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Translational Medicine and Targeted Therapies

Guillaume Canaud
Team description

Our research group is focused on genetic mosaic disorders associated with overgrowth syndromes and vascular anomalies.

Overgrowth syndromes are rare genetic disorders characterized by abnormal tissue growth, which can be localized or generalized. These mutations are not inherited but occur during embryonic development, resulting in somatic mosaicism. The genes involved in overgrowth syndromes are not yet fully understood, but many appear to be part of the RAS/PIK3CA/AKT/mTOR pathway, a significant player in cell growth and proliferation, with gain-of-function mutations in PIK3CA playing a prominent role. Patients typically exhibit complex tissue malformations, including abnormal blood vessels, disordered adipose tissue, muscle hypertrophy, and bone deformities.

We have recently developed a mouse model for PIK3CA-Related Overgrowth Syndrome (PROS) that successfully replicates the patient phenotype. We also identified BYL719 (alpelisib, Novartis), a PIK3CA inhibitor initially developed for oncology, as a potential therapy for PROS. Subsequent testing in our mouse model demonstrated the drug's efficacy. Based on these promising results, we received authorization to treat both adults and children (19 patients aged 4 to 50 years) with severe forms of PROS. The clinical outcomes were remarkable: previously untreatable vascular tumors reduced in size, congestive heart failure improved, and hemihypertrophy was reduced. Notably, the treatment exhibited minimal side effects, leading to the US FDA's approval of alpelisib for PROS patients over 2 years old in April 2022, making it the first and only approved treatment for these disorders.

While the drug is generally beneficial, the response to treatment varies from good to exceptional. We are now delving into the role of each tissue in disease development, as our findings suggest that the physiopathology is more complex than originally thought.

Our current research objectives are as follows:

  1. Develop novel preclinical mouse models of PROS to better understand the disease.
  2. Identify humoral factors and potential biomarkers to enhance our understanding and improve patient care.
  3. Discover new downstream targets of PIK3CA to identify potential therapeutic options.
  4. Investigate the role of PIK3CA activation in cell fate determination

These scientific pursuits are essential in advancing our knowledge of PROS, improving patient outcomes, and contributing to a deeper understanding of the critical role of PIK3CA in various fields of research.

In addition, our group is specialized in drug repositioning with new medical discoveries ongoing for rare diseases not involving the PI3K pathway. More to follow…

 

 

PRIZES AND AWARDS

·     2021 Triennial and international unsolicited Gagna A. & Ch. Van Heck Prize for incurable diseases (National Belgian fund for Scientific Research)

·     2022 Robert Schobinger Award recipient from the International Society for the Study of Vascular Anomalies

