1. Academic Validation
  2. Preclinical 3D model screening reveals digoxin as an effective therapy for a rare and aggressive type of endometrial cancer

Preclinical 3D model screening reveals digoxin as an effective therapy for a rare and aggressive type of endometrial cancer

  • Gynecol Oncol. 2024 Jul 5:188:162-168. doi: 10.1016/j.ygyno.2024.06.029.
Pooja Praveen Kumar 1 DuPreez Smith 1 James Key 2 He Dong 3 Ashtalakshmi Ganapathysamy 3 Vincent Maranda 3 Nelson K Y Wong 4 Marta Llaurado Fernandez 5 Hannah Kim 5 Guihua Zhang 6 Carol Ewanowich 2 Laura Hopkins 7 Andrew Freywald 8 Lynne M Postovit 9 Martin Köbel 10 Yangxin Fu 6 Frederick S Vizeacoumar 8 Franco J Vizeacoumar 11 Mark S Carey 5 Cheng-Han Lee 12
Affiliations

Affiliations

  • 1 Department of Obstetrics and Gynecology, University of Alberta, Edmonton, Alberta, Canada.
  • 2 Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada.
  • 3 Division of Oncology, College of Medicine, University of Saskatchewan, Saskatchewan, Canada.
  • 4 Department of Experimental Therapeutics, BC Cancer, Vancouver, British Columbia, Canada.
  • 5 Department of Obstetrics and Gynecology, University of British Columbia, Vancouver, Canada.
  • 6 Department of Oncology, University of Alberta, Edmonton, Alberta, Canada.
  • 7 Division of Oncology, Cancer Cluster, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada.
  • 8 Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
  • 9 Department of Oncology, University of Alberta, Edmonton, Alberta, Canada; Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
  • 10 Department of Pathology and Laboratory Medicine, Calgary Laboratory Services and University of Calgary, Calgary, Alberta, Canada.
  • 11 Saskatchewan Cancer Agency, Saskatoon, Saskatchewan, Canada; Department of Pathology and Laboratory Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
  • 12 Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada. Electronic address: chenghanlee@gmail.com.
Abstract

Objective: Dedifferentiated endometrial carcinoma (DDEC) characterized by SWItch/Sucrose Non-Fermentable (SWI/SNF) complex inactivation is a highly aggressive type of endometrial Cancer without effective systemic therapy options. Its uncommon nature and aggressive disease trajectory pose significant challenges for therapeutic progress. To address this obstacle, we focused on developing preclinical models tailored to this tumor type and established patient tumor-derived three-dimensional (3D) spheroid models of DDEC.

Methods: High-throughput drug repurposing screens were performed on in vitro 3D spheroid models of DDEC cell lines (SMARCA4-inactivated DDEC-1 and ARID1A/ARID1B co-inactivated DDEC-2). The dose-response relationships of the identified candidate drugs were evaluated in vitro, followed by in vivo evaluation using xenograft models of DDEC-1 and DDEC-2.

Results: Drug screen in 3D models identified multiple cardiac glycosides including digoxin and digitoxin as candidate drugs in both DDEC-1 and DDEC-2. Subsequent in vitro dose-response analyses confirmed the inhibitory activity of digoxin and digitoxin with both drugs showing lower IC50 in DDEC cells compared to non-DDEC endometrial Cancer cells. In in vivo xenograft models, digoxin significantly suppressed the growth of DDEC tumors at clinically relevant serum concentrations.

Conclusion: Using biologically precise preclinical models of DDEC derived from patient tumor samples, our study identified digoxin as an effective drug in suppressing DDEC tumor growth. These findings provide compelling preclinical evidence for the use of digoxin as systemic therapy for SWI/SNF-inactivated DDEC, which may also be applicable to other SWI/SNF-inactivated tumor types.

Keywords

Cardiac glycoside; Dedifferentiated cancer; SWI/SNF; Undifferentiated cancer; Xenograft.

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