1
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Juarez D, Buono R, Matulis SM, Gupta VA, Duong M, Yudiono J, Paul M, Mallya S, Diep G, Hsin P, Lu A, Suh SM, Dong VM, Roberts AW, Leverson JD, Jalaluddin M, Liu Z, Bueno OF, Boise LH, Fruman DA. Statin-induced Mitochondrial Priming Sensitizes Multiple Myeloma Cells to BCL2 and MCL-1 Inhibitors. Cancer Res Commun 2023; 3:2497-2509. [PMID: 37956312 PMCID: PMC10704957 DOI: 10.1158/2767-9764.crc-23-0350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 09/12/2023] [Accepted: 11/03/2023] [Indexed: 11/15/2023]
Abstract
The BCL2 inhibitor venetoclax promotes apoptosis in blood cancer cells and is approved for treatment of chronic lymphocytic leukemia and acute myeloid leukemia. However, multiple myeloma cells are frequently more dependent on MCL-1 for survival, conferring resistance to venetoclax. Here we report that mevalonate pathway inhibition with statins can overcome resistance to venetoclax in multiple myeloma cell lines and primary cells. In addition, statins sensitize to apoptosis induced by MCL-1 inhibitor, S63845. In retrospective analysis of venetoclax clinical studies in multiple myeloma, background statin use was associated with a significantly enhanced rate of stringent complete response and absence of progressive disease. Statins sensitize multiple myeloma cells to venetoclax by upregulating two proapoptotic proteins: PUMA via a p53-independent mechanism and NOXA via the integrated stress response. These findings provide rationale for prospective testing of statins with venetoclax regimens in multiple myeloma. SIGNIFICANCE BH3 mimetics including venetoclax hold promise for treatment of multiple myeloma but rational combinations are needed to broaden efficacy. This study presents mechanistic and clinical data to support addition of pitavastatin to venetoclax regimens in myeloma. The results open a new avenue for repurposing statins in blood cancer.
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Affiliation(s)
- Dennis Juarez
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Roberta Buono
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Shannon M. Matulis
- Department of Hematology and Medical Oncology and the Winship Cancer Institute at Emory University, Atlanta, Georgia
| | - Vikas A. Gupta
- Department of Hematology and Medical Oncology and the Winship Cancer Institute at Emory University, Atlanta, Georgia
| | - Madeleine Duong
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Jacob Yudiono
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Madhuri Paul
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Sharmila Mallya
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Grace Diep
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Peter Hsin
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
| | - Alexander Lu
- Department of Chemistry, University of California, Irvine, California
| | - Sang Mi Suh
- Department of Chemistry, University of California, Irvine, California
| | - Vy M. Dong
- Department of Chemistry, University of California, Irvine, California
| | | | | | | | | | | | - Lawrence H. Boise
- Department of Hematology and Medical Oncology and the Winship Cancer Institute at Emory University, Atlanta, Georgia
| | - David A. Fruman
- Department of Molecular Biology and Biochemistry, University of California, Irvine, California
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2
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Ahmadinejad F, Bos T, Hu B, Britt E, Koblinski J, Souers AJ, Leverson JD, Faber AC, Gewirtz DA, Harada H. Senolytic-Mediated Elimination of Head and Neck Tumor Cells Induced Into Senescence by Cisplatin. Mol Pharmacol 2022; 101:168-180. [PMID: 34907000 PMCID: PMC8969145 DOI: 10.1124/molpharm.121.000354] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/25/2021] [Indexed: 01/10/2023] Open
Abstract
Therapeutic outcomes achieved in head and neck squamous cell carcinoma (HNSCC) patients by concurrent cisplatin-based chemoradiotherapy initially reflect both tumor regression and tumor stasis. However, local and distant metastasis and disease relapse are common in HNSCC patients. In the current work, we demonstrate that cisplatin treatment induces senescence in both p53 wild-type HN30 and p53 mutant HN12 head and neck cancer models. We also show that tumor cells can escape from senescence both in vitro and in vivo. We further establish the effectiveness of the senolytic, ABT-263 (Navitoclax), in elimination of senescent tumor cells after cisplatin treatment. Navitoclax increased apoptosis by 3.3-fold (P ≤ 0.05) at day 7 compared with monotherapy by cisplatin. Additionally, we show that ABT-263 interferes with the interaction between B-cell lymphoma-x large (BCL-XL) and BAX, anti- and pro-apoptotic proteins, respectively, followed by BAX activation, suggesting that ABT-263-induced apoptotic cell death is mediated through BAX. Our in vivo studies also confirm senescence induction in tumor cells by cisplatin, and the promotion of apoptosis coupled with a significant delay of tumor growth after sequential treatment with ABT-263. Sequential treatment with cisplatin followed by ABT-263 extended the humane endpoint to ∼130 days compared with cisplatin alone, where mice survived ∼75 days. These results support the premise that senolytic agents could be used to eliminate residual senescent tumor cells after chemotherapy and thereby potentially delay disease recurrence in head and neck cancer patients. SIGNIFICANCE STATEMENT: Disease recurrence is the most common cause of death in head and neck cancer patients. B-cell lymphoma-x large inhibitors such as ABT-263 (Navitoclax) have the capacity to be used in combination with cisplatin in head and neck cancer patients to eliminate senescent cells and possibly prevent disease relapse.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Hisashi Harada
- Department of Human and Molecular Genetics, School of Medicine (F.A.), Philips Institute for Oral Health Research, School of Dentistry (T.B., E.B., A.C.F., H.H.), Cancer Mouse Models Core (B.H., J.K.), and Department of Pharmacology and Toxicology, School of Medicine (D.A.G.), Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia; and AbbVie, North Chicago, Illinois (A.J.S., J.D.L.)
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3
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Popovic R, Dunbar F, Lu C, Robinson K, Quarless D, Warder SE, Mukherjee N, Pesko J, Souers AJ, Waring JF, Davids MS, Tausch E, Stilgenbauer S, Ross JA, Leverson JD, Kim SY, Chyla BJ. Identification of recurrent genomic alterations in the apoptotic machinery in chronic lymphocytic leukemia patients treated with venetoclax monotherapy. Am J Hematol 2022; 97:E47-E51. [PMID: 34779028 PMCID: PMC10015991 DOI: 10.1002/ajh.26411] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 11/02/2021] [Accepted: 11/05/2021] [Indexed: 01/01/2023]
Affiliation(s)
| | | | - Charles Lu
- AbbVie Inc, North Chicago, Illinois, USA
| | | | | | | | | | - John Pesko
- AbbVie Inc, North Chicago, Illinois, USA
| | | | | | - Matthew S Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Eugen Tausch
- Internal Medicine III, Ulm University, Ulm, Germany
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4
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Ganan-Gomez I, Yang H, Ma F, Montalban-Bravo G, Thongon N, Marchica V, Richard-Carpentier G, Chien K, Manyam G, Wang F, Alfonso A, Chen S, Class C, Kanagal-Shamanna R, Ingram JP, Ogoti Y, Rose A, Loghavi S, Lockyer P, Cambo B, Muftuoglu M, Schneider S, Adema V, McLellan M, Garza J, Marchesini M, Giuliani N, Pellegrini M, Wang J, Walker J, Li Z, Takahashi K, Leverson JD, Bueso-Ramos C, Andreeff M, Clise-Dwyer K, Garcia-Manero G, Colla S. Author Correction: Stem cell architecture drives myelodysplastic syndrome progression and predicts response to venetoclax-based therapy. Nat Med 2022; 28:1097. [PMID: 35484266 PMCID: PMC9117132 DOI: 10.1038/s41591-022-01827-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Irene Ganan-Gomez
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Hui Yang
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Feiyang Ma
- grid.19006.3e0000 0000 9632 6718Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA USA ,grid.214458.e0000000086837370Division of Rheumatology, Department of Internal Medicine, Michigan Medicine, University of Michigan, Ann Arbor, MI USA
| | - Guillermo Montalban-Bravo
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Natthakan Thongon
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Valentina Marchica
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Guillaume Richard-Carpentier
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Kelly Chien
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Ganiraju Manyam
- grid.240145.60000 0001 2291 4776Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Feng Wang
- grid.240145.60000 0001 2291 4776Department of Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Ana Alfonso
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Shuaitong Chen
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Caleb Class
- grid.240145.60000 0001 2291 4776Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Rashmi Kanagal-Shamanna
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Yamini Ogoti
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Ashley Rose
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sanam Loghavi
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Pamela Lockyer
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Benedetta Cambo
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Muharrem Muftuoglu
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Sarah Schneider
- grid.240145.60000 0001 2291 4776Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Vera Adema
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Michael McLellan
- grid.4367.60000 0001 2355 7002McDonnell Genome Institute, Washington University in St. Louis, St. Louis, MO USA
| | - John Garza
- grid.4367.60000 0001 2355 7002McDonnell Genome Institute, Washington University in St. Louis, St. Louis, MO USA
| | - Matteo Marchesini
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA ,Istituto Romagnolo per lo Studio dei Tumori ‘Dino Amadori’, Meldola, Italy
| | - Nicola Giuliani
- grid.10383.390000 0004 1758 0937Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Matteo Pellegrini
- grid.19006.3e0000 0000 9632 6718Molecular Biology Institute, University of California, Los Angeles, Los Angeles, CA USA
| | - Jing Wang
- grid.240145.60000 0001 2291 4776Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Jason Walker
- grid.4367.60000 0001 2355 7002McDonnell Genome Institute, Washington University in St. Louis, St. Louis, MO USA
| | - Ziyi Li
- grid.240145.60000 0001 2291 4776Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Koichi Takahashi
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | | | - Carlos Bueso-Ramos
- grid.240145.60000 0001 2291 4776Department of Hematopathology, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Michael Andreeff
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Karen Clise-Dwyer
- grid.240145.60000 0001 2291 4776Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Guillermo Garcia-Manero
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
| | - Simona Colla
- grid.240145.60000 0001 2291 4776Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX USA
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5
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Ludwig LM, Hawley KM, Banks DB, Thomas-Toth AT, Blazar BR, McNerney ME, Leverson JD, LaBelle JL. Venetoclax imparts distinct cell death sensitivity and adaptivity patterns in T cells. Cell Death Dis 2021; 12:1005. [PMID: 34707089 PMCID: PMC8551340 DOI: 10.1038/s41419-021-04285-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 09/17/2021] [Accepted: 10/08/2021] [Indexed: 12/13/2022]
Abstract
BH3 mimetics are increasingly used as anti-cancer therapeutics either alone or in conjunction with other chemotherapies. However, mounting evidence has also demonstrated that BH3 mimetics modulate varied amounts of apoptotic signaling in healthy immune populations. In order to maximize their clinical potential, it will be essential to understand how BH3 mimetics affect discrete immune populations and to determine how BH3 mimetic pressure causes immune system adaptation. Here we focus on the BCL-2 specific inhibitor venetoclax (ABT-199) and its effects following short-term and long-term BCL-2 blockade on T cell subsets. Seven day "short-term" ex vivo and in vivo BCL-2 inhibition led to divergent cell death sensitivity patterns in CD8+ T cells, CD4+ T cells, and Tregs resulting in shifting of global T cell populations towards a more memory T cell state with increased expression of BCL-2, BCL-XL, and MCL-1. However, twenty-eight day "long-term" BCL-2 blockade following T cell-depleted bone marrow transplantation did not lead to changes in the global T cell landscape. Despite the lack of changes in T cell proportions, animals treated with venetoclax developed CD8+ and CD4+ T cells with high levels of BCL-2 and were more resistant to apoptotic stimuli following expansion post-transplant. Further, we demonstrate through RNA profiling that T cells adapt while under BCL-2 blockade post-transplant and develop a more activated genotype. Taken together, these data emphasize the importance of evaluating how BH3 mimetics affect the immune system in different treatment modalities and disease contexts and suggest that venetoclax should be further explored as an immunomodulatory compound.
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Affiliation(s)
- Lindsey M. Ludwig
- grid.170205.10000 0004 1936 7822Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
| | - Katrina M. Hawley
- grid.170205.10000 0004 1936 7822Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
| | - David B. Banks
- grid.170205.10000 0004 1936 7822Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA ,grid.170205.10000 0004 1936 7822Medical Scientist Training Program, University of Chicago, Chicago, IL USA
| | - Anika T. Thomas-Toth
- grid.170205.10000 0004 1936 7822Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
| | - Bruce R. Blazar
- grid.17635.360000000419368657Department of Pediatrics, Division of Blood and Marrow Transplantation, University of Minnesota, Minneapolis, MN USA
| | - Megan E. McNerney
- grid.170205.10000 0004 1936 7822Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA ,grid.170205.10000 0004 1936 7822Department of Pathology, University of Chicago, Chicago, IL USA
| | - Joel D. Leverson
- grid.431072.30000 0004 0572 4227AbbVie Inc., North Chicago, IL USA
| | - James L. LaBelle
- grid.170205.10000 0004 1936 7822Department of Pediatrics, Section of Hematology/Oncology, University of Chicago, Chicago, IL USA
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6
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Osada N, Kikuchi J, Koyama D, Kuroda Y, Yasui H, Leverson JD, Furukawa Y. mTOR inhibitors sensitize multiple myeloma cells to venetoclax via IKZF3-and Blimp-1-mediated BCL-2 up-regulation. Haematologica 2021; 106:3008-3013. [PMID: 34261294 PMCID: PMC8561283 DOI: 10.3324/haematol.2021.278506] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Naoki Osada
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498
| | - Jiro Kikuchi
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498
| | - Daisuke Koyama
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498
| | - Yoshiaki Kuroda
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japanl; Department of Hematology, National Hospital Organization Hiroshimanishi Medical Center, 4-1-1 Kuba, Otake, Hiroshima 739-0696
| | - Hiroshi Yasui
- The Institute of Medical Science, The University of Tokyo, 4-6-1 Shirokanedai, Minato-ku, Tokyo 108-8639
| | - Joel D Leverson
- Oncology Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL 60064
| | - Yusuke Furukawa
- Division of Stem Cell Regulation, Center for Molecular Medicine, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498.
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7
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Tong Y, Florjancic AS, Clark RF, Lai C, Mastracchio A, Zhu GD, Smith ML, Kovar PJ, Shaw B, Albert DH, Qiu W, Longenecker KL, Liu X, Olson AM, Osterling DJ, Tahir SK, Phillips DC, Leverson JD, Souers AJ, Penning TD. Balancing Properties with Carboxylates: A Lead Optimization Campaign for Selective and Orally Active CDK9 Inhibitors. ACS Med Chem Lett 2021; 12:1108-1115. [PMID: 34267880 DOI: 10.1021/acsmedchemlett.1c00161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
Cyclin-dependent kinase 9 (CDK9) is a serine/threonine kinase involved in the regulation of transcription elongation. An inhibition of CDK9 downregulates a number of short-lived proteins responsible for tumor maintenance and survival, including the antiapoptotic BCL-2 family member MCL-1. As pan-CDK inhibitors under development have faced dosing and toxicity challenges in the clinical setting, we generated selective CDK9 inhibitors that could be amenable to an oral administration. Here, we report the lead optimization of a series of azaindole-based inhibitors. To overcome early challenges with promiscuity and cardiovascular toxicity, carboxylates were introduced into the pharmacophore en route to compounds such as 14 and 16. These CDK9 inhibitors demonstrated a reduced toxicity, adequate pharmacokinetic properties, and a robust in vivo efficacy in mice upon oral dosing.
