C/EBPα Confers Dependence to Fatty Acid Anabolic Pathways and Vulnerability to Lipid Oxidative Stress-Induced Ferroptosis in FLT3-Mutant Leukemia

Although transcription factor CCAAT-enhancer binding protein α (C/EBPα) is critical for normal and leukemic differentiation, its role in cell and metabolic homeostasis is largely unknown in cancer. Here, multiomics analyses uncovered a coordinated activation of C/EBPα and Fms-like tyrosine kinase 3 (FLT3) that increased lipid anabolism in vivo and in patients with FLT3-mutant acute myeloid leukemia (AML). Mechanistically, C/EBPα regulated the fatty acid synthase (FASN)-stearoyl-CoA desaturase (SCD) axis to promote fatty acid (FA) biosynthesis and desaturation. We further demonstrated that FLT3 or C/EBPα inactivation decreased monounsaturated FA incorporation to membrane phospholipids through SCD downregulation. Consequently, SCD inhibition enhanced susceptibility to lipid redox stress that was exploited by combining FLT3 and glutathione peroxidase 4 inhibition to trigger lipid oxidative stress, enhancing ferroptotic death of FLT3-mutant AML cells. Altogether, our study reveals a C/EBPα function in lipid homeostasis and adaptation to redox stress, and a previously unreported vulnerability of FLT3-mutant AML to ferroptosis with promising therapeutic application.

SIGNIFICANCE

FLT3 mutations are found in 30% of AML cases and are actionable by tyrosine kinase inhibitors. Here, we discovered that C/EBPα regulates FA biosynthesis and protection from lipid redox stress downstream mutant-FLT3 signaling, which confers a vulnerability to ferroptosis upon FLT3 inhibition with therapeutic potential in AML. This article is highlighted in the In This Issue feature, p. 1501.

Abstract 4980: Design and functional characterization of a first-in-class irreversible inhibitor of HOIL-1-interacting protein (HOIP) with selective antitumor activity against B-cell non-Hodgkin lymphoma

Activating single-nucleotide polymorphisms of HOIL-1-interacting protein (HOIP), the catalytic subunit of the linear ubiquitin chain assembly complex (LUBAC), have recently been shown to promote myeloid differentiation primary response 88 (MYD88)-mediated B-cell lymphomagenesis. To assess the relevance of targeting HOIP in the activated B-cell-like (ABC) subtype of diffuse large B-cell lymphoma (DLBCL) with MYD88 mutation, we used systems biology to build a mathematical model aimed at evaluating the impact of HOIP depletion on DLBCL. From this model, an AI-mediated query demonstrated that HOIP blockade was associated with the suppression of three main pathophysiological motifs in malignant B cells, i.e., cell growth and proliferation, apoptosis evasion and deregulated metabolism. We then undertook a computational study that consisted of a combinatorial substitution of several α-β unsaturated moieties to be used as covalent binding warheads to the catalytic cysteine residue of HOIP. The resulting chemical library was used on subsequent molecular docking to assess the best HOIP binding candidates. Out of the four candidates synthesized from this library, we isolated compound A (Cpd A), a covalent irreversible inhibitor of HOIP with a pyrido[2,3-d]pyrimidine core, which exerted selective antitumor activity in a panel of ABCL-DLBCL cell lines (mean IC50 at 48hours: 90.7± 13.09 µM) while sparing normal B cells. Immunoprecipitation studies demonstrated that Cpd A was able to modulate the interaction between HOIP and the LUBAC component, SHARPIN, leading to the blockade of NF-κB signaling and to the downregulation of several downstream effectors, including CCL3, IL6 and IRF4. Specificity of Cpd A towards HOIP was confirmed by a drug affinity responsive target stability (DARTS) assay based on the immuno-detection of persistent HOIP peptides after Cpd A-mediated blockade of enzymatic proteolysis, and thereafter in a CRISPR-engineered HOIP-knockout ABC-DLBCL model. Finally, efficacy of the compound was confirmed in vivo in a chicken embryo chorioallantoic membrane (CAM)-derived model of ABCL-DLBCL subjected to a twice weekly dosing with Cpd A, in which the compound achieved a 25% tumor growth inhibition, associated with a 60.5% and 89% reduction in brain and bone marrow infiltration by lymphoma cells, respectively. Altogether, our results confirm that HOIP represents a promising therapeutic target for ABC-DLBCL with activating MYD88 mutation, and that a pyrido[2,3-d]pyrimidine derivative can successfully and specifically block HOIP, resulting in NF-κB disruption and selective antitumor activity in this aggressive subtype of B-cell lymphoma.

