Gene activation of CEBPA using saRNA: preclinical studies of the first in human saRNA drug candidate for liver cancer

Oncogene. 2018 Jun;37(24):3216-3228. doi: 10.1038/s41388-018-0126-2. Epub 2018 Mar 7.

Abstract

Liver diseases are a growing epidemic worldwide. If unresolved, liver fibrosis develops and can lead to cirrhosis and clinical decompensation. Around 5% of cirrhotic liver diseased patients develop hepatocellular carcinoma (HCC), which in its advanced stages has limited therapeutic options and negative survival outcomes. CEPBA is a master regulator of hepatic function where its expression is known to be suppressed in many forms of liver disease including HCC. Injection of MTL-CEBPA, a small activating RNA oligonucleotide therapy (CEBPA-51) formulated in liposomal nanoparticles (NOV340- SMARTICLES) upregulates hepatic CEBPA expression. Here we show how MTL-CEBPA therapy promotes disease reversal in rodent models of cirrhosis, fibrosis, hepatosteatosis, and significantly reduces tumor burden in cirrhotic HCC. Restoration of liver function markers were observed in a carbon-tetrachloride-induced rat model of fibrosis following 2 weeks of MTL-CEBPA therapy. At 14 weeks, animals showed reduction in ascites and enhanced survival rates. MTL-CEBPA reversed changes associated with hepatosteatosis in non-alcoholic methionine and cholic-deficient diet-induced steaotic liver disease. In diethylnitrosamine induced cirrhotic HCC rats, MTL-CEBPA treatment led to a significant reduction in tumor burden. The data included here and the rapid adoption of MTL-CEBPA into a Phase 1 study may lead to new therapeutic oligonucleotides for undruggable diseases.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • CCAAT-Enhancer-Binding Proteins / genetics*
  • Diethylnitrosamine / toxicity
  • End Stage Liver Disease / chemically induced
  • End Stage Liver Disease / genetics
  • End Stage Liver Disease / therapy
  • Gene Expression Regulation, Neoplastic
  • Genetic Therapy / methods*
  • Hep G2 Cells
  • Humans
  • Liver Cirrhosis, Experimental / genetics
  • Liver Cirrhosis, Experimental / therapy*
  • Liver Neoplasms, Experimental / chemically induced
  • Liver Neoplasms, Experimental / genetics
  • Liver Neoplasms, Experimental / therapy
  • Male
  • Mice, Inbred C57BL
  • Mice, Transgenic
  • Middle Aged
  • Non-alcoholic Fatty Liver Disease / etiology
  • Non-alcoholic Fatty Liver Disease / genetics
  • Non-alcoholic Fatty Liver Disease / therapy
  • RNA, Small Untranslated / administration & dosage
  • RNA, Small Untranslated / pharmacology*
  • Rats, Sprague-Dawley
  • Rats, Wistar
  • Transcriptional Activation*

Substances

  • CCAAT-Enhancer-Binding Proteins
  • CEBPA protein, human
  • RNA, Small Untranslated
  • Diethylnitrosamine