New combination therapy shows potential to improve survival in children with neuroblastoma


Kids who are suffering a relapse of the aggressive most cancers often called neuroblastoma have small possibilities of survival. Nonetheless, a gaggle together with researchers at Karolinska Institutet in Sweden have now proven that DHODH blockers, that are well-tolerated in people, can remedy neuroblastoma in mice if administered together with chemotherapy. The examine, revealed within the journal JCI Perception, paves the best way for medical trials of this mixture remedy.

Neuroblastomas are tumours of nerve tissue which can be usually identified in very younger youngsters, usually earlier than the age of two. The illness impacts some 15 to twenty youngsters in Sweden yearly and is the deadliest type of most cancers in infants. This new examine reveals that the protein DHODH (dihydroorotate dehydrogenase), which is concerned in metabolism and DNA synthesis, additionally performs a key position in boosting the tumour progress of aggressive neuroblastomas.

Via focused therapy with particular DHODH blockers, we present in several cell and animal research that most cancers cells die, and that tumours cease rising. That is very promising, as DHODH blockers have been proven to be well-tolerated in medical trials for different problems.”

Ninib Baryawno, senior researcher on the Division of Ladies’s and Kids’s Well being, Karolinska Institutet, and one of many examine’s corresponding authors

Potential to enhance survival

When the researchers mixed DHODH blockers with a chemotherapy already in use for the therapy of youngsters with neuroblastoma, they succeeded in curing mice with an aggressive variant of the illness.

“This mix remedy must be examined clinically because it has the potential to enhance survival in youngsters with neuroblastoma,” says Baryawno. “That is sorely wanted for the reason that possibilities of survival on relapse are sadly small with present therapies.”

The examine was performed in shut collaboration with researchers on the Massachusetts Normal Hospital and the Harvard Stem Cell Institute within the USA. David Sykes, one of many senior authors in Boston, commented:

“That is an thrilling discovering with the true potential to assist sufferers. It additionally highlights the significance of worldwide collaboration.”

Analysing affected person knowledge from over 600 youngsters with neuroblastoma, the researchers discovered that tumours with excessive ranges of DHODH are extra aggressive and lethal. They then handled cell cultures and mice with a selected DHODH blocker known as Brequinar.

Weakens the tumor’s “motor”

When the researchers analysed the gene expression within the tumours, they discovered that Brequinar reduces the exercise of the MYCN gene, one of many “motors” that drives tumour progress. Nonetheless, after therapy, the tumours started to develop once more. This prompted the researchers to mix Brequinar with chemotherapy, which proved to be a recipe for achievement that cured the diseased mice.

“Neuroblastoma is a illness that begins very early in growth, even on the fetal stage,” says joint first creator Thale Kristin Olsen, researcher on the Division of Ladies’s and Kids’s Well being, Karolinska Institutet, and the Division of Immunology, Genetics and Pathology, Uppsala College. “The subsequent step of our analysis is to seek out out why the DHODH protein is so important to tumour progress.”

The examine was financed by the Swedish Childhood Most cancers Basis, the Swedish Analysis Council, the Swedish Most cancers Society, the Most cancers Analysis Funds of Radiumhemmet and the Wenner-Gren Foundations. One of many corresponding authors, David B. Sykes, is co-founder of and shareholder in Clear Creek Bio, marketing consultant for and shareholder in SAFI Biosolutions and marketing consultant for Keros Therapeutics. No different conflicts of curiosity have been reported.


Journal reference:

Olsen, T.Ok., et al. (2022) DHODH is an unbiased prognostic marker and potent therapeutic goal in neuroblastoma. JCI Perception.

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