# Targeting Metabolic Vulnerabilities with Molecular Inhibitors of Oxidative Phosphorylation

> **NIH NIH P50** · UNIVERSITY OF TX MD ANDERSON CAN CTR · 2022 · $315,315

## Abstract

SUMMARY: PROJECT 2
Despite unprecedented successes in many tumor types, molecular targeted therapeutics focused on targeting
activated/amplified oncogenes have not had a meaningful clinical impact on patients with the incurable brain
tumor glioblastoma multiforme (GBM). In this proposal we take a radically different approach to targeted
therapeutics by exploiting genomic deletions, rather than mutant oncogenes, as points of selective vulnerability.
Deletions create attractive therapeutic opportunities as they are usually homogenously distributed, persist during
tumor recurrence, and most importantly, can expose pharmacologically targetable vulnerabilities by collaterally
deleting nearby redundant metabolic housekeeping genes. We explored this concept by utilizing an unbiased
chemical biology approach to identify pharmacologically targetable vulnerabilities exposed by passenger
deletions. We found that inhibitors of mitochondrial oxidative phosphorylation (OxPhos) are selectively toxic to
glioma cells that contained collateral homozygous deletions in the glycolytic gene ENO1. We hypothesized that
the basis for this selective vulnerability is glycolysis-deficiency: ENO1-deleted glioma cells are unable to
upregulate glycolysis in the face of OxPhos inhibition, a compensatory response in normal cells (Pasteur effect).
A corollary of this hypothesis is that other deletions that cause glycolysis deficiency also sensitize to OxPhos
inhibitors. Tool compound OxPhos inhibitors have been extensively used in in vitro studies, but are not drug-like
and have poor pharmacology. MD Anderson’s Institute of Applied Cancer Science (IACS) developed a highly
potent and specific OxPhos inhibitor, IACS-010759, with nM affinity for mitochondrial complex I, which readily
passes the blood brain barrier and is endowed with superb pharmacological properties. In preliminary data we
demonstrated that IACS-010759 destroys glycolysis-deficient glioma cells in culture and eradicates intracranial
xenografts. Preliminary data indicate that the hypoxia PET probe 18F-fluoroazomycin-arabinoside (18F-FAZA)
can be used as a non-invasive in vivo read-out for OxPhos inhibition (target-engagement marker for IACS-
010759), because mitochondrial oxygen consumption is a major driver of tumor-hypoxia. Based on these
exceptionally encouraging pre-clinical results, we will conduct a trial of IACS-010759 on GBM patients with 18F-
FAZA as a target engagement marker. The goal of this proposal is to support this trial by: 1) pre-clinically
validating glycolytic-deficiency as a responder hypothesis and identifying other deletions which confer sensitivity
to IACS-010759 by this mechanism, 2) validating 18F-FAZA as a non-invasive read-out for OxPhos inhibition and
as a predictor of drug-response in glycolytically deficient tumors, and 3) determining target engagement (OxPhos
inhibition) by 18F-FAZA and biochemical response to IACS-010759 in patients with GBMs. This proposal stands
to be the first exa...

## Key facts

- **NIH application ID:** 10476416
- **Project number:** 5P50CA127001-14
- **Recipient organization:** UNIVERSITY OF TX MD ANDERSON CAN CTR
- **Principal Investigator:** Florian Muller
- **Activity code:** P50 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $315,315
- **Award type:** 5
- **Project period:** 2008-09-01 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10476416

## Citation

> US National Institutes of Health, RePORTER application 10476416, Targeting Metabolic Vulnerabilities with Molecular Inhibitors of Oxidative Phosphorylation (5P50CA127001-14). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10476416. Licensed CC0.

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