Brain tumors remain the leading cause of
cancer-related deaths in children and often are associated with long-term sequelae among survivors of current therapies.
Telomerase and telomeres play important roles in
cancer, representing attractive therapeutic targets to treat children with poor-prognosis brain tumors such as diffuse intrinsic pontine
glioma (DIPG), high-grade
glioma (HGG) and high-risk
medulloblastoma (MB). It has shown that DIPG, HGG and MB frequently express
telomerase activity. It is now shown that the
telomerase-dependent incorporation of 6-
thio-2′
deoxyguanosine (6-
thio-dG), a
telomerase substrate precursor analog, into telomeres leads to
telomere dysfunction-induced foci (TIFs) along with extensive
genomic DNA damage,
cell growth inhibition and
cell death of primary stem-like cells derived from patients with DIPG, HGG and MB. Importantly, the effect of 6-
thio-dG is persistent even after
drug withdrawal. Treatment with 6-thio-dG elicits a sequential activation of ATR and ATM pathways and induces G2 / M arrest.
In vivo, treatment of mice bearing MB xenografts with 6-thio-dG delays
tumor growth, increases in-tumor TIFs and
apoptosis. Furthermore, 6-thio-dG crosses the blood-brain barrier and specifically targets
tumor cells in an orthotopic mouse model of DIPG. Together, these findings suggest that 6-thio-dG is a promising approach to treat therapy-resistant telomerase-positive pediatric brain tumors.