Human papillomavirus (HPV) is the causative agent in
cervical cancer. HPV oncogenes are major drivers of the transformed phenotype, and the
cancers remain addicted to these oncogenes. A screen of the human kinome has identified inhibition of
Aurora kinase A (
AURKA) as being synthetically lethal on the background of HPV E7 expression. The investigational
AURKA inhibitor
MLN8237/
Alisertib selectively promoted apoptosis in the HPV
cancers. The apoptosis was driven by an extended mitotic delay in the
Alisertib-treated HPV E7-expressing cells. This had the effect of reducing Mcl-1 levels, which is destabilized in mitosis, and increasing BIM levels, normally destabilized by Aurora A in mitosis. Overexpression of Mcl-1 reduced sensitivity to the
drug. The level of HPV E7 expression influenced the extent of
Alisertib-induced mitotic delay and Mcl-1 reduction. Xenograft experiments with three
cervical cancer cell lines showed
Alisertib inhibited growth of HPV and non-HPV xenografts during treatment. Growth of non-HPV
tumors was delayed, but in two separate HPV
cancer cell lines, regression with no resumption of growth was detected, even at 50 days
after treatment. A transgenic model of premalignant disease driven solely by HPV E7 also demonstrated sensitivity to
drug treatment. Here, we show for the first time that targeting of the
Aurora A kinase in mice using drugs such as
Alisertib results in a curative sterilizing
therapy that may be useful in treating HPV-driven
cancers.