Suppression of Paclitaxel-Induced Neuropathy and Ovarian Tumor Growth by Mn Porphyrin, MnTnBuOE-2-PyP (BMX-001)

Authors

Ivan Spasojevic, Department of Medicine-Division of Oncology and Duke Cancer Institute PK/PD Core Laboratory, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Zhiqing Huang, Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Welida Tamires da Silva, Department of Medicine-Division of Oncology and Duke Cancer Institute PK/PD Core Laboratory, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Weina Duan, Department of Anesthesiology, Multidisciplinary Neuroprotection Laboratories, Center for Perioperative Organ Protection, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Li Du, Department of Anesthesiology, Multidisciplinary Neuroprotection Laboratories, Center for Perioperative Organ Protection, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Cathleen Chen, Department of Medicine-Division of Oncology and Duke Cancer Institute PK/PD Core Laboratory, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Jie Cao, Department of Medicine-Division of Oncology and Duke Cancer Institute PK/PD Core Laboratory, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Shasha Zhang, Department of Anesthesiology, Multidisciplinary Neuroprotection Laboratories, Center for Perioperative Organ Protection, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Hannah Lee, Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Gaomong Lo, Division of Reproductive Sciences, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Artak Tovmasyan, Department of Translational Neuroscience, Barrow Neurological Institute, Phoenix 85013, Arizona, USA.
Huaxin Sheng, Department of Anesthesiology, Multidisciplinary Neuroprotection Laboratories, Center for Perioperative Organ Protection, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Ines Batinic-Haberle, Department of Radiation Oncology, Duke University School of Medicine, Durham 27710, North Carolina, USA.
Angeles Alvarez Secord, Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Duke Cancer Institute, Duke University School of Medicine, Durham 27710, North Carolina, USA.

Document Type

Article

Abstract

Numerous cellular and animal studies demonstrated the ability of redox-active Mn(III) N-alkyl- and N-alkoxyalkylpyridyporphyrins (MnPs) to protect normal tissue while suppressing tumor growth. The mechanism primarily involves the modulation of NF-кB and Nrf2 signaling pathways via catalysis of MnP/HO-driven protein thiol oxidation. Such differential protection/suppression effects have paved the way of Mn porphyrins (commonly known as mimics of superoxide dismutase) into clinical trials, therefore introducing new line of therapeutics that are affecting cellular redox status/oxidative stress, rather than specific proteins. The most clinically advanced Mn porphyrin, Mn(III) meso-tetrakis(N-n-butoxyethyl-2-pyridyl) porphyrin (MnTnBuOE-2-PyP, BMX-001) has progressed into five Phase II clinical trials, two of those related to the injuries of central nervous system. Currently, no efficient treatment for chemotherapy-induced neuropathy is available in clinics. We therefore employed BMX-001 to assess its effect on paclitaxel (PTX)-induced neuropathy. Mechanical (Von-Frey filaments) and thermal (hot plate) stimulation, toxicity (body weight), muscular coordination and general physical condition (rotarod) of female CD-1 mice were evaluated over 3 weeks with 2 mg/kg daily dosing and also at clinically relevant dosing of 0.8 mg/kg given subcutaneously (SC) twice weekly after 1.6 mg/kg loading dose. Data revealed a significant ability of BMX-001 to suppress peripheral neuropathy and neuroinflammation. Importantly, while protecting peripheral tissue, BMX-001 suppressed the tumor growth of CAOV2 high-grade serous ovarian cancer in a mouse subcutaneous xenograft model. Previously, the strong anticancer effect was only seen when Mn porphyrins were combined with radiation, chemotherapy, and ascorbate (Asc). Our data further demonstrate that high-grade serous ovarian cancer is the first in vivo cancer thus far studied where redox-active Mn porphyrin, as a single agent, exhibits strong anticancer effect, comparable to that of PTX. The effect is presumably due to high tumor levels of BMX-001 and high oxidative stress specific to the aggressive chemoresistant CAOV2 cell line. Such a strong anticancer effect of BMX-001 would allow for lowering the dosing of PTX and reducing the neuropathy. The combined neuropathy protection and anticancer efficacy demonstrate, therefore, strong therapeutic potential of BMX-001 for gynecological cancers. Moreover, the ability of BMX-001 to suppress neuropathy may be relevant for all types of cancer where chemotherapeutics that induce neuropathy are used as a standard-of-care.

Keywords

BMX-001, Mn porphyrin, MnTnBuOE-2-PyP5+, SOD mimic, cellular and mouse tumor studies, mouse neuropathy model, ovarian high-grade serous CAOV2 cancer

Medical Subject Headings

Female; Ovarian Neoplasms (drug therapy, pathology); Animals; Paclitaxel (adverse effects); Metalloporphyrins (therapeutic use, pharmacology); Mice; Humans; Peripheral Nervous System Diseases (chemically induced, drug therapy); Cell Line, Tumor

Publication Date

1-1-2025

Publication Title

Oxidative medicine and cellular longevity

E-ISSN

1942-0994

Volume

2025

First Page

6333148

PubMed ID

40900760

Digital Object Identifier (DOI)

10.1155/omcl/6333148

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