ABSTRACT
Title: PROTECT – Harnessing PROTEin degradation for Advanced Childhood Tumors
Background
Survival rates for children with solid tumors, including brain, have largely plateaued over the past three
decades making them the most common cause of disease-related mortality in this age group. After decades of
optimizing chemotherapy and radiotherapy protocols, higher cure rates for childhood solid tumors will no
longer be achieved by “more of the same.” Rather, cures will require innovative interventions that specifically
target the unique biology of these tumors, which are often driven by oncogenic fusions and other pediatric-
specific oncoproteins historically considered difficult drug targets. With advances in targeted protein
degradation and chemical interventions to inhibit protein-protein interactions, it has recently become
tractable to target these proteins previously thought to be “undruggable”. Moreover, unbiased functional
screening approaches, such as CRISPR-Cas9, have revealed new pediatric cancer synthetic lethal liabilities in
need of targeted inhibitors.
Aims
We aim to lead the transformation of delivering such specific treatments to our young patients harnessing the
power of a highly interdisciplinary and collaborative team of world-leading experts in pediatric oncology,
targeted protein degradation, high-throughput chemical screening, medicinal chemistry, structural biology,
tumor biology, preclinical drug testing, and clinical trials, complemented by a trans-Atlantic group of engaged
patient representatives.
Methods
A bold plan will be pursued with a portfolio of projects that balance very high?risk efforts with others nearing
clinical implementation. We will focus on drivers/targets in the following diseases: Ewing sarcoma,
neuroblastoma, synovial sarcoma, ependymoma and high-grade glioma. We will explore different approaches
to target these as yet undrugged paediatric drivers/dependencies, to overcome resistance to available
targeted inhibitors, and to improve the efficacy and therapeutic window of CAR-T treatments.
How the results will be used
The aspiration of our team is to establish a sustainable platform for repeated developmental cycles of
paediatric-specific drug development for emerging targets including a viable financial model to de-risk such
developments for such rare pediatric tumors to the direct benefit of our patients. Specifically, we anticipate
success through (i) delivering at least one optimised protein degrader for its application in early-phase clinical
trials, (ii) enabling the druggability of previously “undruggable” targets, (iii) providing mechanistic insights into
disease, novel targets, and therapy resistance mechanisms and ways to tackle them.