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Travaglini S, Gurnari C, Antonelli S, Marchesi F, De Angelis G, Ottone T, Divona M, Cristiano A, Hajrullaj H, Mengarelli A, Voso MT. Functional characterization and response to FLT3 inhibitors in acute myeloid leukaemia with a non-canonical FLT3 mutation: A proof of concept. Br J Haematol 2023; 203:327-330. [PMID: 37485586 DOI: 10.1111/bjh.18991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 07/05/2023] [Accepted: 07/11/2023] [Indexed: 07/25/2023]
Affiliation(s)
- Serena Travaglini
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Carmelo Gurnari
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
- Department of Translational Hematology and Oncology Research, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio, USA
| | - Silvia Antonelli
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Francesco Marchesi
- Hematology and Stem Cell Transplant Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | | | - Tiziana Ottone
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
- Neuro-Oncohematology, Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
| | - Mariadomenica Divona
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
- Saint Camillus International University of Health Sciences, Rome, Italy
| | - Antonio Cristiano
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | - Hajro Hajrullaj
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
| | | | - Maria Teresa Voso
- Department of Biomedicine and Prevention, University of Tor Vergata, Rome, Italy
- Neuro-Oncohematology, Santa Lucia Foundation, I.R.C.C.S., Rome, Italy
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2
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Jensen CE, Montgomery ND, Galeotti J, Foster MC, Zeidner JF. Clinical and molecular features of FLT3 juxtamembrane domain missense mutations in acute myeloid leukaemia. J Cell Mol Med 2022; 26:6079-6082. [PMID: 36444394 PMCID: PMC9753433 DOI: 10.1111/jcmm.17608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Revised: 10/17/2022] [Accepted: 10/23/2022] [Indexed: 11/30/2022] Open
Affiliation(s)
- Christopher E. Jensen
- Divisions of Hematology and Oncology, Department of Internal MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA,Cecil G. Sheps Center for Health Services ResearchUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Nathan D. Montgomery
- Department of Pathology and Laboratory MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA,Tempus‐RTPDurhamNorth CarolinaUSA
| | - Jonathan Galeotti
- Department of Pathology and Laboratory MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA
| | - Matthew C. Foster
- Divisions of Hematology and Oncology, Department of Internal MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA,Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Joshua F. Zeidner
- Divisions of Hematology and Oncology, Department of Internal MedicineUniversity of North Carolina School of MedicineChapel HillNorth CarolinaUSA,Lineberger Comprehensive Cancer CenterUniversity of North CarolinaChapel HillNorth CarolinaUSA
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3
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Zhou S, Yang B, Xu Y, Gu A, Peng J, Fu J. Understanding gilteritinib resistance to FLT3-F691L mutation through an integrated computational strategy. J Mol Model 2022; 28:247. [PMID: 35932378 DOI: 10.1007/s00894-022-05254-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Accepted: 07/31/2022] [Indexed: 11/25/2022]
Abstract
FMS-like tyrosine kinase 3 (FLT3) serves as an important drug target for acute myeloid leukemia (AML), and gene mutations of FLT3 have been closely associated with AML patients with an incidence rate of ~ 30%. However, the mechanism of the clinically relevant F691L gatekeeper mutation conferred resistance to the drug gilteritinib remained poorly understood. In this study, multiple microsecond molecular dynamics (MD) simulations, end-point free energy calculations, and dynamic correlated and network analyses were performed to investigate the molecular basis of gilteritinib resistance to the FLT3-F691L mutation. The simulations revealed that the resistant mutation largely induced the conformational changes of the activation loop (A-loop), the phosphate-binding loop, and the helix αC of the FLT3 protein. The binding abilities of the gilteritinib to the wild-type and the F691L mutant were different through the binding free energy prediction. The simulation results further indicated that the driving force to determine the binding affinity of gilteritinib was derived from the differences in the energy terms of electrostatic and van der Waals interactions. Moreover, the per-residue free energy decomposition suggested that the four residues (Phe803, Gly831, Leu832, and Ala833) located at the A-loop of FLT3 had a significant impact on the binding affinity of gilteritinib to the F691L mutant. This study may provide useful information for the design of novel FLT3 inhibitors specially targeting the F691L gatekeeper mutant.