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Affiliation(s)
- Yunsong Tong
- Drug Discovery Science & Technology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Alan S. Florjancic
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Rick F. Clark
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Chunqiu Lai
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Anthony Mastracchio
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Gui-dong Zhu
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Morey L. Smith
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Peter J. Kovar
- High Throughput Biology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Bailin Shaw
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Daniel H. Albert
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Wei Qiu
- Structural Biology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Kenton L. Longenecker
- Structural Biology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Xiaoqin Liu
- Pharmacology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Amanda M. Olson
- Pharmacology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Donald J. Osterling
- Pharmacology, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Stephen K. Tahir
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Darren C. Phillips
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Joel D. Leverson
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Andrew J. Souers
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Thomas D. Penning
- Oncology Discovery, Abbvie, 1 North Waukegan Road, North Chicago, Illinois 60064, United States
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8
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Tao ZF, Wang X, Chen J, Ingram JP, Jin S, Judge RA, Kovar PJ, Park C, Sun C, Wakefield BD, Zhou L, Zhang H, Elmore SW, Phillips DC, Judd AS, Leverson JD, Souers AJ. Structure-Based Design of A-1293102, a Potent and Selective BCL-X L Inhibitor. ACS Med Chem Lett 2021; 12:1011-1016. [PMID: 34141086 PMCID: PMC8201748 DOI: 10.1021/acsmedchemlett.1c00162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 05/07/2021] [Indexed: 01/10/2023] Open
Abstract
BCL-XL, an antiapoptotic member of the BCL-2 family of proteins, drives tumor survival and maintenance and thus represents a key target for cancer treatment. Herein we report the rational design of a novel series of selective BCL-XL inhibitors exemplified by A-1293102. This molecule contains structural elements of selective BCL-XL inhibitor A-1155463 and the dual BCL-XL/BCL-2 inhibitors ABT-737 and navitoclax, while representing a distinct pharmacophore as assessed by an objective cheminformatic evaluation. A-1293102 exhibited picomolar binding affinity to BCL-XL and both efficiently and selectively killed BCL-XL-dependent tumor cells. X-ray crystallographic analysis demonstrated a key hydrogen bonding network in the P2 binding pocket of BCL-XL, while the bent-back moiety achieved efficient occupancy of the P4 pocket in a manner similar to that of navitoclax. A-1293102 represents one of the few distinct structural series of selective BCL-XL inhibitors, and thus serves as a useful tool for biological studies as well as a lead compound for further optimization.
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Affiliation(s)
- Zhi-Fu Tao
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Xilu Wang
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Jun Chen
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Justin P. Ingram
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Sha Jin
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Russell A. Judge
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Peter J. Kovar
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Chang Park
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Chaohong Sun
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Brian D. Wakefield
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Li Zhou
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Haichao Zhang
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Steven W. Elmore
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Darren C. Phillips
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Andrew S. Judd
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Joel D. Leverson
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
| | - Andrew J. Souers
- AbbVie Inc., 1 North Waukegan Rd, North
Chicago, Illinois 60064, United States
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9
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Salem AH, Tao ZF, Bueno OF, Chen J, Chen S, Edalji R, Elmore SW, Fournier KM, Harper KC, Hong R, Jenkins GJ, Ji J, Judge RA, Kalvass JC, Klix RC, Ku YY, Leverson JD, Marks RA, Marsh KC, Menon RM, Park CH, Phillips DC, Pu YM, Rosenberg SH, Sanzgiri YD, Sheikh AY, Shi Y, Stolarik D, Suleiman AA, Wang X, Zhang GGZ, Catron ND, Souers AJ. Expanding the Repertoire for "Large Small Molecules": Prodrug ABBV-167 Efficiently Converts to Venetoclax with Reduced Food Effect in Healthy Volunteers. Mol Cancer Ther 2021; 20:999-1008. [PMID: 33785651 DOI: 10.1158/1535-7163.mct-21-0077] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/15/2021] [Accepted: 03/15/2021] [Indexed: 11/16/2022]
Abstract
Since gaining approval for the treatment of chronic lymphocytic leukemia (CLL), the BCL-2 inhibitor venetoclax has transformed the treatment of this and other blood-related cancers. Reflecting the large and hydrophobic BH3-binding groove within BCL-2, venetoclax has significantly higher molecular weight and lipophilicity than most orally administered drugs, along with negligible water solubility. Although a technology-enabled formulation successfully achieves oral absorption in humans, venetoclax tablets have limited drug loading and therefore can present a substantial pill burden for patients in high-dose indications. We therefore generated a phosphate prodrug (3, ABBV-167) that confers significantly increased water solubility to venetoclax and, upon oral administration to healthy volunteers either as a solution or high drug-load immediate release tablet, extensively converts to the parent drug. Additionally, ABBV-167 demonstrated a lower food effect with respect to venetoclax tablets. These data indicate that beyond-rule-of-5 molecules can be successfully delivered to humans via a solubility-enhancing prodrug moiety to afford robust exposures of the parent drug following oral dosing.
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Affiliation(s)
- Ahmed Hamed Salem
- AbbVie, Inc., North Chicago, Illinois.,Ain Shams University, Cairo, Egypt
| | | | | | - Jie Chen
- AbbVie, Inc., North Chicago, Illinois
| | | | | | | | | | | | | | | | | | | | | | | | - Yi-Yin Ku
- AbbVie, Inc., North Chicago, Illinois
| | | | | | | | | | | | | | | | | | | | | | - Yi Shi
- AbbVie, Inc., North Chicago, Illinois
| | | | - Ahmed A Suleiman
- AbbVie Deutschland GmbH & Co. KG, Ludwigshafen am Rhein, Germany
| | - Xilu Wang
- AbbVie, Inc., North Chicago, Illinois
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10
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Ludwig LM, Hawley KM, Blazar BR, McNerney ME, Leverson JD, LaBelle JL. Venetoclax Imparts Distinct Cell Death Sensitivity and Adaptivity Patterns in T Cells Subsets Leading to an Activated Phenotype. Transplant Cell Ther 2021. [DOI: 10.1016/s2666-6367(21)00430-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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11
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Zoeller JJ, Vagodny A, Daniels VW, Taneja K, Tan BY, DeRose YS, Fujita M, Welm AL, Letai A, Leverson JD, Blot V, Bronson RT, Dillon DA, Brugge JS. Navitoclax enhances the effectiveness of EGFR-targeted antibody-drug conjugates in PDX models of EGFR-expressing triple-negative breast cancer. Breast Cancer Res 2020; 22:132. [PMID: 33256808 PMCID: PMC7708921 DOI: 10.1186/s13058-020-01374-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Targeted therapies for triple-negative breast cancer (TNBC) are limited; however, the epidermal growth factor receptor (EGFR) represents a potential target, as the majority of TNBC express EGFR. The purpose of these studies was to evaluate the effectiveness of two EGFR-targeted antibody-drug conjugates (ADC: ABT-414; ABBV-321) in combination with navitoclax, an antagonist of the anti-apoptotic BCL-2 and BCL-XL proteins, in order to assess the translational relevance of these combinations for TNBC. METHODS The pre-clinical efficacy of combined treatments was evaluated in multiple patient-derived xenograft (PDX) models of TNBC. Microscopy-based dynamic BH3 profiling (DBP) was used to assess mitochondrial apoptotic signaling induced by navitoclax and/or ADC treatments, and the expression of EGFR and BCL-2/XL was analyzed in 46 triple-negative patient tumors. RESULTS Treatment with navitoclax plus ABT-414 caused a significant reduction in tumor growth in five of seven PDXs and significant tumor regression in the highest EGFR-expressing PDX. Navitoclax plus ABBV-321, an EGFR-targeted ADC that displays more effective wild-type EGFR-targeting, elicited more significant tumor growth inhibition and regressions in the two highest EGFR-expressing models evaluated. The level of mitochondrial apoptotic signaling induced by single or combined drug treatments, as measured by DBP, correlated with the treatment responses observed in vivo. Lastly, the majority of triple-negative patient tumors were found to express EGFR and co-express BCL-XL and/or BCL-2. CONCLUSIONS The dramatic tumor regressions achieved using combined agents in pre-clinical TNBC models underscore the abilities of BCL-2/XL antagonists to enhance the effectiveness of EGFR-targeted ADCs and highlight the clinical potential for usage of such targeted ADCs to alleviate toxicities associated with combinations of BCL-2/XL inhibitors and systemic chemotherapies.
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Affiliation(s)
- Jason J Zoeller
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, 240 Longwood Avenue, Boston, MA, 02115, USA
| | - Aleksandr Vagodny
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, 240 Longwood Avenue, Boston, MA, 02115, USA
| | - Veerle W Daniels
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | - Krishan Taneja
- Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA
| | - Benjamin Y Tan
- Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA
| | - Yoko S DeRose
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Maihi Fujita
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Alana L Welm
- Department of Oncological Sciences, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA
| | - Anthony Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA, USA
| | | | - Vincent Blot
- Oncology Development, AbbVie, North Chicago, IL, USA
| | | | - Deborah A Dillon
- Department of Pathology, Brigham & Women's Hospital, Boston, MA, USA
| | - Joan S Brugge
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, 240 Longwood Avenue, Boston, MA, 02115, USA.
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12
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Wang L, Doherty GA, Judd AS, Tao ZF, Hansen TM, Frey RR, Song X, Bruncko M, Kunzer AR, Wang X, Wendt MD, Flygare JA, Catron ND, Judge RA, Park CH, Shekhar S, Phillips DC, Nimmer P, Smith ML, Tahir SK, Xiao Y, Xue J, Zhang H, Le PN, Mitten MJ, Boghaert ER, Gao W, Kovar P, Choo EF, Diaz D, Fairbrother WJ, Elmore SW, Sampath D, Leverson JD, Souers AJ. Discovery of A-1331852, a First-in-Class, Potent, and Orally-Bioavailable BCL-X L Inhibitor. ACS Med Chem Lett 2020; 11:1829-1836. [PMID: 33062160 PMCID: PMC7549103 DOI: 10.1021/acsmedchemlett.9b00568] [Citation(s) in RCA: 65] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 03/30/2020] [Indexed: 11/29/2022] Open
Abstract
![]()
Herein
we describe the discovery of A-1331852, a first-in-class
orally active BCL-XL inhibitor that selectively and potently
induces apoptosis in BCL-XL-dependent tumor cells. This
molecule was generated by re-engineering our previously reported BCL-XL inhibitor A-1155463 using structure-based drug design. Key
design elements included rigidification of the A-1155463 pharmacophore
and introduction of sp3-rich moieties capable of generating
highly productive interactions within the key P4 pocket of BCL-XL. A-1331852 has since been used as a critical tool molecule
for further exploring BCL-2 family protein biology, while also representing
an attractive entry into a drug discovery program.
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Affiliation(s)
- Le Wang
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - George A. Doherty
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Andrew S. Judd
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Zhi-Fu Tao
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - T. Matthew Hansen
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Robin R. Frey
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Xiaohong Song
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Milan Bruncko
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Aaron R. Kunzer
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Xilu Wang
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Michael D. Wendt
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - John A. Flygare
- Genentech, Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Nathaniel D. Catron
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Russell A. Judge
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Chang H. Park
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Shashank Shekhar
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Darren C. Phillips
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Paul Nimmer
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Morey L. Smith
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Stephen K. Tahir
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Yu Xiao
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - John Xue
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Haichao Zhang
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Phuong N. Le
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Michael J. Mitten
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Erwin R. Boghaert
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Wenqing Gao
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Peter Kovar
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Edna F. Choo
- Genentech, Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Dolores Diaz
- Genentech, Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Wayne J. Fairbrother
- Genentech, Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Steven W. Elmore
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Deepak Sampath
- Genentech, Inc., 1 DNA Way, South San Francisco, California 94080, United States
| | - Joel D. Leverson
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
| | - Andrew James Souers
- AbbVie Inc., 1 North Waukegan Road, North Chicago, Illinois 60064, United States
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13
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Saleh T, Carpenter VJ, Tyutyunyk‐Massey L, Murray G, Leverson JD, Souers AJ, Alotaibi MR, Faber AC, Reed J, Harada H, Gewirtz DA. Clearance of therapy-induced senescent tumor cells by the senolytic ABT-263 via interference with BCL-X L -BAX interaction. Mol Oncol 2020; 14:2504-2519. [PMID: 32652830 PMCID: PMC7530780 DOI: 10.1002/1878-0261.12761] [Citation(s) in RCA: 76] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/11/2020] [Accepted: 07/07/2020] [Indexed: 01/14/2023] Open
Abstract
Tumor cells undergo senescence in response to both conventional and targeted cancer therapies. The induction of senescence in response to cancer therapy can contribute to unfavorable patient outcomes, potentially including disease relapse. This possibiliy is supported by our findings that tumor cells induced into senescence by doxorubicin or etoposide can give rise to viable tumors in vivo. We further demonstrate sensitivity of these senescent tumor cells to the senolytic ABT-263 (navitoclax), therefore providing a "two-hit" approach to eliminate senescent tumor cells that persist after exposure to chemotherapy or radiation. The sequential combination of therapy-induced senescence and ABT-263 could shift the response to therapy toward apoptosis by interfering with the interaction between BCL-XL and BAX. The administration of ABT-263 after either etoposide or doxorubicin also resulted in marked, prolonged tumor suppression in tumor-bearing animals. These findings support the premise that senolytic therapy following conventional cancer therapy may improve therapeutic outcomes and delay disease recurrence.
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Affiliation(s)
- Tareq Saleh
- Department of Basic Medical SciencesFaculty of MedicineThe Hashemite UniversityZarqaJordan
- Departments of Pharmacology & ToxicologySchool of MedicineMassey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
| | - Valerie J. Carpenter
- Departments of Pharmacology & ToxicologySchool of MedicineMassey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
| | - Liliya Tyutyunyk‐Massey
- Departments of Pharmacology & ToxicologySchool of MedicineMassey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
| | - Graeme Murray
- Department of PhysicsVirginia Commonwealth UniversityRichmondVAUSA
| | | | | | - Moureq R. Alotaibi
- Department of Pharmacology and ToxicologyCollege of PharmacyKing Saud UniversityRiyadhSaudi Arabia
| | - Anthony C. Faber
- Philips Institute for Oral Health ResearchSchool of DentistryMassey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
| | - Jason Reed
- Department of PhysicsVirginia Commonwealth UniversityRichmondVAUSA
| | - Hisashi Harada
- Philips Institute for Oral Health ResearchSchool of DentistryMassey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
| | - David A. Gewirtz
- Departments of Pharmacology & ToxicologySchool of MedicineMassey Cancer CenterVirginia Commonwealth UniversityRichmondVAUSA
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14
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Kohlhapp FJ, Haribhai D, Mathew R, Duggan R, Ellis PA, Wang R, Lasater EA, Shi Y, Dave N, Riehm JJ, Robinson VA, Do AD, Li Y, Orr CJ, Sampath D, Raval A, Merchant M, Bhathena A, Salem AH, Hamel KM, Leverson JD, Donawho C, Pappano WN, Uziel T. Venetoclax Increases Intratumoral Effector T Cells and Antitumor Efficacy in Combination with Immune Checkpoint Blockade. Cancer Discov 2020; 11:68-79. [PMID: 32887697 DOI: 10.1158/2159-8290.cd-19-0759] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2019] [Revised: 07/11/2020] [Accepted: 09/01/2020] [Indexed: 11/16/2022]
Abstract
The antiapoptotic protein BCL2 plays critical roles in regulating lymphocyte development and immune responses, and has also been implicated in tumorigenesis and tumor survival. However, it is unknown whether BCL2 is critical for antitumor immune responses. We evaluated whether venetoclax, a selective small-molecule inhibitor of BCL2, would influence the antitumor activity of immune checkpoint inhibitors (ICI). We demonstrate in mouse syngeneic tumor models that venetoclax can augment the antitumor efficacy of ICIs accompanied by the increase of PD-1+ T effector memory cells. Venetoclax did not impair human T-cell function in response to antigen stimuli in vitro and did not antagonize T-cell activation induced by anti-PD-1. Furthermore, we demonstrate that the antiapoptotic family member BCL-XL provides a survival advantage in effector T cells following inhibition of BCL2. Taken together, these data provide evidence that venetoclax should be further explored in combination with ICIs for cancer therapy. SIGNIFICANCE: The antiapoptotic oncoprotein BCL2 plays critical roles in tumorigenesis, tumor survival, lymphocyte development, and immune system regulation. Here we demonstrate that venetoclax, the first FDA/European Medicines Agency-approved BCL2 inhibitor, unexpectedly can be combined preclinically with immune checkpoint inhibitors to enhance anticancer immunotherapy, warranting clinical evaluation of these combinations.This article is highlighted in the In This Issue feature, p. 1.
