Importantly, AU-24118 exhibited favorable pharmacokinetic profiles in preclinical analyses in mice and rats, and further toxicity testing in mice showed a favorable safety profile. As acquired resistance is common with targeted Cancer therapeutics, experiments were designed to explore potential mechanisms of resistance that may arise with long-term mSWI/SNF ATPase PROTAC treatment. Prostate Cancer cell lines exposed to long-term treatment with high doses of a mSWI/SNF ATPase degrader developed SMARCA4 bromodomain mutations and ABCB1 (ATP binding cassette subfamily B member 1) overexpression as acquired mechanisms of resistance. Intriguingly, while SMARCA4 mutations provided specific resistance to mSWI/SNF degraders, ABCB1 overexpression provided broader resistance to Other potent PROTAC degraders targeting bromodomain-containing protein 4 and AR. The ABCB1 inhibitor, zosuquidar, reversed resistance to all three PROTAC degraders tested. Combined, these findings position mSWI/SNF degraders for clinical translation for patients with enhancer-driven cancers and define strategies to overcome resistance mechanisms that may arise.