OnCo
ideasIdea

Is aneuploidy itself a druggable vulnerability?

Most cancers have the wrong number of chromosomes; normal cells do not. If that difference creates a specific weakness, a drug against it would spare normal tissue by definition.

Chromosomally unstable cells depend on KIF18A, the spindle assembly checkpoint, BCL-XL, and proteostasis; KIF18A inhibitors (sovilnesib, AMG 650) showed activity in platinum-resistant ovarian cancer in 2024-25.

Hypothesis
A CIN score (from WGS or a FISH panel) selects patients whose tumours regress on KIF18A or SAC-directed therapy, and combination with STING-modulating agents converts CIN's immune tolerance into immunity.
Rationale
Sheltzer and Bakhoum lab data; the eDyNAmiC and TRACERx programmes provide biomarkers; early clinical responses in CIN-high ovarian cancer.
What would test it
Randomised phase 2 of a KIF18A inhibitor vs chemotherapy in CIN-high, TP53-mutant platinum-resistant ovarian cancer, with CIN score stratification and micronuclei/STING pharmacodynamics.
Maturity
early clinical

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