Protein synthesis inhibitor omacetaxine is effective against hepatocellular carcinoma

Published on Jun 22, 2021in JCI insight6.205
· DOI :10.1172/JCI.INSIGHT.138197
Ling Li8
Estimated H-index: 8
Gilad Halpert8
Estimated H-index: 8
(JHUSOM: Johns Hopkins University School of Medicine)
+ 19 AuthorsFlorin M. Selaru40
Estimated H-index: 40
(JHUSOM: Johns Hopkins University School of Medicine)
Hepatocellular carcinoma (HCC) is the 6th-most common and the 4th-most deadly cancer worldwide. The development cost of new therapeutics is a major limitation in patient outcomes. Importantly, there is a paucity of preclinical HCC models in which to test new small molecules. Herein, we implemented novel patient-derived organoid (PDO) and patient-derived xenografts (PDX) strategies for high-throughput drug screening. Omacetaxine, an FDA-approved drug for chronic myelogenous leukemia (CML), was found to be a top effective small molecule in HCC PDOs. Next, omacetaxine was tested against a larger cohort of 40 human HCC PDOs. Serial dilution experiments demonstrated that omacetaxine is effective at low (nanomolar) concentrations. Mechanistic studies established that omacetaxine inhibits global protein synthesis, with a disproportionate effect on short-half-life proteins. High-throughput expression screening newly identified molecular targets for omacetaxine, including key oncogenes, such as PLK1. In conclusion, by using an innovative strategy, we report, for the first time, the effectiveness of omacetaxine in HCC. In addition, we newly elucidate key mechanisms of omacetaxine action. Finally, we provide a proof-of-principle basis for future studies applying drug screening PDOs sequenced with candidate validation in PDX models. Clinical trials could be considered to evaluate omacetaxine in patients with HCC.
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