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Affiliation(s)
| | - Dipica Haribhai
- Translational Oncology, AbbVie Inc., North Chicago, Illinois
| | - Rebecca Mathew
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Ryan Duggan
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Paul A Ellis
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Rui Wang
- Translational Oncology, AbbVie Inc., North Chicago, Illinois
| | | | - Yan Shi
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Nimita Dave
- Clinical Pharmacology and Pharmacometrics, AbbVie Inc., North Chicago, Illinois
| | - Jacob J Riehm
- Translational Oncology, AbbVie Inc., North Chicago, Illinois
| | | | - An D Do
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California
| | - Yijin Li
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California
| | - Christine J Orr
- Translational Oncology, Genentech, Inc., South San Francisco, California
| | - Deepak Sampath
- Translational Oncology, Genentech, Inc., South San Francisco, California
| | - Aparna Raval
- Oncology Biomarker Development, Genentech, Inc., South San Francisco, California
| | - Mark Merchant
- Translational Oncology, Genentech, Inc., South San Francisco, California
| | | | - Ahmed Hamed Salem
- Clinical Pharmacology and Pharmacometrics, AbbVie Inc., North Chicago, Illinois
- Faculty of Pharmacy, Ain Shams University, Cairo, Egypt
| | - Keith M Hamel
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | | | | | | | - Tamar Uziel
- Translational Oncology, AbbVie Inc., North Chicago, Illinois.
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15
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Phillips DC, Jin S, Gregory GP, Zhang Q, Xue J, Zhao X, Chen J, Tong Y, Zhang H, Smith M, Tahir SK, Clark RF, Penning TD, Devlin JR, Shortt J, Hsi ED, Albert DH, Konopleva M, Johnstone RW, Leverson JD, Souers AJ. A novel CDK9 inhibitor increases the efficacy of venetoclax (ABT-199) in multiple models of hematologic malignancies. Leukemia 2020; 34:1646-1657. [PMID: 31827241 PMCID: PMC7266741 DOI: 10.1038/s41375-019-0652-0] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Revised: 10/18/2019] [Accepted: 11/13/2019] [Indexed: 01/07/2023]
Abstract
MCL-1 is one of the most frequently amplified genes in cancer, facilitating tumor initiation and maintenance and enabling resistance to anti-tumorigenic agents including the BCL-2 selective inhibitor venetoclax. The expression of MCL-1 is maintained via P-TEFb-mediated transcription, where the kinase CDK9 is a critical component. Consequently, we developed a series of potent small-molecule inhibitors of CDK9, exemplified by the orally active A-1592668, with CDK selectivity profiles that are distinct from related molecules that have been extensively studied clinically. Short-term treatment with A-1592668 rapidly downregulates RNA pol-II (Ser 2) phosphorylation resulting in the loss of MCL-1 protein and apoptosis in MCL-1-dependent hematologic tumor cell lines. This cell death could be attenuated by either inhibiting caspases or overexpressing BCL-2 protein. Synergistic cell killing was also observed between A-1592668 or the related analog A-1467729, and venetoclax in a number of hematologic cell lines and primary NHL patient samples. Importantly, the CDK9 inhibitor plus venetoclax combination was well tolerated in vivo and demonstrated efficacy superior to either agent alone in mouse models of lymphoma and AML. These data indicate that CDK9 inhibitors could be highly efficacious in tumors that depend on MCL-1 for survival or when used in combination with venetoclax in malignancies dependent on MCL-1 and BCL-2.
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Affiliation(s)
- Darren C Phillips
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA.
| | - Sha Jin
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Gareth P Gregory
- Peter MacCallum Cancer Centre, Translational Hematology Program, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- Blood Cancer Therapeutics Laboratory, School of Clinical Sciences at Monash Health, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Qi Zhang
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - John Xue
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Xiaoxian Zhao
- Department of Laboratory Medicine, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Jun Chen
- TEST, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Yunsong Tong
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Haichao Zhang
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Morey Smith
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Stephen K Tahir
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Rick F Clark
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Thomas D Penning
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Jennifer R Devlin
- Peter MacCallum Cancer Centre, Translational Hematology Program, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Grattan Street, Parkville, VIC, 3052, Australia
| | - Jake Shortt
- Blood Cancer Therapeutics Laboratory, School of Clinical Sciences at Monash Health, Monash University, 246 Clayton Rd, Clayton, VIC, 3168, Australia
| | - Eric D Hsi
- Department of Laboratory Medicine, Robert J. Tomsich Pathology and Laboratory Medicine Institute, Cleveland Clinic, Cleveland, OH, 44195, USA
| | - Daniel H Albert
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX, 77030, USA
| | - Ricky W Johnstone
- Peter MacCallum Cancer Centre, Translational Hematology Program, 305 Grattan Street, Melbourne, VIC, 3000, Australia
- The Sir Peter MacCallum Department of Oncology, The University of Melbourne, Grattan Street, Parkville, VIC, 3052, Australia
| | - Joel D Leverson
- Oncology-Development, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
| | - Andrew J Souers
- Oncology-Discovery, AbbVie Inc., 1 North Waukegan Road, North Chicago, IL, 60064, USA
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16
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Zoeller JJ, Vagodny A, Daniels VW, Taneja K, Tan BY, DeRose YS, Fujita M, Welm AL, Letai A, Leverson JD, Blot V, Bronson RT, Dillon DA, Brugge JS. Abstract P3-11-06: Pre-clinical assessment of combined ABT-263/Navitoclax and ABT-414 or ABBV-321 treatment for EGFR-expressing TNBC. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p3-11-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Despite a notable incidence of EGFR1 copy number alterations and/or enrichment of EGFR protein in a significant fraction of TNBCs, clinical application of classical EGFR-targeted therapeutics has been discouraging. Tumor specific EGFR-targeted antibodies (ABT-806) and their antibody-drug conjugates (ADC:414;321), which eliminate side effects associated with systemic anti-EGFR treatments, represent promising alternative therapeutic approaches. 414, comprised of 806 conjugated to the powerful cytotoxic MMAF, has demonstrated notable effectiveness within EGFR1-amplified/mutated tumors. However, since TNBCs are often enriched for EGFR expression in the absence of EGFR1 amplification or mutation, we explored whether neutralization of BCL-2/XL via ABT-263/Navitoclax would enhance the effectiveness of 414. Here, we evaluated 414+263 in a panel of seven EGFR-expressing patient-derived xenograft (PDX) models of TNBC. Tumor-bearing mice were randomized into one of two groups, either 414+263 or placebos. Tumor volumes were calculated via caliper-based measurements pre- and post-treatment. 14 days post-treatment, tumor growth inhibition was observed in five out of seven combination-treated tumor models; however, consistent tumor regressions were only observed in one of these models (HCI-010). Compared to the other PDX models, HCI-010 tumors were distinguished by EGFR1 low polysomy and the highest EGFR expression levels. To further explore combined treatment within HCI-010, we evaluated single-agents. To determine EGFR relevance, we also included a non-tumor targeted ADC (095-MMAF) as a single agent or in combination with 263. Tumor growth inhibition & regressions were observed in either 263 or 414+263 treated tumors. These responses were most significant under combined treatment conditions (avg. regression=40%). Tumor growth was unaffected by 414 or 095-MMAF single agents. Tumors treated with 095-MMAF+263 were comparable to single agent 263. Based upon these results, we considered an alternative EGFR-targeted ADC (321). 321, comprised of an affinity-matured version of 806 conjugated to the powerful cytotoxic PBD, exhibits enhanced EGFR affinities and has demonstrated notable effectiveness within EGFR-overexpressing tumors. To evaluate 321 combined treatment within HCI-010, tumor-bearing mice were randomized into six groups: placebos; 263; 321; 263+321; 095-PBD; 263+095-PBD. Tumor growth inhibition & tumor regressions were maintained under 263 and, unlike 414, also observed under 321 treatments. 321 resulted in dramatic tumor regressions (avg. regression=66%). Notably, 263 enhanced the effectiveness of 321 as evidenced by even more dramatic and near complete tumor regressions (avg. regression=88%). We extended these studies to include HCI-025, an additional PDX characterized by EGFR1 low polysomy and EGFR expression levels comparable to HCI-010. To evaluate 321 combined treatment within HCI-025; we performed a similar six-group study. HCI-025 tumors were also sensitive to single agent 321 (avg. regression=36%). Similar to HCI-010 and as evidenced by dramatic tumor regressions, 263 also enhanced the effectiveness of 321 within HCI-025 (avg. regression=68%). 095-PBD and 263+095-PBD also resulted in HCI-010 and HCI-025 tumor growth inhibition & regressions; however supportive of EGFR-mediated effects, 321 responses were greater than 095-PBD and 263+321 responses were greater than 263+095-PBD. These results underscore the significant potential of BCL-2/XL-inhibitors to enhance the effectiveness of cytotoxic agents delivered via ADCs. Notably, this strategy avoids the toxicities associated with systemic chemotherapy and BCL-2/XL-inhibitors. These results also highlight the translational relevance of 321+263, within the context of EGFR-expressing TNBC.
Citation Format: Jason J Zoeller, Aleksandr Vagodny, Veerle W. Daniels, Krishan Taneja, Benjamin Y. Tan, Yoko S. DeRose, Maihi Fujita, Alana L. Welm, Anthony Letai, Joel D. Leverson, Vincent Blot, Roderick T. Bronson, Deborah A. Dillon, Joan S. Brugge. Pre-clinical assessment of combined ABT-263/Navitoclax and ABT-414 or ABBV-321 treatment for EGFR-expressing TNBC [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P3-11-06.
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17
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Jin S, Cojocari D, Purkal JJ, Popovic R, Talaty NN, Xiao Y, Solomon LR, Boghaert ER, Leverson JD, Phillips DC. 5-Azacitidine Induces NOXA to Prime AML Cells for Venetoclax-Mediated Apoptosis. Clin Cancer Res 2020; 26:3371-3383. [PMID: 32054729 DOI: 10.1158/1078-0432.ccr-19-1900] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 12/13/2019] [Accepted: 02/10/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Patients with acute myeloid leukemia (AML) frequently do not respond to conventional therapies. Leukemic cell survival and treatment resistance have been attributed to the overexpression of B-cell lymphoma 2 (BCL-2) and aberrant DNA hypermethylation. In a phase Ib study in elderly patients with AML, combining the BCL-2 selective inhibitor venetoclax with hypomethylating agents 5-azacitidine (5-Aza) or decitabine resulted in 67% overall response rate; however, the underlying mechanism for this activity is unknown. EXPERIMENTAL DESIGN We studied the consequences of combining two therapeutic agents, venetoclax and 5-Aza, in AML preclinical models and primary patient samples. We measured expression changes in the integrated stress response (ISR) and the BCL-2 family by Western blot and qPCR. Subsequently, we engineered PMAIP1 (NOXA)- and BBC3 (PUMA)-deficient AML cell lines using CRISPR-Cas9 methods to understand their respective roles in driving the venetoclax/5-Aza combinatorial activity. RESULTS In this study, we demonstrate that venetoclax and 5-Aza act synergistically to kill AML cells in vitro and display combinatorial antitumor activity in vivo. We uncover a novel nonepigenetic mechanism for 5-Aza-induced apoptosis in AML cells through transcriptional induction of the proapoptotic BH3-only protein NOXA. This induction occurred within hours of treatment and was mediated by the ISR pathway. NOXA was detected in complex with antiapoptotic proteins, suggesting that 5-Aza may be "priming" the AML cells for venetoclax-induced apoptosis. PMAIP1 knockout confirmed its major role in driving venetoclax and 5-Aza synergy. CONCLUSIONS These data provide a novel nonepigenetic mechanism of action for 5-Aza and its combinatorial activity with venetoclax through the ISR-mediated induction of PMAIP1.
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Affiliation(s)
- Sha Jin
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Dan Cojocari
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Julie J Purkal
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Relja Popovic
- Genomics Research Center, AbbVie Inc., North Chicago, Illinois
| | - Nari N Talaty
- Drug Discovery Science and Technologies, AbbVie Inc., North Chicago, Illinois
| | - Yu Xiao
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
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18
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Lee JS, Roberts A, Juarez D, Vo TTT, Bhatt S, Herzog LO, Mallya S, Bellin RJ, Agarwal SK, Salem AH, Xu T, Jia J, Li L, Hanna JR, Davids MS, Fleischman AG, O'Brien S, Lam LT, Leverson JD, Letai A, Schatz JH, Fruman DA. Statins enhance efficacy of venetoclax in blood cancers. Sci Transl Med 2019; 10:10/445/eaaq1240. [PMID: 29899021 DOI: 10.1126/scitranslmed.aaq1240] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 05/11/2018] [Indexed: 12/14/2022]
Abstract
Statins have shown promise as anticancer agents in experimental and epidemiologic research. However, any benefit that they provide is likely context-dependent, for example, applicable only to certain cancers or in combination with specific anticancer drugs. We report that inhibition of 3-hydroxy-3-methylglutaryl coenzyme A reductase (HMGCR) using statins enhances the proapoptotic activity of the B cell lymphoma-2 (BCL2) inhibitor venetoclax (ABT-199) in primary leukemia and lymphoma cells but not in normal human peripheral blood mononuclear cells. By blocking mevalonate production, HMGCR inhibition suppressed protein geranylgeranylation, resulting in up-regulation of proapoptotic protein p53 up-regulated modulator of apoptosis (PUMA). In support of these findings, dynamic BH3 profiling confirmed that statins primed cells for apoptosis. Furthermore, in retrospective analyses of three clinical studies of chronic lymphocytic leukemia, background statin use was associated with enhanced response to venetoclax, as demonstrated by more frequent complete responses. Together, this work provides mechanistic justification and clinical evidence to warrant prospective clinical investigation of this combination in hematologic malignancies.