Citation Format: Ana Maria Montagut, Marc Antoni Armengol Cubillos, Gema Gorjón-de-Pablo, Judith Farrés, Laia Huguet Garcia, Núria Profitós-Pelejà, Juliana Carvalho Santos, Marcelo Lima Ribeiro, Miranda Fernández-Serrano, Roger Estrada Tejedor, José I. Borrell, Gaël Roué. Design and functional characterization of a first-in-class irreversible inhibitor of HOIL-1-interacting protein (HOIP) with selective antitumor activity against B-cell non-Hodgkin lymphoma. [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 4980.

G protein-coupled receptor 183 mediates the sensitization of Burkitt lymphoma tumors to CD47 immune checkpoint blockade by anti-CD20/PI3Kδi dual therapy

Background

Immunotherapy-based regimens have considerably improved the survival rate of B-cell non-Hodgkin lymphoma (B-NHL) patients in the last decades; however, most disease subtypes remain almost incurable. TG-1801, a bispecific antibody that targets CD47 selectively on CD19+ B-cells, is under clinical evaluation in relapsed/refractory (R/R) B-NHL patients either as a single-agent or in combination with ublituximab, a new generation CD20 antibody.

Methods

A set of eight B-NHL cell lines and primary samples were cultured in vitro in the presence of bone marrow-derived stromal cells, M2-polarized primary macrophages, and primary circulating PBMCs as a source of effector cells. Cell response to TG-1801 alone or combined with the U2 regimen associating ublituximab to the PI3Kδ inhibitor umbralisib, was analyzed by proliferation assay, western blot, transcriptomic analysis (qPCR array and RNA sequencing followed by gene set enrichment analysis) and/or quantification of antibody-dependent cell death (ADCC) and antibody-dependent cell phagocytosis (ADCP). CRISPR-Cas9 gene edition was used to selectively abrogate GPR183 gene expression in B-NHL cells. In vivo, drug efficacy was determined in immunodeficient (NSG mice) or immune-competent (chicken embryo chorioallantoic membrane (CAM)) B-NHL xenograft models.

Results

Using a panel of B-NHL co-cultures, we show that TG-1801, by disrupting the CD47-SIRPα axis, potentiates anti-CD20-mediated ADCC and ADCP. This led to a remarkable and durable antitumor effect of the triplet therapy composed by TG-1801 and U2 regimen, in vitro, as well as in mice and CAM xenograft models of B-NHL. Transcriptomic analysis also uncovered the upregulation of the G protein-coupled and inflammatory receptor, GPR183, as a crucial event associated with the efficacy of the triplet combination. Genetic depletion and pharmacological inhibition of GPR183 impaired ADCP initiation, cytoskeleton remodeling and cell migration in 2D and 3D spheroid B-NHL co-cultures, and disrupted macrophage-mediated control of tumor growth in B-NHL CAM xenografts.

Conclusions

Altogether, our results support a crucial role for GPR183 in the recognition and elimination of malignant B cells upon concomitant targeting of CD20, CD47 and PI3Kδ, and warrant further clinical evaluation of this triplet regimen in B-NHL.

Prognostic impact of micromegakaryocytes in primary myelodysplastic syndromes

Micromegakaryocytes (microMKs) are considered a myelodysplastic feature of myeloid neoplasms in adults, with an adverse prognosis connotation. However, this notion in MDS has not been well proved. In our cohort of 287 MDS, patients with microMKs showed lower overall survival (OS) (HR, 2.12; 95% CI, 1.47-3.06; p = 0.000036) and higher risk of acute myeloid leukemia (AML) evolution (HR, 4.8; 95% CI, 2.9-11.01; p = 0.00021). Results were validated with an independent cohort. In multivariate analysis, the presence of microMKs maintained its independent association with OS (HR, 1.54, 95% CI, 1.13-2.1, p = 0.0059) and AML transformation (HR, 2.28, 95% CI, 1.2-4.4, p = 0.014). Moreover, by adding 1 point to the IPSS-R score in patients with microMKs, we improved the IPSS-R accuracy. Interestingly, adding that 1-point, 29% of intermediate IPSS-R risk group patients were upgraded to the high-risk group. In summary, we confirmed that the presence of microMKs implies worse outcomes in MDS and suggested a modification improving IPSS-R.

Histone Modifications and Their Targeting in Lymphoid Malignancies

In a wide range of lymphoid neoplasms, the process of malignant transformation is associated with somatic mutations in B cells that affect the epigenetic machinery. Consequential alterations in histone modifications contribute to disease-specific changes in the transcriptional program. Affected genes commonly play important roles in cell cycle regulation, apoptosis-inducing signal transduction, and DNA damage response, thus facilitating the emergence of malignant traits that impair immune surveillance and favor the emergence of different B-cell lymphoma subtypes. In the last two decades, the field has made a major effort to develop therapies that target these epigenetic alterations. In this review, we discuss which epigenetic alterations occur in B-cell non-Hodgkin lymphoma. Furthermore, we aim to present in a close to comprehensive manner the current state-of-the-art in the preclinical and clinical development of epigenetic drugs. We focus on therapeutic strategies interfering with histone methylation and acetylation as these are most advanced in being deployed from the bench-to-bedside and have the greatest potential to improve the prognosis of lymphoma patients.

