A Novel Agent for Ovarian Cancer - ABSTRACT
Epithelial ovarian cancer (EOC) is the main subgroup of ovarian cancer, the most lethal
gynecological malignancy. EOC encompasses high-grade serous epithelial ovarian carcinoma,
fallopian tubal, and peritoneal carcinomas, which are considered a single clinical entity due to
their shared clinical behavior, treatment and pathogenesis.
Most women (75%) present with advanced EOC which is treated with cytoreductive
surgery and chemotherapy consisting of a platinum salt plus a taxane. While most patients
respond to first-line chemotherapy, many become platinum resistant. The high mortality of EOC
is attributed to the late diagnosis of the disease and the lack of efficacious therapeutic agents;
rates of survival have not changed in the last 20 years. Thus the development of efficacious and
safe agents for EOC is an unmet and pressing medical need.
Q922 is a proprietary anti-cancer agent that in preliminary studies showed broad
anticancer properties and remarkable safety. In a mouse model of stage III EOC, Q922 showed
rapid tumor regression (53% reduction in tumor load compared to its baseline and 153% reduction
compared to vehicle control). This result is highly promising as in the vast majority of EOC patients
at both initial diagnosis and tumor recurrence the cancer is confined to the peritoneal cavity.
Additional preliminary data indicate safety, a favorable PK pattern and a novel mechanism of
action. The pivotal mechanistic event is induction of strong oxidative stress that activates several
downstream signaling pathways, leading to a profound cytokinetic effect (suppressed
proliferation, induction of apoptosis, and cell cycle block) that, in turn, results in tumor regression.
Using cis-platinum and doxorubicin resistant ovarian cell lines we demonstrated that Q922
ihhibits the growth of platinum and doxorubicin resistant cells with identical potency as the parent
cell line. Finally, Q922 inhibits mutant K-Ras, and suppresses VEGF, a molecule critical to the
introperitoneal spread of EOC.
Our hypothesis is that Q922 is an efficacious and safe agent for the treatment of EOC
acting predominantly through a redox-based mechanism. We propose to evaluate our hypothesis
by pursuing three specific aims: Aim #1: Determine the efficacy and safety of Q922 in EOC. Aim
#2: Determine the pharmacokinetics and biodistribution of Q922. And Aim #3: Determine in vitro
and in vivo the mechanism of action of Q922 in EOC.
Q922, is an outstanding drug candidate for EOC, based on its efficacy, safety, favorable
PK, low cost and ability to inhibit the growth of drug-resistant EOC cells. Our preliminary data
support the strong therapeutic potential of Q922. By assessing key aspects of the pharmacology
of this promising agent, the proposed work will provide the foundation for its further development
as an efficacious and safe treatment for EOC