101
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Liang X, Liu X, Wang B, Zou F, Wang A, Qi S, Chen C, Zhao Z, Wang W, Qi Z, Lv F, Hu Z, Wang L, Zhang S, Liu Q, Liu J. Discovery of 2-((3-Amino-4-methylphenyl)amino)-N-(2-methyl-5-(3-(trifluoromethyl)benzamido)phenyl)-4-(methylamino)pyrimidine-5-carboxamide (CHMFL-ABL-053) as a Potent, Selective, and Orally Available BCR-ABL/SRC/p38 Kinase Inhibitor for Chronic Myeloid Leukemia. J Med Chem 2016; 59:1984-2004. [PMID: 26789553 DOI: 10.1021/acs.jmedchem.5b01618] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Starting from a dihydropyrimidopyrimidine core scaffold based compound 27 (GNF-7), we discovered a highly potent (ABL1: IC50 of 70 nM) and selective (S score (1) = 0.02) BCR-ABL inhibitor 18a (CHMFL-ABL-053). Compound 18a did not exhibit apparent inhibitory activity against c-KIT kinase, which is the common target of currently clinically used BCR-ABL inhibitors. Through significant suppression of the BCR-ABL autophosphorylation (EC50 about 100 nM) and downstream mediators such as STAT5, Crkl, and ERK's phosphorylation, 18a inhibited the proliferation of CML cell lines K562 (GI50 = 14 nM), KU812 (GI50 = 25 nM), and MEG-01 (GI50 = 16 nM). A pharmacokinetic study revealed that 18a had over 4 h of half-life and 24% bioavailability in rats. A 50 mg/kg/day dosage treatment could almost completely suppress tumor progression in the K562 cells inoculated xenograft mouse model. As a potential useful drug candidate for CML, 18a is under extensive preclinical safety evaluation now.
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Affiliation(s)
- Xiaofei Liang
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Xiaochuan Liu
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,Department of Chemistry, University of Science and Technology of China , Hefei, Anhui 230036, P. R. China
| | - Beilei Wang
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Fengming Zou
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Aoli Wang
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,University of Science and Technology of China, P. R. China , Anhui Hefei 230036, P. R. China
| | - Shuang Qi
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Cheng Chen
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Zheng Zhao
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Wenchao Wang
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Ziping Qi
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Fengchao Lv
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,University of Science and Technology of China, P. R. China , Anhui Hefei 230036, P. R. China
| | - Zhenquan Hu
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Li Wang
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Shanchun Zhang
- CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,Hefei Cosource Medicine Technology Co. LTD. , 358 Ganquan Road, Hefei, Anhui 230031, P. R. China
| | - Qingsong Liu
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,University of Science and Technology of China, P. R. China , Anhui Hefei 230036, P. R. China.,Hefei Science Center, Chinese Academy of Sciences , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
| | - Jing Liu
- High Magnetic Field Laboratory, Chinese Academy of Sciences , Mailbox 1110, 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China.,CHMFL-HCMTC Target Therapy Joint Laboratory , 350 Shushanhu Road, Hefei, Anhui 230031, P. R. China
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102
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Distinct GAB2 signaling pathways are essential for myeloid and lymphoid transformation and leukemogenesis by BCR-ABL1. Blood 2016; 127:1803-13. [PMID: 26773044 DOI: 10.1182/blood-2015-06-653006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2015] [Accepted: 01/04/2016] [Indexed: 11/20/2022] Open
Abstract
Tyrosine kinase inhibitors (TKIs) directed against BCR-ABL1, the product of the Philadelphia (Ph) chromosome, have revolutionized treatment of patients with chronic myeloid leukemia (CML). However, acquired resistance to TKIs is a significant clinical problem in CML, and TKI therapy is much less effective against Ph(+)B-cell acute lymphoblastic leukemia (B-ALL). BCR-ABL1, via phosphorylated Tyr177, recruits the adapter GRB2-associated binding protein 2 (GAB2) as part of a GRB2/GAB2 complex. We showed previously that GAB2 is essential for BCR-ABL1-evoked myeloid transformation in vitro. Using a genetic strategy and mouse models of CML and B-ALL, we show here that GAB2 is essential for myeloid and lymphoid leukemogenesis by BCR-ABL1. In the mouse model, recipients of BCR-ABL1-transducedGab2(-/-)bone marrow failed to develop CML-like myeloproliferative neoplasia. Leukemogenesis was restored by expression of GAB2 but not by GAB2 mutants lacking binding sites for its effectors phosphatidylinositol 3-kinase (PI3K) or SRC homology 2-containing phosphotyrosine phosphatase 2 (SHP2). GAB2 deficiency also attenuated BCR-ABL1-induced B-ALL, but only the SHP2 binding site was required. The SHP2 and PI3K binding sites were differentially required for signaling downstream of GAB2. Hence, GAB2 transmits critical transforming signals from Tyr177 to PI3K and SHP2 for CML pathogenesis, whereas only the GAB2-SHP2 pathway is essential for lymphoid leukemogenesis. Given that GAB2 is dispensable for normal hematopoiesis, GAB2 and its effectors PI3K and SHP2 represent promising targets for therapy in Ph(+)hematologic neoplasms.
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103
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Das D, Pramanik U, Patra M, Banerjee M, Chakrabarti A. Differential interactions of imatinib mesylate with the membrane skeletal protein spectrin and hemoglobin. RSC Adv 2016. [DOI: 10.1039/c5ra27276a] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
The anti-leukaemia drug imatinib has been shown to bind to spectrin, and to hemoglobin in its oxy-form with binding dissociation constants of 48 μM and 63 μM at 25 °C respectively.
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Affiliation(s)
- Debashree Das
- Crystallography & Molecular Biology Division
- Saha Institute of Nuclear Physics
- HBNI
- Kolkata 700064
- India
| | - Ushasi Pramanik
- Biophysics, Molecular Biology and Bioinformatics
- University of Calcutta
- Kolkata 700009
- India
| | - Malay Patra
- Chemistry Department
- University of Calcutta
- Kolkata 700009
- India
| | | | - Abhijit Chakrabarti
- Crystallography & Molecular Biology Division
- Saha Institute of Nuclear Physics
- HBNI
- Kolkata 700064
- India
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104
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Amare PSK, Jain H, Kabre S, Walke D, Menon H, Sengar M, Khatri N, Bagal B, Dangi U, Jain H, Subramanian PG, Gujral S. Characterization of Genomic Events Other than Ph and Evaluation of Prognostic Influence on Imatinib in Chronic Myeloid Leukemia (CML): A Study on 1449 Patients from India. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/jct.2016.74030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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105
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Ayala M, Ávila E, Domínguez J, Aquino X, Vela J. Diagnosis and Treatment of Chronic Myeloid Leukemia in the Imatinib Mesylate Era: Report of the Experience at "La Raza" Medical Center in Mexico. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 16:57-62. [PMID: 26699851 DOI: 10.1016/j.clml.2015.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 10/15/2015] [Accepted: 10/26/2015] [Indexed: 11/15/2022]
Abstract
BACKGROUND With the advent of tyrosine kinase inhibitors (TKIs), the prognosis of chronic myeloid leukemia (CML) has undergone significant changes in all age groups and at different clinical stages over the past 15 years. Consequently, although disease incidence has remained stable, cumulative prevalence is increasing. PATIENTS AND METHODS We reviewed our experience with imatinib mesylate (IM) as a first- and second-line treatment for different CML stages to examine demographic and clinical characteristics of patients, cytogenetic and molecular response rates, as well as overall survival (OS), progression-free survival, and event-free survival of patients at the Specialties Hospital of the National Medical Center "La Raza," which belongs to the Mexican Social Security Institute and serves a population with medium to low socioeconomic status. RESULTS We analyzed data of 302 CML patients who received IM as a first- (n = 234) or second-line treatment (n = 68). Overall, 198 of 302 patients (66%) reached a complete cytogenetic response and at least 115 of 302 (38%) achieved a major molecular response. Among 302 IM-treated patients, 55 (18%) achieved a molecular response 4.5 (MR4.5) or major; at the time of writing this report, 283 (93.7%) were alive and 19 (6.29%) had died. At 60 months, OS was 94%. CONCLUSION IM offers long-term OS expectations not previously observed with any other therapy, in addition to a good quality of life. However, more than a third of the patients require further treatment with a second-generation TKI; consequently, expectations for treatment-free remission and long-term OS are reduced. Timely change to second-generation TKIs could improve such expectations.
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Affiliation(s)
- Manuel Ayala
- Departamento de Hematología y Unidad de Trasplante de Células Progenitoras Hematopoyéticas, Hospital de Especialidades del Centro Médico Nacional "La Raza" IMSS, México City, México.
| | - Elsa Ávila
- Departamento de Hematología y Unidad de Trasplante de Células Progenitoras Hematopoyéticas, Hospital de Especialidades del Centro Médico Nacional "La Raza" IMSS, México City, México
| | - Jacqueline Domínguez
- Grupo Consulmed del Hospital de Especialidades del Centro Médico Nacional "La Raza" IMSS, México City, México
| | - Xóchitl Aquino
- Grupo Consulmed del Hospital de Especialidades del Centro Médico Nacional "La Raza" IMSS, México City, México
| | - Jorge Vela
- Departamento de Hematología y Unidad de Trasplante de Células Progenitoras Hematopoyéticas, Hospital de Especialidades del Centro Médico Nacional "La Raza" IMSS, México City, México
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106
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Wang J, Li Q, Wang C, Xiong Q, Lin Y, Sun Q, Jin H, Yang F, Ren X, Pang T. Knock-down of CIAPIN1 sensitizes K562 chronic myeloid leukemia cells to Imatinib by regulation of cell cycle and apoptosis-associated members via NF-κB and ERK5 signaling pathway. Biochem Pharmacol 2015; 99:132-45. [PMID: 26679828 DOI: 10.1016/j.bcp.2015.12.002] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2015] [Accepted: 12/02/2015] [Indexed: 11/15/2022]
Abstract
CIAPIN1 (cytokine-induced apoptosis inhibitor 1) was recently identified as an essential downstream effector of the Ras signaling pathway. However, its potential role in regulating myeloid leukemia cells sensitivity to Imatinib remains unclear. In this study, we found depletion of CIAPIN1 inhibited proliferation and triggered more apoptosis of K562CML (chronic myeloid leukemia) cells with or without Imatinib treatment. Meanwhile, CIAPIN1 depletion decreased ERK5 phosphorylation and NF-κB activity. Importantly, treating CIAPIN1-depleted K562 cells with ERK5 signaling pathway specific inhibitor, XMD8-92, further inhibited proliferation and promoted apoptosis with or without Imatinib treatment. Treatment with the NF-κB specific inhibitor, Bay 11-7082, induced nearly the same inhibition of proliferation and promotion of apoptosis conferred by CIAPIN1 depletion as was observed with XMD8-92 treatment. Further, XMD8-92 and Bay 11-7082 synergistically inhibited proliferation and promoted apoptosis of CIAPIN1-depleted K562 cells with or without Imatinib treatment. The nude mice transplantation model was also performed to confirm the enhanced sensitivity of CIAPIN1-depleted K562 cells to Imatinib. Thus, our results provided a potential management by which CIAPIN1 knock-down might have a crucial impact on enhancing sensitivity of K562 cells to Imatinib in the therapeutic approaches, indicating that CIAPIN1 knock-down might serve as a combination with chemotherapeutical agents in leukemia diseases therapy.
