Unveiling therapeutic prospects: targeting MDM-2 in non-muscle invasive bladder cancer.

Non-muscle invasive bladder cancer (NMIBC) is considered one of the most costly malignancies, requiring significant surgical and therapeutic measures. However, progression and non-responsiveness to immunotherapy are common outcomes of treatment. In this study, we conducted comparative transcriptomic analysis of non-responders from two distinct populations (Asian and American) and identified six common genes associated with disease prognosis. Among these genes, MDM-2 is a major oncogenic protein linked to seven different types of cancers, as it is involved in the degradation of the tumor suppressor protein p53. To address this, we explored novel therapeutic drugs to block the binding of p53 and MDM-2 using a targeted molecular docking approach. High-throughput screening of 2500 drugs from the FDA-approved drug database led to the identification of three drug compounds: Mol-126, Mol-679, and Mol-768. Subsequently, we evaluated the structural stability and binding of these drugs for the targeted inhibition of the MDM-2 active site (hydrophobic cleft) using molecular dynamics simulations. Analysis of five trajectories, including RMSD, RMSF, hydrogen bond, radius of gyration, coulomb short-range electrostatic spectra, and free binding energy, confirmed that Mol-126 exhibited the highest structural stability compared to the reference drug (Alrizomadlin). Notably, Mol-126 is a derivative of 3-phenoxypropionic acid, which shows promise for the development of alternative therapeutic treatments for non-responsive bladder cancer patients.