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He Y, Li J, Ding N, Wang X, Deng L, Xie Y, Ying Z, Liu W, Ping L, Zhang C, Song Y, Zhu J. Combination of Enzastaurin and Ibrutinib synergistically induces anti-tumor effects in diffuse large B cell lymphoma. JOURNAL OF EXPERIMENTAL & CLINICAL CANCER RESEARCH : CR 2019; 38:86. [PMID: 30777096 PMCID: PMC6379963 DOI: 10.1186/s13046-019-1076-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 01/30/2019] [Indexed: 12/15/2022]
Abstract
Background Diffuse large B cell lymphoma (DLBCL) is the most common form of lymphoma. Although durable remissions can be achieved in more than half of these patients, DLBCL remains a significant clinical challenge, with approximately 30% of patients not being cured. BCR-associated kinases (SYK, BTK, and PI3K) inhibitors have exhibited encouraging pre-clinical and clinical effects, as reported by many researchers. Early studies demonstrated that protein kinase C-β (PKCβ) inhibitors alter phosphorylation level the Bruton’s tyrosine kinase (BTK), which leads to enhanced BTK signaling. Here, for the first time, we investigate whether the combination of PKCβ inhibitor enzastaurin and BTK inhibitor ibrutinib has synergistic anti-tumor effects in DLBCL. Methods In vitro cell proliferation was analyzed using Cell Titer-Glo Luminescent Cell Viability Assay. Induction of apoptosis and cell cycle arrest were measured by flow cytometry. Western Blotting analysis was used to detect the essential regulatory enzymes in related signaling pathways. RNA-seq was conducted to evaluate the whole transcriptome changes brought by co-treatment with low doses of enzastaurin and ibrutinib. The synergistic anti-tumor effects of enzastaurin and ibrutinib were also evaluated in vivo. Results Combination of enzastaurin and ibrutinib produced a lasting synergistic effect on the survival and proliferation of DLBCL cells, including reduction of proliferation, promoting apoptosis, inducting G1 phase arrest, preventing cell invasion and migration, and down-regulating activation of downstream signaling. More importantly, whole-transcriptome changes results showed that combination therapy worked synergistically to regulate whole-transcriptome expression compared with enzastaurin and ibrutinib alone. Co-treatment with low doses of enzastaurin and ibrutinib could effectively downregulate BCR, NF-κB, JAK and MAPK related signaling pathway. Furthermore, the mRNA expression analysis further indicated that co-treatment significantly decreased the mRNA levels of NOTCH1. The combination effect in inhibiting proliferation of DLBCL cells probably was realized through suppression of NOTCH1 expression. Finally, the anti-tumor activity of co-treatment also was demonstrated in vivo. Conclusions Combination of enzastaurin and ibrutinib had synergistic anti-tumor effects in DLBCL, independent of molecular subtype. These results provided a sound foundation for an attractive therapeutic treatment, and the simultaneous suppression of BTK and PKCβ might be a new treatment strategy for DLBCL. Electronic supplementary material The online version of this article (10.1186/s13046-019-1076-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yizi He
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Jiao Li
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Ning Ding
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Xiaogan Wang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Lijuan Deng
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Yan Xie
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Zhitao Ying
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Weiping Liu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Lingyan Ping
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Chen Zhang
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China
| | - Yuqin Song
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China.
| | - Jun Zhu
- Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of lymphoma, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, People's Republic of China.
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Cosenza M, Civallero M, Pozzi S, Marcheselli L, Bari A, Sacchi S. The combination of bortezomib with enzastaurin or lenalidomide enhances cytotoxicity in follicular and mantle cell lymphoma cell lines. Hematol Oncol 2014; 33:166-75. [PMID: 25394177 DOI: 10.1002/hon.2179] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2014] [Revised: 10/06/2014] [Accepted: 10/09/2014] [Indexed: 01/19/2023]
Abstract
We analyzed the combination of a proteasome inhibitor (bortezomib) with enzastaurin (PKC/AKT-inhibitor) or lenalidomide (immunomodulatory agent) for the inhibition of proliferation and induction of apoptosis in B-cell lymphoma cell lines and primary malignant cells. The effects of bortezomib, enzastaurin or lenalidomide, alone or in combinations, on cell viability and apoptosis were evaluated using the Cell Proliferation Kit and flow cytometry analysis. The interaction between drugs was examined by the Chou-Talalay method. Cell cycle analysis was performed by flow cytometry. The PI3K/AKT, PKC and MAPK/ERK signaling pathways were analyzed using western blot. Bortezomib with either enzastaurin or lenalidomide synergistically induced anti-proliferative and pro-apoptotic effects in B-cell lymphoma cells, even in the presence of the bone marrow microenvironment. The direct cytotoxicity is mediated by signaling events involving the PI3K/AKT, PKC and MAPK/ERK pathways leading to cell death. The significant increase of apoptosis was mediated by an increased ratio of pro-apoptotic proteins (Bax, Bad and Bim) to anti-apoptotic proteins (Bcl-2, Bcl-xL and Mcl-1), triggering the cleavage of caspases -3, -9, -8 and PARP. Further evaluation of the combination of bortezomib with enzastaurin or lenalidomide for the treatment of B-cell lymphoma is warranted, with the goal to improve the quality of life and survival of patients.
