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NOTCH1 and FBXW7 mutations favor better outcome in pediatric South Indian T-cell acute lymphoblastic leukemia. J Pediatr Hematol Oncol 2015; 37:e23-30. [PMID: 25493453 DOI: 10.1097/mph.0000000000000290] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The NOTCH1 signaling pathway is essential for hematopoiesis and a critical regulatory step for T-cell proliferation and maturation. The E3 ubiquitin ligase FBXW7 controls NOTCH1 protein stability. Mutations in NOTCH1/FBXW7 activate NOTCH signaling and are of prognostic significance in patients with T-cell acute lymphoblastic leukemia (T-ALL). In this study we analyzed NOTCH1 and FBXW7 mutations in 50 South Indian T-ALL patients treated by a modified ALL BFM 95 regimen. The hot spot exons (HD-N, HD-C, TAD, and PEST) of NOTCH1 and exons 9 of the 10 of FBXW7 were polymerase chain reaction amplified and sequenced. In total, 20 of the 50 (40%) T-ALL patients revealed heterozygous mutations in the NOTCH1 domains, and a predominance of missense mutations in HD-N (70%) and PEST (15%) domains. FBXW7 mutations were detected in 5 of the 50 (10%) T-ALL patients. T-ALL patients with NOTCH1/FBXW7 mutations expressed higher protein level of NOTCH1 compared with patients without NOTCH1/FBXW7 mutations. Six of the mutations detected in NOTCH1 were not reported previously. When tested in a Dual Luciferase Renilla reporter assay some of these conferred increased NOTCH activity, suggesting that these are activating mutations. Importantly, 13 of the 20 (65%) NOTCH1/FBXW7-mutated T-ALL patients showed a good prednisone response (P=0.01) and a better clinical outcome compared with NOTCH1/FBXW7 nonmutated patients (P=0.03). These data suggest that NOTCH1/FBXW7 mutations are present in T-ALL patients from Southern India and may be useful biomarkers to predict prognosis in T-ALL.
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Bentley VL, Veinotte CJ, Corkery DP, Pinder JB, LeBlanc MA, Bedard K, Weng AP, Berman JN, Dellaire G. Focused chemical genomics using zebrafish xenotransplantation as a pre-clinical therapeutic platform for T-cell acute lymphoblastic leukemia. Haematologica 2014; 100:70-6. [PMID: 25281505 DOI: 10.3324/haematol.2014.110742] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Cancer therapeutics is evolving to precision medicine, with the goal of matching targeted compounds with molecular aberrations underlying a patient's cancer. While murine models offer a pre-clinical tool, associated costs and time are not compatible with actionable patient-directed interventions. Using the paradigm of T-cell acute lymphoblastic leukemia, a high-risk disease with defined molecular underpinnings, we developed a zebrafish human cancer xenotransplantation model to inform therapeutic decisions. Using a focused chemical genomic approach, we demonstrate that xenografted cell lines harboring mutations in the NOTCH1 and PI3K/AKT pathways respond concordantly to their targeted therapies, patient-derived T-cell acute lymphoblastic leukemia can be successfully engrafted in zebrafish and specific drug responses can be quantitatively determined. Using this approach, we identified a mutation sensitive to γ-secretase inhibition in a xenograft from a child with T-cell acute lymphoblastic leukemia, confirmed by Sanger sequencing and validated as a gain-of-function NOTCH1 mutation. The zebrafish xenotransplantation platform provides a novel cost-effective means of tailoring leukemia therapy in real time.