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MESH Headings
- Animals
- Antineoplastic Agents/pharmacology
- Antineoplastic Agents/therapeutic use
- Cell Cycle/drug effects
- Cell Cycle/physiology
- Cell Survival/drug effects
- Cell Survival/physiology
- Dose-Response Relationship, Drug
- Female
- Gene Knockdown Techniques/methods
- Humans
- Imatinib Mesylate/pharmacology
- Imatinib Mesylate/therapeutic use
- Intracellular Signaling Peptides and Proteins/deficiency
- Intracellular Signaling Peptides and Proteins/genetics
- K562 Cells
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/metabolism
- Mice
- Mice, Inbred BALB C
- Mice, Nude
- Mitogen-Activated Protein Kinase 7/antagonists & inhibitors
- Mitogen-Activated Protein Kinase 7/metabolism
- NF-kappa B/antagonists & inhibitors
- NF-kappa B/metabolism
- Signal Transduction/drug effects
- Signal Transduction/physiology
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Affiliation(s)
- Jian Wang
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Immunology and Biotherapy, National Clinical Research Center of Cancer, Tianjin 300060, China; State Key Laboratory of Experimental Hematology, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing Road 288, Tianjin 300020, China
| | - Qinghua Li
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing Road 288, Tianjin 300020, China
| | - Chijuan Wang
- Department of Breast Cancer Pathology and Research Laboratory, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center of Cancer, Key Laboratory of Breast Cancer Prevention and Therapy, Tianjin Medical University, Ministry of Education, Key Laboratory of Cancer Prevention and Therapy, State Key Laboratory of Breast Cancer Research, Tianjin 300060, China
| | - Qingqing Xiong
- Department of Hepatobiliary Surgery, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Key Laboratory of Cancer Prevention and Therapy, Tianjin 300060, China
| | - Yani Lin
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing Road 288, Tianjin 300020, China
| | - Qian Sun
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Immunology and Biotherapy, National Clinical Research Center of Cancer, Tianjin 300060, China
| | - Hao Jin
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Immunology and Biotherapy, National Clinical Research Center of Cancer, Tianjin 300060, China
| | - Fan Yang
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Immunology and Biotherapy, National Clinical Research Center of Cancer, Tianjin 300060, China
| | - Xiubao Ren
- Department of Immunology, Tianjin Medical University Cancer Institute and Hospital, Key Laboratory of Cancer Immunology and Biotherapy, National Clinical Research Center of Cancer, Tianjin 300060, China
| | - Tianxiang Pang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing Road 288, Tianjin 300020, China.
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107
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Eiring AM, Khorashad JS, Anderson DJ, Yu F, Redwine HM, Mason CC, Reynolds KR, Clair PM, Gantz KC, Zhang TY, Pomicter AD, Kraft IL, Bowler AD, Johnson K, Mac Partlin M, O’Hare T, Deininger MW. β-Catenin is required for intrinsic but not extrinsic BCR-ABL1 kinase-independent resistance to tyrosine kinase inhibitors in chronic myeloid leukemia. Leukemia 2015; 29:2328-37. [PMID: 26202934 PMCID: PMC4675686 DOI: 10.1038/leu.2015.196] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 07/06/2015] [Accepted: 07/13/2015] [Indexed: 12/26/2022]
Abstract
Activation of nuclear β-catenin and expression of its transcriptional targets promotes chronic myeloid leukemia (CML) progression, tyrosine kinase inhibitor (TKI) resistance, and leukemic stem cell self-renewal. We report that nuclear β-catenin has a role in leukemia cell-intrinsic but not -extrinsic BCR-ABL1 kinase-independent TKI resistance. Upon imatinib inhibition of BCR-ABL1 kinase activity, β-catenin expression was maintained in intrinsically resistant cells grown in suspension culture and sensitive cells cultured in direct contact (DC) with bone marrow (BM) stromal cells. Thus, TKI resistance uncouples β-catenin expression from BCR-ABL1 kinase activity. In β-catenin reporter assays, intrinsically resistant cells showed increased transcriptional activity versus parental TKI-sensitive controls, and this was associated with restored expression of β-catenin target genes. In contrast, DC with BM stromal cells promoted TKI resistance, but had little effects on Lef/Tcf reporter activity and no consistent effects on cytoplasmic β-catenin levels, arguing against a role for β-catenin in extrinsic TKI resistance. N-cadherin or H-cadherin blocking antibodies abrogated DC-based resistance despite increasing Lef/Tcf reporter activity, suggesting that factors other than β-catenin contribute to extrinsic, BM-derived TKI resistance. Our data indicate that, while nuclear β-catenin enhances survival of intrinsically TKI-resistant CML progenitors, it is not required for extrinsic resistance mediated by the BM microenvironment.
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Affiliation(s)
- Anna M. Eiring
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | | | - David J. Anderson
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Fan Yu
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
- Beijing Tsinghua Chang Gung Hospital, Tsinghua University, Beijing, China
| | - Hannah M. Redwine
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Clinton C. Mason
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | | | - Phillip M. Clair
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Kevin C. Gantz
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Tian Y. Zhang
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Anthony D. Pomicter
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Ira L. Kraft
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Amber D. Bowler
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
| | - Kara Johnson
- Division of Hematology and Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, U.S.A
| | - Mary Mac Partlin
- Division of Hematology and Medical Oncology, Oregon Health & Science University Knight Cancer Institute, Portland, OR, U.S.A
| | - Thomas O’Hare
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
- Department of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, UT, U.S.A
| | - Michael W. Deininger
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, U.S.A
- Department of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, UT, U.S.A
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108
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Friedman AA, Letai A, Fisher DE, Flaherty KT. Precision medicine for cancer with next-generation functional diagnostics. Nat Rev Cancer 2015; 15:747-56. [PMID: 26536825 PMCID: PMC4970460 DOI: 10.1038/nrc4015] [Citation(s) in RCA: 398] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Precision medicine is about matching the right drugs to the right patients. Although this approach is technology agnostic, in cancer there is a tendency to make precision medicine synonymous with genomics. However, genome-based cancer therapeutic matching is limited by incomplete biological understanding of the relationship between phenotype and cancer genotype. This limitation can be addressed by functional testing of live patient tumour cells exposed to potential therapies. Recently, several 'next-generation' functional diagnostic technologies have been reported, including novel methods for tumour manipulation, molecularly precise assays of tumour responses and device-based in situ approaches; these address the limitations of the older generation of chemosensitivity tests. The promise of these new technologies suggests a future diagnostic strategy that integrates functional testing with next-generation sequencing and immunoprofiling to precisely match combination therapies to individual cancer patients.
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Affiliation(s)
- Adam A Friedman
- Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
| | - Anthony Letai
- Dana-Farber Cancer Institute, Harvard Medical School, 440 Brookline Avenue, Mayer 430, Boston, Massachusetts 02215, USA
| | - David E Fisher
- Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
- Dermatology and Cutaneous Biology Research Center, Massachusetts General Hospital, 149 East 13th Street, Charlestown, Massachusetts 02129, USA
| | - Keith T Flaherty
- Massachusetts General Hospital Cancer Center, Harvard Medical School, 55 Fruit Street, Boston, Massachusetts 02114, USA
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109
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Response and Adverse Effects of Nilotinib in Imatinib-resistant Chronic Myeloid Leukemia Patients: Data From a Developing Country. Clin Ther 2015; 37:2449-57. [PMID: 26409289 DOI: 10.1016/j.clinthera.2015.08.026] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/17/2015] [Accepted: 08/25/2015] [Indexed: 12/31/2022]
Abstract
PURPOSE The purpose of this study was to determine the frequency of major cytogenetic response (MCyR) and adverse events with nilotinib in adults with imatinib-resistant Philadelphia chromosome-positive chronic myeloid leukemia (CML). METHODS This is a descriptive cross-sectional study conducted at The Aga Khan University Hospital in Karachi from October 17, 2010, to October 17, 2011. A cytogenetic assessment using fluorescent in situ hybridization was performed on peripheral blood before initiation of treatment and 6 months after treatment with nilotinib. The frequency of adverse effects was assessed at 6 months, and the patient overall survival was calculated after 3 years. FINDINGS This study enrolled 82 imatinib-resistant patients. The mean (SD) patient age was 38.9 (12.2) years. There were 62 patients (75.6%) in chronic phase, 15 patients (18.3%) in accelerated phase, and 5 patients (6%) in blast crisis phase. At 6 months cytogenetic studies were available for 40 (52%) of 77 patients, and MCyR was observed in 31 (77.5%) of 77 patients. The patients in chronic phase had the highest frequency of MCyR (n = 27 [87%] of 31). We observed 6 deaths (7.3%), and the overall survival at 3 years was 92.7%. There was isolated thrombocytopenia in 12 patients (15.6%). The most frequent nonhematologic adverse events were myalgia and headache. IMPLICATIONS The nilotinib response rates were higher in chronic phase patients, and the most common adverse events were thrombocytopenia, myalgia, and headache.
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110
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Thompson PA, Kantarjian HM, Cortes JE. Diagnosis and Treatment of Chronic Myeloid Leukemia in 2015. Mayo Clin Proc 2015; 90:1440-54. [PMID: 26434969 PMCID: PMC5656269 DOI: 10.1016/j.mayocp.2015.08.010] [Citation(s) in RCA: 68] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 08/23/2015] [Accepted: 08/24/2015] [Indexed: 01/13/2023]
Abstract
Few neoplastic diseases have undergone a transformation in a relatively short period like chronic myeloid leukemia (CML) has in the last few years. In 1960, CML was the first cancer in which a unique chromosomal abnormality was identified and a pathophysiologic correlation suggested. Landmark work followed, recognizing the underlying translocation between chromosomes 9 and 22 that gave rise to this abnormality and, shortly afterward, the specific genes involved and the pathophysiologic implications of this novel rearrangement. Fast forward a few years and this knowledge has given us the most remarkable example of a specific therapy that targets the dysregulated kinase activity represented by this molecular change. The broad use of tyrosine kinase inhibitors has resulted in an improvement in the overall survival to the point where the life expectancy of patients today is nearly equal to that of the general population. Still, there are challenges and unanswered questions that define the reasons why the progress still escapes many patients, and the details that separate patients from ultimate cure. In this article, we review our current understanding of CML in 2015, present recommendations for optimal management, and discuss the unanswered questions and what could be done to answer them in the near future.
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MESH Headings
- Clinical Protocols
- Diagnosis, Differential
- Disease Progression
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/physiopathology
- Patient Outcome Assessment
- Philadelphia Chromosome
- Prognosis
- Protein Kinase Inhibitors/classification
- Protein Kinase Inhibitors/pharmacology
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Affiliation(s)
- Philip A Thompson
- Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston
| | - Hagop M Kantarjian
- Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston
| | - Jorge E Cortes
- Department of Leukemia, The University of Texas, MD Anderson Cancer Center, Houston.
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111
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Pérez-Jacobo F, Tuna-Aguilar E, Demichelis-Gómez R, Crespo-Solís E, Valencia-Rocha U, Aguayo Á, López-Karpovitch X. Prognostic Factors, Response to Treatment, and Survival in Patients With Chronic Myeloid Leukemia in Blast Phase: A Single-Institution Survey. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2015; 15:778-84. [PMID: 26500135 DOI: 10.1016/j.clml.2015.09.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2015] [Revised: 09/15/2015] [Accepted: 09/21/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Data from 51 patients (23 women) with chronic myeloid leukemia (CML) in blast phase (BP) were analyzed in order to identify prognostic factors for complete hematologic response (CHR) and survival. PATIENTS AND METHODS Forty-four patients experienced disease progression from chronic or accelerated phase, and 7 cases presented as CML-BP. Thirteen patients (25.5%) had extramedullary involvement at diagnosis, and 71% were myeloid BP. Clonal evolution was identified in 53% of the cases, and the abnormalities most frequently observed were isochromosome (17q), double Philadelphia chromosome, and trisomy 8. Forty-five patients received treatment: 60% chemotherapy (CT) alone and 40% CT plus tyrosine kinase inhibitors (TKI) or TKI alone; 42% of them experienced CHR. RESULTS Median overall survival (OS) in patients whose disease responded to treatment was 7 months (95% confidence interval, 1.7-6.2 months), with a median disease-free survival of 5 months (95% confidence interval, 2.8-5.8 months). One out of 3 patients who underwent hematopoietic stem-cell transplantation remains alive. Multivariate analysis revealed that lymphoid BP and TKI therapy had a statistically significant positive impact as prognostic factors for CHR. In the multivariate analysis, age > 60 years, hemoglobin < 10 g/dL, and complex karyotype were statistically significant negative prognostic factors for OS. There was no statistical significant difference in OS between patients who received only CT (1988-2002) with those treated with CT plus TKI (2003-2013). CONCLUSION This is the first study in Mexico to report prognostic factors associated with CHR and OS in patients with CML-BP.