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Affiliation(s)
- J Scott Lee
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA 92697, USA
| | - Andrew Roberts
- Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA.
| | - Dennis Juarez
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA 92697, USA
| | - Thanh-Trang T Vo
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA 92697, USA
| | - Shruti Bhatt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Lee-Or Herzog
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA 92697, USA
| | - Sharmila Mallya
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA 92697, USA
| | | | | | - Ahmed Hamed Salem
- Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA.,Department of Clinical Pharmacy, Faculty of Pharmacy, Ain Shams University, Cairo 11566, Egypt
| | - Tu Xu
- Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA
| | - Jia Jia
- Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA
| | - Lingxiao Li
- Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - John R Hanna
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Matthew S Davids
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Angela G Fleischman
- Department of Medicine, University of California, Irvine, Irvine, CA 92697, USA
| | - Susan O'Brien
- Department of Medicine, University of California, Irvine, Irvine, CA 92697, USA
| | - Lloyd T Lam
- Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA
| | - Joel D Leverson
- Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA
| | - Anthony Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jonathan H Schatz
- Department of Medicine, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, FL 33136, USA
| | - David A Fruman
- Department of Molecular Biology and Biochemistry, University of California, Irvine, Irvine, CA 92697, USA.
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19
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Haikala HM, Anttila JM, Savelius M, Marques E, Raatikainen T, Ilander M, Hakanen H, Mattson J, Heikkila P, Leidenius M, Joensuu H, Mustjoki S, Kovanen P, Eilers M, Leverson JD, Klefström JT. Abstract LB-189: Pharmacological reactivation of MYC-dependent apoptosis cooperates with anti-PD1 immunotherapy. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-lb-189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Elevated MYC levels sensitize tumor cells to apoptosis but the therapeutic potential of this mechanism remains unclear. We find, in a model of MYC-driven breast cancer, that pharmacological activation of AMPK dramatically synergizes with BCL-2/BCL-XL inhibitors to activate MYC-dependent apoptosis. We demonstrate the translational potential of an AMPK and BCL- 2/BCL-XL co-targeting strategy in ex vivo and in vivo models of MYC-high breast cancer. Metformin combined with either navitoclax or venetoclax efficiently inhibits tumor growth, confers survival benefits and induces tumor infiltration by immune cells. However, withdrawal of the drugs allowed tumor re- growth with presentation of PD1+/CD8+ T cell infiltrates, suggesting immune escape. A two-step treatment regimen, beginning with neoadjuvant metformin+venetoclax to induce apoptosis and followed by tumor resection and adjuvant metformin+venetoclax+anti-PD1 treatment to overcome immune escape, led to durable antitumor responses even after drug withdrawal. We demonstrate that pharmacological reactivation of MYC-dependent apoptosis is a powerful antitumor strategy involving both tumor cell depletion and immunosurveillance.
Citation Format: Heidi M. Haikala, Johanna M. Anttila, Mariel Savelius, Elsa Marques, Tiina Raatikainen, Mette Ilander, Henna Hakanen, Johanna Mattson, Paivi Heikkila, Marjut Leidenius, Heikki Joensuu, Satu Mustjoki, Panu Kovanen, Martin Eilers, Joel D. Leverson, Juha T. Klefström. Pharmacological reactivation of MYC-dependent apoptosis cooperates with anti-PD1 immunotherapy [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr LB-189.
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Zoeller JJ, Vagodny A, Taneja K, Tan BY, O'Brien N, Slamon DJ, Sampath D, Leverson JD, Bronson RT, Dillon DA, Brugge JS. Neutralization of BCL-2/X L Enhances the Cytotoxicity of T-DM1 In Vivo. Mol Cancer Ther 2019; 18:1115-1126. [PMID: 30962322 PMCID: PMC6758547 DOI: 10.1158/1535-7163.mct-18-0743] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/08/2019] [Accepted: 04/02/2019] [Indexed: 12/11/2022]
Abstract
One of the most recent advances in the treatment of HER2+ breast cancer is the development of the antibody-drug conjugate, T-DM1. T-DM1 has proven clinical benefits for patients with advanced and/or metastatic breast cancer who have progressed on prior HER2-targeted therapies. However, T-DM1 resistance ultimately occurs and represents a major obstacle in the effective treatment of this disease. Because anti-apoptotic BCL-2 family proteins can affect the threshold for induction of apoptosis and thus limit the effectiveness of the chemotherapeutic payload, we examined whether inhibition of BCL-2/XL would enhance the efficacy of T-DM1 in five HER2-expressing patient-derived breast cancer xenograft models. Inhibition of BCL-2/XL via navitoclax/ABT-263 significantly enhanced the cytotoxicity of T-DM1 in two of three models derived from advanced and treatment-exposed metastatic breast tumors. No additive effects of combined treatment were observed in the third metastatic tumor model, which was highly sensitive to T-DM1, as well as a primary treatment-exposed tumor, which was refractory to T-DM1. A fifth model, derived from a treatment naïve primary breast tumor, was sensitive to T-DM1 but markedly benefited from combination treatment. Notably, both PDXs that were highly responsive to the combination therapy expressed low HER2 protein levels and lacked ERBB2 amplification, suggesting that BCL-2/XL inhibition can enhance sensitivity of tumors with low HER2 expression. Toxicities associated with combined treatments were significantly ameliorated with intermittent ABT-263 dosing. Taken together, these studies provide evidence that T-DM1 cytotoxicity could be significantly enhanced via BCL-2/XL blockade and support clinical investigation of this combination beyond ERBB2-amplified and/or HER2-overexpressed tumors.
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Affiliation(s)
- Jason J Zoeller
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Aleksandr Vagodny
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Krishan Taneja
- Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts
| | - Benjamin Y Tan
- Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts
| | - Neil O'Brien
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Dennis J Slamon
- Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California
| | - Deepak Sampath
- Translational Oncology, Genentech, San Francisco, California
| | | | | | - Deborah A Dillon
- Department of Pathology, Brigham & Women's Hospital, Boston, Massachusetts
| | - Joan S Brugge
- Department of Cell Biology and Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts.
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21
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Leverson JD. A New Staple: Peptide-Targeted Covalent Inhibitors. Cell Chem Biol 2019; 23:1043-1044. [PMID: 27662249 DOI: 10.1016/j.chembiol.2016.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
In this issue of Cell Chemical Biology, Huhn et al. (2016) unveil a clever strategy for selectively and irreversibly inhibiting an anti-apoptotic protein, BFL-1. The authors describe stapled peptides bearing carefully placed electrophiles that target a unique cysteine residue in BFL-1 via covalent modification, thus representing an extension of the stapled peptide concept into the covalent inhibitor space.
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Affiliation(s)
- Joel D Leverson
- Oncology Development, AbbVie, Inc., 1 Waukegan Road, North Chicago, IL 60064, USA.
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22
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Han L, Zhang Q, Dail M, Shi C, Cavazos A, Ruvolo VR, Zhao Y, Kim E, Rahmani M, Mak DH, Jin SS, Chen J, Phillips DC, Koller PB, Jacamo R, Burks JK, DiNardo C, Daver N, Jabbour E, Wang J, Kantarjian HM, Andreeff M, Grant S, Leverson JD, Sampath D, Konopleva M. Concomitant targeting of BCL2 with venetoclax and MAPK signaling with cobimetinib in acute myeloid leukemia models. Haematologica 2019; 105:697-707. [PMID: 31123034 PMCID: PMC7049339 DOI: 10.3324/haematol.2018.205534] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 05/22/2019] [Indexed: 12/13/2022] Open
Abstract
The pathogenesis of acute myeloid leukemia (AML) involves serial acquisition of mutations controlling several cellular processes, requiring combination therapies affecting key downstream survival nodes in order to treat the disease effectively. The BCL2 selective inhibitor venetoclax has potent anti-leukemia efficacy; however, resistance can occur due to its inability to inhibit MCL1, which is stabilized by the MAPK pathway. In this study, we aimed to determine the anti-leukemia efficacy of concomitant targeting of the BCL2 and MAPK pathways by venetoclax and the MEK1/2 inhibitor cobimetinib, respectively. The combination demonstrated synergy in seven of 11 AML cell lines, including those resistant to single agents, and showed growth-inhibitory activity in over 60% of primary samples from patients with diverse genetic alterations. The combination markedly impaired leukemia progenitor functions, while maintaining normal progenitors. Mass cytometry data revealed that BCL2 protein is enriched in leukemia stem/progenitor cells, primarily in venetoclax-sensitive samples, and that cobimetinib suppressed cytokine-induced pERK and pS6 signaling pathways. Through proteomic profiling studies, we identified several pathways inhibited downstream of MAPK that contribute to the synergy of the combination. In OCI-AML3 cells, the combination downregulated MCL1 protein levels and disrupted both BCL2:BIM and MCL1:BIM complexes, releasing BIM to induce cell death. RNA sequencing identified several enriched pathways, including MYC, mTORC1, and p53 in cells sensitive to the drug combination. In vivo, the venetoclax-cobimetinib combination reduced leukemia burden in xenograft models using genetically engineered OCI-AML3 and MOLM13 cells. Our data thus provide a rationale for combinatorial blockade of MEK and BCL2 pathways in AML.
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Affiliation(s)
- Lina Han
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.,Department of Hematology, First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Qi Zhang
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Monique Dail
- Department of Oncology Biomarkers, Genentech, South San Francisco, CA, USA
| | - Ce Shi
- Department of Hematology, First Affiliated Hospital, Harbin Medical University, Harbin, China
| | - Antonio Cavazos
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Vivian R Ruvolo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Yang Zhao
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Eugene Kim
- Department of Oncology Biomarkers, Genentech, South San Francisco, CA, USA
| | - Mohamed Rahmani
- College of Medicine, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE.,Division of Hematology/Oncology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Duncan H Mak
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | | | - Jun Chen
- AbbVie Inc., North Chicago, IL, USA
| | | | - Paul Bottecelli Koller
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Rodrigo Jacamo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jared K Burks
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Courtney DiNardo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Naval Daver
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Elias Jabbour
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Jing Wang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Hagop M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Michael Andreeff
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Steven Grant
- Division of Hematology/Oncology, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Deepak Sampath
- Department of Translational Oncology, Genentech, South San Francisco, CA, USA
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX, USA
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23
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Iavarone C, Zervantonakis IK, Selfors LM, Palakurthi S, Liu JF, Drapkin R, Matulonis UA, Hallberg D, Velculescu VE, Leverson JD, Sampath D, Mills GB, Brugge JS. Combined MEK and BCL-2/X L Inhibition Is Effective in High-Grade Serous Ovarian Cancer Patient-Derived Xenograft Models and BIM Levels Are Predictive of Responsiveness. Mol Cancer Ther 2019; 18:642-655. [PMID: 30679390 PMCID: PMC6399746 DOI: 10.1158/1535-7163.mct-18-0413] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 08/30/2018] [Accepted: 01/14/2019] [Indexed: 11/16/2022]
Abstract
Most patients with late-stage high-grade serous ovarian cancer (HGSOC) initially respond to chemotherapy but inevitably relapse and develop resistance, highlighting the need for novel therapies to improve patient outcomes. The MEK/ERK pathway is activated in a large subset of HGSOC, making it an attractive therapeutic target. Here, we systematically evaluated the extent of MEK/ERK pathway activation and efficacy of pathway inhibition in a large panel of well-annotated HGSOC patient-derived xenograft models. The vast majority of models were nonresponsive to the MEK inhibitor cobimetinib (GDC-0973) despite effective pathway inhibition. Proteomic analyses of adaptive responses to GDC-0973 revealed that GDC-0973 upregulated the proapoptotic protein BIM, thus priming the cells for apoptosis regulated by BCL2-family proteins. Indeed, combination of both MEK inhibitor and dual BCL-2/XL inhibitor (ABT-263) significantly reduced cell number, increased cell death, and displayed synergy in vitro in most models. In vivo, GDC-0973 and ABT-263 combination was well tolerated and resulted in greater tumor growth inhibition than single agents. Detailed proteomic and correlation analyses identified two subsets of responsive models-those with high BIM at baseline that was increased with MEK inhibition and those with low basal BIM and high pERK levels. Models with low BIM and low pERK were nonresponsive. Our findings demonstrate that combined MEK and BCL-2/XL inhibition has therapeutic activity in HGSOC models and provide a mechanistic rationale for the clinical evaluation of this drug combination as well as the assessment of the extent to which BIM and/or pERK levels predict drug combination effectiveness in chemoresistant HGSOC.
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Affiliation(s)
- Claudia Iavarone
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Ioannis K Zervantonakis
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Laura M Selfors
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts
| | - Sangeetha Palakurthi
- Belfer Institute for Applied Cancer Res, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Joyce F Liu
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Ronny Drapkin
- Penn Ovarian Cancer Res Center, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
| | - Ursula A Matulonis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, Massachusetts
| | - Dorothy Hallberg
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Victor E Velculescu
- The Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Deepak Sampath
- Translational Oncology, Genentech, South San Francisco, California
| | - Gordon B Mills
- Department of Systems Biology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Joan S Brugge
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, Massachusetts.
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Heisey DAR, Lochmann TL, Floros KV, Coon CM, Powell KM, Jacob S, Calbert ML, Ghotra MS, Stein GT, Maves YK, Smith SC, Benes CH, Leverson JD, Souers AJ, Boikos SA, Faber AC. The Ewing Family of Tumors Relies on BCL-2 and BCL-X L to Escape PARP Inhibitor Toxicity. Clin Cancer Res 2018; 25:1664-1675. [PMID: 30348635 DOI: 10.1158/1078-0432.ccr-18-0277] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 07/11/2018] [Accepted: 10/17/2018] [Indexed: 11/16/2022]
Abstract
PURPOSE It was recently demonstrated that the EWSR1-FLI1 t(11;22)(q24;12) translocation contributes to the hypersensitivity of Ewing sarcoma to PARP inhibitors, prompting clinical evaluation of olaparib in a cohort of heavily pretreated Ewing sarcoma tumors. Unfortunately, olaparib activity was disappointing, suggesting an underappreciated resistance mechanism to PARP inhibition in patients with Ewing sarcoma. We sought to elucidate the resistance factors to PARP inhibitor therapy in Ewing sarcoma and identify a rational drug combination capable of rescuing PARP inhibitor activity. EXPERIMENTAL DESIGN We employed a pair of cell lines derived from the same patient with Ewing sarcoma prior to and following chemotherapy, a panel of Ewing sarcoma cell lines, and several patient-derived xenograft (PDX) and cell line xenograft models. RESULTS We found olaparib sensitivity was diminished following chemotherapy. The matched cell line pair revealed increased expression of the antiapoptotic protein BCL-2 in the chemotherapy-resistant cells, conferring apoptotic resistance to olaparib. Resistance to olaparib was maintained in this chemotherapy-resistant model in vivo, whereas the addition of the BCL-2/XL inhibitor navitoclax led to tumor growth inhibition. In 2 PDXs, olaparib and navitoclax were minimally effective as monotherapy, yet induced dramatic tumor growth inhibition when dosed in combination. We found that EWS-FLI1 increases BCL-2 expression; however, inhibition of BCL-2 alone by venetoclax is insufficient to sensitize Ewing sarcoma cells to olaparib, revealing a dual necessity for BCL-2 and BCL-XL in Ewing sarcoma survival. CONCLUSIONS These data reveal BCL-2 and BCL-XL act together to drive olaparib resistance in Ewing sarcoma and reveal a novel, rational combination therapy that may be put forward for clinical trial testing.
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Affiliation(s)
- Daniel A R Heisey
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Timothy L Lochmann
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Konstantinos V Floros
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Colin M Coon
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Krista M Powell
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Sheeba Jacob
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Marissa L Calbert
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Maninderjit S Ghotra
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Giovanna T Stein
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | - Steven C Smith
- Division of Anatomic Pathology, Virginia Commonwealth University, Richmond, Virginia
| | - Cyril H Benes
- Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | | | | | - Sosipatros A Boikos
- Hematology, Oncology and Palliative Care, School of Medicine and Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | - Anthony C Faber
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia.