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Affiliation(s)
| | | | - Dale P Corkery
- Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS
| | | | | | | | - Andrew P Weng
- Terry Fox Laboratory, British Columbia Cancer Agency, Vancouver, BC
| | - Jason N Berman
- IWK Health Centre, Halifax, NS Pediatrics and Microbiology & Immunology Dalhousie University, Halifax, NS, Canada
| | - Graham Dellaire
- Pathology, Dalhousie University, Halifax, NS Biochemistry and Molecular Biology, Dalhousie University, Halifax, NS
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53
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Fragoso R, Barata JT. PTEN and leukemia stem cells. Adv Biol Regul 2014; 56:22-29. [PMID: 24961634 DOI: 10.1016/j.jbior.2014.05.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2014] [Revised: 05/21/2014] [Accepted: 05/22/2014] [Indexed: 06/03/2023]
Abstract
Leukemia stem cells (LSCs) are considered responsible for leukemia initiation, relapse and resistance to chemotherapy. These cells have self-renewal capacity and originate the other cells in the leukemia pool. Therefore, in order to completely eradicate leukemia cells and consequently cure the disease, therapies should in principle necessarily target LSCs. However, the fact that LSCs share functional and phenotypic properties with normal hematopoietic stem cells (HSCs) poses a significant challenge: how to target LSCs without damaging normal HSCs and compromising hematopoiesis? The discovery that PTEN regulates LSCs and HSCs through different mechanisms, demonstrated that it is possible to identify pathways that differentially impact leukemia and normal stem cell function and opened new therapeutic perspectives for the selective elimination of LSCs. In this review, we briefly discuss the mechanisms that regulate PTEN function in LSCs and HSCs and their potential for the development of LSC-targeted therapies.
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Affiliation(s)
- Rita Fragoso
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal
| | - João T Barata
- Instituto de Medicina Molecular, Faculdade de Medicina, Universidade de Lisboa, Av. Prof. Egas Moniz, 1649-028 Lisboa, Portugal.
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54
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Martelli AM, Lonetti A, Buontempo F, Ricci F, Tazzari PL, Evangelisti C, Bressanin D, Cappellini A, Orsini E, Chiarini F. Targeting signaling pathways in T-cell acute lymphoblastic leukemia initiating cells. Adv Biol Regul 2014; 56:6-21. [PMID: 24819383 DOI: 10.1016/j.jbior.2014.04.004] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 04/11/2014] [Accepted: 04/16/2014] [Indexed: 06/03/2023]
Abstract
Leukemia initiating cells (LICs) represent a reservoir that is believed to drive relapse and resistance to chemotherapy in blood malignant disorders. T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive neoplastic disorder of immature hematopoietic precursors committed to the T-cell lineage. T-ALL comprises about 15% of pediatric and 25% of adult ALL cases and is prone to early relapse. Although the prognosis of T-ALL has improved especially in children due to the use of new intensified treatment protocols, the outcome of relapsed T-ALL cases is still poor. Putative LICs have been identified also in T-ALL. LICs are mostly quiescent and for this reason highly resistant to chemotherapy. Therefore, they evade treatment and give rise to disease relapse. At present great interest surrounds the development of targeted therapies against signaling networks aberrantly activated in LICs and important for their survival and drug-resistance. Both the Notch1 pathway and the phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR) network are involved in T-ALL LIC survival and drug-resistance and could be targeted by small molecules. Thus, Notch1 and PI3K/Akt/mTOR inhibitors are currently being developed for clinical use either as single agents or in combination with conventional chemotherapy for T-ALL patient treatment. In this review, we summarize the existing knowledge of the relevance of Notch1 and PI3K/Akt/mTOR signaling in T-ALL LICs and we examine the rationale for targeting these key signal transduction networks by means of selective pharmacological inhibitors.
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Affiliation(s)
- Alberto M Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via Irnerio 48, 40126 Bologna, Italy.