·     2022 Prix Galien

·     2024 Cornell University Medical College Centennial Medaille

·     2024 Grand Prix concours innovation i-Lab

·     2024 Grand Prix Inserm de l’Innovation

Key publications
Bayard C, Segna E, Taverne M, Fraissenon A, Hennocq Q, Periou B, Zerbib L, Ladraa S, Chapelle C, Hoguin C, Kaltenbach S, Villarese P, Asnafi V, Broissand C, Nemazanyy I, Autret G, Goudin N, Legendre C, Authier FJ, Viel T, Tavitian B, Gitiaux C, Fraitag S, Duong JP, Delcros C, Sergent B, Picard A, Dussiot M, Guibaud L, Khonsari R, Canaud G. Hemifacial myohyperplasia is due to somatic muscular PIK3CA gain-of-function mutations and responds to pharmacological inhibition. J Exp Med. 2023; Nov 6;220(11):e20230926. doi: 10.1084/jem.20230926. PMID: 37712948 ; PMCID: PMC10503430.
Canaud G, Lopez Gutierrez JC, Irvine A, Ankrah N, Branle F, Papadimitrou A, Ridolfi A, O'Connell P, Adams D. Retrospective Real-World Evidence Study of Alpelisib for Treatment of PIK3CA-Related Overgrowth Spectrum (PROS). Genet Med. 2023; doi: 10.1016/j.gim.2023.100969.
Yamaguchi J, Isnard P, Robil N, de la Grange P, Hoguin C, Schmitt A, Hummel A, Mégret J, Goudin N, Luka M, Ménager MM, Masson C, Zarhrate M, Bôle-Feysot C, Janiszewska M, Polyak K, Dairou J, Baldassari S, Baulac S, Broissand C, Legendre C, Terzi F, Canaud G. PIK3CA inhibition in models of proliferative glomerulonephritis and lupus nephritis. J Clin Invest. 2024; Jun 6:e176402. Epub ahead of print. doi: 10.1172/JCI176402. PMID: 38842935 .
Zerbib L, Ladraa S, Fraissenon A, Bayard C, Firpion M, Venot Q, Protic S, Hoguin C, Thomas A, Fraitag S, Duong JP, Kaltenbach S, Balducci E, Lefevre C, Villarese P, Asnafi V, Broissand C, Goudin N, Nemazanyy I, Autret G, Tavitian B, Legendre C, Arzouk N, Minard-Colin V, Chopinet C, Dussiot M, Adams DM, Mirault T, Guibaud L, Isenring P, Canaud G. Targeted therapy for capillary-venous malformations. Signal Transduct Target Ther. 2024; Jun 17;9(1):146. doi: 10.1038/s41392-024-01862-9. PMID: 38880808 ; PMCID: PMC11180659.
Fraissenon A, Bayard C, Morin G, Benichi S, Hoguin C, Protic S, Zerbib L, Ladraa S, Firpion M, Blauwblomme T, Naggara O, Duruisseaux M, Delous M, Boitel C, Bringuier PP, Payen L, Legendre C, Kaltenbach S, Balducci E, Villarese P, Asnafi V, Bisdorff A, Guibaud L, Canaud G. Sotorasib for Vascular Malformations Associated with KRAS G12C Mutation. N Engl J Med. 2024; Jul 25;391(4):334-342. doi: 10.1056/NEJMoa2309160. PMID: 39018528 .
Yamaguchi J and Canaud G. mTOR Signaling and Human Physiology Relevant to Kidney Disease. J Am Soc Nephrol . 2024; doi: 10.1681/ASN.0000000000000450.
Morin G, Zerbib L, Kaltenbach S, Fraissenon A, E, Balducci E, Asnafi V and Canaud G. PIK3CA-related disorders: From Disease Mechanism to Evidence-Based Treatments. Annu Rev Genomics Hum Genet. 2024; doi: 10.1146/annurev-genom-121222-114518.
Morin G, Garneau AP, Bouzakher N, Ségot L, Fraissenon A, Blondel A, Petit F, Chopinet C, Mayeux F, Fayoux P, Dompmartin A, Bodemer C, Balducci E, Kaltenbach S, Villarese P, Asnafi V, Legendre C, Broissand C, Fraitag S, Quelin C, Goudin N, Guibaud L, Canaud G. Somatic PIK3R1 mutations in the iSH2 domain are accessible to PI3Kα inhibition. EMBO Mol Med. 2025; May 19. Epub ahead of print. doi: 10.1038/s44321-025-00249-9. PMID: 40389643 .
Venot Q, Firpion M, Ladraa S, Bayard C, Magassa S, Di Guardo R, Fraissenon A, Hoguin C, Protic S, Morin G, Mayeux F, Gourdon G, Fraitag S, Balducci E, Kaltenbach S, Villarese P, Asnafi V, Viel T, Autret G, Tavitian B, Goudin N, Guibaud L, Bolino A, Canaud G. PIK3CA gain-of-function mutation in Schwann cells leads to severe neuropathy and aerobic glycolysis through a non-cell autonomous effect. Proc Natl Acad Sci U S A. 2025; Jul;122(26):e2424867122. Epub 2025 Jun 24. doi: 10.1073/pnas.2424867122. PMID: 40553493 .
Morin G, Fraissenon A, Chopinet C, Balducci E, Kaltenbach S, Villarese P, Asnafi V, Guibaud L, Canaud G. First report of successful pregnancies after treatment with alpelisib for PIK3CA-related overgrowth spectrum. Eur J Hum Genet. 2025; Jun 6. Epub ahead of print. doi: 10.1038/s41431-025-01885-y. PMID: 40481231 .
Gabriel Morin, Pierre Isnard & Guillaume Canaud. Drug repurposing in PIK3CA-related overgrowth spectrum: breakthroughs from overgrowth syndromes to kidney disease. Kidney International. 2025; doi: 10.1016/j.kint.2025.08.041 .
Morin G, Galasso I and Canaud G. Vascular malformations: from genetics to therapeutics. EMBO Mol Med. 2025; doi: 10.1038/s44321-025-00344-x. PMID: 41272322 .
Funding and grants