1
|
Properties of Leukemic Stem Cells in Regulating Drug Resistance in Acute and Chronic Myeloid Leukemias. Biomedicines 2022; 10:biomedicines10081841. [PMID: 36009388 PMCID: PMC9405586 DOI: 10.3390/biomedicines10081841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 07/26/2022] [Accepted: 07/27/2022] [Indexed: 11/17/2022] Open
Abstract
Notoriously known for their capacity to reconstitute hematological malignancies in vivo, leukemic stem cells (LSCs) represent key drivers of therapeutic resistance and disease relapse, posing as a major medical dilemma. Despite having low abundance in the bulk leukemic population, LSCs have developed unique molecular dependencies and intricate signaling networks to enable self-renewal, quiescence, and drug resistance. To illustrate the multi-dimensional landscape of LSC-mediated leukemogenesis, in this review, we present phenotypical characteristics of LSCs, address the LSC-associated leukemic stromal microenvironment, highlight molecular aberrations that occur in the transcriptome, epigenome, proteome, and metabolome of LSCs, and showcase promising novel therapeutic strategies that potentially target the molecular vulnerabilities of LSCs.
Collapse
|
2
|
Filik Y, Bauer K, Hadzijusufovic E, Haider P, Greiner G, Witzeneder N, Hoermann G, Hohensinner PJ, Gleixner KV, Wojta J, Sperr WR, Valent P. PI3-kinase inhibition as a strategy to suppress the leukemic stem cell niche in Ph+ chronic myeloid leukemia. Am J Cancer Res 2021; 11:6042-6059. [PMID: 35018241 PMCID: PMC8727792] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 11/03/2021] [Indexed: 06/14/2023] Open
Abstract
Recent data suggest that the disease-associated microenvironment, known as the leukemic stem cell (LSC) niche, is substantially involved in drug resistance of LSC in BCR-ABL1+ chronic myeloid leukemia (CML). Attacking the LSC niche in CML may thus be an effective approach to overcome drug resistance. We have recently shown that osteoblasts are a major site of niche-mediated LSC resistance against second- and third-generation tyrosine kinase inhibitors (TKI) in CML. In the present study, we screened for drugs that are capable of suppressing the growth and viability of osteoblasts and/or other niche cells and can thereby overcome TKI resistance of CML LSC. Proliferation was analyzed by determining 3H-thymidine uptake in niche-related cells, and apoptosis was measured by Annexin-V/DAPI-staining and flow cytometry. We found that the dual PI3 kinase (PI3K) and mTOR inhibitor BEZ235 and the selective pan-PI3K inhibitor copanlisib suppress proliferation of primary osteoblasts (BEZ235 IC50: 0.05 μM; copanlisib IC50: 0.05 μM), the osteoblast cell line CAL-72 (BEZ235 IC50: 0.5 μM; copanlisib IC50: 1 μM), primary umbilical vein-derived endothelial cells (BEZ235 IC50: 0.5 μM; copanlisib IC50: 0.5 μM), and the vascular endothelial cell line HMEC-1 (BEZ235 IC50: 1 μM; copanlisib IC50: 1 μM), whereas no comparable effects were seen with the mTOR inhibitor rapamycin. Furthermore, we show that BEZ235 and copanlisib cooperate with nilotinib and ponatinib in suppressing proliferation and survival of osteoblasts and endothelial cells. Finally, BEZ235 and copanlisib were found to overcome osteoblast-mediated resistance against nilotinib and ponatinib in K562 cells, KU812 cells and primary CD34+/CD38- CML LSC. Together, targeting osteoblastic niche cells through PI3K inhibition may be a new effective approach to overcome niche-induced TKI resistance in CML. Whether this approach can be translated into clinical application and can counteract drug resistance of LSC in patients with CML remains to be determined in clinical trials.
