Combination of carmustine and selenite effectively inhibits tumor growth by targeting androgen receptor, androgen receptor-variants and Akt in preclinical models: New hope for patients with prostate cancer

Despite established androgen receptor (AR) antagonists, AR/AR-variants signaling remain a major obstacle for the successful treatment of castration resistant prostate cancer (CRPC). In addition, CRPC cells adapt to survive via AR-independent pathways to escape next generation therapies. Therefore, there is an urgent need for drugs that can target these signaling pathways in CRPC. In the present study, we sought to determine whether carmustine and selenite in combination could induce apoptosis and inhibit growth of CRPC in-vitro and in-vivo. CRPC (22Rv1, VCaP and PC-3) cell culture and xenograft mouse model were used. Combination of carmustine and selenite treatment significantly increased reactive oxygen species, apoptosis and growth inhibition in CRPC cells with down regulation of anti-apoptotic (Bcl-2 and Mcl-1) and proliferative proteins (c-Myc and cyclin-D1). This effect was associated with complete reduction of AR/AR-variants, AR-V7, PSA and significant induction of p27Kip1. Combination treatment substantially abolished phospho-Akt, phospho-GSK-3β and anchorage-independent growth in AR-positive and AR-negative cells. Consistent with in-vitro results, combination treatment effectively induced apoptosis and completely inhibited xenograft tumor growth and markedly reduced AR/AR-variants, AR-V7, PSA, and Bcl-2 in xenograft tumors without causing genotoxicity in host mice. Individual agent treatment showed only partial effect. The combination treatment showed a significant synergistic effect. The present study is the first to demonstrate that the combination of carmustine and selenite treatment completely suppressed CRPC tumor growth by reducing AR/AR-variants and Akt signaling. Our findings suggest that the combination of carmustine and selenite could constitute a promising next-generation therapy for successful treatment of patients with CRPC. This article is protected by copyright. All rights reserved.

International journal of cancer. 2016 May 20 [Epub ahead of print]

Vijayalakshmi Thamilselvan, Mani Menon, Sivagnanam Thamilselvan

Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, 48202, USA., Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, 48202, USA., Vattikuti Urology Institute, Henry Ford Health System, Detroit, MI, 48202, USA.