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Brunetti M, Iasenza IA, Jenner AL, Raynal NJM, Eppert K, Craig M. Mathematical modelling of clonal reduction therapeutic strategies in acute myeloid leukemia. Leuk Res 2024; 140:107485. [PMID: 38579483 DOI: 10.1016/j.leukres.2024.107485] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 02/21/2024] [Accepted: 03/12/2024] [Indexed: 04/07/2024]
Abstract
Over the years, the overall survival of older patients diagnosed with acute myeloid leukemia (AML) has not significantly increased. Although standard cytotoxic therapies that rapidly eliminate dividing myeloblasts are used to induce remission, relapse can occur due to surviving therapy-resistant leukemic stem cells (LSCs). Hence, anti-LSC strategies have become a key target to cure AML. We have recently shown that previously approved cardiac glycosides and glucocorticoids target LSC-enriched CD34+ cells in the primary human AML 8227 model with more efficacy than normal hematopoietic stem cells (HSCs). To translate these in vitro findings into humans, we developed a mathematical model of stem cell dynamics that describes the stochastic evolution of LSCs in AML post-standard-of-care. To this, we integrated population pharmacokinetic-pharmacodynamic (PKPD) models to investigate the clonal reduction potential of several promising candidate drugs in comparison to cytarabine, which is commonly used in high doses for consolidation therapy in AML patients. Our results suggest that cardiac glycosides (proscillaridin A, digoxin and ouabain) and glucocorticoids (budesonide and mometasone) reduce the expansion of LSCs through a decrease in their viability. While our model predicts that effective doses of cardiac glycosides are potentially too toxic to use in patients, simulations show the possibility of mometasone to prevent relapse through the glucocorticoid's ability to drastically reduce LSC population size. This work therefore highlights the prospect of these treatments for anti-LSC strategies and underlines the use of quantitative approaches to preclinical drug translation in AML.
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Affiliation(s)
- Mia Brunetti
- Département de Mathématiques et de Statistiques, Université de Montréal, 2900 Édouard Montpetit Blvd, Montréal, Québec H3T 1J4, Canada; Sainte-Justine University Hospital Azrieli Research Center, 3175 Chem. de la Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, Canada
| | - Isabella A Iasenza
- Division of Experimental Medicine, Department of Medicine, McGill University, 845 Sherbrooke St W, Montréal, Québec H3A 0G4, Canada; Research Institute of the McGill University Health Centre, 1001 Décarie Blvd, Montréal, Québec H4A 3J1, Canada
| | - Adrianne L Jenner
- School of Mathematical Sciences, Queensland University of Technology, 2 George St, Brisbane, QLD 4000, Australia
| | - Noël J-M Raynal
- Sainte-Justine University Hospital Azrieli Research Center, 3175 Chem. de la Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, Canada; Département de Pharmacologie et Physiologie, Université de Montréal, 2900 Édouard Montpetit Blvd, Montréal, Québec H3T 1J4, Canada
| | - Kolja Eppert
- Research Institute of the McGill University Health Centre, 1001 Décarie Blvd, Montréal, Québec H4A 3J1, Canada; Department of Pediatrics, McGill University, 845 Sherbrooke St W, Montréal, Québec H3A 0G4, Canada
| | - Morgan Craig
- Département de Mathématiques et de Statistiques, Université de Montréal, 2900 Édouard Montpetit Blvd, Montréal, Québec H3T 1J4, Canada; Sainte-Justine University Hospital Azrieli Research Center, 3175 Chem. de la Côte-Sainte-Catherine, Montréal, Québec H3T 1C5, Canada.