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Affiliation(s)
- Fernando Pérez-Jacobo
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Elena Tuna-Aguilar
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Roberta Demichelis-Gómez
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Erick Crespo-Solís
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Ubaldo Valencia-Rocha
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Álvaro Aguayo
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México
| | - Xavier López-Karpovitch
- Chronic Leukemia Clinic, Department of Hematology and Oncology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México.
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112
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Giotopoulos G, van der Weyden L, Osaki H, Rust AG, Gallipoli P, Meduri E, Horton SJ, Chan WI, Foster D, Prinjha RK, Pimanda JE, Tenen DG, Vassiliou GS, Koschmieder S, Adams DJ, Huntly BJP. A novel mouse model identifies cooperating mutations and therapeutic targets critical for chronic myeloid leukemia progression. J Exp Med 2015; 212:1551-69. [PMID: 26304963 PMCID: PMC4577832 DOI: 10.1084/jem.20141661] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 07/28/2015] [Indexed: 12/14/2022] Open
Abstract
The introduction of highly selective ABL-tyrosine kinase inhibitors (TKIs) has revolutionized therapy for chronic myeloid leukemia (CML). However, TKIs are only efficacious in the chronic phase of the disease and effective therapies for TKI-refractory CML, or after progression to blast crisis (BC), are lacking. Whereas the chronic phase of CML is dependent on BCR-ABL, additional mutations are required for progression to BC. However, the identity of these mutations and the pathways they affect are poorly understood, hampering our ability to identify therapeutic targets and improve outcomes. Here, we describe a novel mouse model that allows identification of mechanisms of BC progression in an unbiased and tractable manner, using transposon-based insertional mutagenesis on the background of chronic phase CML. Our BC model is the first to faithfully recapitulate the phenotype, cellular and molecular biology of human CML progression. We report a heterogeneous and unique pattern of insertions identifying known and novel candidate genes and demonstrate that these pathways drive disease progression and provide potential targets for novel therapeutic strategies. Our model greatly informs the biology of CML progression and provides a potent resource for the development of candidate therapies to improve the dismal outcomes in this highly aggressive disease.
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MESH Headings
- Animals
- DNA Transposable Elements
- Fusion Proteins, bcr-abl/genetics
- Gene Expression Regulation, Leukemic
- Genes, myb
- Hematopoietic Stem Cells/pathology
- Humans
- Leukemia, Experimental/drug therapy
- Leukemia, Experimental/genetics
- Leukemia, Experimental/mortality
- Leukemia, Experimental/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/mortality
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Mice, Transgenic
- Molecular Targeted Therapy/methods
- Mutagenesis, Insertional
- Mutation
- Tumor Cells, Cultured
- Vascular Endothelial Growth Factor C/genetics
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Affiliation(s)
- George Giotopoulos
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Louise van der Weyden
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Hikari Osaki
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Alistair G Rust
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, UK Tumour Profiling Unit, The Institute of Cancer Research, Chester Beatty Laboratories, London SW3 6JB, England, UK
| | - Paolo Gallipoli
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Eshwar Meduri
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Sarah J Horton
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Wai-In Chan
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Donna Foster
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
| | - Rab K Prinjha
- Epinova DPU, GlaxoSmithKline, Medicines Research Centre, Stevenage SG1 2NY, England, UK
| | - John E Pimanda
- Lowy Cancer Research Centre and the Prince of Wales Clinical School, University of New South Wales, Sydney, NSW 2052, Australia
| | - Daniel G Tenen
- Cancer Science Institute, National University of Singapore, Singapore 119077 Harvard Stem Cell Institute, Harvard Medical School, Boston, MA 02115
| | - George S Vassiliou
- Haematological Cancer Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge CB10 1SA, England, UK
| | - Steffen Koschmieder
- Department of Hematology, Oncology, Hemostaseology, and Stem Cell Transplantation, Faculty of Medicine, RWTH Aachen University, 52062 Aachen, Germany
| | - David J Adams
- Experimental Cancer Genetics, Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, CB10 1SA, UK
| | - Brian J P Huntly
- Department of Haematology, Cambridge Institute for Medical Research and Addenbrooke's Hospital, University of Cambridge, Cambridge CB2 0XY, England, UK Wellcome Trust - Medical Research Council Cambridge Stem Cell Institute, University of Cambridge, Cambridge CB2 1TN, England, UK
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113
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Ostendorf BN, Nogai H, Baldus CD, Burmeister T, Arnold R. BCR-ABL Mutation-Guided Therapy for CML Blast Crisis: A Case Report. Biomark Insights 2015; 10:25-8. [PMID: 26379418 PMCID: PMC4554357 DOI: 10.4137/bmi.s22279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Revised: 06/28/2015] [Accepted: 06/29/2015] [Indexed: 12/27/2022] Open
Abstract
The management of patients with chronic myeloid leukemia (CML) in advanced phases is challenging and requires the consideration of different treatment approaches, including targeted therapy with tyrosine kinase inhibitors, cytotoxic chemotherapy, and allogeneic stem cell transplantation. Here, we present the case of a patient with CML in mixed phenotype blast phase illustrating the integration of these strategies and demonstrating the need for close monitoring of treatment response in order to individually adjust treatment regimens.
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Affiliation(s)
- Benjamin N Ostendorf
- Charité University Medicine, Department of Hematology, Oncology and Tumor Immunology, Berlin, Germany
| | | | - Claudia D Baldus
- Charité University Medicine, Department of Hematology, Oncology and Tumor Immunology, Berlin, Germany
| | - Thomas Burmeister
- Charité University Medicine, Department of Hematology, Oncology and Tumor Immunology, Berlin, Germany. ; Labor Berlin, Hematology Division, Tumor Genetics, Berlin, Germany
| | - Renate Arnold
- Charité University Medicine, Department of Hematology, Oncology and Tumor Immunology, Berlin, Germany
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114
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Gambacorti‐Passerini C, Kantarjian HM, Kim D, Khoury HJ, Turkina AG, Brümmendorf TH, Matczak E, Bardy‐Bouxin N, Shapiro M, Turnbull K, Leip E, Cortes JE. Long-term efficacy and safety of bosutinib in patients with advanced leukemia following resistance/intolerance to imatinib and other tyrosine kinase inhibitors. Am J Hematol 2015; 90:755-68. [PMID: 26040495 PMCID: PMC5132035 DOI: 10.1002/ajh.24034] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Accepted: 04/04/2015] [Indexed: 01/24/2023]
Abstract
Long-term efficacy and safety of bosutinib (≥4 years follow-up from last enrolled patient) were evaluated in an ongoing phase 1/2 study in the advanced leukemia cohort with prior treatment failure (accelerated-phase [AP, n = 79] chronic myeloid leukemia [CML], blast-phase [BP, n = 64] CML, acute lymphoblastic leukemia [ALL, n = 24]). Fourteen AP, 2 BP, and 1 ALL patient remained on bosutinib at 4 years (vs. 38, 8, 1 at 1 year); median (range) treatment durations: 10.2 (0.1-88.6), 2.8 (0.03-55.9), 0.97 (0.3-89.2) months. Among AP and BP patients, 57% and 28% newly attained or maintained baseline overall hematologic response (OHR); 40% and 37% attained/maintained major cytogenetic response (MCyR) by 4 years (most by 12 months). In responders at 1 versus 4 years, Kaplan-Meier (KM) probabilities of maintaining OHR were 78% versus 49% (AP) and 28% versus 19% (BP); KM probabilities of maintaining MCyR were 65% versus 49% (AP) and 21% versus 21% (BP). Most common AEs (AP, BP) were gastrointestinal (96%; 83%), primarily diarrhea (85%; 64%), which was typically low grade (maximum grade 1/2: 81%; 59%) and transient; no patient discontinued due to diarrhea. Serious AEs occurred in 44 (56%) AP and 37 (58%) BP patients, most commonly pneumonia (n = 9) for AP and pyrexia (n = 6) for BP; 11 and 13 died within 30 days of last dose (2 considered bosutinib-related [AP] per investigator). Responses were durable in ∼50% AP responders at 4 years (∼25% BP patients responded at year 1, suggesting possible bridge-to-transplant role in BP patients); toxicity was manageable.
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Affiliation(s)
| | - Hagop M. Kantarjian
- Department of LeukemiaDivision of Cancer MedicineUniversity of Texas MD Anderson Cancer CenterHoustonTexas
| | - Dong‐Wook Kim
- Department of HematologySeoul St. Mary's HospitalSeoulSouth Korea
| | - Hanna J. Khoury
- Division of HematologyWinship Cancer Institute of Emory UniversityAtlantaGeorgia
| | | | - Tim H. Brümmendorf
- Clinic for OncologyHematologyand Stem Cell TransplantationUniversitätsklinikum Aachen, RWTH AachenGermany
- OncologyHematologyand Stem Cell TransplantationUniversitätsklinikum Hamburg‐EppendorfHamburgGermany
| | | | | | | | | | | | - Jorge E. Cortes
- Department of LeukemiaDivision of Cancer MedicineUniversity of Texas MD Anderson Cancer CenterHoustonTexas
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115
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Bagca BG, Ozalp O, Kurt CC, Mutlu Z, Saydam G, Gunduz C, Avci CB. Ruxolitinib induces autophagy in chronic myeloid leukemia cells. Tumour Biol 2015; 37:1573-9. [PMID: 26298727 DOI: 10.1007/s13277-015-3947-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 08/17/2015] [Indexed: 12/22/2022] Open
Abstract
Ruxolitinib is the first agent used in myelofibrosis treatment with its potent JAK2 inhibitory effect. In this novel study, we aimed to discover the anti-leukemic effect of ruxolitinib in K-562 human chronic myeloid leukemia cell line compared to NCI-BL 2171 human healthy B lymphocyte cell line. Cytotoxic effect of ruxolitinib was determined by using WST-1 assay. IC50 values for K-562 and NCI-BL 2171 cell lines were defined as 20 and 23.6 μM at the 48th hour, respectively. Autophagic effects of ruxolitinib were detected by measuring LC3B-II protein formation. Ruxolitinib induced autophagic cell death in K-562 and NCI-BL 2171 cell lines 2.11- and 1.79-fold compared to control groups, respectively. To determine the autophagy-related gene expression changes, total RNA was isolated from K-562 and NCI-BL 2171 cells treated with ruxolitinib and untreated cells as control group. Reverse transcription procedure was performed for cDNA synthesis, and gene expressions were shown by RT-qPCR. Ruxolitinib treatment caused a notable decrease in expression of AKT, mTOR, and STAT autophagy inhibitor genes in K-562 cells, contrariwise control cell line. Ruxolitinib is a promising agent in chronic myeloid leukemia treatment by blocking JAK/STAT pathway known as downstream of BCR-ABL and triggering autophagy. This is the first study that reveals the relationship between ruxolitinib and autophagy induction.
