Structure-activity relationship of dihydropyridines for rhabdomyosarcoma

Childhood muscle-related cancer rhabdomyosarcoma is a rare disease with a 50-year unmet clinical need for the patients presented with advanced disease. The rarity of ∼350 cases per year in North America generally diminishes the viability of large-scale, pharmaceutical industry driven drug development efforts for rhabdomyosarcoma. In this study, we performed a large-scale screen of 640,000 compounds to identify the dihydropyridine (DHP) class of anti-hypertensives as a priority compound hit. A structure-activity relationship was uncovered with increasing cell growth inhibition as side chain length increases at the ortho and para positions of the parent DHP molecule. Growth inhibition was consistent across n = 21 rhabdomyosarcoma cell line models. Anti-tumor activity in vitro was paralleled by studies in vivo. The unexpected finding was that the action of DHPs appears to be other than on the DHP receptor (i.e., L-type voltage-gated calcium channel). These findings provide the basis of a medicinal chemistry program to develop dihydropyridine derivatives that retain anti-rhabdomyosarcoma activity without anti-hypertensive effects. •640,000 compounds were screened for potential hits, leads or therapeutic agents for treating rhabdomyosarcoma.•The dihydropyridine (DHP) class of anti-hypertensives were found to be priority compound hits.•The DHP drug azelnidipine was selected as a lead compound for consistent anti-tumor cell activity.•Anti-tumor activity of azelnidipine in vitro was paralleled by studies in vivo.•The action of the DHP drugs was found to be other than on the DHP receptor (i.e., L-type voltage-gated calcium channel).