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An integrative systems biology approach to overcome venetoclax resistance in acute myeloid leukemia. PLoS Comput Biol 2022; 18:e1010439. [PMID: 36099249 PMCID: PMC9469948 DOI: 10.1371/journal.pcbi.1010439] [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: 06/16/2021] [Accepted: 07/25/2022] [Indexed: 11/19/2022] Open
Abstract
The over-expression of the Bcl-2 protein is a common feature of many solid cancers and hematological malignancies, and it is typically associated with poor prognosis and resistance to chemotherapy. Bcl-2-specific inhibitors, such as venetoclax, have recently been approved for the treatment of chronic lymphocytic leukemia and small lymphocytic lymphoma, and they are showing promise in clinical trials as a targeted therapy for patients with relapsed or refractory acute myeloid leukemia (AML). However, successful treatment of AML with Bcl-2-specific inhibitors is often followed by the rapid development of drug resistance. An emerging paradigm for overcoming drug resistance in cancer treatment is through the targeting of mitochondrial energetics and metabolism. In AML in particular, it was recently observed that inhibition of mitochondrial translation via administration of the antibiotic tedizolid significantly affects mitochondrial bioenergetics, activating the integrated stress response (ISR) and subsequently sensitizing drug-resistant AML cells to venetoclax. Here we develop an integrative systems biology approach to acquire a deeper understanding of the molecular mechanisms behind this process, and in particular, of the specific role of the ISR in the commitment of cells to apoptosis. Our multi-scale mathematical model couples the ISR to the intrinsic apoptosis pathway in venetoclax-resistant AML cells, includes the metabolic effects of treatment, and integrates RNA, protein level, and cellular viability data. Using the mathematical model, we identify the dominant mechanisms by which ISR activation helps to overcome venetoclax resistance, and we study the temporal sequencing of combination treatment to determine the most efficient and robust combination treatment protocol. In this work, we develop a multi-scale systems biology approach to study the mechanisms by which the integrated stress response (ISR) activation helps to overcome venetoclax resistance in acute myeloid leukemia (AML). The multi-scale model enables the integration of RNA-level, protein-level, and cellular viability and proliferation data. The model developed in this work can predict several important features of the resistant AML cell lines that are consistent with experimental data. Further, our integrative systems biology approach led to the determination of the optimal combination treatment protocol.
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Lomeli LM, Iniguez A, Tata P, Jena N, Liu ZY, Van Etten R, Lander AD, Shahbaba B, Lowengrub JS, Minin VN. Optimal experimental design for mathematical models of haematopoiesis. J R Soc Interface 2021; 18:20200729. [PMID: 33499768 PMCID: PMC7879761 DOI: 10.1098/rsif.2020.0729] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 01/04/2021] [Indexed: 11/12/2022] Open
Abstract
The haematopoietic system has a highly regulated and complex structure in which cells are organized to successfully create and maintain new blood cells. It is known that feedback regulation is crucial to tightly control this system, but the specific mechanisms by which control is exerted are not completely understood. In this work, we aim to uncover the underlying mechanisms in haematopoiesis by conducting perturbation experiments, where animal subjects are exposed to an external agent in order to observe the system response and evolution. We have developed a novel Bayesian hierarchical framework for optimal design of perturbation experiments and proper analysis of the data collected. We use a deterministic model that accounts for feedback and feedforward regulation on cell division rates and self-renewal probabilities. A significant obstacle is that the experimental data are not longitudinal, rather each data point corresponds to a different animal. We overcome this difficulty by modelling the unobserved cellular levels as latent variables. We then use principles of Bayesian experimental design to optimally distribute time points at which the haematopoietic cells are quantified. We evaluate our approach using synthetic and real experimental data and show that an optimal design can lead to better estimates of model parameters.
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Affiliation(s)
- Luis Martinez Lomeli
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
| | - Abdon Iniguez
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
| | - Prasanthi Tata
- Division of Hematology/Oncology, University of California Irvine, Irvine, CA, USA
| | - Nilamani Jena
- Division of Hematology/Oncology, University of California Irvine, Irvine, CA, USA
| | - Zhong-Ying Liu
- Division of Hematology/Oncology, University of California Irvine, Irvine, CA, USA
| | - Richard Van Etten
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
- Division of Hematology/Oncology, University of California Irvine, Irvine, CA, USA
- Department of Biological Chemistry, University of California Irvine, Irvine, CA, USA
- Center for Cancer Systems Biology, University of California Irvine, Irvine, CA, USA
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
| | - Arthur D. Lander
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
- Center for Cancer Systems Biology, University of California Irvine, Irvine, CA, USA
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
- Department of Developmental and Cell Biology, University of California Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
| | - Babak Shahbaba
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
- Center for Cancer Systems Biology, University of California Irvine, Irvine, CA, USA
- Department of Statistics, University of California Irvine, Irvine, CA, USA
| | - John S. Lowengrub
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
- Center for Cancer Systems Biology, University of California Irvine, Irvine, CA, USA
- Chao Family Comprehensive Cancer Center, University of California Irvine, Irvine, CA, USA
- Department of Biomedical Engineering, University of California Irvine, Irvine, CA, USA
- Department of Mathematics, University of California Irvine, Irvine, CA, USA
| | - Vladimir N. Minin
- Center for Complex Biological Systems, University of California Irvine, Irvine, CA, USA
- Center for Cancer Systems Biology, University of California Irvine, Irvine, CA, USA
- Department of Statistics, University of California Irvine, Irvine, CA, USA
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