| | - Annalisa Lonetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via Irnerio 48, 40126 Bologna, Italy
| | - Francesca Buontempo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via Irnerio 48, 40126 Bologna, Italy
| | - Francesca Ricci
- Immunohematology and Transfusion Center, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - Pier Luigi Tazzari
- Immunohematology and Transfusion Center, Policlinico S.Orsola-Malpighi, Bologna, Italy
| | - Camilla Evangelisti
- Institute of Molecular Genetics, National Research Council, via di Barbiano 1/10, 40136 Bologna, Italy; Musculoskeletal Cell Biology Laboratory, IOR, via di Barbiano 1/10, 40136 Bologna, Italy
| | - Daniela Bressanin
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via Irnerio 48, 40126 Bologna, Italy
| | - Alessandra Cappellini
- Department of Human, Social and Health Sciences, University of Cassino, 03043 Cassino, Italy
| | - Ester Orsini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, via Irnerio 48, 40126 Bologna, Italy
| | - Francesca Chiarini
- Institute of Molecular Genetics, National Research Council, via di Barbiano 1/10, 40136 Bologna, Italy; Musculoskeletal Cell Biology Laboratory, IOR, via di Barbiano 1/10, 40136 Bologna, Italy
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55
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Bandapalli OR, Schuessele S, Kunz JB, Rausch T, Stütz AM, Tal N, Geron I, Gershman N, Izraeli S, Eilers J, Vaezipour N, Kirschner-Schwabe R, Hof J, von Stackelberg A, Schrappe M, Stanulla M, Zimmermann M, Koehler R, Avigad S, Handgretinger R, Frismantas V, Bourquin JP, Bornhauser B, Korbel JO, Muckenthaler MU, Kulozik AE. The activating STAT5B N642H mutation is a common abnormality in pediatric T-cell acute lymphoblastic leukemia and confers a higher risk of relapse. Haematologica 2014; 99:e188-92. [PMID: 24972766 DOI: 10.3324/haematol.2014.104992] [Citation(s) in RCA: 93] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Affiliation(s)
- Obul R Bandapalli
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
| | - Stephanie Schuessele
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
| | - Joachim B Kunz
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
| | - Tobias Rausch
- European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany
| | - Adrian M Stütz
- European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany
| | - Noa Tal
- Childhood Leukemia Research Institute and Department of Pediatric Hemato-Oncology, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Israel
| | - Ifat Geron
- Childhood Leukemia Research Institute and Department of Pediatric Hemato-Oncology, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Israel Division of Biological Sciences and Department of Medicine Stem Cell Program, University of California, San Diego, La Jolla, CA, USA
| | - Nava Gershman
- Childhood Leukemia Research Institute and Department of Pediatric Hemato-Oncology, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Israel
| | - Shai Izraeli
- Childhood Leukemia Research Institute and Department of Pediatric Hemato-Oncology, Sheba Medical Center, Tel Hashomer, and Tel Aviv University, Israel
| | - Juliane Eilers
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
| | - Nina Vaezipour
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
| | | | - Jana Hof
- Department of Pediatric Oncology/Hematology, Charité - Universitätsmedizin Berlin, Germany German Cancer Consortium (DKTK) and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Arend von Stackelberg
- Department of Pediatric Oncology/Hematology, Charité - Universitätsmedizin Berlin, Germany
| | - Martin Schrappe
- Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Germany
| | - Martin Stanulla
- Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Germany Department of Pediatric Hematology/Oncology, Medical School Hannover, Germany
| | - Martin Zimmermann
- Department of Pediatric Hematology/Oncology, Medical School Hannover, Germany
| | - Rolf Koehler
- Department of Human Genetics, University of Heidelberg, Germany
| | - Smadar Avigad
- Molecular Oncology, Felsenstein Medical Research Center and Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | | | | | | | - Beat Bornhauser
- Department of Oncology, University Children's Hospital Zurich, Switzerland
| | - Jan O Korbel
- European Molecular Biology Laboratory (EMBL), Genome Biology Unit, Heidelberg, Germany
| | - Martina U Muckenthaler
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
| | - Andreas E Kulozik
- Department of Pediatric Oncology, Hematology and Immunology, Children's Hospital, University of Heidelberg, Germany Molecular Medicine Partnership Unit, EMBL-University of Heidelberg, Germany
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56
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Evangelisti C, Evangelisti C, Chiarini F, Lonetti A, Buontempo F, Bressanin D, Cappellini A, Orsini E, McCubrey JA, Martelli AM. Therapeutic potential of targeting mTOR in T-cell acute lymphoblastic leukemia (review). Int J Oncol 2014; 45:909-18. [PMID: 24968804 DOI: 10.3892/ijo.2014.2525] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 06/12/2014] [Indexed: 11/05/2022] Open
Abstract
T-cell acute lymphoblastic leukemia (T-ALL) is a heterogeneous neoplastic disorder of immature hematopoietic precursors committed to the T-cell lineage. T-ALL comprises about 15% of pediatric and 25% of adult ALL cases. Even if the prognosis of T-ALL has improved especially in the childhood due to the use of new intensified treatment protocols, the outcome of relapsed patients who are resistant to conventional chemotherapeutic drugs or who relapse is still poor. For this reason, there is a need for novel and less toxic targeted therapies against signaling pathways aberrantly activated in T-ALL, such as the phosphoinositide 3-kinase (PI3K)/Akt/mammalian target of rapamycin (mTOR). Small molecules designed to target key components of this signaling axis have proven their efficacy both in vitro and in vivo in pre-clinical settings of T-ALL. In particular, different classes of mTOR inhibitors have been disclosed by pharmaceutical companies, and they are currently being tested in clinical trials for treating T-ALL patients. One of the most promising approaches for the treatment of T-ALL seems to be the combination of mTOR inhibitors with traditional chemotherapeutic agents. This could lead to a lower drug dosage that may circumvent the systemic side effects of chemotherapeutics. In this review, we focus on the different classes of mTOR inhibitors that will possibly have an impact on the therapeutic arsenal we have at our disposal against T-ALL.