Antitumor Activity of the Novel BTK Inhibitor TG-1701 Is Associated with Disruption of Ikaros Signaling in Patients with B-cell Non-Hodgkin Lymphoma

PURPOSE

Despite the remarkable activity of BTK inhibitors (BTKi) in relapsed B-cell non-Hodgkin lymphoma (B-NHL), no clinically-relevant biomarker has been associated to these agents so far. The relevance of phosphoproteomic profiling for the early identification of BTKi responders remains underexplored.

EXPERIMENTAL DESIGN

A set of six clinical samples from an ongoing phase I trial dosing patients with chronic lymphocytic leukemia (CLL) with TG-1701, a novel irreversible and highly specific BTKi, were characterized by phosphoproteomic and RNA sequencing (RNA-seq) analysis. The activity of TG-1701 was evaluated in a panel of 11 B-NHL cell lines and mouse xenografts, including two NF-κB- and BTK^C481S-driven BTKi-resistant models. Biomarker validation and signal transduction analysis were conducted through real-time PCR, Western blot analysis, immunostaining, and gene knockout (KO) experiments.

RESULTS

A nonsupervised, phosphoproteomic-based clustering did match the early clinical outcomes of patients with CLL and separated a group of "early-responders" from a group of "late-responders." This clustering was based on a selected list of 96 phosphosites with Ikaros-pSer442/445 as a potential biomarker for TG-1701 efficacy. TG-1701 treatment was further shown to blunt Ikaros gene signature, including YES1 and MYC, in early-responder patients as well as in BTKi-sensitive B-NHL cell lines and xenografts. In contrast, Ikaros nuclear activity and signaling remained unaffected by the drug in vitro and in vivo in late-responder patients and in BTK^C481S, BTK^KO, and noncanonical NF-κB models.

CONCLUSIONS

These data validate phosphoproteomic as a valuable tool for the early detection of response to BTK inhibition in the clinic, and for the determination of drug mechanism of action.

Recent Advances in the Targeting of Epigenetic Regulators in B-Cell Non-Hodgkin Lymphoma

In the last 10 years, major advances have been made in the diagnosis and development of selective therapies for several blood cancers, including B-cell non-Hodgkin lymphoma (B-NHL), a heterogeneous group of malignancies arising from the mature B lymphocyte compartment. However, most of these entities remain incurable and current treatments are associated with variable efficacy, several adverse events, and frequent relapses. Thus, new diagnostic paradigms and novel therapeutic options are required to improve the prognosis of patients with B-NHL. With the recent deciphering of the mutational landscapes of B-cell disorders by high-throughput sequencing, it came out that different epigenetic deregulations might drive and/or promote B lymphomagenesis. Consistently, over the last decade, numerous epigenetic drugs (or epidrugs) have emerged in the clinical management of B-NHL patients. In this review, we will present an overview of the most relevant epidrugs tested and/or used so far for the treatment of different subtypes of B-NHL, from first-generation epigenetic therapies like histone acetyl transferases (HDACs) or DNA-methyl transferases (DNMTs) inhibitors to new agents showing selectivity for proteins that are mutated, translocated, and/or overexpressed in these diseases, including EZH2, BET, and PRMT. We will dissect the mechanisms of action of these epigenetic inhibitors, as well as the molecular processes underlying their lack of efficacy in refractory patients. This review will also provide a summary of the latest strategies being employed in preclinical and clinical settings, and will point out the most promising lines of investigation in the field.

Acute toxicity of anionic and non-ionic surfactants to aquatic organisms

The environmental risk of surfactants requires toxicity measurements. As different test organisms have different sensitivity to the toxics, it is necessary to establish the most appropriate organism to classify the surfactant as very toxic, toxic, harmful or safe, in order to establish the maximum permissible concentrations in aquatic ecosystems. We have determined the toxicity values of various anionic surfactants ether carboxylic derivatives using four test organisms: the freshwater crustacean Daphnia magna, the luminescent bacterium Vibrio fischeri, the microalgae Selenastrum capricornutum (freshwater algae) and Phaeodactylum tricornutum (seawater algae). In addition, in order to compare and classify the different families of surfactants, we have included a compilation of toxicity data of surfactants collected from literature. The results indicated that V. fischeri was more sensitive to the toxic effects of the surfactants than was D. magna or the microalgae, which was the least sensitive. This result shows that the most suitable toxicity assay for surfactants may be the one using V. fischeri. The toxicity data revealed considerable variation in toxicity responses with the structure of the surfactants regardless of the species tested. The toxicity data have been related to the structure of the surfactants, giving a mathematical relationship that helps to predict the toxic potential of a surfactant from its structure. Model-predicted toxicity agreed well with toxicity values reported in the literature for several surfactants previously studied. Predictive models of toxicity is a handy tool for providing a risk assessment that can be useful to establish the toxicity range for each surfactant and the different test organisms in order to select efficient surfactants with a lower impact on the aquatic environment.

