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Clinical perspectives of BET inhibition in ovarian cancer

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Abstract

Background

Bromodomain and extra-terminal (BET) proteins are epigenetic readers that bind to acetylated lysines of histones and regulate gene transcription. BET protein family members mediate the expression of various oncogenic drivers in ovarian cancer, such as the MYC and Neuregulin 1 (NRG1) genes. BRD4, the most thoroughly studied member of the BET family, is amplified in a significant subset of high-grade serous carcinomas (HGSC) of the ovary. It has been reported that BET inhibitors can attenuate the proliferation and dissemination of ovarian cancer cells by inhibiting oncogenic pathways, such as the FOXM1 and JAK/STAT pathways. BET inhibition can re-sensitize resistant ovarian cancer cells to already approved anticancer agents, including cisplatin and PARP inhibitors. This synergism was also confirmed in vivo in animal models. These and other preclinical results provide a promising basis for the application of BET inhibitors in ovarian cancer treatment. Currently, Phase I/II clinical trials explore the safety and efficacy profiles of BET inhibitors in various solid tumors, including ovarian tumors. Here, we review current knowledge on the molecular effects and preclinical activities of BET inhibitors in ovarian tumors.

Conclusions

BET proteins have emerged as new druggable targets for ovarian cancer. BET inhibitors may enhance antitumor activity when co-administered with conventional treatment regimens. Results from ongoing Phase I/II studies are anticipated to confirm this notion.

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  1. Department of Clinical Therapeutics, Alexandra Hospital, National and Kapodistrian University of Athens, 11528, Athens, Greece

    Angeliki Andrikopoulou, Michalis Liontos, Konstantinos Koutsoukos, Meletios-Athanasios Dimopoulos & Flora Zagouri

  2. School of Medicine, National and Kapodistrian University of Athens, 80 Vasilissis Sofias Avenue, 11528, Athens, Greece

    Angeliki Andrikopoulou, Michalis Liontos, Konstantinos Koutsoukos, Meletios-Athanasios Dimopoulos & Flora Zagouri

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ML has received honoraria from Roche, Astra Zeneca, Astellas, MSD, Janssen, Bristol-Myers-Squibb and IPSEN. KK has received honoraria from Roche, BMS, MSD and IPSEN. MAD has received honoraria through participation in advisory boards from Amgen, Bristol-Myers-Squibb, Celgene, Janssen and Takeda. FZ has received honoraria for lectures and has served as an advisor for Astra-Zeneca, Daiichi, Eli-Lilly, Merck, Novartis, Pfizer and Roche. The remaining authors declare no conflict of interest.

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Andrikopoulou, A., Liontos, M., Koutsoukos, K. et al. Clinical perspectives of BET inhibition in ovarian cancer. Cell Oncol. 44, 237–249 (2021). https://doi.org/10.1007/s13402-020-00578-6

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