ONC201
is a first-in-class imipridone molecule currently in clinical
trials for the treatment of multiple cancers. Despite enormous clinical
potential, the mechanism of action is controversial. To investigate
the mechanism of ONC201 and identify compounds with improved potency,
we tested a series of novel ONC201 analogues (TR compounds) for effects
on cell viability and stress responses in breast and other cancer
models. The TR compounds were found to be ∼50–100 times
more potent at inhibiting cell proliferation and inducing the integrated
stress response protein ATF4 than ONC201. Using immobilized TR compounds,
we identified the human mitochondrial caseinolytic protease P (ClpP)
as a specific binding protein by mass spectrometry. Affinity chromatography/drug
competition assays showed that the TR compounds bound ClpP with ∼10-fold
higher affinity compared to ONC201. Importantly, we found that the
peptidase activity of recombinant ClpP was strongly activated by ONC201
and the TR compounds in a dose- and time-dependent manner with the
TR compounds displaying a ∼10–100 fold increase in potency
over ONC201. Finally, siRNA knockdown of ClpP in SUM159 cells reduced
the response to ONC201 and the TR compounds, including induction of
CHOP, loss of the mitochondrial proteins (TFAM, TUFM), and the cytostatic
effects of these compounds. Thus, we report that ClpP directly binds
ONC201 and the related TR compounds and is an important biological
target for this class of molecules. Moreover, these studies provide,
for the first time, a biochemical basis for the difference in efficacy
between ONC201 and the TR compounds.