Combined HDAC and ATM inhibition with radiation in preclinical glioblastoma models.

Authors

Susan Qualls-Histed, Kaitlyn Chung, Gozde Uzunalli, Sonam Patel, Elizabeth Hayes, Kyria Kelley-Wolfe, Elaine Cabrales, Tanmayee Durshelwar, Liiban Said, Nicole E Salisbury, Siddhi Desai, Keely Orndorff, Nader Sanai, An-Chi Tien, Artak Tovmasyan, Shwetal Mehta

Published in

bioRxiv : the preprint server for biology. Oct 07, 2026. Epub Oct 07, 2026.

Abstract

Brain-penetrant histone deacetylase inhibitors (HDACi) are promising radiosensitizing agents for glioblastoma (GBM). HDAC inhibitors can impair DNA damage response (DDR) pathways and promote persistent DNA damage. Here, we evaluated whether combined inhibition of HDAC and the DNA repair kinase, ataxia-telangiectasia mutated (ATM), could synergize with radiation (IR) and improve therapeutic efficacy in GBM.
In vitro dose-response assays were performed in patient-derived xenograft (PDX)-derived glioma stem cells (GSCs) with both inhibitors of HDAC (quisinostat, QST) and ATM (AZD1390) with or without IR treatment to assess synergy. Pharmacodynamic responses were evaluated by immunoblotting for histone acetylation, DDR signaling, and DNA damage markers. Transcriptomic analyses were performed to evaluate treatment-associated changes in DNA repair pathways. The combination of QST, AZD1390, and IR was further evaluated in an orthotopic GBM survival study.
Combined treatment with QST and AZD1390 produced synergistic radiosensitization in multiple GSC models in vitro . Furthermore, QST combined with IR suppressed transcription of homologous recombination (HR) pathway genes in GSCs, impairing double-strand break repair capacity through an epigenetic mechanism that does not directly inhibit ATM kinase activity. Pharmacodynamic analyses confirmed that QST increased histone acetylation while AZD1390 suppressed ATM signaling, together impairing complementary mechanisms to increase radiosensitivity of GSCs. In an orthotopic GBM model, QST combined with IR significantly prolonged survival compared with IR alone. However, the addition of AZD1390 did not provide a significant survival benefit beyond QST+IR, and AZD1390 combined with IR did not significantly improve survival relative to IR alone.
Combined HDAC and ATM inhibition with QST and AZD1390 enhances radiosensitivity in patient-derived GBM cells, mechanistically underpinned by QST-mediated increase in DNA damage and dual disruption of DDR through complementary, non-overlapping mechanisms. However, this in vitro synergy did not confer additional survival benefit beyond QST+IR in an orthotopic GBM model under the dosing conditions tested, suggesting pharmacological limitations with the tumor microenvironment or suboptimal dosing schedules may have constrained in vivo efficacy.

PMID:
42926668
Bibliographic data and abstract were imported from PubMed on 25 Oct 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.