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Affiliation(s)
- Bakiye Goker Bagca
- Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey.
| | - Ozgun Ozalp
- Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey
| | - Cansu Caliskan Kurt
- Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey
| | - Zeynep Mutlu
- Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey
| | - Guray Saydam
- Department of Hematology, School of Medicine, Ege University, Izmir, Turkey
| | - Cumhur Gunduz
- Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey
| | - Cigir Biray Avci
- Department of Medical Biology, School of Medicine, Ege University, Izmir, Turkey
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116
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Computational and experimental single cell biology techniques for the definition of cell type heterogeneity, interplay and intracellular dynamics. Curr Opin Biotechnol 2015; 34:9-15. [DOI: 10.1016/j.copbio.2014.10.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 10/21/2014] [Accepted: 10/22/2014] [Indexed: 12/31/2022]
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117
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Accelerated phase chronic myeloid leukemia: evaluation of clinical criteria as predictors of survival, major cytogenetic response and progression to blast phase. Rev Bras Hematol Hemoter 2015; 37:341-7. [PMID: 26408370 PMCID: PMC4685086 DOI: 10.1016/j.bjhh.2015.07.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2015] [Revised: 06/09/2015] [Accepted: 07/07/2015] [Indexed: 01/30/2023] Open
Abstract
Background Published criteria defining the accelerated phase in chronic myeloid leukemia are heterogeneous and little is known about predictors of poor outcome. Methods This is a retrospective study of 139 subjects in the accelerated phase of chronic myeloid leukemia treated with imatinib at a single center in Brazil. The objective was to identify risk factors for survival, major cytogenetic response and progression to blast phase in this population. The factors analyzed were: blasts 10–29%, basophils ≥ 20%, platelets > 1 × 106/μL or <1 × 105/μL and white blood cells > 1 × 105/μL in the peripheral blood, as well as clonal evolution, splenomegaly, hemoglobin < 10 g/dL, time between diagnosis of chronic myeloid leukemia and imatinib treatment, and hematologic toxicity. Results Risk factors for poor survival in multivariate analysis were Grades 3–4 hematologic toxicity (p-value = 0.001), blasts 10–29% (p-value = 0.023), and hemoglobin < 10 g/dL (p-value = 0.04). Risk factors for not achieving major cytogenetic response were blasts 10–29% (p-value = 0.007), hemoglobin < 10 g/dL (p-value = 0.001), and previous use of interferon (p-value = 0.032). Risk factors for progression to the blast phase were hemoglobin < 10 g/dL (p-value = 0.005), basophils ≥ 20% (p-value = 0.023), and time from diagnosis of chronic myeloid leukemia to imatinib treatment > 12 months (p-value = 0.030). Conclusion These data indicate that patients with the above risk factors have a worse prognosis. This information can guide the therapy to be used.
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119
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Chen J, Zhou M, Zhang Q, Xu J, Ouyang J. Gambogic acid induces death of K562 cells through autophagy and apoptosis mechanisms. Leuk Lymphoma 2015; 56:2953-8. [PMID: 25699654 DOI: 10.3109/10428194.2015.1018251] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study was aimed to detect the effects of gambogic acid (GA) on the growth of chronic myelogenous leukemia (CML) K562 cells. Our results showed that GA induced the accumulation of autophagic vacuoles and up-regulation of two autophagy-related proteins (Beclin 1 and LC3). GA also induced down-regulation of mRNA levels of BCR-ABL fusion gene and SQSTM1/sequestosome 1 (p62) protein levels. After treatment by chloroquine (CQ) and pan caspase inhibitor Z-VAD-FMK (PC), both GA-induced autophagy and apoptosis were inhibited. Our study demonstrates that GA may induce cell death through autophagy and apoptosis pathways in CML K562 cells. A cross-talk mechanism exists between GA-induced autophagy and apoptosis. However, the mechanism of GA for inducing autophagy and apoptosis need further clarification.
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Affiliation(s)
- Jinhao Chen
- a Department of Hematology , Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China
| | - Min Zhou
- a Department of Hematology , Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China
| | - Qian Zhang
- a Department of Hematology , Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China
| | - Jingyan Xu
- a Department of Hematology , Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China
| | - Jian Ouyang
- a Department of Hematology , Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School , Nanjing, Jiangsu , China
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120
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Fernandes J. The study of homology between tumor progression genes and members of retroviridae as a tool to predict target-directed therapy failure. Front Pharmacol 2015; 6:92. [PMID: 25983693 PMCID: PMC4416442 DOI: 10.3389/fphar.2015.00092] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 04/16/2015] [Indexed: 11/30/2022] Open
Abstract
Oncogenes are the primary candidates for target-directed therapy, given that they are involved directly in the progression and resistance of tumors. However, the appearance of point mutations can hinder the treatment of patients with these new molecules, raising costs and the need to development new analogs that target the novel mutations. Based on an analysis of homologies, the present study discusses the possibility of predicting the failure of a protein as a pharmacological target, due to its similarities with retrovirus sequences, which have extremely high mutation rates. This analysis was based on the molecular evidence available in the literature, and widely-used and well-established PSI-BLAST, with two iterations and maximum of 500 aligned sequences. The possibility of predicting which newly-discovered genes involved in tumor progression would likely result in the failure of targeted therapy, using free, simple and automated bioinformatics tools, could provide substantial savings in the time and financial resources needed for long-term drug development.
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Affiliation(s)
- Janaina Fernandes
- NUMPEX-BIO, Federal University of Rio de Janeiro, Duque de Caxias , Rio de Janeiro, Brazil ; Institute for Translational Research on Health and Environment in the Amazon Region - INPeTAm, Federal University of Rio de Janeiro , Rio de Janeiro, Brazil
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121
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Saußele S, Silver RT. Management of chronic myeloid leukemia in blast crisis. Ann Hematol 2015; 94 Suppl 2:S159-65. [PMID: 25814082 DOI: 10.1007/s00277-015-2324-0] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 12/07/2014] [Indexed: 12/15/2022]
Abstract
Due to the high efficacy of BCR-ABL tyrosine kinase inhibition (TKI) in chronic phase (CP) chronic myeloid leukemia (CML), the frequency of blast crisis (BC) is greatly reduced compared to the pre-TKI era. However, TKI treatment of BC has only marginally improved the number of favorable responses, including remissions, which for the most part have only been transitory. Occasionally, they provide a therapeutic window to perform an allogeneic stem cell transplantation (allo-SCT). The challenge remains to improve management of BC with the limited options available. We review and summarize articles pertaining to the treatment of BC CML published after 2002. Additionally, we will discuss whether there is a need for a new definition of BC and/or treatment failure.
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Affiliation(s)
- S Saußele
- III. Medizinische Klinik, Medizinische Fakultät Mannheim, Universität Heidelberg, Pettenkoferstr. 22, 68169, Mannheim, Germany,
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122
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Current challenges in clinical development of "targeted therapies": the case of acute myeloid leukemia. Blood 2015; 125:2461-6. [PMID: 25762181 DOI: 10.1182/blood-2015-01-561373] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2015] [Accepted: 03/02/2015] [Indexed: 12/31/2022] Open
Abstract
A fundamental difficulty in testing "targeted therapies" in acute myeloid leukemia (AML) is the limitations of preclinical models in capturing inter- and intrapatient genomic heterogeneity. Clinical trials typically focus on single agents despite the routine emergence of resistant subclones and experience in blast-phase chronic myeloid leukemia and acute promyelocytic leukemia arguing against this strategy. Inclusion of only relapsed-refractory, or unfit newly diagnosed, patients risks falsely negative results. There is uncertainty as to whether eligibility should require demonstration of the putative target and regarding therapeutic end points. Although use of in vivo preclinical models employing primary leukemic cells is first choice, newer preclinical models including "organoids" and combinations of pharmacologic and genetic approaches may better align models with human AML. We advocate earlier inclusion of combinations ± chemotherapy and of newly diagnosed patients into clinical trials. When a drug plausibly targets a pathway uniquely related to a specific genetic aberration, eligibility should begin with this subset, including patients with other malignancies, with subsequent extension to other patients. In other cases, a more open-minded approach to initial eligibility would facilitate quicker identification of responsive subsets. Complete remission without minimal residual disease seems a particularly useful short-term end point. Genotypic and phenotypic studies should be prespecified and performed routinely to distinguish responders from nonresponders.
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123
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Woessner DW, Eiring AM, Bruno BJ, Zabriskie MS, Reynolds KR, Miller GD, O'Hare T, Deininger MW, Lim CS. A coiled-coil mimetic intercepts BCR-ABL1 dimerization in native and kinase-mutant chronic myeloid leukemia. Leukemia 2015; 29:1668-75. [PMID: 25721898 PMCID: PMC4621806 DOI: 10.1038/leu.2015.53] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/05/2015] [Accepted: 01/09/2015] [Indexed: 01/14/2023]
Abstract
Targeted therapy of chronic myeloid leukemia is currently based on small-molecule inhibitors that directly bind the tyrosine kinase domain of BCR-ABL1. This strategy has generally been successful, but is subject to drug resistance due to point mutations in the kinase domain. Kinase activity requires transactivation of BCR-ABL1 following an oligomerization event, which is mediated by the coiled-coil (CC) domain at the N-terminus of the protein. Here, we describe a rationally engineered mutant version of the CC domain, called CCmut3, which interferes with BCR-ABL1 oligomerization and promotes apoptosis in BCR-ABL1-expressing cells, regardless of kinase domain mutation status. CCmut3 exhibits strong pro-apoptotic and anti-proliferative activity in cell lines expressing native BCR-ABL1, single kinase domain mutant BCR-ABL1 (E255V and T315I) or compound mutant BCR-ABL1 (E255V/T315I). Moreover, CCmut3 inhibits colony formation by primary CML CD34+ cells ex vivo, including a sample expressing the T315I mutant. These data suggest that targeting BCR-ABL1 with CC mutants may provide a novel alternative strategy for treating patients with resistance to current targeted therapies.
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Affiliation(s)
- D W Woessner
- Department of Pharmacology and Toxicology, College of Pharmacy, The University of Utah, Salt Lake City, UT, USA
| | - A M Eiring
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA
| | - B J Bruno
- Department of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The University of Utah, Salt Lake City, UT, USA
| | - M S Zabriskie
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA
| | - K R Reynolds
- Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA
| | - G D Miller
- Department of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The University of Utah, Salt Lake City, UT, USA
| | - T O'Hare
- 1] Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA [2] Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, UT, USA
| | - M W Deininger
- 1] Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA [2] Division of Hematology and Hematologic Malignancies, The University of Utah, Salt Lake City, UT, USA
| | - C S Lim
- 1] Huntsman Cancer Institute, The University of Utah, Salt Lake City, UT, USA [2] Department of Pharmaceutics and Pharmaceutical Chemistry, College of Pharmacy, The University of Utah, Salt Lake City, UT, USA
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124
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Cutillas PR. Role of phosphoproteomics in the development of personalized cancer therapies. Proteomics Clin Appl 2015; 9:383-95. [PMID: 25488289 DOI: 10.1002/prca.201400104] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Revised: 10/20/2014] [Accepted: 11/18/2014] [Indexed: 01/08/2023]
Abstract
Cell signalling pathways driven by protein and lipid kinases contribute to the onset and progression of virtually all cancer types. Consequently, several inhibitors against these enzymes have clinical utility for the treatment of different forms of cancer. A problem that hampers further development is that not all patients respond equally well to kinase inhibitors and a significant proportion of those that initially respond eventually develop resistance. This review considers how an integrative analysis of kinase signalling may be used to address this issue. Advances in the biophysics of mass spectrometry, in biochemical procedures for phosphopeptide enrichment, and in computational approaches for label-free quantification have contributed to the development of phosphoproteomics workflows compatible with the analysis of clinical material. These developments, together with new bioinformatics tools to derive information on signalling circuitry from phosphoproteomics data, allow investigating kinase networks with unprecedented depth. Phosphoproteomics technology is starting to be used in translational research and, with further developments, such methods may also be able to measure the circuitry of cancer signalling networks in routine clinical assays. This review reflects on how this information could be used to accurately predict the best kinase inhibitor for each individual cancer patient.