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Leverson JD, Cojocari D. Hematologic Tumor Cell Resistance to the BCL-2 Inhibitor Venetoclax: A Product of Its Microenvironment? Front Oncol 2018; 8:458. [PMID: 30406027 PMCID: PMC6204401 DOI: 10.3389/fonc.2018.00458] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 10/01/2018] [Indexed: 12/14/2022] Open
Abstract
BCL-2 family proteins regulate the intrinsic pathway of programmed cell death (apoptosis) and play a key role in the development and health of multicellular organisms. The dynamics of these proteins' expression and interactions determine the survival of all cells in an organism, whether the healthy cells of a fully competent immune system or the diseased cells of an individual with cancer. Anti-apoptotic proteins like BCL-2, BCL-XL, and MCL-1 are well-known for maintaining tumor cell survival and are therefore attractive drug targets. The BCL-2-selective inhibitor venetoclax has been approved for use in chronic lymphocytic leukemia and is now being studied in a number of other hematologic malignancies. As clinical data mature, hypotheses have begun to emerge regarding potential mechanisms of venetoclax resistance. Here, we review accumulating evidence that lymphoid microenvironments play a key role in determining hematologic tumor cell sensitivity to venetoclax.
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Affiliation(s)
- Joel D. Leverson
- Oncology Development, AbbVie, Inc., North Chicago, IL, United States
| | - Dan Cojocari
- Oncology Discovery, AbbVie, Inc., North Chicago, IL, United States
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26
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Song KA, Lochmann TL, Patel NU, Ham J, Windle BE, Harada H, Leverson JD, Souers AJ, Hata AN, Ebi H, Faber AC. Abstract B31: A protein synthesis switch underlies initial survival of EGFR-mutant lung cancer to EGFR inhibitors. Clin Cancer Res 2018. [DOI: 10.1158/1557-3265.aacriaslc18-b31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
EGFR inhibitors (EGFRi) are effective at inducing transient tumor shrinkage in EGFR-mutant lung cancers. The efficacy of these drugs however is mitigated by the outgrowth of resistant cells: this is most often manifested by a secondary mutation in EGFR, T790M, which leads to reactivation of key intracellular signaling despite continued drug treatment. We recently demonstrated that T790M can occur both at low frequencies prior to initiation of EGFR inhibitor therapy, or alternatively arise de novo during treatment (Hata et al., Nat Med 2016). Since some cancers form T790M mutations de novo, one potential therapeutic strategy to thwart resistance is to identify the cells surviving initial therapy (referred to as persister cells or drug-tolerant cells [DTCs]) that eventually acquire the T790M mutation, and eliminate them prior to T790M acquisition. To this end, we hypothesized that some cells were refractory to EGFR inhibitor-induced apoptosis, surviving initial therapy and forming a reservoir of cells that could then eventually acquire T790M. We demonstrate that Western blots of lysates from EGFR-mutant lung cancers surviving initial therapy to the EGFR inhibitor gefitinib detect quick (<10 days) and selective upregulation of the anti-apoptotic protein MCL-1. We performed experiments with fluorescent-tagged exogenous MCL-1-expressing cells and demonstrate enrichment of MCL-1-expressing cells following gefitinib treatment by high-content imaging; these cells persisted as early survivors. Accordingly, exogenous expression of MCL-1 prevented gefitinib from shrinking EGFR-mutant lung cancer tumors, and the emergence of DTCs could be largely thwarted by co-incubation with MCL-1 specific inhibitors A-1210477 and S63845. Mechanistically, we report DTCs undergo a “translational switch” that manifests in increased cap-dependent mRNA translation of MCL-1, which corresponds to cellular upregulation of mTOR/eIF4 and downregulation of ribosomal proteins. These data reveal a novel mechanism in which lung cancer cells adapt to short-term pressures of apoptosis-inducing kinase inhibitors by shifting protein biosynthesis through cap-dependent translation of MCL-1 protein. Moreover, in EGFR-mutant lung cancer, MCL-1 is a key molecule governing the emergence of early DTCs to EGFR inhibitors and can be effectively co-targeted with clinically-emerging MCL-1 inhibitors, which may delay the acquisition of secondary mutations including T790M mutations, therefore prolonging therapy efficacy.
Citation Format: Kyung-A Song, Timothy L. Lochmann, Neha U. Patel, Jungoh Ham, Brad E. Windle, Hisashi Harada, Joel D. Leverson, Andrew J. Souers, Aaron N. Hata, Hiromichi Ebi, Anthony C. Faber. A protein synthesis switch underlies initial survival of EGFR-mutant lung cancer to EGFR inhibitors [abstract]. In: Proceedings of the Fifth AACR-IASLC International Joint Conference: Lung Cancer Translational Science from the Bench to the Clinic; Jan 8-11, 2018; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2018;24(17_Suppl):Abstract nr B31.
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Affiliation(s)
- Kyung-A Song
- 1Virginia Commonwealth University, Richmond, VA,
| | | | | | - Jungoh Ham
- 1Virginia Commonwealth University, Richmond, VA,
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27
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Song KA, Hosono Y, Turner C, Jacob S, Lochmann TL, Murakami Y, Patel NU, Ham J, Hu B, Powell KM, Coon CM, Windle BE, Oya Y, Koblinski JE, Harada H, Leverson JD, Souers AJ, Hata AN, Boikos S, Yatabe Y, Ebi H, Faber AC. Increased Synthesis of MCL-1 Protein Underlies Initial Survival of EGFR-Mutant Lung Cancer to EGFR Inhibitors and Provides a Novel Drug Target. Clin Cancer Res 2018; 24:5658-5672. [PMID: 30087143 DOI: 10.1158/1078-0432.ccr-18-0304] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 06/29/2018] [Accepted: 08/01/2018] [Indexed: 11/16/2022]
Abstract
Purpose: EGFR inhibitors (EGFRi) are effective against EGFR-mutant lung cancers. The efficacy of these drugs, however, is mitigated by the outgrowth of resistant cells, most often driven by a secondary acquired mutation in EGFR, T790M We recently demonstrated that T790M can arise de novo during treatment; it follows that one potential therapeutic strategy to thwart resistance would be identifying and eliminating these cells [referred to as drug-tolerant cells (DTC)] prior to acquiring secondary mutations like T790M Experimental Design: We have developed DTCs to EGFRi in EGFR-mutant lung cancer cell lines. Subsequent analyses of DTCs included RNA-seq, high-content microscopy, and protein translational assays. Based on these results, we tested the ability of MCL-1 BH3 mimetics to combine with EGFR inhibitors to eliminate DTCs and shrink EGFR-mutant lung cancer tumors in vivo Results: We demonstrate surviving EGFR-mutant lung cancer cells upregulate the antiapoptotic protein MCL-1 in response to short-term EGFRi treatment. Mechanistically, DTCs undergo a protein biosynthesis enrichment resulting in increased mTORC1-mediated mRNA translation of MCL-1, revealing a novel mechanism in which lung cancer cells adapt to short-term pressures of apoptosis-inducing kinase inhibitors. Moreover, MCL-1 is a key molecule governing the emergence of early EGFR-mutant DTCs to EGFRi, and we demonstrate it can be effectively cotargeted with clinically emerging MCL-1 inhibitors both in vitro and in vivo Conclusions: Altogether, these data reveal that this novel therapeutic combination may delay the acquisition of secondary mutations, therefore prolonging therapy efficacy. Clin Cancer Res; 24(22); 5658-72. ©2018 AACR.
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Affiliation(s)
- Kyung-A Song
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Yasuyuki Hosono
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Crystal Turner
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Sheeba Jacob
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Timothy L Lochmann
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Yoshiko Murakami
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan
| | - Neha U Patel
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Jungoh Ham
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Bin Hu
- Department of Pathology, VCU School of Medicine, Richmond, Virginia
| | - Krista M Powell
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Colin M Coon
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Brad E Windle
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | - Yuko Oya
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya, Japan
| | | | - Hisashi Harada
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia
| | | | | | - Aaron N Hata
- Massachusetts General Hospital Cancer Center and Department of Medicine, Harvard Medical School, Boston, Massachusetts
| | - Sosipatros Boikos
- Division of Hematology, Oncology and Palliative Care, Virginia Commonwealth University, Massey Cancer Center, Richmond, Virginia
| | - Yasushi Yatabe
- Department of Pathology and Molecular Diagnostics, Aichi Cancer Center, Nagoya, Japan.,Precision Medicine Center, Aichi Cancer Center, Nagoya, Japan
| | - Hiromichi Ebi
- Division of Molecular Therapeutics, Aichi Cancer Center Research Institute, Nagoya, Japan. .,Precision Medicine Center, Aichi Cancer Center, Nagoya, Japan
| | - Anthony C Faber
- Philips Institute for Oral Health Research, VCU School of Dentistry and Massey Cancer Center, Richmond, Virginia.
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28
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Rahmani M, Nkwocha J, Hawkins E, Pei X, Parker RE, Kmieciak M, Leverson JD, Sampath D, Ferreira-Gonzalez A, Grant S. Cotargeting BCL-2 and PI3K Induces BAX-Dependent Mitochondrial Apoptosis in AML Cells. Cancer Res 2018; 78:3075-3086. [PMID: 29559471 DOI: 10.1158/0008-5472.can-17-3024] [Citation(s) in RCA: 86] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/17/2018] [Accepted: 03/16/2018] [Indexed: 02/07/2023]
Abstract
Inhibitors targeting BCL-2 apoptotic proteins have significant potential for the treatment of acute myeloid leukemia (AML); however, complete responses are observed in only 20% of patients, suggesting that targeting BCL-2 alone is insufficient to yield durable responses. Here, we assessed the efficacy of coadministration of the PI3K/mTOR inhibitor GDC-0980 or the p110β-sparing PI3K inhibitor taselisib with the selective BCL-2 antagonist venetoclax in AML cells. Tetracycline-inducible downregulation of BCL-2 significantly sensitized MV4-11 and MOLM-13 AML cells to PI3K inhibition. Venetoclax/GDC-0980 coadministration induced rapid and pronounced BAX mitochondrial translocation, cytochrome c release, and apoptosis in various AML cell lines in association with AKT/mTOR inactivation and MCL-1 downregulation; ectopic expression of MCL-1 significantly protected cells from this regimen. Combined treatment was also effective against primary AML blasts from 17 patients, including those bearing various genetic abnormalities. Venetoclax/GDC-0980 markedly induced apoptosis in primitive CD34+/38-/123+ AML cell populations but not in normal hematopoietic progenitor CD34+ cells. The regimen was also active against AML cells displaying intrinsic or acquired venetoclax resistance or tumor microenvironment-associated resistance. Either combinatorial treatment markedly reduced AML growth and prolonged survival in a systemic AML xenograft mouse model and diminished AML growth in two patient-derived xenograft models. Venetoclax/GDC-0980 activity was partially diminished in BAK-/- cells and failed to induce apoptosis in BAX-/- and BAX-/-BAK-/- cells, whereas BIM-/- cells were fully sensitive. Similar results were observed with venetoclax alone in in vitro and in vivo systemic xenograft models. Collectively, these studies demonstrate that venetoclax/GDC-0980 exhibits potent anti-AML activity primarily through BAX and, to a lesser extent, BAK. These findings argue that dual BCL-2 and PI3K inhibition warrants further evaluation in AML.Significance: Combined treatment with clinically relevant PI3K and BCL-2 inhibitors may prove effective in the treatment of acute myeloid leukemia. Cancer Res; 78(11); 3075-86. ©2018 AACR.
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Affiliation(s)
- Mohamed Rahmani
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia. .,College of Medicine, Sharjah Institute for Medical Research, University of Sharjah, Sharjah, UAE
| | - Jewel Nkwocha
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia
| | - Elisa Hawkins
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia
| | - Xinyan Pei
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia
| | - Rebecca E Parker
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia
| | - Maciej Kmieciak
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia
| | | | | | - Andrea Ferreira-Gonzalez
- Department of Pathology, Virginia Commonwealth University and the Massey Cancer Center, Richmond, Virginia
| | - Steven Grant
- Department of Internal Medicine, Virginia Commonwealth University and the Massey Cancer Center, Virginia. .,Department of Biochemistry, Virginia Commonwealth University and the Massey Cancer Center, Richmond, Virginia.,Department of Pharmacology, Virginia Commonwealth University and the Massey Cancer Center, Richmond, Virginia.,Department of Human and Molecular Genetics, Virginia Commonwealth University, the Virginia Institute for Molecular Medicine and the Massey Cancer Center, Richmond, Virginia
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29
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Carter BZ, Mak PY, Mu H, Zhou H, Mak DH, Schober W, Leverson JD, Zhang B, Bhatia R, Huang X, Cortes J, Kantarjian H, Konopleva M, Andreeff M. Combined targeting of BCL-2 and BCR-ABL tyrosine kinase eradicates chronic myeloid leukemia stem cells. Sci Transl Med 2017; 8:355ra117. [PMID: 27605552 DOI: 10.1126/scitranslmed.aag1180] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/01/2016] [Indexed: 12/11/2022]
Abstract
BCR-ABL tyrosine kinase inhibitors (TKIs) are effective against chronic myeloid leukemia (CML), but they rarely eliminate CML stem cells. Disease relapse is common upon therapy cessation, even in patients with complete molecular responses. Furthermore, once CML progresses to blast crisis (BC), treatment outcomes are dismal. We hypothesized that concomitant targeting of BCL-2 and BCR-ABL tyrosine kinase could overcome these limitations. We demonstrate increased BCL-2 expression at the protein level in bone marrow cells, particularly in Lin(-)Sca-1(+)cKit(+) cells of inducible CML in mice, as determined by CyTOF mass cytometry. Further, selective inhibition of BCL-2, aided by TKI-mediated MCL-1 and BCL-XL inhibition, markedly decreased leukemic Lin(-)Sca-1(+)cKit(+) cell numbers and long-term stem cell frequency and prolonged survival in a murine CML model. Additionally, this combination effectively eradicated CD34(+)CD38(-), CD34(+)CD38(+), and quiescent stem/progenitor CD34(+) cells from BC CML patient samples. Our results suggest that BCL-2 is a key survival factor for CML stem/progenitor cells and that combined inhibition of BCL-2 and BCR-ABL tyrosine kinase has the potential to significantly improve depth of response and cure rates of chronic-phase and BC CML.
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Affiliation(s)
- Bing Z Carter
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
| | - Po Yee Mak
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hong Mu
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hongsheng Zhou
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Duncan H Mak
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Wendy Schober
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joel D Leverson
- Department of Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA
| | - Bin Zhang
- Division of Hematopoietic Stem Cell and Leukemia Research, Beckman Research Institute, City of Hope Cancer Center, Duarte, CA 91010, USA
| | - Ravi Bhatia
- Division of Hematology and Oncology, University of Alabama at Birmingham, Birmingham, AL 35294, USA
| | - Xuelin Huang
- Department of Biostatistics, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Jorge Cortes
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hagop Kantarjian
- Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Marina Konopleva
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael Andreeff
- Section of Molecular Hematology and Therapy, Department of Leukemia, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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30
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Pan R, Ruvolo V, Mu H, Leverson JD, Nichols G, Reed JC, Konopleva M, Andreeff M. Synthetic Lethality of Combined Bcl-2 Inhibition and p53 Activation in AML: Mechanisms and Superior Antileukemic Efficacy. Cancer Cell 2017; 32:748-760.e6. [PMID: 29232553 PMCID: PMC5730338 DOI: 10.1016/j.ccell.2017.11.003] [Citation(s) in RCA: 177] [Impact Index Per Article: 25.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Revised: 09/16/2017] [Accepted: 11/06/2017] [Indexed: 12/16/2022]
Abstract
Evasion of apoptosis is a hallmark of cancer. Bcl-2 and p53 represent two important nodes in apoptosis signaling pathways. We find that concomitant p53 activation and Bcl-2 inhibition overcome apoptosis resistance and markedly prolong survival in three mouse models of resistant acute myeloid leukemia (AML). Mechanistically, p53 activation negatively regulates the Ras/Raf/MEK/ERK pathway and activates GSK3 to modulate Mcl-1 phosphorylation and promote its degradation, thus overcoming AML resistance to Bcl-2 inhibition. Moreover, Bcl-2 inhibition reciprocally overcomes apoptosis resistance to p53 activation by switching cellular response from G1 arrest to apoptosis. The efficacy, together with the mechanistic findings, reveals the potential of simultaneously targeting these two apoptosis regulators and provides a rational basis for clinical testing of this therapeutic approach.
