# Enhancing Chemoradiation Efficacy through Unbiased Drug Discovery Approaches

> **NIH NIH U01** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2021 · $596,334

## Abstract

A major barrier to improving cure rates in locally advanced cancers is our inability to make progress beyond what
chemoradiation (CRT) can currently deliver. Combination strategies using molecular targeted therapies with CRT
hold promise for improving outcomes further. While many drugs could enhance the effects of radiation alone, we
have discovered that the effects are quite unpredictable when drugs are combined with chemotherapy and
radiotherapy. The successful translation of adding molecular targeted agents to CRT would require an
understanding of the molecular pathways that enable the cancer cell to survive under conditions of CRT.
Inhibiting these pathways with molecular targeted drugs will be synergistic with CRT in the cancer-specific
context. Using a set of molecular targeted drugs from the CTEP portfolio as an initial starting point, we will
investigate two hard-to-treat cancer types treated with CRT, non-small cell lung cancer (NSCLC) and pancreatic
ductal adenocarcinoma (PDAC). We will identify drugs that could synergize with radiation and CRT using a high
throughput clonogenic survival screen that we have developed on validated cancer lines and then test the most
clinically promising combinations of agents to multiple cell lines with varying genetic backgrounds, first in vitro
and then further validated using 2 in vivo models: a panel of patient-derived xenografts (PDXs) and orthotopic
tumor models using syngeneic tumors, all done in combination with clinically-relevant chemotherapies. The
pharmacokinetic and pharmacodynamic properties of these drugs with chemotherapy in animals and tumors will
be assessed in order to determine the optimal sequencing approach with conventionally fractionated
radiotherapy. Since we have discovered that chemotherapy significantly alters the response of cancer cells to
radiation and targeted drugs, we will also evaluate the molecular mechanisms that explain the response to CRT,
and identify potential factors that may influence this response using 4 major approaches. In the first more classic
approach, we will assess DNA damage repair pathways and reactive oxygen species generation when targeted
agents are combined with radiation or CRT. Second, we will use reverse phase protein arrays (RPPA) to assess
the functional proteome to determine pathways that may be altered with molecular targeted drugs in the setting
of RT or CRT. In the third approach, we will use Stable Isotope Labeling with Amino Acids (SILAC) to assess
global proteomic and phosphoproteomic changes that occur with radiation and CRT treatment, and how these
pathways could be altered with specific molecular targeted therapies. Lastly, we will use Imaging Mass
Spectrometry to analyze drug distribution within the various tumor models and assess how the
pharmacodynamic heterogeneity impacts CRT responsiveness. Our proposal will not only identify the most
promising drugs that could best be combined with CRT in NSCLC and PDAC, but we will have iden...

## Key facts

- **NIH application ID:** 10223893
- **Project number:** 5U01CA216468-05
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Sunil Krishnan
- **Activity code:** U01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2021
- **Award amount:** $596,334
- **Award type:** 5
- **Project period:** 2017-09-05 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10223893

## Citation

> US National Institutes of Health, RePORTER application 10223893, Enhancing Chemoradiation Efficacy through Unbiased Drug Discovery Approaches (5U01CA216468-05). Retrieved via AI Analytics 2026-05-28 from https://api.ai-analytics.org/grant/nih/10223893. Licensed CC0.

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