Determining preclinical safety of Aclarubicin in pediatric malignancies

作者：Darleen S. Tu, Aaron Olson, Kimberly S. Waggie, Nicolas M. Garcia, Virginia J. Hoglund, Stephanie Walter, Jenna R Rosinski, Harini Sadeeshkumar, Radhika A. Patel, Erolcan Sayar, Michael Haffner, Lisa Maves, Jacques Neefjes, Jay F. Sarthy, Elizabeth R. Lawlor, Shireen Ganapathi · 发表于：bioRxiv (Cold Spring Harbor Laboratory) · 年份：2025 · DOI：10.1101/2025.05.20.654130 · 研究领域：Chemotherapy-induced cardiotoxicity and mitigation、Lung Cancer Research Studies、Chemotherapy-induced organ toxicity mitigation

Abstract Background Anthracyclines are among the most effective chemotherapeutic agents used to treat pediatric malignancies. However, their clinical use is limited by dose-dependent toxicities, particularly cardiotoxicity and secondary malignancies. Aclarubicin (Acla) is an anthracycline derivative that induces chromatin damage while sparing DNA, offering potential therapeutic benefit with reduced longterm toxicity. Methods We evaluated the anti-tumor efficacy and safety profile of Acla in multiple in vitro pediatric cancer models and in vivo mouse models designed to mimic anthracycline re-treatment following prior doxorubicin (Doxo) exposure. Tumor growth, genotoxic stress, survival, and organ toxicity were assessed. Results Acla demonstrated robust anti-tumor activity comparable to Doxo across diverse pediatric in vitro models. Unlike Doxo, Acla treatment did not induce significant genotoxic stress. In vivo , mice receiving Acla after Doxo exposure showed no evidence of cumulative cardiotoxicity or end-organ damage. In contrast, a second course of Doxo led to significant toxic mortality, but was surprisingly not attributable to classic cardiac injury. Conclusion Our study highlights Acla as a promising anthracycline derivative for pediatric cancers, with potent anti-tumor efficacy and a superior safety profile, even following prior anthracycline exposure. These results support continued investigation of chromatin-damaging anthracyclines that can kill pediatric cancer cells...