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Affiliation(s)
- Camilla Evangelisti
- Institute of Molecular Genetics, National Research Council, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Cecilia Evangelisti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesca Chiarini
- Institute of Molecular Genetics, National Research Council, Rizzoli Orthopedic Institute, Bologna, Italy
| | - Annalisa Lonetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Francesca Buontempo
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Daniela Bressanin
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Alessandra Cappellini
- Department of Human Social and Health Sciences, University of Cassino, Cassino, Italy
| | - Ester Orsini
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - James A McCubrey
- Department of Microbiology and Immunology, Brody School of Medicine, East Carolina University, Greenville, NC, USA
| | - Alberto M Martelli
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
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57
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PTEN microdeletions in T-cell acute lymphoblastic leukemia are caused by illegitimate RAG-mediated recombination events. Blood 2014; 124:567-78. [PMID: 24904117 DOI: 10.1182/blood-2014-03-562751] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Phosphatase and tensin homolog (PTEN)-inactivating mutations and/or deletions are an independent risk factor for relapse of T-cell acute lymphoblastic leukemia (T-ALL) patients treated on Dutch Childhood Oncology Group or German Cooperative Study Group for Childhood Acute Lymphoblastic Leukemia protocols. Some monoallelic mutated or PTEN wild-type patients lack PTEN protein, implying that additional PTEN inactivation mechanisms exist. We show that PTEN is inactivated by small deletions affecting a few exons in 8% of pediatric T-ALL patients. These microdeletions were clonal in 3% and subclonal in 5% of patients. Conserved deletion breakpoints are flanked by cryptic recombination signal sequences (cRSSs) and frequently have non-template-derived nucleotides inserted in between breakpoints, pointing to an illegitimate RAG recombination-driven activity. Identified cRSSs drive RAG-dependent recombination in a reporter system as efficiently as bona fide RSSs that flank gene segments of the T-cell receptor locus. Remarkably, equivalent microdeletions were detected in thymocytes of healthy individuals. Microdeletions strongly associate with the TALLMO subtype characterized by TAL1 or LMO2 rearrangements. Primary and secondary xenotransplantation of TAL1-rearranged leukemia allowed development of leukemic subclones with newly acquired PTEN microdeletions. Ongoing RAG activity may therefore actively contribute to the acquisition of preleukemic hits, clonal diversification, and disease progression.
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58
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Veigaard C, Aggerholm A, Hasle H, Kjeldsen E. Extreme hyperleukocytosis in a pediatric T-ALL patient with a rare translocation, t(7;19)(q35;p13), and submicroscopic deletions at 4q25, 7q33 and 10q23. Leuk Res Rep 2014; 3:4-7. [PMID: 24596673 PMCID: PMC3939383 DOI: 10.1016/j.lrr.2013.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 09/24/2013] [Accepted: 09/30/2013] [Indexed: 11/17/2022] Open
Abstract
Although childhood T-cell acute lymphoblastic leukemia (T-ALL) is a high-risk disease the outcome can vary considerably. The varying outcomes suggest that unrecognized factors may contribute to disease progression. We report on a 2-year-old T-ALL patient presenting with a very short history of constipation and extreme hyperleukocytosis (WBC 882×10(9)/L). In her leukemic cells we detected the very rare translocation t(7;19)(q35;p13) and LYL1 overexpression. Additionally, we detected submicroscopic deletions at 4q25, 7q33 and 10q23 by oligo-aCGH analysis. We suggest that LYL1 overexpression contributed to the leukemic state and propose that the observed microdeletions may have influenced to the rapid disease progression.
