Background::Wild-type FLT3 (WT-FLT3) has emerged as a relevant molecular
target in Acute Myeloid Leukemia (AML), with increasing evidence implicating its
role in leukemic proliferation and resistance, even in the absence of FLT3 mutations. Although
gilteritinib is an approved FLT3 inhibitor, its efficacy in WT-FLT3 AML remains
limited, underscoring the need for alternative strategies.
Method::We filtered 1,737 FDA-approved anticancer agents from the Selleckchem
database using computational techniques to identify possible WT-FLT3 inhibitors. A total
of 118 druglike compounds were docked against the WT-FLT3 binding site as determined
by gilteritinib using AutoDock Vina; ADMET screening and MD simulations of
150 ns were executed on hit compounds using the ADMETSar server and GROMACS
software, respectively.
results::118 drugs were druglike while 56 of them returned binding energy (BE) between -8.0 and -10.3 kcal/mol. However, amlexanox (-9.5), sanguinarine (-10.3), crizotinib (-9.5), (s)-crizotinib (-9.7), and rutaecarpine (-10.0) showed the best binding potentials. Also, they exhibited acceptable ADMET profile, structural stability, and dynamics. However, amlexanox stood out as the most stable and stronger candidate for therapeutic applications against FLT 3
Results::In the end, 56 compounds with binding energies between -8.0 and -10.3 kcal/-
mol were obtained, while the control, gilteritinib, returned -6.4 kcal/mol. Among this
subset, Amlexanox (-9.5), sanguinarine (-10.3), crizotinib (-9.7), (S)-crizotinib (-9.7),
and rutaecarpine (-10.0) showed high predicted affinity. Predictions from ADMET and
150 ns MD simulations indicated that amlexanox had stable, specific interactions with
the WT-FLT3 active site, superior ADMET, and a concentrated free-energy basin with
increased conformational stability. In contrast, sanguinarine and others raised significant
toxicity risks.
Conclusion::These results suggest amlexanox is a potential new repurposing agent as a
WT-FLT3 inhibitor in AML. This potential outcome needs urgent experimental confirmation
through in vitro and in vivo models.