4.7 Article

Targeted MDM2 Degradation Reveals a New Vulnerability for p53-Inactivated Triple-Negative Breast Cancer

Journal

CANCER DISCOVERY
Volume 13, Issue 5, Pages 1210-1229

Publisher

AMER ASSOC CANCER RESEARCH
DOI: 10.1158/2159-8290.CD-22-1131

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This study discovered the increased aggressiveness and therapy resistance in p53-inactivated TNBC. The researchers designed a new PROTAC to selectively target MDM2 for degradation and demonstrated its therapeutic effect in TNBC models. Transcriptomic analysis revealed the upregulation of p53 family target genes and the crucial role of MDM2 in the survival of p53-inactivated TNBC cells. This study provides a potential therapeutic strategy for TNBC.
Triple-negative breast cancers (TNBC) frequently inactivate p53, increasing their aggressiveness and therapy resistance. We identifi ed an unexpected protein vulner-ability in p53-inactivated TNBC and designed a new PROteolysis TArgeting Chimera (PROTAC) to target it. Our PROTAC selectively targets MDM2 for proteasome-mediated degradation with high-affi nity binding and VHL recruitment. MDM2 loss in p53 mutant/deleted TNBC cells in two-dimensional/three-dimensional culture and TNBC patient explants, including relapsed tumors, causes apoptosis while sparing normal cells. Our MDM2-PROTAC is stable in vivo , and treatment of TNBC xenograft-bearing mice demonstrates tumor on-target effi cacy with no toxicity to normal cells, signifi cantly extending survival. Transcriptomic analyses revealed upregulation of p53 family target genes. Investigations showed activation and a required role for TAp73 to mediate MDM2-PROTAC-induced apoptosis. Our data, challenging the current MDM2/p53 paradigm, show MDM2 is required for p53-inactivated TNBC cell survival, and PROTAC-targeted MDM2 degradation is an innovative potential therapeutic strategy for TNBC and superior to existing MDM2 inhibitors.SIGNIFICANCE: p53-inactivated TNBC is an aggressive, therapy-resistant, and lethal breast cancer subtype. We designed a new compound targeting an unexpected vulnerability we identifi ed in TNBC. Our MDM2-targeted degrader kills p53-inactivated TNBC cells, highlighting the requirement for MDM2 in TNBC cell survival and as a new therapeutic target for this disease. See related and 1043.

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