1. Academic Validation
  2. High-throughput drug screening reveals Pyrvinium pamoate as effective candidate against pediatric MLL-rearranged acute myeloid leukemia

High-throughput drug screening reveals Pyrvinium pamoate as effective candidate against pediatric MLL-rearranged acute myeloid leukemia

  • Transl Oncol. 2021 May;14(5):101048. doi: 10.1016/j.tranon.2021.101048.
Priscilla Wander 1 Susan T C J M Arentsen-Peters 2 Sandra S Pinhanҫos 3 Bianca Koopmans 2 M Emmy M Dolman 2 Rijndert Ariese 4 Frank L Bos 4 Patricia Garrido Castro 2 Luke Jones 2 Pauline Schneider 2 Miriam Guillen Navarro 2 Jan J Molenaar 2 Anne C Rios 4 C Michel Zwaan 1 Ronald W Stam 5
Affiliations

Affiliations

  • 1 Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS Utrecht, Netherlands; Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, Netherlands.
  • 2 Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS Utrecht, Netherlands.
  • 3 Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS Utrecht, Netherlands; CNC-Center for Neurosciences and Cell Biology, University of Coimbra, Coimbra, Portugal.
  • 4 Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS Utrecht, Netherlands; Oncode Institute, Utrecht, Netherlands.
  • 5 Princess Máxima Center for Pediatric Oncology, Heidelberglaan 25, 3584CS Utrecht, Netherlands. Electronic address: R.W.Stam@prinsesmaximacentrum.nl.
Abstract

Pediatric MLL-rearranged acute myeloid leukemia (AML) has a generally unfavorable outcome, primarily due to relapse and drug resistance. To overcome these difficulties, new therapeutic agents are urgently needed. Yet, implementing novel drugs for clinical use is a time-consuming, laborious, costly and high-risk process. Therefore, we applied a drug-repositioning strategy by screening drug libraries, comprised of >4000 compounds that are mostly FDA-approved, in a high-throughput format on primary MLL-rearranged AML cells. Here we identified pyrvinium pamoate (pyrvinium) as a novel candidate drug effective against MLL-rearranged AML, eliminating all cell viability at <1000 nM. Additional screening of identified drug hits on non-leukemic bone marrow samples, resulted in a decrease in cell viability of ∼50% at 1000 nM pyrvinium, suggesting a therapeutic window for targeting leukemic cells specifically. Validation of pyrvinium on an extensive panel of AML cell lines and primary AML samples showed comparable viabilities as the drug screen data, with pyrvinium achieving IC50 values of <80 nM in these samples. Remarkably, pyrvinium also induced cell toxicity in primary MLL-AF10+ AML cells, an MLL-rearrangement associated with a poor outcome. While pyrvinium is able to inhibit the Wnt pathway in Other Diseases, this unlikely explains the efficacy we observed as β-catenin was not expressed in the AML cells tested. Rather, we show that pyrvinium co-localized with the mitochondrial stain in cells, and hence may act by inhibiting mitochondrial respiration. Overall, this study shows that pyrvinium is highly effective against MLL-rearranged AML in vitro, and therefore represents a novel potential candidate for further studies in MLL-rearranged AML.

Keywords

High-throughput drug library screen; MLL-rearranged AML; Pediatric acute myeloid leukemia; Pyrvinium pamoate.

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