Collapse
Affiliation(s)
- Yüksel Filik
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of ViennaVienna, Austria
| | - Karin Bauer
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of ViennaVienna, Austria
| | - Emir Hadzijusufovic
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of ViennaVienna, Austria
- Department/Clinic for Companion Animals and Horses, Clinic for Small Animals, Clinical Unit of Internal Medicine, University of Veterinary Medicine ViennaVienna, Austria
| | - Patrick Haider
- Department of Internal Medicine II, Division of Cardiology, Medical University of ViennaVienna, Austria
| | - Georg Greiner
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Laboratory Medicine, Medical University of ViennaVienna, Austria
- Ihr Labor, Medical Diagnostic LaboratoriesVienna, Austria
| | - Nadine Witzeneder
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Laboratory Medicine, Medical University of ViennaVienna, Austria
| | - Gregor Hoermann
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Laboratory Medicine, Medical University of ViennaVienna, Austria
- MLL Munich Leukemia LaboratoryMunich, Germany
| | - Philipp J Hohensinner
- Department of Internal Medicine II, Division of Cardiology, Medical University of ViennaVienna, Austria
| | - Karoline V Gleixner
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of ViennaVienna, Austria
| | - Johann Wojta
- Department of Internal Medicine II, Division of Cardiology, Medical University of ViennaVienna, Austria
- Ludwig Boltzmann Institute for Cardiovascular Research, Medical University of ViennaVienna, Austria
| | - Wolfgang R Sperr
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of ViennaVienna, Austria
| | - Peter Valent
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaVienna, Austria
- Department of Internal Medicine I, Division of Hematology and Hemostaseology, Medical University of ViennaVienna, Austria
| |
Collapse
|
3
|
Gleixner KV, Filik Y, Berger D, Schewzik C, Stefanzl G, Sadovnik I, Degenfeld-Schonburg L, Eisenwort G, Schneeweiss-Gleixner M, Byrgazov K, Sperr WR, Mayer J, Lion T, Valent P. Asciminib and ponatinib exert synergistic anti-neoplastic effects on CML cells expressing BCR-ABL1 T315I-compound mutations. Am J Cancer Res 2021; 11:4470-4484. [PMID: 34659899 PMCID: PMC8493398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/19/2021] [Indexed: 06/13/2023] Open
Abstract
Ponatinib is a tyrosine kinase inhibitor (TKI) directed against BCR-ABL1 which is successfully used in patients with BCR-ABL1 T315I+ chronic myeloid leukemia (CML). However, BCR-ABL1 compound mutations may develop during therapy in these patients and may lead to drug resistance. Asciminib is a novel drug capable of targeting most BCR-ABL1 mutant-forms, including BCR-ABL1T315I, but remains ineffective against most BCR-ABL1T315I+ compound mutation-bearing sub-clones. We demonstrate that asciminib synergizes with ponatinib in inducing growth-arrest and apoptosis in patient-derived CML cell lines and murine Ba/F3 cells harboring BCR-ABL1 T315I or T315I-including compound mutations. Asciminib and ponatinib also produced cooperative effects on CRKL phosphorylation in BCR-ABL1-transformed cells. The growth-inhibitory effects of the drug combination 'asciminib+ponatinib' was further enhanced by hydroxyurea (HU), a drug which has lately been described to suppresses the proliferation of BCR-ABL1 T315I+ CML cells. Cooperative drug effects were also observed in patient-derived CML cells. Most importantly, we were able to show that the combinations 'asciminib+ponatinib' and 'asciminib+ponatinib+HU' produce synergistic apoptosis-inducing effects in CD34+/CD38- CML stem cells obtained from patients with chronic phase CML or BCR-ABL1 T315I+ CML blast phase. Together, asciminib, ponatinib and HU synergize in producing anti-leukemic effects in multi-resistant CML cells, including cells harboring T315I+ BCR-ABL1 compound mutations and CML stem cells. The clinical efficacy of this TKI combination needs to be evaluated within the frame of upcoming clinical trials.
Collapse
Affiliation(s)
- Karoline V Gleixner
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| | - Yüksel Filik
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| | - Daniela Berger
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
| | - Christina Schewzik
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
| | - Gabriele Stefanzl
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| | - Irina Sadovnik
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| | - Lina Degenfeld-Schonburg
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
| | - Gregor Eisenwort
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| | - Mathias Schneeweiss-Gleixner
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
- Department of Internal Medicine III, Division of Gastroenterology & Hepatology, Medical University of ViennaAustria
| | | | - Wolfgang R Sperr
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| | - Jiří Mayer
- Department of Internal Medicine, Hematology and Oncology, Faculty of Medicine, Masaryk UniversityBrno, Czech Republic
- Department of Internal Medicine, Hematology and Oncology, University Hospital BrnoCzech Republic
| | - Thomas Lion
- Children’s Cancer Research Institute (CCRI)Vienna, Austria
| | - Peter Valent
- Department of Internal Medicine I, Division of Hematology & Hemostaseology, Medical University of ViennaAustria
- Ludwig Boltzmann Institute for Hematology and Oncology, Medical University of ViennaAustria
| |
Collapse
|