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Affiliation(s)
- Pedro R Cutillas
- Integrative Cell Signalling and Proteomics, Centre for Haemato-Oncology, John Vane Science Centre, Barts Cancer Institute, Queen Mary University of London, Charterhouse Square, London, UK
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125
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Wang W, Lv FF, Du Y, Li N, Chen Y, Chen L. The effect of nilotinib plus arsenic trioxide on the proliferation and differentiation of primary leukemic cells from patients with chronic myoloid leukemia in blast crisis. Cancer Cell Int 2015; 15:10. [PMID: 25698901 PMCID: PMC4334604 DOI: 10.1186/s12935-015-0158-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Accepted: 01/05/2015] [Indexed: 12/02/2022] Open
Abstract
Aim To determine the effects of arsenic trioxide (ATO) and nilotinib (AMN107, Tasigna) alone or in combination on the proliferation and differentiation of primary leukemic cells from patients with chronic myeloid leukemia in the blast crisis phase (CML-BC). Methods Cells were isolated from the bone marrow of CML-BC patients and were treated with 1 μM ATO and 5 nM nilotinib, either alone or in combination. Cell proliferation was evaluated using a MTT assay. Cell morphology and the content of hemoglobin were examined with Wright-Giemsa staining and benzidine staining, respectively. The expression of cell surface markers was determined using flow cytometric analysis. The levels of mRNA and protein were analyzed using RT-PCR and Western blotting, respectively. Results ATO and nilotinib alone or in combination suppressed cell proliferation in a dose- and time-dependent pattern (P < 0.01 vs. control). Drug treatments promoted erythroid differentiation of CML-BC cells, with a decreased nuclei/cytoplasm ratio but increased hemoglobin content and glycophorin A (GPA) expression (P < 0.01 compared with control). In addition, macrophage and granulocyte lineage differentiation was also induced after drug treatment. The mRNA and protein levels of basic helix-loop-helix (bHLH) transcription factor T-cell acute lymphocytic leukemia protein 1 (TAL1) and B cell translocation gene 1 (BTG1) were both upregulated after 3 days of ATO and Nilotinib treatment. Conclusions Our findings indicated that ATO and nilotinib treatment alone or in combination greatly suppressed cell proliferation but promoted the differentiation of CML-BC cells towards multiple-lineages. Nilotinib alone preferentially induced erythroid differentiation while combined treatment with ATO preferentially induced macrophage and granulocyte lineage differentiation.
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Affiliation(s)
- Wei Wang
- Department of Hematology, Southeast Hospital Affiliated to Xiamen University (the 175th Hospital of Chinese PLA), NO.269, Zhanghua Middle Road, Zhangzhou, Fujian 363000 China
| | - Fei-Fei Lv
- Department of Hematology, Southeast Hospital Affiliated to Xiamen University (the 175th Hospital of Chinese PLA), NO.269, Zhanghua Middle Road, Zhangzhou, Fujian 363000 China
| | - Yan Du
- Department of Hematology, Southeast Hospital Affiliated to Xiamen University (the 175th Hospital of Chinese PLA), NO.269, Zhanghua Middle Road, Zhangzhou, Fujian 363000 China
| | - Nannan Li
- Department of Hematology, Southeast Hospital Affiliated to Xiamen University (the 175th Hospital of Chinese PLA), NO.269, Zhanghua Middle Road, Zhangzhou, Fujian 363000 China
| | - YaLing Chen
- Department of Hematology, Southeast Hospital Affiliated to Xiamen University (the 175th Hospital of Chinese PLA), NO.269, Zhanghua Middle Road, Zhangzhou, Fujian 363000 China
| | - LiHong Chen
- Department of Hematology, Southeast Hospital Affiliated to Xiamen University (the 175th Hospital of Chinese PLA), NO.269, Zhanghua Middle Road, Zhangzhou, Fujian 363000 China
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126
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Gambacorti-Passerini C, Piazza R. How I treat newly diagnosed chronic myeloid leukemia in 2015. Am J Hematol 2015; 90:156-61. [PMID: 25370814 DOI: 10.1002/ajh.23887] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 10/31/2014] [Indexed: 12/30/2022]
Abstract
The initial treatment for chronic myeloid leukemia in chronic phase (CP-CML) represents a complex process, which includes a prompt and precise diagnosis, the choice among three available tyrosine kinase inhibitors (TKIs), and the initial management of care for these patients, which will protract over a very long period of time. This manuscript summarizes different data on activity, side effects, and supportive measures available for each TKI, the need for particular care in the logistical organization of CML management, the scenario which will be opened by the future availability of generic imatinib. The opinion of the authors is that imatinib remains the first-line treatment for CP-CML; this strategy, accompanied by intensive monitoring and possible dose modification/drug switch after the initial 3-12 months of treatment presently assures a normal life expectancy to the population of newly diagnosed patients with CP-CML.
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Affiliation(s)
- Carlo Gambacorti-Passerini
- Department of Health Sciences; University of Milano-Bicocca, Section of Hematology, San Gerardo Hospital; Monza Italy
| | - Rocco Piazza
- Department of Health Sciences; University of Milano-Bicocca, Section of Hematology, San Gerardo Hospital; Monza Italy
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127
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Meng Y, Lin YL, Roux B. Computational study of the "DFG-flip" conformational transition in c-Abl and c-Src tyrosine kinases. J Phys Chem B 2015; 119:1443-56. [PMID: 25548962 PMCID: PMC4315421 DOI: 10.1021/jp511792a] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
![]()
Protein
tyrosine kinases are crucial to cellular signaling pathways
regulating cell growth, proliferation, metabolism, differentiation,
and migration. To maintain normal regulation of cellular signal transductions,
the activities of tyrosine kinases are also highly regulated. The
conformation of a three-residue motif Asp-Phe-Gly (DFG) near the N-terminus
of the long “activation” loop covering the catalytic
site is known to have a critical impact on the activity of c-Abl and
c-Src tyrosine kinases. A conformational transition of the DFG motif
can switch the enzyme from an active (DFG-in) to an inactive (DFG-out)
state. In the present study, the string method with swarms-of-trajectories
was used to computationally determine the reaction pathway connecting
the two end-states, and umbrella sampling calculations were carried
out to characterize the thermodynamic factors affecting the conformations
of the DFG motif in c-Abl and c-Src kinases. According to the calculated
free energy landscapes, the DFG-out conformation is clearly more favorable
in the case of c-Abl than that of c-Src. The calculations also show
that the protonation state of the aspartate residue in the DFG motif
strongly affects the in/out conformational transition in c-Abl, although
it has a much smaller impact in the case of c-Src due to local structural
differences.
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Affiliation(s)
- Yilin Meng
- Department of Biochemistry and Molecular Biology, The University of Chicago , 929 E. 57th Street, Chicago, Illinois, 60637, United States
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128
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Inhibition of Aurora kinase B is important for biologic activity of the dual inhibitors of BCR-ABL and Aurora kinases R763/AS703569 and PHA-739358 in BCR-ABL transformed cells. PLoS One 2014; 9:e112318. [PMID: 25426931 PMCID: PMC4245092 DOI: 10.1371/journal.pone.0112318] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 10/06/2014] [Indexed: 12/21/2022] Open
Abstract
ABL tyrosine kinase inhibitors (TKI) like Imatinib, Dasatinib and Nilotinib are the gold standard in conventional treatment of CML. However, the emergence of resistance remains a major problem. Alternative therapeutic strategies of ABL TKI-resistant CML are urgently needed. We asked whether dual inhibition of BCR-ABL and Aurora kinases A-C could overcome resistance mediated by ABL kinase mutations. We therefore tested the dual ABL and Aurora kinase inhibitors PHA-739358 and R763/AS703569 in Ba/F3- cells ectopically expressing wild type (wt) or TKI-resistant BCR-ABL mutants. We show that both compounds exhibited strong anti-proliferative and pro-apoptotic activity in ABL TKI resistant cell lines including cells expressing the strongly resistant T315I mutation. Cell cycle analysis indicated polyploidisation, a consequence of continued cell cycle progression in the absence of cell division by Aurora kinase inhibition. Experiments using drug resistant variants of Aurora B indicated that PHA-739358 acts on both, BCR-ABL and Aurora Kinase B, whereas Aurora kinase B inhibition might be sufficient for the anti-proliferative activity observed with R763/AS703569. Taken together, our data demonstrate that dual ABL and Aurora kinase inhibition might be used to overcome ABL TKI resistant CML.
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Abstract
The mutator phenotype hypothesis proposes that the mutation rate of normal cells is insufficient to account for the large number of mutations found in human cancers. Consequently, human tumors exhibit an elevated mutation rate that increases the likelihood of a tumor acquiring advantageous mutations. The hypothesis predicts that tumors are composed of cells harboring hundreds of thousands of mutations, as opposed to a small number of specific driver mutations, and that malignant cells within a tumor therefore constitute a highly heterogeneous population. As a result, drugs targeting specific mutated driver genes or even pathways of mutated driver genes will have only limited anticancer potential. In addition, because the tumor is composed of such a diverse cell population, tumor cells harboring drug-resistant mutations will exist prior to the administration of any chemotherapeutic agent. We present recent evidence in support of the mutator phenotype hypothesis, major arguments against this concept, and discuss the clinical consequences of tumor evolution fueled by an elevated mutation rate. We also consider the therapeutic possibility of altering the rate of mutation accumulation. Most significantly, we contend that there is a need to fundamentally reconsider current approaches to personalized cancer therapy. We propose that targeting cellular pathways that alter the rate of mutation accumulation in tumors will ultimately prove more effective than attempting to identify and target mutant driver genes or driver pathways.
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Affiliation(s)
- Edward J Fox
- Department of Pathology, University of Washington, Seattle, WA, 98195, USA
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130
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Nair V, Sharma A, Kotwal J, Bhikshapathy M, Mishra DK, Das S, Sharma S, Kapoor R, Singh J, Nair V, Uday Y, Kotwal A. Monitoring of response to therapy with imatinib mesylate in Chronic Myeloid Leukemia in chronic phase (CML-CP). Med J Armed Forces India 2014; 70:315-20. [PMID: 25382903 DOI: 10.1016/j.mjafi.2014.07.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 07/17/2014] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND The BCR-ABL tyrosine kinase is a well validated therapeutic target in Chronic Myeloid Leukemia (CML). Imatinib mesylate (IM), a tyrosine kinase inhibitor is highly effective in the treatment of chronic phase CML. BCR - ABL transcripts have been well established as a molecular marker to document response to therapy in CML. Periodic monitoring of this marker helps in evolving therapeutic strategies with IM and also in diagnosing early relapse. This study was undertaken to monitor therapeutic response to IM in CML in chronic phase (CML-CP) by assessing BCR-ABL by real time quantitative PCR (RQ-PCR) techniques and to determine the effectiveness of the Indian generic IM. METHODS One hundred consecutive patients of CML in chronic phase (CML-CP) were treated with an Indian generic of IM. Eighty-five patients were evaluable at 12 months of therapy. At entry, diagnosis of CML-CP was confirmed by FISH and RQ-PCR. Response to therapy was monitored by assessing BCR-ABL levels by RQ-PCR at 6 and 12 months of therapy. Regular follow up of patients was done to evaluate the safety profile of IM used in these patients. RESULTS Complete hematological response (CHR) rates at 3, 6, 9 and 12 months were 92%, 94%, 100% and 100% respectively. The total molecular response at 12 months was 43.52% of which complete molecular response (CMR) was noted in 17.64% and major molecular response (MMR) was observed in 25.88%. A cumulative survival probability of 0.8 was observed. CONCLUSION The Indian generic molecule of IM is effective in the treatment of CML-CP. The cost of Indian generic molecule is less than Rs. 10,000 per month there by making this affordable for large number of CML-CP patients in India.
