Article
Author: Maddalo, Danilo ; Steensma, Matthew R ; Staben, Steven T ; Essenburg, Curt J ; den Besten, Willem ; Graveel, Carrie R ; Kleinheinz, Tracy ; Wertz, Ingrid E ; Peale, Frank ; Fairbrother, Wayne J ; Yu, Kebing ; Forrest, William F ; Deshmukh, Gauri ; Wolfrum, Emily ; Levy, Elizabeth ; Villemure, Elisia ; Shemorry, Anna ; Blaquiere, Nicole ; Mulvihill, Melinda M ; Tovar, Elizabeth A ; Nagapudi, Karthik ; Blake, Robert A
Proximity-inducing compounds that modulate target protein homeostasis represent an emerging therapeutic strategy. While the inherent complexity of these bifunctional compounds presents certain challenges, their unique composition offers opportunities to co-opt specific cellular effectors to enhance therapeutic impact. In this study, we systematically evaluate a series of bifunctional degrader compounds engineered with the estrogen receptor-alpha (ERα) inhibitor endoxifen linked to various bioactive ubiquitin ligase ligands. Notably, ERα degraders containing pan-IAP antagonist ligands significantly reduced the proliferation of ERα-dependent cells compared to clinical-stage ERα degraders. These pan-IAP antagonist-based ERα degraders leverage distinct effector ligases to achieve dual therapeutic effects: They utilize XIAP within tumor cells to promote ERα degradation and activate cIAP1/2 in both tumor and immune cells to induce TNFα, which drives tumor cell death. Our findings illustrate a broader concept that co-opting the discrete functions of selected cellular effectors, while simultaneously modulating therapeutic target protein homeostasis, are dual strategies that can significantly enhance the efficacy of induced proximity therapeutics.