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Affiliation(s)
- Christopher Veigaard
- Hemodiagnostic Laboratory, Department of Hematology, Aarhus University Hospital, Tage-Hansens Gade 2, Ent. 4A, 8000 Aarhus C, Denmark
| | - Anni Aggerholm
- Hemodiagnostic Laboratory, Department of Hematology, Aarhus University Hospital, Tage-Hansens Gade 2, Ent. 4A, 8000 Aarhus C, Denmark
| | - Henrik Hasle
- Department of Pediatrics, Aarhus University Hospital, Brendstrupgaardsvej 100, 8200 Aarhus N, Denmark
| | - Eigil Kjeldsen
- Hemodiagnostic Laboratory, Department of Hematology, Aarhus University Hospital, Tage-Hansens Gade 2, Ent. 4A, 8000 Aarhus C, Denmark
- Correspondence to: Hemodiagnostic Laboratory, Cancer Cytogenetics Section, Department of Hematology, Aarhus University Hospital, Tage-HansensGade 2Ent 4A, DK-8000 Aarhus C, Denmark. Tel.: +45 7846 7799; fax: +45 7846 7399.
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59
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Piovan E, Yu J, Tosello V, Herranz D, Ambesi-Impiombato A, Da Silva AC, Sanchez-Martin M, Perez-Garcia A, Rigo I, Castillo M, Indraccolo S, Cross JR, de Stanchina E, Paietta E, Racevskis J, Rowe JM, Tallman MS, Basso G, Meijerink JP, Cordon-Cardo C, Califano A, Ferrando AA. Direct reversal of glucocorticoid resistance by AKT inhibition in acute lymphoblastic leukemia. Cancer Cell 2013; 24:766-76. [PMID: 24291004 PMCID: PMC3878658 DOI: 10.1016/j.ccr.2013.10.022] [Citation(s) in RCA: 201] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2011] [Revised: 05/25/2013] [Accepted: 10/31/2013] [Indexed: 01/30/2023]
Abstract
Glucocorticoid resistance is a major driver of therapeutic failure in T cell acute lymphoblastic leukemia (T-ALL). Here, we identify the AKT1 kinase as a major negative regulator of the NR3C1 glucocorticoid receptor protein activity driving glucocorticoid resistance in T-ALL. Mechanistically, AKT1 impairs glucocorticoid-induced gene expression by direct phosphorylation of NR3C1 at position S134 and blocking glucocorticoid-induced NR3C1 translocation to the nucleus. Moreover, we demonstrate that loss of PTEN and consequent AKT1 activation can effectively block glucocorticoid-induced apoptosis and induce resistance to glucocorticoid therapy. Conversely, pharmacologic inhibition of AKT with MK2206 effectively restores glucocorticoid-induced NR3C1 translocation to the nucleus, increases the response of T-ALL cells to glucocorticoid therapy, and effectively reverses glucocorticoid resistance in vitro and in vivo.