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Affiliation(s)
- Velu Nair
- Dean & Deputy Commandant, Armed Forces Medical College, Pune 411040, India
| | - Ajay Sharma
- Consultant (Medicine & Clinical Hematology), Army Hospital (R&R), Delhi Cantt 110010, India
| | - Jyoti Kotwal
- Senior Advisor, (Pathology & Hematopathologist), Army Hospital (R&R), Delhi Cantt 110010, India
| | | | - D K Mishra
- Ex-Senior Advisor (Pathology & Hematopathologist), Army Hospital (R&R), Delhi Cantt 110010, India
| | - Satyaranjan Das
- Clinical Hematologist, Army Hospital (R&R), Delhi Cantt 110010, India
| | - Sanjeevan Sharma
- Clinical Hematologist, Army Hospital (R&R), Delhi Cantt 110010, India
| | - Rajan Kapoor
- Clinical Hematologist, Army Hospital (R&R), Delhi Cantt 110010, India
| | - Jasjit Singh
- Clinical Hematologist, Army Hospital (R&R), Delhi Cantt 110010, India
| | - Vivek Nair
- Senior Resident (Dermatology), Maulana Azad Medical College, New Delhi 110002, India
| | - Y Uday
- Senior Resident (Clinical Hematology), PGIMER, Chandigarh, India
| | - Atul Kotwal
- Director, AFMS (Med Research), O/o DGAFMS, Ministry of Defence, New Delhi, India ; Professor and Head, Dept of Community Medicine, Army College of Medical Sciences, New Delhi 11001, India
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Reboursiere E, Chantepie S, Gac AC, Reman O. Rare but authentic Philadelphia-positive acute myeloblastic leukemia: two case reports and a literature review of characteristics, treatment and outcome. Hematol Oncol Stem Cell Ther 2014; 8:28-33. [PMID: 25300567 DOI: 10.1016/j.hemonc.2014.09.002] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 08/13/2014] [Accepted: 09/05/2014] [Indexed: 11/15/2022] Open
Abstract
The Philadelphia chromosome (Ph+), corresponding to translocation t(9;22), is found in chronic myeloid leukemia (CML) and acute lymphoblastic leukemia. Several cases of Ph+ acute myeloid leukemia (AML) have been reported in the literature. A retrospective study of Ph+ AML between 2001 and 2012 was conducted through a review of the literature. Among 400 AML patients, two cases of Ph+ AML (0.5%) were identified and treated with conventional chemotherapy with or without tyrosine kinase inhibitors (TKIs), followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT). One patient had a complex karyotype including 7 monosomy (-7) and p190 BCR-ABL fusion transcript. Both patients remain in complete molecular remission. To date, 21 Ph+ AML cases treated with TKIs have been described in the literature with a median overall survival of 18months. One-third of the patients had additional karyotypic abnormalities, and 14% had -7. Molecular analysis showed 59% p210 and 41% p190 fusion protein. Relapse rate was observed in 38% of patients with p190 compared to 10% in patients with p210. Allo-HSCT was performed in eight patients; two relapsed (25%). Cytogenetic (-7) and molecular features help to distinguish Ph+ AML from CML. Survival improved with TKIs, particularly in association with conventional chemotherapy and allo-HSCT. Further studies of Ph+ AML patients are needed to better define this entity, its prognostic value, and therapeutic strategy.
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Affiliation(s)
- Emilie Reboursiere
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France
| | - Sylvain Chantepie
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France.
| | - Anne-Claire Gac
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France
| | - Oumedaly Reman
- Department of Hematology, University Hospital, Avenue de la Cote de Nacre, 14000 Caen, France
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Gardner LA, Klawitter J, Gregory MA, Zaberezhnyy V, Baturin D, Pollyea DA, Takebe N, Christians U, Gore L, DeGregori J, Porter CC. Inhibition of calcineurin combined with dasatinib has direct and indirect anti-leukemia effects against BCR-ABL1(+) leukemia. Am J Hematol 2014; 89:896-903. [PMID: 24891015 DOI: 10.1002/ajh.23776] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 05/27/2014] [Accepted: 05/28/2014] [Indexed: 12/16/2022]
Abstract
Treatment of BCR-ABL1(+) leukemia has been revolutionized with the development of tyrosine kinase inhibitors. However, patients with BCR-ABL1(+) acute lymphoblastic leukemia and subsets of patients with chronic myeloid leukemia are at high risk of relapse despite kinase inhibition therapy, necessitating novel treatment strategies. We previously reported synthetic lethality in BCR-ABL1(+) leukemia cells by blocking both calcineurin/NFAT signaling and BCR-ABL1, independent of drug efflux inhibition by cyclosporine. Here, using RNA-interference we confirm that calcineurin inhibition sensitizes BCR-ABL1(+) cells to tyrosine kinase inhibition in vitro. However, when we performed pharmacokinetic and pharmacodynamic studies of dasatinib and cyclosporine in mice, we found that co-administration of cyclosporine increases peak concentrations and the area under the curve of dasatinib, which contributes to the enhanced disease control. We also report the clinical experience of two subjects in whom we observed more hematopoietic toxicity than expected while enrolled in a Phase Ib trial designed to assess the safety and tolerability of adding cyclosporine to dasatinib in humans. Thus, the anti-leukemia benefit of co-administration of cyclosporine and dasatinib is mechanistically pleiotropic, but may not be tolerable, at least as administered in this trial. These data highlight some of the challenges associated with combining targeted agents to treat leukemia.
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Affiliation(s)
- Lori A. Gardner
- Department of Pediatrics; University of Colorado School of Medicine; Aurora Colorado
| | - Jelena Klawitter
- Department of Anesthesiology; University of Colorado School of Medicine; Aurora Colorado
| | - Mark A. Gregory
- Department of Biochemistry and Molecular Genetics; University of Colorado School of Medicine; Aurora Colorado
| | - Vadym Zaberezhnyy
- Department of Biochemistry and Molecular Genetics; University of Colorado School of Medicine; Aurora Colorado
| | - Dmitry Baturin
- Department of Pediatrics; University of Colorado School of Medicine; Aurora Colorado
| | - Daniel A. Pollyea
- Investigational Drug Branch; Cancer Therapy Evaluation Program, National Cancer Institute; Rockville Maryland
| | - Naoko Takebe
- Investigational Drug Branch; Cancer Therapy Evaluation Program, National Cancer Institute; Rockville Maryland
| | - Uwe Christians
- Department of Anesthesiology; University of Colorado School of Medicine; Aurora Colorado
| | - Lia Gore
- Department of Pediatrics; University of Colorado School of Medicine; Aurora Colorado
- Department of Medicine; University of Colorado School of Medicine; Aurora Colorado
| | - James DeGregori
- Department of Pediatrics; University of Colorado School of Medicine; Aurora Colorado
- Department of Biochemistry and Molecular Genetics; University of Colorado School of Medicine; Aurora Colorado
- Department of Immunology; University of Colorado School of Medicine; Aurora Colorado
| | - Christopher C. Porter
- Department of Pediatrics; University of Colorado School of Medicine; Aurora Colorado
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133
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Allogeneic hematopoietic SCT in combination with tyrosine kinase inhibitor treatment compared with TKI treatment alone in CML blast crisis. Bone Marrow Transplant 2014; 49:1146-54. [DOI: 10.1038/bmt.2014.146] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2013] [Revised: 05/12/2014] [Accepted: 05/27/2014] [Indexed: 01/11/2023]
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134
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Jabbour EJ, Hughes TP, Cortés JE, Kantarjian HM, Hochhaus A. Potential mechanisms of disease progression and management of advanced-phase chronic myeloid leukemia. Leuk Lymphoma 2014; 55:1451-62. [PMID: 24050507 PMCID: PMC4186697 DOI: 10.3109/10428194.2013.845883] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Despite vast improvements in the treatment of Philadelphia chromosome-positive chronic myeloid leukemia (CML) in chronic phase (CP), advanced stages of CML, accelerated phase or blast crisis, remain notoriously difficult to treat. Treatments that are highly effective against CML-CP produce disappointing results against advanced disease. Therefore, a primary goal of therapy should be to maintain patients in CP for as long as possible, by (1) striving for deep, early molecular response to treatment; (2) using tyrosine kinase inhibitors that lower risk of disease progression; and (3) more closely observing patients who demonstrate cytogenetic risk factors at diagnosis or during treatment.
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MESH Headings
- Blast Crisis/diagnosis
- Blast Crisis/etiology
- Blast Crisis/therapy
- Disease Management
- Disease Progression
- Humans
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/diagnosis
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/etiology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/therapy
- Leukemia, Myeloid, Accelerated Phase/diagnosis
- Leukemia, Myeloid, Accelerated Phase/drug therapy
- Leukemia, Myeloid, Accelerated Phase/etiology
- Neoplasm Staging
- Prognosis
- Treatment Outcome
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Affiliation(s)
- Elias J. Jabbour
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Timothy P. Hughes
- Department of Hematology, The University of Adelaide, Adelaide, Australia
| | - Jorge E. Cortés
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Hagop M. Kantarjian
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX
| | - Andreas Hochhaus
- Abteilung Hämatologie/Onkologie, Universitätsklinikum Jena, Jena, Germany
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135
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Kosztyu P, Bukvova R, Dolezel P, Mlejnek P. Resistance to daunorubicin, imatinib, or nilotinib depends on expression levels of ABCB1 and ABCG2 in human leukemia cells. Chem Biol Interact 2014; 219:203-10. [PMID: 24954033 DOI: 10.1016/j.cbi.2014.06.009] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 05/30/2014] [Accepted: 06/10/2014] [Indexed: 01/11/2023]
Abstract
The effect of ABCB1 (P-gp, (P-glycoprotein), MDR1) and ABCG2 (BCRP1, (breast cancer resistance protein 1)) expressions on cell resistance to daunorubicin (DRN), imatinib, and nilotinib was studied in human leukemia cells. We used a set of cells derived from a parental K562 cell line, expressing various levels of ABCB1 and ABCG2, respectively. The function of ABCB1 and ABCG2 was confirmed using calcein AM and pheophorbide A accumulation assays, respectively. These assays indicated distinct differences in activities of ABCB1 and ABCG2 which corresponded to their expression levels. We observed that the resistance to DRN and imatinib was proportional to the expression level of ABCB1. Similarly, the resistance to nilotinib and imatinib was proportional to the expression level of ABCG2. Importantly, K562/DoxDR05 and K562/ABCG2-Z cells with the lowest expressions of ABCB1 and ABCG2, respectively, failed to reduce the intracellular levels of imatinib to provide a significant resistance to this drug. However, the K562/DoxDR05 and K562/ABCG2-Z cells significantly decreased the intracellular levels of DRN and nilotinib, respectively, thereby mediating significant resistances to these drugs. Only cells which expression of ABCB1 or ABCG2 exceeded a certain level exhibited a significantly decreased intracellular level of imatinib, and this effect was accompanied by a significantly increased resistance to this drug. Our results clearly indicated that resistance to anticancer drugs mediated by main ABC transporters, ABCB1 and ABCG2, strongly depends on their expressions at protein levels. Importantly, resistance for one drug might be maintained while resistance for other ones might become undetectable at low transporter expression levels.
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Affiliation(s)
- Petr Kosztyu
- Department of Biology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 77515, Czech Republic
| | - Romana Bukvova
- Department of Biology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 77515, Czech Republic
| | - Petr Dolezel
- Department of Biology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 77515, Czech Republic
| | - Petr Mlejnek
- Department of Biology, Faculty of Medicine and Dentistry, Palacky University Olomouc, Hnevotinska 3, Olomouc 77515, Czech Republic.
