Although rare, ATC is the most lethal histotype of thyroid cancer [33]. ATC patients generally have a palpable, size variable and irregular rigid mass in the thyroid with or without hoarseness, dysphagia and dispones. Clinical pathology of ATC is characterized by rapid cell growth and the ability to metastasize to other organs of the body, especially lungs, bones and brain. These features contribute to its high mortality. At present, the principle of ATC treatment is total thyroidectomy combined with postoperatively systemic chemotherapy, radiotherapy and other therapeutic strategies. Although multimodality strategies have been demonstrated to be better than monotherapy, the vast majority of ATC patients still have a very poor survival because they are unresponsive to conventional antitumor agents. Thus, it is urgent to develop more effective therapeutic drugs for ATC treatment.
For the last decades, paclitaxel emerged as one of the most important compounds broadly used in the therapy of breast, ovarian, lung, head and neck cancers [4]. A phase 2 clinical trial first proposed the efficacy of continuous infusion paclitaxel every 3 weeks for 1 to 6 cycles in 20 patients with ATC [34]. Besides, another study analyzed the clinical data of 13 patients undergoing paclitaxel treatment every week, and finally observed 1 patient as complete response (CR) [35]. These observations indicate that paclitaxel treatment may be beneficial to prolong the survival of ATC patients. Meanwhile, there are studies demonstrating that antitumor effect of paclitaxel in ATC can be further enhanced when combined with lenvatinib, sorafenib or radiotherapy [36, 37]. However, traditional paclitaxel often causes serious side-effects besides drug resistance. Thus, it is essential to develop new taxoids with better pharmacological properties and improved activity in order to overcome the problems with traditional paclitaxel in cancer therapy. Evidently, new taxanes can effectively control advanced cancers including ATC [35–39], indicating that it may be a promising therapeutic strategy to prolong the survival of ATC patients without serious toxic side-effects.
In this study, we evaluated 5 novel DFV-taxoids (SB-T-1285106, SB-T-1285205, SB-T-1285406, SB-T-1285506 and SB-T-1285605), which were modified at the C2, C10 positions based on chemo-structure of paclitaxel. We next compared their antitumor activity with paclitaxel by a series of in vitro and in vivo experiments. The results showed that all of these taxoids exhibited exceptionally high potency than paclitaxel against ATC cells, as reflected by their lower IC50 values and more potent inhibition of cell proliferation, colony formation and tumorigenic potential in nude mice. Besides, these DFV-taxoids also exhibited more apparently G2/M phase arrest in ATC cells compared to paclitaxel. More importantly, we did not observe serious toxic side-effects, indicating that these DFV-taxoids such as SB-T-1285406 is a safe and effective agent for ATC therapy.
To clarify the mechanism of these taxoids showing better antitumor effect than paclitaxel, we performed in vitro tubulin polymerization assay, and found that these taxoids induced GTP-independent tubulin polymerization faster than paclitaxel, implying that there exists difference in structure between microtubules formed with these taxoids and paclitaxel. These results were in consistent with our previous study [8], besides the difference in binding rates, our previous study also mentioned rapid tubulin polymerization of new generation taxoids producing numerous short microtubules compared with paclitaxel, which may also be another difference between the DFV-taxoids and paclitaxel. This may be the main reason why these taxoids exhibit potent antitumor effect than paclitaxel.
To further look into the mechanism behind this difference, we performed molecular docking to analyze their interaction with β-tubulin. In fact, we have found that the DFV-taxoids possess unique and specific interactions with β-tubulin through organofluorine groups in the molecule, which do not exist in paclitaxel. The difluoromethoxy group of SB-T-1285406 interacts with His229 and Phe272 (Fig. 7b (2)). The difluoromethoxy group makes van der Waals interactions with the proximal surface of the protein consisting of Phe272, while simultaneously forming a hydrogen bond (OCF2H—N) with the delta nitrogen of His229. In the case of trifluoromethoxy-taxoids, one of the fluorine atoms can form a hydrogen bond with the amine hydrogen of His229 (NH—F-CF2CO) (Fig. S5). The introduction of the DFV group did not change the overall “T-taxol”-type conformation, while there are DFV-specific interactions of the two fluorine atoms with surrounding residues Ser236, Ala233 and Phe272, which paclitaxel does not have (Fig. 7b (3)). Since the 3’-DFV group is located substantially closer to Phe272, as compared to the 3’-phenyl group of paclitaxel, this van der Waals contact would make the binding of the DFV-taxoid tighter than paclitaxel. As the electrostatic surface representation in Fig. 7b (4) indicates, the hydrophobicity of this pocket allows the tighter and more favorable binding of these organofluorine moieties, as compared to paclitaxel.
In summary, by a series of extensive in vitro and in vivo experiments, we demonstrate that these five novel DFV-taxoids exhibit promising antitumor effect in ATC cells. They exhibit better antitumor activity than paclitaxel, thereby causing shorten therapeutic periods and less side-effects during several cycles of chemotherapy. Thus, our data indicate that these taxoids as monotherapy or in combination with other antitumor agents will provide a relatively safe and effective strategy for the treatment of ATC patients.