Novel opportunities for thymidylate metabolism as a therapeutic target

Peter M Wilson, William Fazzone, Melissa J LaBonte, Jinxia Deng, Nouri Neamati, Robert D Ladner, Melissa LaBonte Wilson

Research output: Contribution to journalArticlepeer-review

52 Citations (Scopus)


For over 40 years, the fluoropyrimidine 5-fluorouracil (5-FU) has remained the central agent in therapeutic regimens employed in the treatment of colorectal cancer and is frequently combined with the DNA-damaging agents oxaliplatin and irinotecan, increasing response rates and improving overall survival. However, many patients will derive little or no benefit from treatment, highlighting the need to identify novel therapeutic targets to improve the efficacy of current 5-FU-based chemotherapeutic strategies. dUTP nucleotidohydrolase (dUTPase) catalyzes the hydrolysis of dUTP to dUMP and PPi, providing substrate for thymidylate synthase (TS) and DNA synthesis and repair. Although dUTP is a normal intermediate in DNA synthesis, its accumulation and misincorporation into DNA as uracil is lethal. Importantly, uracil misincorporation represents an important mechanism of cytotoxicity induced by the TS-targeted class of chemotherapeutic agents including 5-FU. A growing body of evidence suggests that dUTPase is an important mediator of response to TS-targeted agents. In this article, we present further evidence showing that elevated expression of dUTPase can protect breast cancer cells from the expansion of the intracellular uracil pool, translating to reduced growth inhibition following treatment with 5-FU. We therefore report the implementation of in silico drug development techniques to identify and develop small-molecule inhibitors of dUTPase. As 5-FU and the oral 5-FU prodrug capecitabine remain central agents in the treatment of a variety of malignancies, the clinical utility of a small-molecule inhibitor to dUTPase represents a viable strategy to improve the clinical efficacy of these mainstay chemotherapeutic agents.

Original languageEnglish
Pages (from-to)3029-37
Number of pages9
JournalMolecular Cancer Therapeutics
Issue number9
Publication statusPublished - Sept 2008


  • Adenocarcinoma
  • Antineoplastic Agents
  • Breast Neoplasms
  • Cell Line, Tumor
  • Computational Biology
  • DNA Damage
  • Drug Design
  • Drug Resistance, Neoplasm
  • Fluorouracil
  • Humans
  • Immunohistochemistry
  • Pyrophosphatases
  • Reproducibility of Results
  • Thymidine


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