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Affiliation(s)
- Rongqing Pan
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Vivian Ruvolo
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hong Mu
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | | | - Gwen Nichols
- Roche Pharmaceutical Research & Early Development, Roche Innovation Center New York, New York, NY 10016, USA
| | - John C Reed
- Roche Pharma Research & Early Development, Roche Innovation Center Basel, 4070 Basel, Switzerland
| | - Marina Konopleva
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael Andreeff
- Section of Molecular Hematology and Therapy, Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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31
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Leverson JD, Sampath D, Souers AJ, Rosenberg SH, Fairbrother WJ, Amiot M, Konopleva M, Letai A. Found in Translation: How Preclinical Research Is Guiding the Clinical Development of the BCL2-Selective Inhibitor Venetoclax. Cancer Discov 2017; 7:1376-1393. [PMID: 29146569 DOI: 10.1158/2159-8290.cd-17-0797] [Citation(s) in RCA: 84] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Revised: 10/12/2017] [Accepted: 10/19/2017] [Indexed: 12/12/2022]
Abstract
Since the discovery of apoptosis as a form of programmed cell death, targeting the apoptosis pathway to induce cancer cell death has been a high-priority goal for cancer therapy. After decades of effort, drug-discovery scientists have succeeded in generating small-molecule inhibitors of antiapoptotic BCL2 family proteins. Innovative medicinal chemistry and structure-based drug design, coupled with a strong fundamental understanding of BCL2 biology, were essential to the development of BH3 mimetics such as the BCL2-selective inhibitor venetoclax. We review a number of preclinical studies that have deepened our understanding of BCL2 biology and facilitated the clinical development of venetoclax.Significance: Basic research into the pathways governing programmed cell death have paved the way for the discovery of apoptosis-inducing agents such as venetoclax, a BCL2-selective inhibitor that was recently approved by the FDA and the European Medicines Agency. Preclinical studies aimed at identifying BCL2-dependent tumor types have translated well into the clinic thus far and will likely continue to inform the clinical development of venetoclax and other BCL2 family inhibitors. Cancer Discov; 7(12); 1376-93. ©2017 AACR.
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Affiliation(s)
| | | | | | | | | | - Martine Amiot
- CRCINA, INSERM, CNRS, Université de Nantes, Université d'Angers, Nantes, France
| | - Marina Konopleva
- The University of Texas MD Anderson Cancer Center, Houston, Texas
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32
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Lochmann TL, Floros KV, Naseri M, Powell KM, Cook W, March RJ, Stein GT, Greninger P, Maves YK, Saunders LR, Dylla SJ, Costa C, Boikos SA, Leverson JD, Souers AJ, Krystal GW, Harada H, Benes CH, Faber AC. Venetoclax Is Effective in Small-Cell Lung Cancers with High BCL-2 Expression. Clin Cancer Res 2017; 24:360-369. [PMID: 29118061 DOI: 10.1158/1078-0432.ccr-17-1606] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/05/2017] [Accepted: 10/25/2017] [Indexed: 11/16/2022]
Abstract
Purpose: Small-cell lung cancer (SCLC) is an often-fatal neuroendocrine carcinoma usually presenting as extensive disease, carrying a 3% 5-year survival. Despite notable advances in SCLC genomics, new therapies remain elusive, largely due to a lack of druggable targets.Experimental Design: We used a high-throughput drug screen to identify a venetoclax-sensitive SCLC subpopulation and validated the findings with multiple patient-derived xenografts of SCLC.Results: Our drug screen consisting of a very large collection of cell lines demonstrated that venetoclax, an FDA-approved BCL-2 inhibitor, was found to be active in a substantial fraction of SCLC cell lines. Venetoclax induced BIM-dependent apoptosis in vitro and blocked tumor growth and induced tumor regressions in mice bearing high BCL-2-expressing SCLC tumors in vivo BCL-2 expression was a predictive biomarker for sensitivity in SCLC cell lines and was highly expressed in a subset of SCLC cell lines and tumors, suggesting that a substantial fraction of patients with SCLC could benefit from venetoclax. Mechanistically, we uncover a novel role for gene methylation that helped discriminate high BCL-2-expressing SCLCs.Conclusions: Altogether, our findings identify venetoclax as a promising new therapy for high BCL-2-expressing SCLCs. Clin Cancer Res; 24(2); 360-9. ©2017 AACR.
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Affiliation(s)
- Timothy L Lochmann
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Konstantinos V Floros
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Mitra Naseri
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Krista M Powell
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Wade Cook
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia
| | - Ryan J March
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Giovanna T Stein
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Patricia Greninger
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | | | | | - Scott J Dylla
- AbbVie Stemcentrx LLC, South San Francisco, California
| | - Carlotta Costa
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts
| | - Sosipatros A Boikos
- Division of Hematology, Oncology, & Palliative Care, Massey Cancer Center, Virginia Commonwealth University, Richmond, Virginia
| | | | | | - Geoffrey W Krystal
- Department of Internal Medicine, Virginia Commonwealth University, McGuire Veterans Affairs Medical Center, Richmond, Virginia
| | - Hisashi Harada
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia.
| | - Cyril H Benes
- Center for Cancer Research, Massachusetts General Hospital, Harvard Medical School, Charlestown, Massachusetts.
| | - Anthony C Faber
- VCU Philips Institute, School of Dentistry and Massey Cancer Center; Richmond, Virginia.
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33
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Zervantonakis IK, Iavarone C, Chen HY, Selfors LM, Palakurthi S, Liu JF, Drapkin R, Matulonis U, Leverson JD, Sampath D, Mills GB, Brugge JS. Systems analysis of apoptotic priming in ovarian cancer identifies vulnerabilities and predictors of drug response. Nat Commun 2017. [PMID: 28848242 DOI: 10.1038/s41467-017-00263-7]+[] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2022] Open
Abstract
The lack of effective chemotherapies for high-grade serous ovarian cancers (HGS-OvCa) has motivated a search for alternative treatment strategies. Here, we present an unbiased systems-approach to interrogate a panel of 14 well-annotated HGS-OvCa patient-derived xenografts for sensitivity to PI3K and PI3K/mTOR inhibitors and uncover cell death vulnerabilities. Proteomic analysis reveals that PI3K/mTOR inhibition in HGS-OvCa patient-derived xenografts induces both pro-apoptotic and anti-apoptotic signaling responses that limit cell killing, but also primes cells for inhibitors of anti-apoptotic proteins. In-depth quantitative analysis of BCL-2 family proteins and other apoptotic regulators, together with computational modeling and selective anti-apoptotic protein inhibitors, uncovers new mechanistic details about apoptotic regulators that are predictive of drug sensitivity (BIM, caspase-3, BCL-XL) and resistance (MCL-1, XIAP). Our systems-approach presents a strategy for systematic analysis of the mechanisms that limit effective tumor cell killing and the identification of apoptotic vulnerabilities to overcome drug resistance in ovarian and other cancers.High-grade serous ovarian cancers (HGS-OvCa) frequently develop chemotherapy resistance. Here, the authors through a systematic analysis of proteomic and drug response data of 14 HGS-OvCa PDXs demonstrate that targeting apoptosis regulators can improve response of these tumors to inhibitors of the PI3K/mTOR pathway.
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Affiliation(s)
- Ioannis K Zervantonakis
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Claudia Iavarone
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Hsing-Yu Chen
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Laura M Selfors
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Sangeetha Palakurthi
- Belfer Center for Applied Cancer Research, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Joyce F Liu
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Ronny Drapkin
- Penn Ovarian Cancer Research Center, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA
| | - Ursula Matulonis
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Joel D Leverson
- Oncology Development, AbbVie, Inc, North Chicago, IL, 60064, USA
| | - Deepak Sampath
- Translational Oncology, Genentech, South San Francisco, CA, 94080, USA
| | - Gordon B Mills
- Department of Systems Biology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Joan S Brugge
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA.
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Zervantonakis IK, Iavarone C, Chen HY, Selfors LM, Palakurthi S, Liu JF, Drapkin R, Matulonis U, Leverson JD, Sampath D, Mills GB, Brugge JS. Systems analysis of apoptotic priming in ovarian cancer identifies vulnerabilities and predictors of drug response. Nat Commun 2017. [PMID: 28848242 DOI: 10.1038/s41467-017-00263-7] [] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
The lack of effective chemotherapies for high-grade serous ovarian cancers (HGS-OvCa) has motivated a search for alternative treatment strategies. Here, we present an unbiased systems-approach to interrogate a panel of 14 well-annotated HGS-OvCa patient-derived xenografts for sensitivity to PI3K and PI3K/mTOR inhibitors and uncover cell death vulnerabilities. Proteomic analysis reveals that PI3K/mTOR inhibition in HGS-OvCa patient-derived xenografts induces both pro-apoptotic and anti-apoptotic signaling responses that limit cell killing, but also primes cells for inhibitors of anti-apoptotic proteins. In-depth quantitative analysis of BCL-2 family proteins and other apoptotic regulators, together with computational modeling and selective anti-apoptotic protein inhibitors, uncovers new mechanistic details about apoptotic regulators that are predictive of drug sensitivity (BIM, caspase-3, BCL-XL) and resistance (MCL-1, XIAP). Our systems-approach presents a strategy for systematic analysis of the mechanisms that limit effective tumor cell killing and the identification of apoptotic vulnerabilities to overcome drug resistance in ovarian and other cancers.High-grade serous ovarian cancers (HGS-OvCa) frequently develop chemotherapy resistance. Here, the authors through a systematic analysis of proteomic and drug response data of 14 HGS-OvCa PDXs demonstrate that targeting apoptosis regulators can improve response of these tumors to inhibitors of the PI3K/mTOR pathway.
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Affiliation(s)
- Ioannis K Zervantonakis
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Claudia Iavarone
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Hsing-Yu Chen
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Laura M Selfors
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA
| | - Sangeetha Palakurthi
- Belfer Center for Applied Cancer Research, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Joyce F Liu
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Ronny Drapkin
- Penn Ovarian Cancer Research Center, Department of Obstetrics and Gynecology, University of Pennsylvania School of Medicine, Philadelphia, PA, 19104, USA
| | - Ursula Matulonis
- Department of Medical Oncology, Dana Farber Cancer Institute, Boston, MA, 02115, USA
| | - Joel D Leverson
- Oncology Development, AbbVie, Inc, North Chicago, IL, 60064, USA
| | - Deepak Sampath
- Translational Oncology, Genentech, South San Francisco, CA, 94080, USA
| | - Gordon B Mills
- Department of Systems Biology, MD Anderson Cancer Center, Houston, TX, 77030, USA
| | - Joan S Brugge
- Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA, 02115, USA.
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Iavarone C, Zervantonakis I, Selfors LM, Palakurthi S, Liu JF, Matulonis UA, Drapkin RI, Mills GB, Leverson JD, Sampath D, Brugge JS. Abstract 4033: Combined MEK and BCL-2/XL inhibition as a potential drug combination for the treatment of high-grade serous ovarian cancer. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-4033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
High-grade serous ovarian cancer (HGSOC) accounts for 70-80% of ovarian cancer deaths. Despite an initial response to platinum-based chemotherapy, treatment resistance eventually occurs in most patients. The overall aim of our studies is to identify synergistic drug combinations for the treatment of HGSOC and biomarkers that predict sensitivity for future translation in clinical trials. In particular, this study focuses on the vulnerabilities of patient-derived ovarian cancer cells to combined inhibition of the MEK pathway and the anti-apoptotic proteins BCL-2 and BCL-XL.
The Ras/MAPK pathway is activated in a subset of HGSOC by gene copy alterations. However, MEK inhibitors have not been evaluated in HGSOC. In this study, we used a collection of 14 primary samples derived from ascites cells of platinum-resistant HGSOC patients (Liu JF et al. 2016). We investigated the sensitivity of these tumor cells to the MEK inhibitor cobimetinib (GDC-0973). Treatment with GDC-0973 had no effects on cell viability in vitro in any of the patient-derived models. To investigate the response to MEK inhibition, we performed Reverse Phase Protein Array of the tumor cells treated with 0.3μM of GDC-0973 in vitro. We found that MEK inhibition by GDC-0973 reduced cell cycle progression markers and upregulated the pro-apoptotic protein BIM. Since more than half of the models express high levels of anti-apoptotic BCL-2 family proteins which neutralize BIM, we examined the effects of antagonism of BCL-2 pro-survival proteins in combination with GDC-0973. Treatment with a combination of GDC-0973 and the BCL-2/XL antagonist, navitoclax (ABT-263) significantly reduced cell number and increased cell death in 10 out of 14 patient-derived models. Protein levels of BIM following treatment with GDC-0973 correlated with sensitivity to the drug combination (R2=0.8 p<0.0001). Interestingly, the BIM levels after MEK inhibition correlate with BIM protein levels before the treatment, suggesting that baseline BIM levels could be used as biomarker of sensitivity. Levels of the pro-survival protein MCL-1 also played a critical role in patient-derived cells that were resistant to the drug combination. Indeed, treatment with a specific MCL-1 inhibitor, A-1210477, in combination with GDC-0973 and ABT-263 led to dramatic tumor cell killing in vitro compared to dual combination of GDC-0973 and ABT-263.
Finally, we tested the combination of GDC-0973 and ABT-263 in vivo and preliminary results indicate that the drug combination is well tolerated and is able to significantly reduce tumor growth in patient-derived xenograft models (n=4).