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136
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Imatinib: a breakthrough of targeted therapy in cancer. CHEMOTHERAPY RESEARCH AND PRACTICE 2014; 2014:357027. [PMID: 24963404 PMCID: PMC4055302 DOI: 10.1155/2014/357027] [Citation(s) in RCA: 193] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 05/06/2014] [Indexed: 12/14/2022]
Abstract
Deregulated protein tyrosine kinase activity is central to the pathogenesis of human cancers. Targeted therapy in the form of selective tyrosine kinase inhibitors (TKIs) has transformed the approach to management of various cancers and represents a therapeutic breakthrough. Imatinib was one of the first cancer therapies to show the potential for such targeted action. Imatinib, an oral targeted therapy, inhibits tyrosine kinases specifically BCR-ABL, c-KIT, and PDGFRA. Apart from its remarkable success in CML and GIST, Imatinib benefits various other tumors caused by Imatinib-specific abnormalities of PDGFR and c-KIT. Imatinib has also been proven to be effective in steroid-refractory chronic graft-versus-host disease because of its anti-PDGFR action. This paper is a comprehensive review of the role of Imatinib in oncology.
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137
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Bu Q, Cui L, Li J, Du X, Zou W, Ding K, Pan J. SAHA and S116836, a novel tyrosine kinase inhibitor, synergistically induce apoptosis in imatinib-resistant chronic myelogenous leukemia cells. Cancer Biol Ther 2014; 15:951-62. [PMID: 24759597 DOI: 10.4161/cbt.28931] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Limited treatment options are available for chronic myelogenous leukemia (CML) patients who develop imatinib mesylate (IM) resistance. Here we proposed a novel combination regimen, a co-administration of S116836, a novel small molecule multi-targeted tyrosine kinase inhibitor that was synthesized by rational design, and histone deacetylases inhibitor (HDACi) suberoylanilide hydroxamic acid (SAHA), to overcome IM resistance in CML. S116836 at low concentrations used in the present study mildly downregulates auto-tyrosine phosphorylation of Bcr-Abl. SAHA, an FDA-approved HDACi drug, at 1 μM has modest anti-tumor activity in treating CML. However, we found a synergistic interaction between SAHA and S116836 in Bcr-Abl-positive CML cells that were sensitive or resistant to IM. Exposure of KBM5 and KBM5-T315I cells to minimal or non-toxic concentrations of SAHA and S116836 synergistically reduced cell viability and induced cell death. Co-treatment with SAHA and S116838 repressed the expressions of anti-apoptosis proteins, such as Mcl-1 and XIAP, but promoted Bim expression and mitochondrial damage. Of importance, treatment with both drugs significantly reduced cell viability of primary human CML cells, as compared with either agent alone. Taken together, our findings suggest that SAHA exerts synergistically with S116836 at a non-toxic concentration to promote apoptosis in the CML, including those resistant to imatinib or dasatinib.
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Affiliation(s)
- Qiangui Bu
- Department of Pathophysiology; Zhongshan School of Medicine; Sun Yat-sen University; Guangzhou, PR China
| | - Lijing Cui
- Department of Pathophysiology; Zhongshan School of Medicine; Sun Yat-sen University; Guangzhou, PR China
| | - Juan Li
- Department of Hematology; The First Affiliated Hospital; Sun Yat-sen University; Guangzhou, PR China
| | - Xin Du
- Department of Hematology; Guangdong Provincial People's Hospital; Guangzhou, PR China
| | - Waiyi Zou
- Department of Hematology; The First Affiliated Hospital; Sun Yat-sen University; Guangzhou, PR China
| | - Ke Ding
- Key Laboratory of Regenerative Biology and Institute of Chemical Biology; Guangzhou Institute of Biomedicine and Health; Chinese Academy of Sciences; Guangzhou, PR China
| | - Jingxuan Pan
- Department of Pathophysiology; Zhongshan School of Medicine; Sun Yat-sen University; Guangzhou, PR China; State Key Laboratory of Ophthalmology; Zhongshan Ophthalmic Center; Sun Yat-sen University; Guangzhou, PR China; Collaborative Innovation Center for Cancer Medicine; State Key Laboratory of Oncology in South China; Sun Yat-Sen University Cancer Center; Guangzhou, PR China
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Du Y, Xia Y, Pan X, Chen Z, Wang A, Wang K, Li J, Zhang J. Fenretinide targets chronic myeloid leukemia stem/progenitor cells by regulation of redox signaling. Antioxid Redox Signal 2014; 20:1866-80. [PMID: 24021153 PMCID: PMC3967369 DOI: 10.1089/ars.2012.4935] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS We have recently shown that fenretinide preferentially targets CD34(+) cells of acute myeloid leukemia (AML), and here, we test whether this agent exerts the effect on CD34(+) cells of chronic myeloid leukemia (CML), which are refractory to imatinib. RESULTS As tested by colony-forming cell assays using clinical specimens, both number and size of total colonies derived from CD34(+) CML cells were significantly reduced by fenretinide, and by combining fenretinide with imatinib. In particular, colonies derived from erythroid progenitors and more primitive pluripotent/multipotent progenitors were highly sensitive to fenretinide/fenretinide plus imatinib. Accordantly, fenretinide appeared to induce apoptosis in CD34(+) CML cells, particularly with regard to the cells in the subpopulation of CD34(+)CD38(-). Through cell quiescent assays, including Ki-67 negativity test, we added evidence that nonproliferative CD34(+) CML cells were largely eliminated by fenretinide. Transcriptome and molecular data further showed that mechanisms underlying the apoptosis in CD34(+) CML cells were highly complex, involving multiple events of oxidative stress responses. INNOVATION AND CONCLUSION As compared with CD34(+) AML cells, the apoptotic effects of fenretinide on CD34(+) CML cells were more prominent whereas less varied among the samples of different patients, and also various stress-responsive events appeared to be more robust in fenretinide-treated CD34(+) CML cells. Thus, the combination of fenretinide with imatinib may represent a more sophisticated strategy for CML treatment, in which imatinib mainly targets leukemic blast cells through the intrinsic pathway of apopotosis, whereas fenretinide primarily targets CML stem/progenitor cells through the oxidative/endoplasmic reticulum stress-mediated pathway.
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Affiliation(s)
- Yanzhi Du
- 1 Key Laboratory of Stem Cell Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences (SIBS), Chinese Academy of Sciences (CAS), Shanghai Jiao Tong University School of Medicine (SJTU-SM) , Shanghai, China
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139
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Sui T, Ma L, Bai X, Li Q, Xu X. Resveratrol inhibits the phosphatidylinositide 3-kinase/protein kinase B/mammalian target of rapamycin signaling pathway in the human chronic myeloid leukemia K562 cell line. Oncol Lett 2014; 7:2093-2098. [PMID: 24932295 PMCID: PMC4049760 DOI: 10.3892/ol.2014.2014] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2013] [Accepted: 03/14/2014] [Indexed: 11/05/2022] Open
Abstract
Resveratrol inhibits the initiation, promotion and progression of tumors, however, the mechanism by which resveratrol inhibits the proliferation of the human chronic myeloid leukemia K562 cell line remains unclear. The present study was conducted to investigate the effect of resveratrol on the activation of the phosphatidylinositide 3-kinase (PI3K)/protein kinase B (Akt)/mammalian target of rapamycin (mTOR) signaling cascade in K562 cells. Resveratrol showed significant cytotoxic effects and induced apoptosis in K562 cells in a dose- and time-dependent manner. In addition, resveratrol attenuated the phosphorylation of PI3K, Akt and mTOR in the K562 cells. Furthermore, the selected inhibitors of PI3K (LY294002), Akt (SH-6) and mTOR (rapamycin) enhanced the effects of resveratrol in K562 cells. In addition, cyclin D1 levels were found to decrease and the activation of caspase-3 was observed. Resveratrol was also found to significantly attenuate the phosphorylation of the downstream molecules, p70S6K and 4EBP1. These results suggested that the downregulation of the PI3K/Akt/mTOR signaling cascades may be a crucial mediator in the inhibition of proliferation and induction of apoptosis by resveratrol in K562 cells.
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Affiliation(s)
- Tao Sui
- Department of Hematology, Tianjin First Center Hospital, Tianjin 300192, P.R. China
| | - Li Ma
- Department of Hematology, Tianjin First Center Hospital, Tianjin 300192, P.R. China
| | - Xue Bai
- Department of Hematology, Tianjin First Center Hospital, Tianjin 300192, P.R. China
| | - Qing Li
- Department of Hematology, Tianjin First Center Hospital, Tianjin 300192, P.R. China
| | - Xinnv Xu
- Key Laboratory for Critical Care Medicine of the Ministry of Health, Tianjin First Center Hospital, Tianjin 300192, P.R. China
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Wang H, Yu J, Zhang L, Xiong Y, Chen S, Xing H, Tian Z, Tang K, Wei H, Rao Q, Wang M, Wang J. RPS27a promotes proliferation, regulates cell cycle progression and inhibits apoptosis of leukemia cells. Biochem Biophys Res Commun 2014; 446:1204-10. [PMID: 24680683 DOI: 10.1016/j.bbrc.2014.03.086] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 03/18/2014] [Indexed: 01/24/2023]
Abstract
Ribosomal protein S27a (RPS27a) could perform extra-ribosomal functions besides imparting a role in ribosome biogenesis and post-translational modifications of proteins. The high expression level of RPS27a was reported in solid tumors, and we found that the expression level of RPS27a was up-regulated in advanced-phase chronic myeloid leukemia (CML) and acute leukemia (AL) patients. In this study, we explored the function of RPS27a in leukemia cells by using CML cell line K562 cells and its imatinib resistant cell line K562/G01 cells. It was observed that the expression level of RPS27a was high in K562 cells and even higher in K562/G01 cells. Further analysis revealed that RPS27a knockdown by shRNA in both K562 and K562G01 cells inhibited the cell viability, induced cell cycle arrest at S and G2/M phases and increased cell apoptosis induced by imatinib. Combination of shRNA with imatinib treatment could lead to more cleaved PARP and cleaved caspase-3 expression in RPS27a knockdown cells. Further, it was found that phospho-ERK(p-ERK) and BCL-2 were down-regulated and P21 up-regulated in RPS27a knockdown cells. In conclusion, RPS27a promotes proliferation, regulates cell cycle progression and inhibits apoptosis of leukemia cells. It appears that drugs targeting RPS27a combining with tyrosine kinase inhibitor (TKI) might represent a novel therapy strategy in TKI resistant CML patients.
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Affiliation(s)
- Houcai Wang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Jing Yu
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Lixia Zhang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Yuanyuan Xiong
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Shuying Chen
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Haiyan Xing
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Zheng Tian
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Kejing Tang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Hui Wei
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Qing Rao
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Min Wang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China
| | - Jianxiang Wang
- State Key Laboratory of Experimental Hematology, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Tianjin 300020, China.
