# Mechanism underpinning synergy with combined treatment of MTI-101 and Dexamethasone in Multiple Myeloma

> **NIH NIH R44** · MODULATION THERAPEUTICS, INC. · 2020 · $212,660

## Abstract

ABSTRACT
Multiple myeloma (MM) is the second most common hematopoietic cancer and while survival rates have slowly
increase in the last 10 years, the five-year survival is just over 50%. The high number of patients that become
refractory to current therapies is the core reason for the low long-term survival. Therefore, there is a crucial need
to develop unique drugs that are active in refractory and resistant patients. Modulation Therapeutics is
developing a first in class peptide, MTI-101, that stimulates a CD44/ITGA4 complex resulting in an increase of
intracellular Ca2+ levels inducing necrosis. The company has acquired patents for the parent molecule, MTI-101,
and derivative (MTI-102) covering the intellectual property for both composition of matter and use in cancer.
Non-GLP and GLP toxicity testing are slated to be done soon in preparation for the submission of an IND
package to the FDA. Thus, Modulation Therapeutics provides the ideal environment to receive the training
required to obtain the next level position in drug development in any pharmaceutical company. Women are
greatly under-represented in upper administrative positions in part due to the lack to training needed to progress
from the entry-level research workforce. One goal of this proposal is to provide the research and entrepreneurial
skills underpinning the transition to administrative positions such as director of drug development. To receive
that training, the female senior scientist at Modulation Therapeutics will be involved in all stages of developing,
assembling, and submitting the IND package to the FDA. In addition, the leadership training will include the
development and role as project leader of a parallel research project proposed in this revision. The research
project will investigate the synergistic interaction of the lead compound for Modulation Therapeutics, MTI-101
and dexamethasone (Dex), a common drug administered in combination regimen for treatment of MM. Both MTI-
101 and Dex modulate calcium flux in cells and combination therapy with Dex and MTI-101 would likely increase
MTI-101 Ca2+ induced programmed necrosis. We found that combination treatment of MTI-101/Dex increased
cell death and resulted in greatest synergistic activity in MM cell lines pretreatment with Dex (24 h) followed by
an additional Dex/MTI-101 treatment (16 h). Based on these results, we hypothesize that dexamethasone is
modulating the expression of proteins involved in store-operated channels to potentiate MTI-101 mediated by
Ca2+ induced necrosis. Live-cell imaging of Ca2+ flux and cell death using Dex-treated MM cells exposed to an
MTI-101/Dex combination treatment provide insight into the mechanism of the observed synergy. Furthermore,
in vitro analysis of Dex mediated of expression of proteins involved in calcium flux by qRT-PCR, Western Blot,
and RNA seq will further elucidate the mechanism of action facilitating the cell death observed with MTI-101/
Dex combination therapy. MTI-101...

## Key facts

- **NIH application ID:** 10080460
- **Project number:** 3R44CA221554-03S1
- **Recipient organization:** MODULATION THERAPEUTICS, INC.
- **Principal Investigator:** Lori Hazlehurst
- **Activity code:** R44 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $212,660
- **Award type:** 3
- **Project period:** 2017-09-25 → 2021-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10080460

## Citation

> US National Institutes of Health, RePORTER application 10080460, Mechanism underpinning synergy with combined treatment of MTI-101 and Dexamethasone in Multiple Myeloma (3R44CA221554-03S1). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10080460. Licensed CC0.

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