Fanconi's anemia (FA) is a genetically heterogeneous inherited disorder characterized by bone marrow failure, birth defects and cancer susceptibility. At the cellular level, FA features hypersensitivity to DNA cross-linking agents, cell cycle abnormalities and abnormal responses to cytokines. Therapy for the hematopoietic defects of FA has consisted of supportive care, stem cell transplantation and administration of androgens such as oxymetholone. Unfortunately, even successfully transplanted FA patients have a very high risk for subsequent solid tumors, especially squamous cell carcinomas of oropharyngeal and urogenital areas.
The pharmacological treatment of FA has been unchanged for several decades and for this reason our group has embarked on systematic search for small molecule therapeutics that could benefit FA patients. This effort has been made possible by the cloning of 16 FA genes and biochemical insights into the function of FA proteins. Mouse models, zebra fish models and FA patient cell lines, including IPSC are available for screening and validation.
The specific goals of small molecule interventions are to delay or prevent hematopoietic failure and also to delay or prevent carcinogenesis.
To date we have shown that the superoxide dismutase mimetic drug Tempol can significantly delay tumor formation in FA mice. Similarly, resveratrol clearly improved hematopoiesis in the same model.
Medium throughput screens have revealed numerous new molecules which ameliorate the FA phenotypes of cells, mice and zebrafish respectively. Using genetic approaches we also have identified the p53 pathway as a therapeutic target in FA.
These therapeutic opportunities and progress in FA small molecule screening will be discussed.
Citation Format: Markus Grompe, John Postlethwait, Alan D'Andrea, Susan Olson, Qingshuo Zhang, Grover Bagby. Fanconi's anemia: Emerging therapeutic opportunities. [abstract]. In: Proceedings of the AACR Special Conference: Cancer Susceptibility and Cancer Susceptibility Syndromes; Jan 29-Feb 1, 2014; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(23 Suppl):Abstract nr IA05. doi:10.1158/1538-7445.CANSUSC14-IA05