In vivo manipulation of the protein homeostasis network in rhabdomyosarcoma

Kristen Kwong1, Yue Pan1, Jacqueline Morales1

  • 1Department of Pediatrics, Division of Oncology, University of California San Francisco, San Francisco, CA 94143, USA.

Oncotarget
|August 29, 2025
PubMed

Insights

Targeting protein homeostasis (proteostasis) with p97 inhibitors shows promise for rhabdomyosarcoma (RMS) treatment. This approach activates the unfolded protein response (UPR) and induces cancer cell death, offering a new therapeutic strategy.

Area of Science:

  • Molecular Biology
  • Cancer Biology
  • Drug Discovery

Background:

  • The protein homeostasis (proteostasis) network is crucial for cellular health and is often dysregulated in cancer.
  • Rhabdomyosarcoma (RMS), a pediatric soft tissue sarcoma, has limited treatment options for relapsed patients.
  • Inhibiting heat shock protein 70-kD (HSP70) chaperones with MAL3-101 induces RMS cell death via unfolded protein response (UPR) activation.

Purpose of the Study:

  • To investigate proteostasis inhibitors as a therapeutic strategy for RMS.
  • To screen proteostasis components that could mimic MAL3-101's effects in vivo.
  • To explore the therapeutic potential of targeting VCP (p97 ATPase) in RMS.

Main Methods:

  • Screening of proteostasis components.
  • Inhibition of VCP (p97 ATPase) and assessment of UPR activation and apoptosis in RMS cells.
  • Evaluation of a preclinical p97 inhibitor in mouse models and patient-derived xenografts.
  • RNA sequencing of resistant tumors to identify biomarkers.

Main Results:

  • VCP inhibition activates the UPR and induces RMS apoptosis, similar to MAL3-101.
  • A preclinical p97 inhibitor demonstrated improved bioavailability and anti-tumor activity compared to MAL3-101 in vivo.
  • Tumor xenografts showed variable sensitivity to p97 inhibitors, with resistance linked to elevated autophagy.

Conclusions:

  • Proteostasis inhibition, particularly targeting VCP, represents a viable therapeutic strategy for slowing RMS growth.
  • Elevated autophagy in resistant tumors suggests it as a biomarker for proteostasis adaptability.
  • Targeting compensatory mechanisms within the proteostasis network may lead to synergistic therapeutic outcomes in RMS.