Our studies provide significant evidence that combined inhibition of MEK and BCL-2/XL may be an effective drug combination for treatment of HGSOC and that the pro-apoptotic protein BIM may serve as a predictive biomarker to stratify patients that can benefit from these targeted therapies
Citation Format: Claudia Iavarone, Ioannis Zervantonakis, Laura M. Selfors, Sangeetha Palakurthi, Joyce F. Liu, Ursula A. Matulonis, Ronny I. Drapkin, Gordon B. Mills, Joel D. Leverson, Deepak Sampath, Joan S. Brugge. Combined MEK and BCL-2/XL inhibition as a potential drug combination for the treatment of high-grade serous ovarian cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 4033. doi:10.1158/1538-7445.AM2017-4033
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Affiliation(s)
| | | | | | - Sangeetha Palakurthi
- 2Belfer Institute for Applied Cancer Science, Dana-Farber Cancer Institute, Boston, MA
| | - Joyce F. Liu
- 3Dana Farber Cancer Institute, Department of Medical Oncology, Boston, MA
| | | | - Ronny I. Drapkin
- 4Obstetrics and Gynecology Department, University of Pennsylvania, Philadelphia, PA
| | - Gordon B. Mills
- 5Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX
| | | | - Deepak Sampath
- 7Department of Translational Oncology, Genentech, South San Francisco, CA
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Floros KV, Song KA, Lochmann TL, Hughes MT, Heisey DA, Harada H, Hu B, Koblinski J, Souers AJ, Leverson JD, Faber AC. Abstract 3082: Deficient NOXA in HER2-amplified breast cancer drives kinase inhibitor resistance. Cancer Res 2017. [DOI: 10.1158/1538-7445.am2017-3082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The purpose of this study is the development of a novel combination therapy that targets HER2-amplified breast cancer. About one quarter of breast cancers harbor amplification of HER2. HER2 is a transmembrane receptor tyrosine kinase (RTK) belonging to the ERBB family of receptors (ERBB1-4). Upon hetero- and homo-dimerization, HER2 activates several key intracellular pathways, regulating many cellular functions including proliferation and survival. HER2 inhibitors (HER2i) (e.g. the receptor tyrosine kinase (RTK) inhibitor, lapatinib) are now part of standard care for treating HER2-amplified breast cancers. However, despite their anti-cancer benefit, these drugs have limited efficacy as monotherapies, which contrasts to other RTK inhibitors in other RTK-driven cancers. To better understand this apparent dichotomy, in the present study, we evaluated potential modifiers of HER2i therapy. Here, we found that the pro-apoptotic NOXA, a member of the B-cell CLL/lymphoma 2 (BCL2) family which acts mainly via inhibitory binding of the pro-survival MCL-1, was markedly down-regulated in breast cancers compared to other cancers, and this was largely attributed to the HER2-amplified subset. Experimentally, overexpressing NOXA or silencing MCL-1 dramatically sensitizes HER2 amplified breast cancer cell lines to lapatinib via apoptosis. Consistently, pharmaceutical inhibition of MCL-1 sensitizes HER2-amplified breast cancers to lapatinib in vitro and in vivo. Mechanistically, disruption of MCL-1:BIM complexes and MCL-1:BAK underlie dual HER2i/MCL-1i therapy. Therefore, deficient NOXA expression constitutes a bonafide apoptotic block in HER2 amplified breast cancers, contributes to mitigated HER2i responses, and presents a rational combination therapy that may improve HER2i responses.
Citation Format: Konstantinos V. Floros, Kyung-A Song, Timothy L. Lochmann, Mark T. Hughes, Daniel A. Heisey, Hisashi Harada, Bin Hu, Jennifer Koblinski, Andrew J. Souers, Joel D. Leverson, Anthony C. Faber. Deficient NOXA in HER2-amplified breast cancer drives kinase inhibitor resistance [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 3082. doi:10.1158/1538-7445.AM2017-3082
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Tahir SK, Smith ML, Hessler P, Rapp LR, Idler KB, Park CH, Leverson JD, Lam LT. Potential mechanisms of resistance to venetoclax and strategies to circumvent it. BMC Cancer 2017; 17:399. [PMID: 28578655 PMCID: PMC5457565 DOI: 10.1186/s12885-017-3383-5] [Citation(s) in RCA: 120] [Impact Index Per Article: 17.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 05/24/2017] [Indexed: 11/20/2022] Open
Abstract
Background Venetoclax (ABT-199), a first-in-class orally bioavailable BCL-2-selective inhibitor, was recently approved by the FDA for use in patients with 17p-deleted chronic lymphocytic leukemia who have received prior therapy. It is also being evaluated in numerous clinical trials for treating patients with various hematologic malignancies. As with any targeted cancer therapy, it is critically important to identify potential mechanisms of resistance, both for patient stratification and developing strategies to overcome resistance, either before it develops or as it emerges. Methods In order to gain a more comprehensive insight into the nature of venetoclax resistance mechanisms, we evaluated the changes in the BCL-2 family members at the genetic and expression levels in seven different venetoclax-resistant derived leukemia and lymphoma cell lines. Results Gene and protein expression analyses identified a number of different alterations in the expression of pro- and anti-apoptotic BCL-2 family members. In the resistant derived cells, an increase in either or both the anti-apoptotic proteins BCL-XL or MCL-1, which are not targeted by venetoclax was observed, and either concomitant or exclusive with a decrease in one or more pro-apoptotic proteins. In addition, mutational analysis also revealed a mutation in the BH3 binding groove (F104L) that could potentially interfere with venetoclax-binding. Not all changes may be causally related to venetoclax resistance and may only be an epiphenomenon. For resistant cell lines showing elevations in BCL-XL or MCL-1, strong synergistic cell killing was observed when venetoclax was combined with either BCL-XL- or MCL-1-selective inhibitors, respectively. This highlights the importance of BCL-XL- and MCL-1 as causally contributing to venetoclax resistance. Conclusions Overall our study identified numerous changes in multiple resistant lines; the changes were neither mutually exclusive nor universal across the cell lines tested, thus exemplifying the complexity and heterogeneity of potential resistance mechanisms. Identifying and evaluating their contribution has important implications for both patient selection and the rational development of strategies to overcome resistance. Electronic supplementary material The online version of this article (doi:10.1186/s12885-017-3383-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Stephen K Tahir
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Morey L Smith
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Paul Hessler
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Lisa Roberts Rapp
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Kenneth B Idler
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Chang H Park
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Joel D Leverson
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA
| | - Lloyd T Lam
- AbbVie Oncology, North Waukegan Road North, Chicago, IL, 60064-6098, USA.
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Ashkenazi A, Fairbrother WJ, Leverson JD, Souers AJ. From basic apoptosis discoveries to advanced selective BCL-2 family inhibitors. Nat Rev Drug Discov 2017; 16:273-284. [DOI: 10.1038/nrd.2016.253] [Citation(s) in RCA: 508] [Impact Index Per Article: 72.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Punnoose EA, Leverson JD, Peale F, Boghaert ER, Belmont LD, Tan N, Young A, Mitten M, Ingalla E, Darbonne WC, Oleksijew A, Tapang P, Yue P, Oeh J, Lee L, Maiga S, Fairbrother WJ, Amiot M, Souers AJ, Sampath D. Expression Profile of BCL-2, BCL-XL, and MCL-1 Predicts Pharmacological Response to the BCL-2 Selective Antagonist Venetoclax in Multiple Myeloma Models. Mol Cancer Ther 2016; 15:1132-44. [DOI: 10.1158/1535-7163.mct-15-0730] [Citation(s) in RCA: 180] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 02/15/2016] [Indexed: 11/16/2022]
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Abstract
Abstract
Many cancer cells maintain survival through over-expression of anti-apoptotic BCL-2 family proteins, which sequester high levels of their pro-apoptotic counterparts. While this makes BCL-2 proteins compelling targets for the development of cancer therapeutics, synthesizing small molecules capable of disrupting these protein-protein interactions has been a major challenge for the field. Structure-based drug design led to the discovery of navitoclax (ABT-263), a dual inhibitor of BCL-2 and BCL-XL. Navitoclax has shown promising activity in the clinic but its efficacy has been limited by thrombocytopenia caused by BCL-XL inhibition. To avoid this toxicity, we designed a BCL-2-selective inhibitor, venetoclax (ABT-199/GDC-0199), that maintains efficacy in hematologic malignancies while sparing platelets. In this presentation, I will review the preclinical work that led to the discovery of venetoclax, the translational studies that have pointed to utility for venetoclax in a variety of cancers, and the results from ongoing clinical studies, in which venetoclax has demonstrated clear signs of activity. I will discuss what we have learned from multiple iterations of translational work between the bench and the bedside, and how we are using a toolkit of highly selective BCL-2 family inhibitors to parse the roles of BCL-2 family proteins in cancer cell survival.
JDL is an AbbVie employee. The design, study conduct and financial support was provided by AbbVie and Genentech. AbbVie and Genentech participated in the data generation, interpretation of data, review and approval of this publication (A5107572).
Citation Format: Joel D. Leverson. Clinical proof of concept for the first-in-class BCL-2-selective inhibitor venetoclax (ABT-199/GDC-0199). [abstract]. In: Proceedings of the Fourth AACR International Conference on Frontiers in Basic Cancer Research; 2015 Oct 23-26; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2016;76(3 Suppl):Abstract nr IA34.
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Iavarone C, Zervantonakis I, Chen HY, Palakurthi SS, Liu JF, Matulonis UA, Drapkin RI, Mills GB, Leverson JD, Sampath D, Brugge JS. Abstract B48: Design of effective combination therapies for high-grade serous ovarian cancer using patient-derived xenograft models. Clin Cancer Res 2016. [DOI: 10.1158/1557-3265.ovca15-b48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Despite advances in understanding the genetics and molecular biology of high grade serous ovarian cancer, there have not been any significant improvements in the outcome of patients treated with approved therapies to date. The overall aim of our studies is to identify synergistic drug combinations for the treatment of high-grade serous ovarian (HGS-Ov) cancer and the biomarkers that predict sensitivity for future translation in clinical trials. In particular, this study focuses on the vulnerabilities of patient-derived ovarian cancer cells to inhibition of anti-apoptotic proteins and the design of novel combination therapies to overcome drug resistance and improve the response of selected patients to a particular set of targeted therapies.
Previous studies from our lab provided evidence that inhibition of BCL-2/XL can significantly enhance the sensitivity of tumor cells to targeted therapies in ovarian and breast cancer cell line models (Muranen T, et al. Cancer Cell 2012). In this study, we evaluated the efficacy of this combination treatment in ascites cells derived from 15 high-grade serous patient-derived ovarian cancer xenografts (PDXs). We found that inhibitors of PI3K/mTOR (GNE-493) and BCL-2/XL (ABT-737) act synergistically ex vivo, with an ~15 fold variability among the 15 patient-derived samples. A large scale in vivo experiment is ongoing to evaluate the efficacy of this combined treatment in six PDX models.
To identify biomarkers that predict drug sensitivity we performed proteomic Reverse Phase Protein Array (RPPA) and immunoblot analyses. We found that baseline levels of the pro-apoptotic protein BIM correlate with sensitivity to BCL-2/XL inhibition. This motivated us to examine the basis for low BIM expression. In three of the least sensitive PDX models, we found that low levels of BIM correlated with ERK activation based on increased ERK phosphorylation and that inhibition of MEK by PD-0325901 in these models caused upregulation of BIM, as predicted from previous published reports which demonstrated that phosphorylation of BIM by ERK causes its degradation (Ley R, et al. Biol Chem 2003). We then examined the sensitivity of these PDX models to ABT-737 and PD-0325901, MEK162, or CI-1040 ex vivo and observed strong synergy resulting in reduction of cell viability and increased cell death. These results suggest that low BIM/high phosphoERK is a potential biomarker for sensitivity of ovarian tumors to combined MEK and BCL-2/XL inhibition. We now plan to examine the efficacy of drug combinations that target MEK and BCL-2/XL in these PDX models in vivo.
Our studies promise to lead to the identification of new drug combination therapies for HGS-Ov cancer treatment and predictive biomarkers to stratify patients that can benefit from these targeted therapies.
Citation Format: Claudia Iavarone, Ioannis Zervantonakis, Hsing-Yu Chen, Sangeetha S. Palakurthi, Joyce Fu Liu, Ursula A. Matulonis, Ronny I. Drapkin, Gordon B. Mills, Joel D. Leverson, Deepak Sampath, Joan S. Brugge. Design of effective combination therapies for high-grade serous ovarian cancer using patient-derived xenograft models. [abstract]. In: Proceedings of the AACR Special Conference on Advances in Ovarian Cancer Research: Exploiting Vulnerabilities; Oct 17-20, 2015; Orlando, FL. Philadelphia (PA): AACR; Clin Cancer Res 2016;22(2 Suppl):Abstract nr B48.
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Affiliation(s)
- Claudia Iavarone
- 1Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA,
| | - Ioannis Zervantonakis
- 1Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA,
| | - Hsing-Yu Chen
- 1Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA,
| | | | - Joyce Fu Liu
- 3Dana Farber Cancer Institute, Department of Medical Oncology, Boston, MA,
| | | | - Ronny I. Drapkin
- 4Obstetrics and Gynecology Department, University of Pennsylvania, Philadelphia, PA,
| | - Gordon B. Mills
- 5The University of Texas MD Anderson Cancer Center, Houston, TX,
| | | | - Deepak Sampath
- 7Translational Oncology, Genentech, South San Francisco, CA
| | - Joan S. Brugge
- 1Department of Cell Biology, Ludwig Center at Harvard, Harvard Medical School, Boston, MA,
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Benito JM, Godfrey L, Kojima K, Hogdal L, Wunderlich M, Geng H, Marzo I, Harutyunyan KG, Golfman L, North P, Kerry J, Ballabio E, Chonghaile TN, Gonzalo O, Qiu Y, Jeremias I, Debose L, O'Brien E, Ma H, Zhou P, Jacamo R, Park E, Coombes KR, Zhang N, Thomas DA, O'Brien S, Kantarjian HM, Leverson JD, Kornblau SM, Andreeff M, Müschen M, Zweidler-McKay PA, Mulloy JC, Letai A, Milne TA, Konopleva M. MLL-Rearranged Acute Lymphoblastic Leukemias Activate BCL-2 through H3K79 Methylation and Are Sensitive to the BCL-2-Specific Antagonist ABT-199. Cell Rep 2015; 13:2715-27. [PMID: 26711339 PMCID: PMC4700051 DOI: 10.1016/j.celrep.2015.12.003] [Citation(s) in RCA: 104] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 10/21/2015] [Accepted: 11/19/2015] [Indexed: 12/25/2022] Open
Abstract
Targeted therapies designed to exploit specific molecular pathways in aggressive cancers are an exciting area of current research. Mixed Lineage Leukemia (MLL) mutations such as the t(4;11) translocation cause aggressive leukemias that are refractory to conventional treatment. The t(4;11) translocation produces an MLL/AF4 fusion protein that activates key target genes through both epigenetic and transcriptional elongation mechanisms. In this study, we show that t(4;11) patient cells express high levels of BCL-2 and are highly sensitive to treatment with the BCL-2-specific BH3 mimetic ABT-199. We demonstrate that MLL/AF4 specifically upregulates the BCL-2 gene but not other BCL-2 family members via DOT1L-mediated H3K79me2/3. We use this information to show that a t(4;11) cell line is sensitive to a combination of ABT-199 and DOT1L inhibitors. In addition, ABT-199 synergizes with standard induction-type therapy in a xenotransplant model, advocating for the introduction of ABT-199 into therapeutic regimens for MLL-rearranged leukemias.