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Affiliation(s)
- Erich Piovan
- Institute for Cancer Genetics, Columbia University, New York, NY, 10032, USA
- UOC Immunologia e Diagnostica Molecolare Oncologica, Istituto Oncologico Veneto—IRCCS, Padova, 35128, Italy
- Dipartimento di Scienze Chirurgiche, Oncologiche e Gastroenterologiche, Universita’ di Padova, Padova, Padova, Veneto, 35128, Italy
| | - Jiyang Yu
- Department of Biomedical Informatics, Columbia University, New York, NY, 10032, USA
- Department of Systems Biology, Columbia University, New York, NY, 10032, USA
| | - Valeria Tosello
- Institute for Cancer Genetics, Columbia University, New York, NY, 10032, USA
- Istituto Oncologico Veneto, IRCCS, Padova, Veneto, 35128, Italy
| | - Daniel Herranz
- Institute for Cancer Genetics, Columbia University, New York, NY, 10032, USA
| | | | | | | | | | - Isaura Rigo
- Institute for Cancer Genetics, Columbia University, New York, NY, 10032, USA
| | - Mireia Castillo
- Department of Pathology, Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Stefano Indraccolo
- UOC Immunologia e Diagnostica Molecolare Oncologica, Istituto Oncologico Veneto—IRCCS, Padova, 35128, Italy
| | - Justin R Cross
- Donald B. and Catherine C. Marron Cancer Metabolism Center, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065 USA
| | - Elisa de Stanchina
- Antitumor Assessment Core Facility, Memorial Sloan-Kettering Cancer Center, New York, NY, 10065 USA
| | - Elisabeth Paietta
- Department of Medicine, Albert Einstein School of Medicine, Bronx, NY, 10461, USA
- New York Medical College and Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Janis Racevskis
- Department of Medicine, Albert Einstein School of Medicine, Bronx, NY, 10461, USA
- New York Medical College and Albert Einstein College of Medicine, Bronx, NY, 10461, USA
| | - Jacob M Rowe
- Hematology Department, Shaare Zedek Hospital, Jerusalem, 91031, Israel
| | - Martin S Tallman
- Leukemia Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA
| | - Giuseppe Basso
- Dipartimento di Salute della Donna e del Bambino, Università di Padova, via Giustiniani 3, 35128, Padova, Italy
| | - Jules P Meijerink
- Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children’s Hospital, Rotterdam, South Holland, 010 7040704, the Netherlands
| | - Carlos Cordon-Cardo
- Department of Pathology, Mount Sinai School of Medicine, New York, NY, 10029, USA
| | - Andrea Califano
- Institute for Cancer Genetics, Columbia University, New York, NY, 10032, USA
- Department of Biomedical Informatics, Columbia University, New York, NY, 10032, USA
- Department of Systems Biology, Columbia University, New York, NY, 10032, USA
| | - Adolfo A. Ferrando
- Institute for Cancer Genetics, Columbia University, New York, NY, 10032, USA
- Department of Pathology, Mount Sinai School of Medicine, New York, NY, 10029, USA
- Department of Pediatrics, Columbia University Medical Center, New York, NY, 10032, USA
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60
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Trinquand A, Tanguy-Schmidt A, Ben Abdelali R, Lambert J, Beldjord K, Lengliné E, De Gunzburg N, Payet-Bornet D, Lhermitte L, Mossafa H, Lhéritier V, Bond J, Huguet F, Buzyn A, Leguay T, Cahn JY, Thomas X, Chalandon Y, Delannoy A, Bonmati C, Maury S, Nadel B, Macintyre E, Ifrah N, Dombret H, Asnafi V. Toward a NOTCH1/FBXW7/RAS/PTEN-based oncogenetic risk classification of adult T-cell acute lymphoblastic leukemia: a Group for Research in Adult Acute Lymphoblastic Leukemia study. J Clin Oncol 2013; 31:4333-42. [PMID: 24166518 DOI: 10.1200/jco.2012.48.5292] [Citation(s) in RCA: 169] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The Group for Research in Adult Acute Lymphoblastic Leukemia (GRAALL) recently reported a significantly better outcome in T-cell acute lymphoblastic leukemia (T-ALL) harboring NOTCH1 and/or FBXW7 (N/F) mutations compared with unmutated T-ALL. Despite this, one third of patients with N/F-mutated T-ALL experienced relapse. PATIENTS AND METHODS In a series of 212 adult T-ALLs included in the multicenter randomized GRAALL-2003 and -2005 trials, we searched for additional N/K-RAS mutations and PTEN defects (mutations and gene deletion). RESULTS N/F mutations were identified in 143 (67%) of 212 patients, and lack of N/F mutation was confirmed to be associated with a poor prognosis. K-RAS, N-RAS, and PTEN mutations/deletions were identified in three (1.6%) of 191, 17 (8.9%) of 191, and 21 (12%) of 175 patients, respectively. The favorable prognostic significance of N/F mutations was restricted to patients without RAS/PTEN abnormalities. These observations led us to propose a new T-ALL oncogenetic classifier defining low-risk patients as those with N/F mutation but no RAS/PTEN mutation (97 of 189 patients; 51%) and all other patients (49%; including 13% with N/F and RAS/PTEN mutations) as high-risk patients. In multivariable analysis, this oncogenetic classifier remained the only significant prognostic covariate (event-free survival: hazard ratio [HR], 3.2; 95% CI, 1.9 to 5.15; P < .001; and overall survival: HR, 3.2; 95% CI, 1.9 to 5.6; P < .001). CONCLUSION These data demonstrate that the presence of N/F mutations in the absence of RAS or PTEN abnormalities predicts good outcome in almost 50% of adult T-ALL. Conversely, the absence of N/F or presence of RAS/PTEN alterations identifies the remaining cohort of patients with poor prognosis.
