Compound shows early promise in fighting breast cancer

A study recently published in the journal Molecular Cancer showed that quinoxaline di-N-oxide (DCQ) was effective in fighting breast cancer cells in mice and in vitro conditions.

"DCQ is active against many types of cancers, but breast cancer was a good candidate because similar kinds of therapy have failed to show promising results against breast tumours," said lead author Khaled Ghattass, who conducted the research as a PhD student at the American University in Beirut (AUB) and is now a project manager for the clinical research organization, Ergomed.

During earlier research by Ghattass' team at AUB, professors Hala Gali-Muhtasib and Makhlouf Haddadin, had found that DCQ's effectiveness is enhanced under hypoxic conditions, or oxygen-deprived areas.

In other words, the drug becomes active once it reaches a hypoxic region, or as soon as it enters the tumour. This could be a potent treatment for late-stage cancers – such as breast cancer – that develop large, solid tumours high in hypoxia. The study results show the first time that a hypoxia-activated cytotoxin has been found to fight certain breast cancers.

Gali-Muhtasib said: "This drug did not just block this tumour from developing further and reduce its size, it also blocked its translocation and metastasis to the lungs and liver."

Both the most recent work by Ghattass, as well as previous studies by Gali-Muhtasib and Haddadin, which focused on colon cancer, have raised the interest of peers in the field. Raja Fayad, a physician and professor at the University of South Carolina specializing in colon cancer and public health, hopes to test the drug in his laboratory.

"DCQ compound is a promising drug that can be used to treat early and late stages of colon cancer," Fayad said. "We can study whether DCQ reduces cancer burden in animals with primary and metastatic colon cancer, especially in tumour regions with hypoxia, which is well documented in one of my research animal models."

The drug is also promising because it can be combined with radiation therapy to treat more aggressive forms of cancer. Haddadin, Fady Geara, and Gali-Muhtasib have shown that DCQ acts as a radio-sensitizer – making tumours more sensitive to radiation therapy.

Researchers are also hoping to test the drug on cancer stem cells in the the lab of Marwan Sabban at AUB, in which they carried out the tests on mice.

The drug is in its early stages of development and a long way from clinical trials. Researchers have yet to conduct extensive studies on absorption, distribution, metabolism and excretion to determine the best concentration levels, toxicity and the maximum tolerable doses for humans.

As it is, the drug is dispensed in liquids like ethanol and methanol and, in this medium, is toxic to humans. "DCQ is soluble in organic compounds, not in water, and those organic compounds could be toxic when ingested by humans or animals," Gali-Muhtasib says.

"The major barrier is to make this drug water-soluble so we can capsule it and eventually give it to humans [in trials]."

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