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Abstract 3858: Inflammation and oncogene in hepatocellular carcinoma: Clinical relevance and experimental targeted therapy

Hepatocellular carcinoma (HCC) poses a major public health problem worldwide and novel, effective therapeutic approaches for this devastating disease are urgently needed. The overexpression or activation of the MDM2 oncogene frequently occurs in HCC and is linked to cancer growth, poor survival, metastasis, and resistance to treatment. We have hypothesized that MDM2 is a promising therapeutic target for HCC therapy. We have recently discovered that the transcription factor NFAT1 upregulates MDM2 expression, promoting cancer cell growth, migration, invasion, and angiogenesis. The present study was designed to demonstrate the role of the NFAT1-MDM2 pathway in HCC progression and its value in developing HCC targeted therapy. We systemically investigated the expression and association of MDM2 and NFAT1 in 254 pairs of human HCC and matched non-cancerous tissue samples. High-throughput virtual and cell-based screenings were carried out for search for lead compounds targeting both NFAT1 and MDM2. The in vitro and in vivo anti-HCC activities and underlying mechanisms of action were further evaluated in HCC cell lines with various p53 backgrounds. Our results demonstrated that, compared with the non-malignant peritumoral tissues MDM2 and NFAT1 were overexpressed in HCC tissues, which were correlated with poor prognosis and increased metastasis. Based on molecular modeling study, Biacore assay, and pull-down assays, one of the lead compounds, named MA242, was identified as a potent and selective MDM2 and NFAT1 dual inhibitor. Mechanistically, M242 directly bound to MDM2 and NFAT1 proteins with high affinity and induced their protein degradation. MA242 also inhibited NFAT1-mediated MDM2 transcription. At cellular level, MA242 decreased cell proliferation, and induced apoptosis and G2/M phase arrest in various HCC cell lines, regardless of the p53 status. Furthermore, M242 inhibited the tumor growth and metastasis in orthotopic and patient-derived xenograft (PDX) models of HCC, without any obvious host toxicity. In conclusion, MDM2 and NFAT1 expression can serve as predictors of survival in patients with HCC. Dual MDM2 and NFAT1 inhibitors may represent a first-in-class clinical candidates for the treatment of HCC, including tumors lacking functional p53. This project is supported by NIH R01 CA186662 and R01 CA214019 and ACS RSG-15-009-01-CDD. Citation Format: Wei Wang, Jianwen Cheng, Jiang-Jiang Qin, Bo Hu, Bhavitavya Nijampatnam, Sadanandan Velu, Xin-Rong Yang, Jia Fan, Ruiwen Zhang. Inflammation and oncogene in hepatocellular carcinoma: Clinical relevance and experimental targeted therapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3858.