A fragment prodrug discovered in a phenotypic screen

Glioblastoma multiforme (GBM) is a particularly nasty type of brain tumor with few drug options aside from the DNA alkylating agent temozolomide (TMZ), which is toxic and not particularly effective. Drugs fail for multiple reasons, among them the difficulty many small molecules have crossing the blood-brain barrier. A recent Nature paper by Luis Parada and a large group of collaborators at Memorial Sloan Kettering Cancer Center and elsewhere describes a promising new approach.

 

The researchers screened >200,000 molecules (not necessarily fragments) against primary GBM cells to look for compounds that reduced viability. Generically toxic molecules are so common that they (literally) grow on trees, so hits were counter-screened against mouse embryonic fibroblasts to looks for molecules that selectively killed GBM cells. This led to a rule-of-three compliant compound the researchers dubbed gliocidin.

 

Figuring out how gliocidin works turned out to be a complicated quest, starting with a genome-wide CRISPR-Cas9 screen to look for genes that either protected or sensitized cells to gliocidin. Subsequent work, including knocking out specific genes of interest and LC-MS/MS studies of metabolites, revealed that gliocidin leads to inhibition of a protein called inosine monophosphate dehydrogenase 2 (IMPDH2), which is necessary for guanine synthesis.

 

However, gliocidin is not a direct inhibitor of IMPDH2. Rather, it is is essentially a "pro-prodrug". Gliocidin is first converted into gliocidin-monocucleotide by the enzyme NAMPT (a target we wrote about back in 2014), and subsequently converted to gliocidin-adenine dinucleotide (GAD) by the enzyme NMNAT1. Cryo-EM showed that GAD binds at the NAD⁺ cofactor binding site of IMPDH2, blocking enzyme activity.

In addition to being a DNA-alkylating agent, TMZ induces NMNAT1 expression, thereby increasing conversion of gliocidin to GAD. Consistent with this, the combination of gliocidin and TMZ was more effective than either agent alone in mouse xenograft models. This is a lovely paper that reads like a detective story, and I’m only able to scratch the surface in a brief blog post. It also has multiple lessons for FBDD.

 

First, as expected given its molecular properties, gliocidin has excellent brain penetration. Vicki Nienaber argued in 2009 that FBDD may be ideally suited for finding molecules that can cross the blood-brain barrier, and gliocidin is a case in point.

 

Second, this paper answers emphatically in the affirmative the question we posed in 2022: “Is phenotypic fragment screening worthwhile?”

 

Third, this is another example of in situ inhibitor assembly to generate an analog of NAD⁺; we wrote about a small fragment targeting a different protein here. Given that fragments are the size of many metabolites, fragments as prodrugs could be a productive area of research.

 

But such a prodrug approach is not without risks. In that 2014 post about NAMPT inhibitors, I noted that some molecules had poorly characterized off-target activities, which could perhaps now be explained through this type of in situ activation. The new paper found that GAD does not inhibit two different NAD⁺ or NADPH-dependent enzymes, but hitting off-target enzymes will be something to watch for during optimization. I look forward to following this story.