Assessment of a recently developed boron-based HIF inhibitor as a prospective therapy for renal cell carcinoma (RCC) - Inactivation of the VHL tumor suppressor protein (pVHL) is frequently observed in clear cell Renal Cell
Carcinoma (RCC). The mutated pVHL does not bind and degrade the regulatory α-subunits of the hypoxia-
inducible factor (HIF-1/2/3α) under normoxia causing overexpression of HIF-dependent pro-angiogenic factors
such as VEGF, EPO, PDGF, etc. As a result, RCCs are highly vascular in nature. Extensive studies have
established that the inhibition of the HIF pathway is sufficient to suppress tumor growth by the VHL‒/‒ RCC
cells, offering an attractive target to treat this disease. We have shown that pure honokiol inhibits the HIF
pathway and hypoxia-mediated expression of pro-angiogenic genes in a number of cancer cell lines. Honokiol
also inhibits constitutively active HIF pathway and expression of pro-angiogenic genes in VHL‒/‒ RCC4 cells
under normoxia. Further, we have determined the mechanism of action of honokiol using chromatin
immunoprecipitation experiments. These finding have allowed us to synthesize a new class of boron based
HIF inhibitors with improved efficacy and anti-angiogenic properties under in vitro conditions. In this project we
propose two specific aims: (i) determine the structure-activity-relationship (SAR) of honokiol analogs on the
inhibition of the HIF pathway and (ii) determine the efficacy of selected honokiol analogs in a xenograft RCC
mouse model. At the completion of this project, our expectation is that we will have evaluated the potential
therapeutic efficacy of honokiol analogs as a treatment strategy for RCC. In addition to primary positive impact
of our findings, potential outcomes may benefit treatment of other systemic problems associated with VHL
mutations, e.g. hemangioblastomas of retina and CNS. Finally, activation of the HIF pathway plays critical roles
in the development of many different cancer types at multiple stages. Evaluation of honokiol analogs as
inhibitors of the HIF pathway is expected to provide an important tool to further define the contribution of this
pathway in cancer development and resistance.
Relevance to Public Health: RCC is an important disease with ≈60,000 new cases predicted each year with
>13,000 deaths. The clear cell carcinoma are the most common form of RCC and making up nearly 70% of
cases. Unfortunately, cure for RCC is only available to those with limited stage disease which can be surgically
resected, as to date systemic therapies cannot eradicate the cancer if it has spread distantly. In advanced
stages, systemic therapies are given to stabilize the disease. No conventional cytotoxic chemotherapy agents
have demonstrated significant activity in this disease as monotherapy or combinations. Anti-VEGF therapies
have been largely ineffective, possibly due to contribution of other pro-angiogenic factors, such as EPO,
PDGF, etc. in RCC. Thus, there remains an unmet medical need to develop more effective treatments for
RCC. The proposed research will evaluate honokiol and its analogs as inhibitors of the HIF pathway and more
effective therapeutic agent for the treatment of RCC.