An enzyme-responsive double-locked amonafide prodrug for the treatment of glioblastoma with minimal side effects

Amonafide (ANF), a topoisomerase II inhibitor and DNA intercalator, has exhibited promise in phase II trials but faces significant limitations due to adverse side effects. Here, we have developed a novel enzyme-triggered fluorogenic prodrug, AcKLP, that incorporates dual-locked enzyme activation, ensuring that the prodrug remains inactive until it confronts the unique enzymatic environment of glioblastoma cells. This approach minimizes premature activation and reduces toxicity to normal cells, with an IC50 > 100 μM for human umbilical vein endothelial cells (HUVEC) and ∼2.3 μM for human glioblastoma cells (U87). Upon activation of AcKLP by two distinct enzymes prevalent in glioblastoma cells, amonafide is released and emits a fluorescence signal response, facilitating treatment and the monitoring of real-time drug distribution. Mechanistic studies indicate that AcKLP mainly induces autophagic cell death in U87 cells. Moreover, three-dimensional multicellular U87 tumor spheroid assays and in vivo experiments confirm the potent antiproliferative activity of AcKLP against glioblastoma cells. This work demonstrates a novel de-caging strategy to improve the selectivity and efficacy of amonafide for cancer therapy.