TMET-29. TARGETING IDH1-MUTATED OLIGODENDROGLIOMA WITH ACID CERAMIDASE INHIBITORS

Abstract BACKGROUND Currently, an estimated 14,950 people lives with oligodendroglioma in the United States. Oligodendroglioma is genetically defined as a tumor harboring isocitrate dehydrogenase 1 or 2 mutations (IDH1mut/IDH2mut). Previously, we reported that in IDH1mut gliomas, D-2HG, the product of IDH1 mutant enzyme produces an increase in monounsaturated fatty acid levels that are incorporated into ceramides, tilting the S1P-to-ceramide rheostat toward apoptosis. Herein, we exploited this imbalance to further induce and IDHmut-specific glioma cell death. METHODS TCGA and CCGA data were used to explore the association between acid ceramidase (AC) gene expression and patient survival. CCK8 viability assays were carried out to measure the sensitivity of glioma cell lines to acid ceramidase inhibitors. Western blot and liquid chromatography-mass spectrometry analyses were performed for studying the mechanism of action of acid ceramidase inhibitors. The in vivo efficacy of the SABRAC drug, an irreversible inhibitor of AC, was evaluated in an orthotopic oligodendroglioma xenograft mice model using TS603 patient-derived oligodendroglioma cells. RESULTS. We report for the first time that the inhibition of acid ceramidase (AC) induces apoptosis and increases the survival of mice with IDH1mut oligodendroglioma. We demonstrated an IDH1mut-specific cytotoxicity of SABRAC, in patient-derived oligodendroglioma cells. Exploring the mechanism of action of this drug, we found that SABRAC activates both extrinsic and intrinsic apoptosis in an ER stress-independent manner, pointing to a direct action of AC-related ceramides in mitochondria permeability. The activation of apoptosis detected under SABRAC treatment was associated with up to a 30-fold increase in some ceramide levels and its derivatives from the salvage pathway. CONCLUSIONS We propose AC as a novel therapeutic target in oligodendroglioma with IDH1mut and we are conducting additional preclinical testing.