Aurora Kinase A inhibition enhances DNA damage and tumor cell death with 131I-MIBG therapy in high-risk neuroblastoma

Background Neuroblastoma is the most common extra-cranial pediatric solid tumor. 131 I-metaiodobenzylguanidine (MIBG) is a targeted radiopharmaceutical highly specific for neuroblastoma tumors, providing potent radiotherapy to widely metastatic disease. Aurora kinase A (AURKA) plays a role in mitosis and stabilization of the MYCN protein in neuroblastoma. We aimed to study the impact of AURKA inhibitors on DNA damage and tumor cell death in combination with 131 I-MIBG therapy in a pre-clinical model of high-risk neuroblastoma. Results Using an in vivo model of high-risk neuroblastoma, we demonstrated a marked combinatorial effect of 131 I-MIBG and alisertib on tumor growth. In MYCN amplified cell lines, the combination of radiation and an AURKA A inhibitor increased DNA damage and apoptosis and decreased MYCN protein levels. Conclusion The combination of AURKA inhibition with 131 I-MIBG treatment is active in resistant neuroblastoma models.