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141
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Mathijssen RHJ, Sparreboom A, Verweij J. Determining the optimal dose in the development of anticancer agents. Nat Rev Clin Oncol 2014; 11:272-81. [DOI: 10.1038/nrclinonc.2014.40] [Citation(s) in RCA: 119] [Impact Index Per Article: 11.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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142
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Paoloni M, Webb C, Mazcko C, Cherba D, Hendricks W, Lana S, Ehrhart EJ, Charles B, Fehling H, Kumar L, Vail D, Henson M, Childress M, Kitchell B, Kingsley C, Kim S, Neff M, Davis B, Khanna C, Trent J. Prospective molecular profiling of canine cancers provides a clinically relevant comparative model for evaluating personalized medicine (PMed) trials. PLoS One 2014; 9:e90028. [PMID: 24637659 PMCID: PMC3956546 DOI: 10.1371/journal.pone.0090028] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2013] [Accepted: 01/28/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Molecularly-guided trials (i.e. PMed) now seek to aid clinical decision-making by matching cancer targets with therapeutic options. Progress has been hampered by the lack of cancer models that account for individual-to-individual heterogeneity within and across cancer types. Naturally occurring cancers in pet animals are heterogeneous and thus provide an opportunity to answer questions about these PMed strategies and optimize translation to human patients. In order to realize this opportunity, it is now necessary to demonstrate the feasibility of conducting molecularly-guided analysis of tumors from dogs with naturally occurring cancer in a clinically relevant setting. METHODOLOGY A proof-of-concept study was conducted by the Comparative Oncology Trials Consortium (COTC) to determine if tumor collection, prospective molecular profiling, and PMed report generation within 1 week was feasible in dogs. Thirty-one dogs with cancers of varying histologies were enrolled. Twenty-four of 31 samples (77%) successfully met all predefined QA/QC criteria and were analyzed via Affymetrix gene expression profiling. A subsequent bioinformatics workflow transformed genomic data into a personalized drug report. Average turnaround from biopsy to report generation was 116 hours (4.8 days). Unsupervised clustering of canine tumor expression data clustered by cancer type, but supervised clustering of tumors based on the personalized drug report clustered by drug class rather than cancer type. CONCLUSIONS Collection and turnaround of high quality canine tumor samples, centralized pathology, analyte generation, array hybridization, and bioinformatic analyses matching gene expression to therapeutic options is achievable in a practical clinical window (<1 week). Clustering data show robust signatures by cancer type but also showed patient-to-patient heterogeneity in drug predictions. This lends further support to the inclusion of a heterogeneous population of dogs with cancer into the preclinical modeling of personalized medicine. Future comparative oncology studies optimizing the delivery of PMed strategies may aid cancer drug development.
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Affiliation(s)
- Melissa Paoloni
- Comparative Oncology Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Craig Webb
- Van Andel Research Institute, Grand Rapids, Michigan, United States of America
| | - Christina Mazcko
- Comparative Oncology Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - David Cherba
- Van Andel Research Institute, Grand Rapids, Michigan, United States of America
| | - William Hendricks
- Translational Genomics Research Institute (TGen), Phoenix, Arizona, United States of America
| | - Susan Lana
- Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado, United States of America
| | - E. J. Ehrhart
- Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado, United States of America
| | - Brad Charles
- Colorado State University, College of Veterinary Medicine, Fort Collins, Colorado, United States of America
| | - Heather Fehling
- Clinical Reference Laboratory, Lenexa, Kansas, United States of America
| | - Leena Kumar
- Clinical Reference Laboratory, Lenexa, Kansas, United States of America
| | - David Vail
- University of Wisconsin-Madison, School of Veterinary Medicine, Madison, Wisconsin, United States of America
| | - Michael Henson
- University of Minnesota, College of Veterinary Medicine, St. Paul, Minnesota, United States of America
| | - Michael Childress
- Purdue University, School of Veterinary Medicine, West Lafayette, Indiana, United States of America
| | - Barbara Kitchell
- Michigan State University, College of Veterinary Medicine, East Lansing, Michigan, United States of America
| | - Christopher Kingsley
- Translational Genomics Research Institute (TGen), Phoenix, Arizona, United States of America
| | - Seungchan Kim
- Translational Genomics Research Institute (TGen), Phoenix, Arizona, United States of America
| | - Mark Neff
- Van Andel Research Institute, Grand Rapids, Michigan, United States of America
| | - Barbara Davis
- Translational Genomics Research Institute (TGen), Phoenix, Arizona, United States of America
| | - Chand Khanna
- Comparative Oncology Program, Center for Cancer Research, National Cancer Institute, Bethesda, Maryland, United States of America
| | - Jeffrey Trent
- Van Andel Research Institute, Grand Rapids, Michigan, United States of America
- Translational Genomics Research Institute (TGen), Phoenix, Arizona, United States of America
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143
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Zhu Y, Qian SX. Clinical efficacy and safety of imatinib in the management of Ph(+) chronic myeloid or acute lymphoblastic leukemia in Chinese patients. Onco Targets Ther 2014; 7:395-404. [PMID: 24623982 PMCID: PMC3949731 DOI: 10.2147/ott.s38846] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Imatinib mesylate is considered the standard first-line systemic treatment for patients with chronic myeloid leukemia (CML) and functions by targeting BCR-ABL tyrosine kinases. Imatinib has substantially changed the clinical management and improved the prognosis of CML and Philadelphia chromosome-positive acute lymphocytic leukemia (Ph+ ALL). Here, we review the pharmacology, mode of action, and pharmacokinetics of imatinib; Chinese efficacy studies in CML and Ph+ ALL; safety and tolerability; patient-focused perspectives, such as quality of life, patient satisfaction, acceptability, and adherence; and uptake of imatinib.
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Affiliation(s)
- Yu Zhu
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, People's Republic of China
| | - Si-Xuan Qian
- Department of Hematology, The First Affiliated Hospital of Nanjing Medical University, Jiangsu Province Hospital, Nanjing, Jiangsu Province, People's Republic of China
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144
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Estrada-González PK, Gómez-Ceja L, Montesinos JJ, Mayani H, Chávez-González A, Meillón L, Delgado N, Sánchez-Nava E, Flores-Figueroa E. Decreased frequency, but normal functional integrity of mesenchymal stromal cells derived from untreated and Imatinib-treated chronic myeloid leukemia patients. Leuk Res 2014; 38:594-600. [PMID: 24661629 DOI: 10.1016/j.leukres.2014.02.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2013] [Revised: 02/18/2014] [Accepted: 02/20/2014] [Indexed: 02/07/2023]
Abstract
In vitro, Imatinib inhibits the proliferation and stimulates the osteogenic and adipogenic differentiation of mesenchymal stromal cells (MSC). However, it is unknown whether Imatinib affects the biology of MSC in vivo. We asked whether MSC from long-term Imatinib-treated CML patients were affected by the in vivo treatment. MSC from untreated and Imatinib-treated patients displayed normal functional properties (i.e. proliferation, immunophenotype, differentiation and hematopoietic supportive capacity) - but a decreased frequency. In vitro, Imatinib lost its effect when discontinued; which suggest that it has a reversible effect on MSC. Therefore it might lose its effect on MSC after discontinuation in vivo.
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Affiliation(s)
- P K Estrada-González
- Niche and Microenvironment Laboratory, Oncology Research Unit, Oncology Hospital, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Coyoacán, México City, Mexico
| | - L Gómez-Ceja
- Niche and Microenvironment Laboratory, Oncology Research Unit, Oncology Hospital, Mexico; Posgrado en Ciencias Biológicas, Universidad Nacional Autónoma de México, Coyoacán, México City, Mexico
| | - J J Montesinos
- Mesenchymal Stem Cells Laboratory, Oncology Research Unit, Oncology Hospital, Mexico
| | - H Mayani
- Hematopoietic Stem Cells Laboratory, Oncology Research Unit, Oncology Hospital, Mexico
| | - A Chávez-González
- Leukemic Stem Cells Laboratory, Oncology Research Unit, Oncology Hospital, Mexico
| | - L Meillón
- Hematology Service, Bernardo Sepulveda Hospital, National Medical Center, IMSS, México City, Mexico
| | - N Delgado
- Hematology Service, Bernardo Sepulveda Hospital, National Medical Center, IMSS, México City, Mexico
| | - E Sánchez-Nava
- Hematology Service, Bernardo Sepulveda Hospital, National Medical Center, IMSS, México City, Mexico
| | - E Flores-Figueroa
- Niche and Microenvironment Laboratory, Oncology Research Unit, Oncology Hospital, Mexico.
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145
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Arora VK, Schenkein E, Murali R, Subudhi SK, Wongvipat J, Balbas MD, Shah N, Cai L, Efstathiou E, Logothetis C, Zheng D, Sawyers CL. Glucocorticoid receptor confers resistance to antiandrogens by bypassing androgen receptor blockade. Cell 2014; 155:1309-22. [PMID: 24315100 DOI: 10.1016/j.cell.2013.11.012] [Citation(s) in RCA: 727] [Impact Index Per Article: 72.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 08/16/2013] [Accepted: 11/02/2013] [Indexed: 12/18/2022]
Abstract
The treatment of advanced prostate cancer has been transformed by novel antiandrogen therapies such as enzalutamide. Here, we identify induction of glucocorticoid receptor (GR) expression as a common feature of drug-resistant tumors in a credentialed preclinical model, a finding also confirmed in patient samples. GR substituted for the androgen receptor (AR) to activate a similar but distinguishable set of target genes and was necessary for maintenance of the resistant phenotype. The GR agonist dexamethasone was sufficient to confer enzalutamide resistance, whereas a GR antagonist restored sensitivity. Acute AR inhibition resulted in GR upregulation in a subset of prostate cancer cells due to relief of AR-mediated feedback repression of GR expression. These findings establish a mechanism of escape from AR blockade through expansion of cells primed to drive AR target genes via an alternative nuclear receptor upon drug exposure.
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Affiliation(s)
- Vivek K Arora
- Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA; Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
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Homoharringtonine contributes to imatinib sensitivity by blocking the EphB4/RhoA pathway in chronic myeloid leukemia cell lines. Med Oncol 2014; 31:836. [PMID: 24415355 DOI: 10.1007/s12032-013-0836-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 12/27/2013] [Indexed: 01/29/2023]
Abstract
The purpose was to investigate the role of EphB4 in imatinib (IM) resistance and the mechanism responsible for homoharringtonine (HHT) contributing to imatinib sensitivity for a chronic myeloid leukemia (CML) cell lines. We established cell lines from a patient with CML at the time of first diagnosis and relapsed phase and designated them as NPhA1 and NPhA2, respectively. Stable underexpressing EphB4 cells (NPhA2-sh) were obtained. The activated signal proteins in cells were tested by Western blot. The EphB4 was overexpressed in IM-resistant NPhA2 in comparison with the NPhA1 cell line, but the expression of EphB4 mRNA and protein significantly decreased in knockdown NPhA2-EphB4-sh cells compared with NPhA2 and NPhA1 (P < 0.001) cell lines. NPhA2-EphB4-sh cells were sensitive to IM (IC50 0.93 mg/L), and NPhA2 showed IM resistance (IC50 5.45 mg/L) (P < 0.001). Meanwhile, phospho-Rac1/cdc42 was significantly increased in NPhA2 cells compared to NPhA2-EphB4-sh (P < 0.001). The apoptosis rate reached 58.71 ± 2.39 % with NPhA2 cells incubated with HHT + IM, which was higher than NPhA2 cells incubated with IM alone (P = 0.002). IC50 of NPhA2 cells incubated with IM was 5.45 mg/L. However, co-stimulation with HHT + IM decreased the IC50 of NPhA2 cells from 5.45 to 1.17 mg/L (P < 0.001). Furthermore, HHT blocked the expressions of EphB4/RhoA, but did not down-regulate the phospho-MEK/ERK in NPhA2 cells. The overexpression of EphB4 contributed to IM resistance in CML line cells. EphB4/RhoA may be a new marker of IM resistance. HHT + IM gained more treatment advantages than IM alone by blocking EphB4/RhoA pathways in CML cell lines.
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147
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Hiwase DK, Yeung DT, White DL. Optimizing the selection of kinase inhibitors for chronic myeloid leukemia patients. Expert Rev Hematol 2014; 4:285-99. [DOI: 10.1586/ehm.11.19] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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148
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Zámečníkova A. Targeting the BCR–ABL tyrosine kinase in chronic myeloid leukemia as a model of rational drug design in cancer. Expert Rev Hematol 2014; 3:45-56. [DOI: 10.1586/ehm.09.66] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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149
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Schmidt S, Wolf D. Role of gene-expression profiling in chronic myeloid leukemia. Expert Rev Hematol 2014; 2:93-103. [DOI: 10.1586/17474086.2.1.93] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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150
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Keller G, Schafhausen P, Brummendorf TH. Bosutinib: a dual SRC/ABL kinase inhibitor for the treatment of chronic myeloid leukemia. Expert Rev Hematol 2014; 2:489-97. [DOI: 10.1586/ehm.09.42] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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