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Affiliation(s)
- Maria Cosenza
- Program of Innovative Therapies in Oncology and Haematology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Monica Civallero
- Program of Innovative Therapies in Oncology and Haematology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Samantha Pozzi
- Program of Innovative Therapies in Oncology and Haematology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Luigi Marcheselli
- Program of Innovative Therapies in Oncology and Haematology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessia Bari
- Program of Innovative Therapies in Oncology and Haematology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
| | - Stefano Sacchi
- Program of Innovative Therapies in Oncology and Haematology, Department of Diagnostic, Clinical and Public Health Medicine, University of Modena and Reggio Emilia, Modena, Italy
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Garg R, Benedetti LG, Abera MB, Wang H, Abba M, Kazanietz MG. Protein kinase C and cancer: what we know and what we do not. Oncogene 2014; 33:5225-37. [PMID: 24336328 DOI: 10.1038/onc.2013.524] [Citation(s) in RCA: 197] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/20/2013] [Accepted: 10/20/2013] [Indexed: 02/08/2023]
Abstract
Since their discovery in the late 1970s, protein kinase C (PKC) isozymes represent one of the most extensively studied signaling kinases. PKCs signal through multiple pathways and control the expression of genes relevant for cell cycle progression, tumorigenesis and metastatic dissemination. Despite the vast amount of information concerning the mechanisms that control PKC activation and function in cellular models, the relevance of individual PKC isozymes in the progression of human cancer is still a matter of controversy. Although the expression of PKC isozymes is altered in multiple cancer types, the causal relationship between such changes and the initiation and progression of the disease remains poorly defined. Animal models developed in the last years helped to better understand the involvement of individual PKCs in various cancer types and in the context of specific oncogenic alterations. Unraveling the enormous complexity in the mechanisms by which PKC isozymes have an impact on tumorigenesis and metastasis is key for reassessing their potential as pharmacological targets for cancer treatment.
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Affiliation(s)
- R Garg
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - L G Benedetti
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M B Abera
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - H Wang
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - M Abba
- Centro de Investigaciones Inmunológicas Básicas y Aplicadas (CINIBA), Facultad de Ciencias Médicas, Universidad Nacional de La Plata, La Plata, Argentina
| | - M G Kazanietz
- Department of Pharmacology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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Vergote IB, Chekerov R, Amant F, Harter P, Casado A, Emerich J, Bauknecht T, Mansouri K, Myrand SP, Nguyen TS, Shi P, Sehouli J. Randomized, Phase II, Placebo-Controlled, Double-Blind Study With and Without Enzastaurin in Combination With Paclitaxel and Carboplatin As First-Line Treatment Followed by Maintenance Treatment in Advanced Ovarian Cancer. J Clin Oncol 2013; 31:3127-32. [DOI: 10.1200/jco.2012.44.9116] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Enzastaurin is an oral serine/threonine kinase inhibitor antitumor agent. Our phase II trial tested the efficacy and safety of enzastaurin added to a standard carboplatin/paclitaxel chemotherapy regimen in patients with newly diagnosed advanced ovarian cancer. Patients and Methods This was a randomized, placebo-controlled study in patients with International Federation of Gynecology and Obstetrics stage IIB to IV ovarian, fallopian tube, or peritoneal epithelial carcinoma. Patients were randomly assigned to six cycles of chemotherapy (paclitaxel/carboplatin ± enzastaurin [PCE/PC]) followed by maintenance therapy (enzastaurin/placebo). Primary end point was progression-free survival (PFS). Secondary measures included response rate, safety assessment, and translational research. Results A total of 142 patients were randomly assigned to PCE (n = 69) or PC (n = 73). Patients in the PCE group had a 3.7-month longer median PFS compared with patients in the PC group; this was not statistically significant (hazard ratio [HR], 0.80; 95% CI, 0.50 to 1.29; P = .37). Safety profiles of the treatment arms were comparable. Frequency of discontinuation because of adverse events was similar (PCE, 11.9%; PC, 9.7%). Multivariate analyses confirmed the importance of optimal debulking with regard to PFS (debulking optimal v suboptimal: HR, 0.51; 95% CI, 0.30 to 0.85; P = .009). HR for covariate stage (stage IIB to IIIB v IIIC to IV) was not statistically significant (0.75; 95% CI, 0.38 to 1.47; P = .40). Translational research of immunohistochemistry protein assays did not identify any markers significantly associated with treatment difference regarding PFS. Conclusion The PCE combination increased PFS, but it was not significantly superior to PC in this phase II study.
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Affiliation(s)
- Ignace B. Vergote
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Radoslav Chekerov
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Frederic Amant
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Philipp Harter
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Antonio Casado
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Janusz Emerich
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Thomas Bauknecht
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Kambiz Mansouri
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Scott P. Myrand
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Tuan S. Nguyen
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Peipei Shi
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
| | - Jalid Sehouli
- Ignace B. Vergote and Frederic Amant, University Hospital, Leuven, Belgium; Radoslav Chekerov and Jalid Sehouli, University Medicine of Berlin, Berlin; Philipp Harter, Kliniken Essen Mitte, Essen; Thomas Bauknecht and Kambiz Mansouri, Lilly Deutschland, Bad Homburg, Germany; Antonio Casado, Hospital Universitario San Carlos, Madrid, Spain; Janusz Emerich, Provincial Specialist Hospital, Slupsk, Poland; and Scott P. Myrand, Tuan S. Nguyen, and Peipei Shi, Eli Lilly, Indianapolis, IN
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