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Affiliation(s)
- Shibo Zhou
- Department of Radiology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing, 210009, Jiangsu, China
| | - Bo Yang
- Department of Radiology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing, 210009, Jiangsu, China
| | - Yufeng Xu
- Department of Radiotherapy, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing, 210009, Jiangsu, China
| | - Aihua Gu
- Department of Medicine, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing, 210009, Jiangsu, China
| | - Juan Peng
- Department of Ultrasonography, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, 210011, Jiangsu, China
| | - Jinfeng Fu
- Department of Radiology, Jiangsu Cancer Hospital, The Affiliated Cancer Hospital of Nanjing Medical University, Jiangsu Institute of Cancer Research, Nanjing, 210009, Jiangsu, China.
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4
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Stasik S, Kramer M, Zukunft S, Röllig C, Baldus CD, Platzbecker U, Serve H, Müller-Tidow C, Schäfer-Eckart K, Kaufmann M, Krause S, Sauer T, Hänel M, Neubauer A, Ehninger G, Bornhäuser M, Schetelig J, Middeke JM, Thiede C. Point Mutations in the FLT3-ITD Region Are Rare but Recurrent Alterations in Adult AML and Associated With Concomitant KMT2A-PTD. Front Oncol 2022; 12:862991. [PMID: 35387132 PMCID: PMC8977490 DOI: 10.3389/fonc.2022.862991] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 02/23/2022] [Indexed: 12/19/2022] Open
Abstract
FLT3-ITD mutations are common druggable alterations in patients with acute myeloid leukemia (AML) and associated with poor prognosis. Beside typical ITD mutations, point mutations and deletions in the juxtamembrane domain (JMD) have been observed. However, due to the low frequency of these alterations, there is only limited information on molecular and clinical associations. To evaluate the prognostic impact of non-ITD mutations in the FLT3 JMD region, we analyzed a large cohort of 1,539 adult AML patients treated in different protocols of the Study Alliance Leukemia, using next-generation sequencing. Non-ITD point mutations and deletions within the FLT3 JMD were identified with a prevalence of ~1.23% (n = 19). Both FLT3-ITD and non-ITD mutations were associated with a higher rate of NPM1 (42%-61%; p < 0.001) and DNMT3A mutations (37%-43%; p < 0.001), as well as an increased percentage of peripheral blood (54%-65%) and bone marrow blast cells (74%; p < 0.001), compared to FLT3-wild-type patients. Most significantly, AML patients with FLT3 non-ITD mutations had a higher rate of concomitant KMT2A-PTD mutations (37.5%; p < 0.001) as compared to FLT3-ITD (7%) or FLT3-wild-type cases (4.5%). In a multivariable analysis, FLT3 non-ITD mutations were not an independent prognostic factor. However, patients with dual FLT3 non-ITD and KMT2A-PTD mutations showed a trend for inferior outcome, which points at a functional interaction in this subset of AML.
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Affiliation(s)
- Sebastian Stasik
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.,German Cancer Consortium (DKTK), Partner Site Dresden, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Michael Kramer
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Sven Zukunft
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Christoph Röllig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Claudia D Baldus
- Hämatologie und Onkologie, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Uwe Platzbecker
- Medizinische Klinik und Poliklinik I, Hämatologie und Zelltherapie, Universitätsklinikum Leipzig, Leipzig, Germany
| | - Hubert Serve
- Medizinische Klinik II, Universitätsklinikum Frankfurt, Frankfurt am Main, Germany.,German Cancer Consortium (DKTK), Partner Site Frankfurt, and German Cancer Research Center (DKFZ), Heidelberg, Germany
| | | | | | - Martin Kaufmann
- Abteilung für Hämatologie, Onkologie und Palliativmedizin, Robert-Bosch-Krankenhaus, Stuttgart, Germany
| | - Stefan Krause
- Medizinische Klinik V, Universitätsklinikum Erlangen, Erlangen, Germany
| | - Tim Sauer
- Medizinische Klinik V, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Mathias Hänel
- Medizinische Klinik III, Klinikum Chemnitz, Chemnitz, Germany
| | - Andreas Neubauer
- Klinik für Hämatologie, Onkologie, Immunologie, Philipps Universität Marburg, Marburg, Germany
| | - Gerhard Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Martin Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.,National Center for Tumor Diseases, Dresden, Germany
| | - Johannes Schetelig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.,Deutsche Knochenmarkspenderdatei (DKMS) Clinical Trials Unit, Dresden, Germany
| | - Jan M Middeke
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Christian Thiede
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus, Dresden, Germany.,AgenDix GmbH, Dresden, Germany
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