Prostate cancer (PCa) progression to metastatic castration-resistant prostate cancer (mCRPC) remains a significant therapeutic challenge, with limited treatment options. Increasing evidence implicates inflammation and the tumour microenvironment as critical drivers of resistance. We identified human group IIA secreted phospholipase A2 (hGIIA) as a key pro-inflammatory effector highly expressed in PCa; where it promotes tumour progression not only through its enzymatic activity but also through previously uncharacterised protein–protein interactions.
We describe kesonotide (cyclo-((2-Nal)-Leu-Ser-(2-Nal)-Arg)), a novel cyclic peptide designed to inhibit hGIIA’s catalysis-independent interactions with EGFR and vimentin. In PC-3 cells, kesonotide blocks hGIIA-driven EGFR phosphorylation (p = 0.0016), downstream pERK (p = 0.0039) and cPLA2-α signalling (p = 0.0478), suppresses prostaglandin E₂ (PGE₂) production (p = 0.0065), and induces vimentin-mediated aggresome formation and apoptosis in vitro (p < 0.0001). Notably, the IC₅₀ for kesonotide inhibition of the hGIIA–vimentin interaction was 56.5 µM.
Kesonotide demonstrated potent anti-tumour activity in vivo, reducing tumour volume significantly in xenografts of early stage (p<0.05) and late stage PCa (p<0.001) —at doses as low as 0.1 mg/kg orally. Survival benefits were marked for late stage PCa: 27% of animals treated with kesonotide survived the 6-month study, which is higher than the response rate for docetaxel (12%), the current standard of care for men with castrate-resistant PCa. Tumour regression or stasis was observed in all long-term survivors. Kesonotide showed excellent safety in mice and rats, with no observable toxicity in 28-day OECD-compliant studies, and demonstrated 10% oral bioavailability and strong cell permeability.
These findings establish kesonotide as a lead compound targeting non-catalytic functions of hGIIA and support its clinical development. Given that hGIIA, EGFR, and vimentin are overexpressed in other malignancies, this mechanism may have broader oncologic relevance beyond prostate cancer.