Acute toxicity of alkylpolyglucosides to Vibrio fischeri, Daphnia magna and microalgae: a comparative study

In this paper, toxicity values of alkylpolyglucosides have been determined by applying the 24-h immobilization test with Daphnia magna, the LumiStox(®) 300 test which employs the luminescent bacteria Photobacterium phosphoreum and the test with Selenastrum capricornutum. Three alkylpolyglucosides with different alkyl chain and degree of polymerisation have been tested. For all tests, the results indicated that Vibrio fischeri was more sensitive to toxic effects from alkylpolyglucosides than was D. magna or S. capricornutum. The results demonstrate considerable variation in toxicity responses within structurally related glucose-based surfactants regardless of the species tested. The toxicity increased as the critical micelle concentration decreased, and as the alkyl chain length and resultant hydrophobicity increased.

Effect of concentration on the primary and ultimate biodegradation of alkylpolyglucosides in aerobic biodegradation tests

This study examines the primary and ultimate biodegradation of a non-ionic surfactant, an alkylpolyglucoside, in ready biodegradability tests. The surfactant concentration was tested by the anthrone method, while the ultimate biodegradation (mineralization) was analyzed by the total organic carbon determinations. The influence of the concentration on the extent of primary and ultimate biodegradation and the kinetics of degradation also were determined. The primary and ultimate biodegradation was studied at different initial concentrations-15, 25, 50, 75, and 100 mg/L. The increasing concentration of test chemical from 15 to 100 mg/L resulted in a decrease in the relative maximum mineralization rate and longer estimated lag times by a factor of approximately 4.3. During the degradative process, two different stages were noted; these are better described with Quiroga and first-order kinetic models, respectively. For the study of the influence of concentration, the parameters characteristic of the biodegradation profiles in the different biodegradation assays were evaluated.

Acute toxicity and relationship between metabolites and ecotoxicity during the biodegradation process of non-ionic surfactants: fatty-alcohol ethoxylates, nonylphenol polyethoxylate and alkylpolyglucosides

The toxicity values of fatty-alcohol ethoxylates, nonylphenol polyethoxylate, and alkylpolyglucosides have been determined by applying assays with luminescent bacteria. Also, the relation between metabolites and ecotoxicity during the biodegradation process has been determined. The biodegradation tests were carried out according to the OECD 301 E test for ready biodegradability. In these tests a solution of the surfactant, representing the sole carbon source for the microorganisms, was tested in a mineral medium, inoculated and incubated under aerobic conditions in the dark. The toxicity of surfactants is related to their molecular structure (Quantitative Structure Activity Relationships, QSAR). For the alkylpolyglucosides, toxicity expressed as EC(50) is related with the critical micelle concentration (CMC), the hydrophilic-lipophilic balance (HLB) of the surfactant, and the hydrophobic alkyl chain (R). The results indicate that toxicity increased as the CMC decreased and as the hydrophobicity increased and R rose. For fatty-alcohol ethoxylates, parameters characteristic studied have been HLB, number of units of ethylene oxide and the alkyl chain length. Relationships found are in agreement with the fact that increasing the alkyl chain length leads to a lower EC(50), whereas increasing ethoxylation leads to a lower toxicity. An analysis of the behaviour of the toxicity and HLB again indicates that the toxicity was greater for surfactants with a smaller HLB. The evolution of the toxicity was studied over the biodegradation process, expressed as a percentage of inhibition. For all the non-ionic surfactants assayed, except for the nonylphenol polyethoxylate, a major decline was found in toxicity during the first days of the biodegradation assay and at all the concentrations tested.

Simplified spectrophotometric method using methylene blue for determining anionic surfactants: applications to the study of primary biodegradation in aerobic screening tests

In the present work, we propose a simplified spectrophotometric method for determining anionic surfactants, based on the formation of the ionic pair anionic surfactant-methylene blue (AS-MB). This method, in relation to the conventional analytic procedure, considerably reduces not only the quantity of chloroform used in extracting the ionic pair formed, but also the time and the quantity of sample necessary to perform the assay, eliminating the filtration stage. The method has been simplified by displacing the transfer equilibrium of the ionic pair AS-MB towards the organic phase, augmenting the volumetric relationship of chloroform/sample. The method proposed has been applied in the study of primary biodegradation kinetics of linear alkylbenzenesulfonate (LAS).