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Affiliation(s)
- Juliana M Benito
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Laura Godfrey
- Weatherall Institute of Molecular Medicine, Molecular Haematology Unit, NIHR Oxford Biomedical Research Centre Programme, University of Oxford, Headington, Oxford OX3 9DS, UK
| | - Kensuke Kojima
- Division of Hematology, Respiratory Medicine and Oncology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga 840-8502, Japan
| | - Leah Hogdal
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Mark Wunderlich
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Huimin Geng
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Isabel Marzo
- Department of Biochemistry, Molecular and Cell Biology, University of Zaragoza, 50018 Zaragoza, Spain
| | - Karine G Harutyunyan
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Leonard Golfman
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Phillip North
- Weatherall Institute of Molecular Medicine, Molecular Haematology Unit, NIHR Oxford Biomedical Research Centre Programme, University of Oxford, Headington, Oxford OX3 9DS, UK
| | - Jon Kerry
- Weatherall Institute of Molecular Medicine, Molecular Haematology Unit, NIHR Oxford Biomedical Research Centre Programme, University of Oxford, Headington, Oxford OX3 9DS, UK
| | - Erica Ballabio
- Weatherall Institute of Molecular Medicine, Molecular Haematology Unit, NIHR Oxford Biomedical Research Centre Programme, University of Oxford, Headington, Oxford OX3 9DS, UK
| | - Triona Ní Chonghaile
- Department of Physiology and Medical Physics, Royal College of Surgeons in Ireland, York House, Dublin 2, Ireland
| | - Oscar Gonzalo
- Department of Biochemistry, Molecular and Cell Biology, University of Zaragoza, 50018 Zaragoza, Spain
| | - Yihua Qiu
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Irmela Jeremias
- German Research Center for Environmental Health (GmbH), 85764 Neuherberg, Germany
| | - LaKiesha Debose
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Eric O'Brien
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Helen Ma
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Ping Zhou
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Rodrigo Jacamo
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Eugene Park
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Kevin R Coombes
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Nianxiang Zhang
- Department of Bioinformatics and Computational Biology, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Deborah A Thomas
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Susan O'Brien
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Hagop M Kantarjian
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Joel D Leverson
- Department of Oncology Development, AbbVie Inc., North Chicago, IL 60064, USA
| | - Steven M Kornblau
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Michael Andreeff
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Markus Müschen
- Department of Laboratory Medicine, University of California, San Francisco, San Francisco, CA 94143, USA
| | - Patrick A Zweidler-McKay
- Division of Pediatrics, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - James C Mulloy
- Cancer and Blood Diseases Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Anthony Letai
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Thomas A Milne
- Weatherall Institute of Molecular Medicine, Molecular Haematology Unit, NIHR Oxford Biomedical Research Centre Programme, University of Oxford, Headington, Oxford OX3 9DS, UK.
| | - Marina Konopleva
- Department of Leukemia, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
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43
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Leverson JD, Phillips DC, Mitten MJ, Boghaert ER, Diaz D, Tahir SK, Belmont LD, Nimmer P, Xiao Y, Ma XM, Lowes KN, Kovar P, Chen J, Jin S, Smith M, Xue J, Zhang H, Oleksijew A, Magoc TJ, Vaidya KS, Albert DH, Tarrant JM, La N, Wang L, Tao ZF, Wendt MD, Sampath D, Rosenberg SH, Tse C, Huang DCS, Fairbrother WJ, Elmore SW, Souers AJ. Exploiting selective BCL-2 family inhibitors to dissect cell survival dependencies and define improved strategies for cancer therapy. Sci Transl Med 2015; 7:279ra40. [PMID: 25787766 DOI: 10.1126/scitranslmed.aaa4642] [Citation(s) in RCA: 392] [Impact Index Per Article: 43.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The BCL-2/BCL-XL/BCL-W inhibitor ABT-263 (navitoclax) has shown promising clinical activity in lymphoid malignancies such as chronic lymphocytic leukemia. However, its efficacy in these settings is limited by thrombocytopenia caused by BCL-XL inhibition. This prompted the generation of the BCL-2-selective inhibitor venetoclax (ABT-199/GDC-0199), which demonstrates robust activity in these cancers but spares platelets. Navitoclax has also been shown to enhance the efficacy of docetaxel in preclinical models of solid tumors, but clinical use of this combination has been limited by neutropenia. We used venetoclax and the BCL-XL-selective inhibitors A-1155463 and A-1331852 to assess the relative contributions of inhibiting BCL-2 or BCL-XL to the efficacy and toxicity of the navitoclax-docetaxel combination. Selective BCL-2 inhibition suppressed granulopoiesis in vitro and in vivo, potentially accounting for the exacerbated neutropenia observed when navitoclax was combined with docetaxel clinically. By contrast, selectively inhibiting BCL-XL did not suppress granulopoiesis but was highly efficacious in combination with docetaxel when tested against a range of solid tumors. Therefore, BCL-XL-selective inhibitors have the potential to enhance the efficacy of docetaxel in solid tumors and avoid the exacerbation of neutropenia observed with navitoclax. These studies demonstrate the translational utility of this toolkit of selective BCL-2 family inhibitors and highlight their potential as improved cancer therapeutics.
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Affiliation(s)
| | | | | | | | - Dolores Diaz
- Genentech Inc., South San Francisco, CA 94080, USA
| | | | | | | | - Yu Xiao
- AbbVie Inc., North Chicago, IL 60064, USA
| | | | - Kym N Lowes
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia. Department of Medical Biology, University of Melbourne, Parkville, Victoria 3010, Australia
| | | | - Jun Chen
- AbbVie Inc., North Chicago, IL 60064, USA
| | - Sha Jin
- AbbVie Inc., North Chicago, IL 60064, USA
| | | | - John Xue
- AbbVie Inc., North Chicago, IL 60064, USA
| | | | | | | | | | | | | | - Nghi La
- Genentech Inc., South San Francisco, CA 94080, USA
| | - Le Wang
- AbbVie Inc., North Chicago, IL 60064, USA
| | - Zhi-Fu Tao
- AbbVie Inc., North Chicago, IL 60064, USA
| | | | | | | | - Chris Tse
- AbbVie Inc., North Chicago, IL 60064, USA
| | - David C S Huang
- Walter and Eliza Hall Institute of Medical Research, Parkville, Victoria 3052, Australia. Department of Medical Biology, University of Melbourne, Parkville, Victoria 3010, Australia
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Phillips DC, Xiao Y, Lam LT, Litvinovich E, Roberts-Rapp L, Souers AJ, Leverson JD. Loss in MCL-1 function sensitizes non-Hodgkin's lymphoma cell lines to the BCL-2-selective inhibitor venetoclax (ABT-199). Blood Cancer J 2015; 5:e368. [PMID: 26565405 PMCID: PMC4670945 DOI: 10.1038/bcj.2015.88] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Revised: 08/05/2015] [Accepted: 08/20/2015] [Indexed: 02/06/2023] Open
Abstract
As a population, non-Hodgkin's lymphoma (NHL) cell lines positive for the t(14;18) translocation and/or possessing elevated BCL2 copy number (CN; BCL2(High)) are exquisitely sensitive to navitoclax or the B-cell lymphoma protein-2 (BCL-2)-selective inhibitor venetoclax. Despite this, some BCL2(High) cell lines remain resistant to either agent. Here we show that the MCL-1-specific inhibitor A-1210477 sensitizes these cell lines to navitoclax. Chemical segregation of this synergy with the BCL-2-selective inhibitor venetoclax or BCL-XL-selective inhibitor A-1155463 indicated that MCL-1 and BCL-2 are the two key anti-apoptotic targets for sensitization. Similarly, the CDK inhibitor flavopiridol downregulated MCL-1 expression and synergized with venetoclax in BCL2(High) NHL cell lines to a similar extent as A-1210477. A-1210477 also synergized with navitoclax in the majority of BCL2(Low) NHL cell lines. However, chemical segregation with venetoclax or A-1155463 revealed that synergy was driven by BCL-XL inhibition in this population. Collectively these data emphasize that BCL2 status is predictive of venetoclax potency in NHL not only as a single agent, but also in the adjuvant setting with anti-tumorigenic agents that inhibit MCL-1 function. These studies also potentially identify a patient population (BCL2(Low)) that could benefit from BCL-XL (navitoclax)-driven combination therapy.
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Affiliation(s)
- D C Phillips
- Oncology Discovery, AbbVie Inc., North Chicago, IL, USA
| | - Y Xiao
- Oncology Discovery, AbbVie Inc., North Chicago, IL, USA
| | - L T Lam
- Oncology Discovery, AbbVie Inc., North Chicago, IL, USA
| | | | | | - A J Souers
- Oncology Development, AbbVie Inc., North Chicago, IL, USA
| | - J D Leverson
- Oncology Development, AbbVie Inc., North Chicago, IL, USA
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45
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Carter BZ, Mak PY, Mu H, Zhou H, Mak DH, Schober W, Leverson JD, Zhang B, Bhatia R, Cortes J, Kantarjian H, Konopleva M, Andreeff M. Combined Targeting of Bcl-2 and Bcr-Abl Tyrosine Kinase Eradicates Chronic Myeloid Leukemia Stem/Progenitor Cells. Clinical Lymphoma Myeloma and Leukemia 2015. [DOI: 10.1016/j.clml.2015.07.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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46
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Ackler S, Oleksijew A, Chen J, Chyla BJ, Clarin J, Foster K, McGonigal T, Mishra S, Schlessinger S, Smith ML, Tahir SK, Leverson JD, Souers AJ, Boghaert ER, Hickson J. Clearance of systemic hematologic tumors by venetoclax (Abt-199) and navitoclax. Pharmacol Res Perspect 2015; 3:e00178. [PMID: 26516589 PMCID: PMC4618648 DOI: 10.1002/prp2.178] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 07/23/2015] [Accepted: 08/03/2015] [Indexed: 11/11/2022] Open
Abstract
The Bcl-2 family inhibitors venetoclax and navitoclax demonstrated potent antitumor activity in chronic lymphocytic leukemia patients, notably in reducing marrow load and adenopathy. Subsequent trials with venetoclax have been initiated in non-Hodgkin's lymphoma and multiple myeloma patients. Traditional preclinical models fall short either in faithfully recapitulating disease progression within such compartments or in allowing the direct longitudinal analysis of systemic disease. We show that intravenous inoculation of engineered RS4;11 (acute lymphoblastic leukemia) and Granta 519 (mantle cell lymphoma) bioluminescent reporter cell lines result in tumor engraftment of bone marrow, with additional invasion of the central nervous system in the case of Granta 519. Importantly, apoptosis induction and response of these systemically engrafted tumors to Bcl-2 family inhibitors alone or in combination with standard-of-care agents could be monitored longitudinally with optical imaging, and was more accurately reflective of the observed clinical response.
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Affiliation(s)
| | | | - Jun Chen
- AbbVie Inc. North Chicago, Illinois
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47
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Jin S, Tapang P, Osterling DJ, Gao W, Albert DH, Souers AJ, Leverson JD, Phillips DC, Chen J. Abstract 6: Quantitative assessment of BCL-2:BIM complexes as a pharmacodynamic marker for venetoclax (ABT-199). Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
The BCL-2-selective inhibitor venetoclax (ABT-199) binds with high affinity to the BH3-binding groove of BCL-2, thereby competing for binding with the BH3-only protein BIM (Souers et al., 2013). Venetoclax is currently being evaluated in clinical trials for CLL, AML, multiple myeloma and NHL. To facilitate these studies, we developed and validated a 384-well electrochemiluminescent ELISA (MSD, Gaithersburg, MD,USA) that quantifies expression of BCL-2, BCL-XL, and MCL-1protein alone or in complex with BIM. We subsequently quantified expression of BCL-2 and BCL-2:BIM complexes in 16 hematologic tumor cell lines. We found the EC50 of venetoclax in these tumor cell lines to correlate strongly with baseline BCL-2:BIM complex levels. This correlation was superior to the correlation between venetoclax EC50 and absolute BCL-2 expression. We also applied the assay to measure disruption of BCL-2:BIM complexes in vivo. Treatment of the Non-Hodgkin's Lymphoma (NHL) xenograft model SU-DHL-4 with a BCL-2-selective inhibitor resulted in disruption of tumor BCL-2:BIM complexes that aligned with serum and tumor concentrations of inhibitor. Collectively, these data demonstrate that quantifying BCL-2:BIM complexes offers an accurate means of assessing target engagement by venetoclax and, potentially, predicting its efficacy. The utility of this assay is currently being assessed in clinical trials.
Citation Format: Sha Jin, Paul Tapang, Donald J. Osterling, Wenqing Gao, Daniel H. Albert, Andrew J. Souers, Joel D. Leverson, Darren C. Phillips, Jun Chen. Quantitative assessment of BCL-2:BIM complexes as a pharmacodynamic marker for venetoclax (ABT-199). [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 6. doi:10.1158/1538-7445.AM2015-6
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Affiliation(s)
- Sha Jin
- Abbvie Inc., North Chicago, IL
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48
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Xiao Y, Nimmer P, Sheppard GS, Bruncko M, Hessler P, Lu X, Roberts-Rapp L, Pappano WN, Elmore SW, Souers AJ, Leverson JD, Phillips DC. MCL-1 Is a Key Determinant of Breast Cancer Cell Survival: Validation of MCL-1 Dependency Utilizing a Highly Selective Small Molecule Inhibitor. Mol Cancer Ther 2015; 14:1837-47. [PMID: 26013319 DOI: 10.1158/1535-7163.mct-14-0928] [Citation(s) in RCA: 90] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 05/13/2015] [Indexed: 11/16/2022]
Abstract
Hyperexpression of antiapoptotic BCL-2 family proteins allows cells to survive despite the receipt of signals that would ordinarily induce their deletion, a facet frequently exploited by tumors. Tumors addicted to the BCL-2 family proteins for survival are now being targeted therapeutically. For example, navitoclax, a BCL-2/BCL-XL/BCL-W inhibitor, is currently in phase I/II clinical trials in numerous malignancies. However, the related family member, MCL-1, limits the efficacy of navitoclax and other chemotherapeutic agents. In the present study, we identify breast cancer cell lines that depend upon MCL-1 for survival and subsequently determine the mechanism of apoptosis mediated by the MCL-1 selective inhibitor A-1210477. We demonstrate that apoptosis resulting from a loss in MCL-1 function requires expression of the proapoptotic protein BAK. However, expression of BCL-XL can limit apoptosis resulting from loss in MCL-1 function through sequestration of free BIM. Finally, we demonstrate substantial synergy between navitoclax and MCL-1 siRNA, the direct MCL-1 inhibitor A-1210477, or the indirect MCL-1 inhibitor flavopiridol, highlighting the therapeutic potential for inhibiting BCL-XL and MCL-1 in breast cancer.
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Affiliation(s)
- Yu Xiao
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Paul Nimmer
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | | | - Milan Bruncko
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Paul Hessler
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
| | - Xin Lu
- Oncology Discovery, AbbVie Inc., North Chicago, Illinois
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49
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Leverson JD. Chemical parsing: Dissecting cell dependencies with a toolkit of selective BCL-2 family inhibitors. Mol Cell Oncol 2015; 3:e1050155. [PMID: 27308564 PMCID: PMC4845185 DOI: 10.1080/23723556.2015.1050155] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 05/07/2015] [Accepted: 05/07/2015] [Indexed: 10/31/2022]
Abstract
The BCL-2/BCL-XL inhibitor navitoclax has shown promise for the treatment of cancer but on-target toxicities have limited its utility. Recently, the generation of selective BCL-2 family inhibitors has enabled a careful dissection of BCL-2 biology, and early work indicates that these molecules have improved therapeutic profiles for the treatment of cancer.
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50
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Bruncko M, Wang L, Sheppard GS, Phillips DC, Tahir SK, Xue J, Erickson S, Fidanze S, Fry E, Hasvold L, Jenkins GJ, Jin S, Judge RA, Kovar PJ, Madar D, Nimmer P, Park C, Petros AM, Rosenberg SH, Smith ML, Song X, Sun C, Tao ZF, Wang X, Xiao Y, Zhang H, Tse C, Leverson JD, Elmore SW, Souers AJ. Correction to Structure-Guided Design of a Series of MCL-1 Inhibitors with High Affinity and Selectivity. J Med Chem 2015; 58:4089. [PMID: 25933255 DOI: 10.1021/acs.jmedchem.5b00616] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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