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Affiliation(s)
- Amélie Trinquand
- Amélie Trinquand, Raouf Ben Abdelali, Etienne Lengliné, Noémie De Gunzburg, Ludovic Lhermitte, Jonathan Bond, Agnès Buzyn, Elizabeth Macintyre, and Vahid Asnafi, University Paris Descartes, Centre National de la Recherche Scientifique (CNRS) Unité Mixte de Recherche (UMR)-8147, and Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Necker-Enfants Malades; Jérôme Lambert, UMR-S-717, Hôpital Saint-Louis, AP-HP; Kheira Beldjord, Etienne Lengliné, and Hervé Dombret, University Paris 7, Hôpital Saint-Louis, AP-HP, and Institut Universitaire d'Hématologie, EA3518, Paris; Aline Tanguy-Schmidt and Norbert Ifrah, Pôle de Recherche et d'Enseignement Supérieur L'Université Nantes Angers Le Mans, Centre Hospitalier Universitaire Angers Service des Maladies du Sang et L'Institut National de la Santé et de la Recherche Médicale (INSERM) U892, Angers; Dominique Payet-Bornet and Bertrand Nadel, Center of Immunology of Marseille Luminy, Aix-Marseille University, INSERM U1104 and Centre National de la Recherche Scientifique (CNRS) UMR-7280, Marseille; Hossein Mossafa, Laboratoire Cerba, Cergy-Pontoise; Véronique Lhéritier and Xavier Thomas, Centre Hospitalier Lyon Sud, Lyon; Françoise Huguet, Hôpital Purpan, Toulouse; Thibaud Leguay, Centre Hospitalier du Haut Lévêque, Pessac; Jean-Yves Cahn, UMR-5525 CNRS-Université Joseph Fourier, Grenoble; Caroline Bonmati, Centre Hospitalier Régional Hôpital de Brabois, Vandoeuvre Les Nancy; Sebastien Maury, Hôpital Henry Mondor, Creteil, France; Yves Chalandon, University Hospital of Geneva, Geneva, Switzerland; and André Delannoy, Hopital de Jolimont, La Louviere, Belgium
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Prognostic relevance of integrated genetic profiling in adult T-cell acute lymphoblastic leukemia. Blood 2013; 122:74-82. [PMID: 23687089 DOI: 10.1182/blood-2013-03-491092] [Citation(s) in RCA: 117] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Adult T-cell acute lymphoblastic leukemia (T-ALL) is an aggressive hematologic tumor associated with poor outcome. In this study, we analyzed the prognostic relevance of genetic alterations, immunophenotypic markers, and microarray gene expression signatures in a panel of 53 adult T-ALL patients treated in the Eastern Cooperative Oncology Group E2993 clinical trial. An early immature gene expression signature, the absence of bi-allelic TCRG deletion, CD13 surface expression, heterozygous deletions of the short arm of chromosome 17, and mutations in IDH1/IDH2 and DNMT3A genes are associated with poor prognosis in this series. In contrast, expression of CD8 or CD62L, homozygous deletion of CDKN2A/CDKN2B, NOTCH1 and/or FBXW7 mutations, and mutations or deletions in the BCL11B tumor suppressor gene were associated with improved overall survival. Importantly, the prognostic relevance of CD13 expression and homozygous CDKN2A/CDKN2B deletions was restricted to cortical and mature T-ALLs. Conversely, mutations in IDH1/IDH2 and DNMT3A were specifically associated with poor outcome in early immature adult T-ALLs. This trial was registered at www.clinicaltrials.gov as #NCT00002514.
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