Human Oncology and Pathogenesis Program, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
J Clin Invest. 2010 Oct;120(10):3578-93. doi: 10.1172/JCI42442. Epub 2010 Sep 13.
JAK2 kinase inhibitors were developed for the treatment of myeloproliferative neoplasms (MPNs), following the discovery of activating JAK2 mutations in the majority of patients with MPN. However, to date JAK2 inhibitor treatment has shown limited efficacy and apparent toxicities in clinical trials. We report here that an HSP90 inhibitor, PU-H71, demonstrated efficacy in cell line and mouse models of the MPN polycythemia vera (PV) and essential thrombocytosis (ET) by disrupting JAK2 protein stability. JAK2 physically associated with both HSP90 and PU-H71 and was degraded by PU-H71 treatment in vitro and in vivo, demonstrating that JAK2 is an HSP90 chaperone client. PU-H71 treatment caused potent, dose-dependent inhibition of cell growth and signaling in JAK2 mutant cell lines and in primary MPN patient samples. PU-H71 treatment of mice resulted in JAK2 degradation, inhibition of JAK-STAT signaling, normalization of peripheral blood counts, and improved survival in MPN models at doses that did not degrade JAK2 in normal tissues or cause substantial toxicity. Importantly, PU-H71 treatment also reduced the mutant allele burden in mice. These data establish what we believe to be a novel therapeutic rationale for HSP90 inhibition in the treatment of JAK2-dependent MPN.
JAK2 激酶抑制剂是在大多数骨髓增殖性肿瘤(MPN)患者中发现激活的 JAK2 突变后开发出来的,用于治疗 MPN。然而,迄今为止,JAK2 抑制剂在临床试验中的疗效有限,且具有明显的毒性。我们在此报告,HSP90 抑制剂 PU-H71 通过破坏 JAK2 蛋白稳定性,在 MPN 真性红细胞增多症(PV)和原发性血小板增多症(ET)的细胞系和小鼠模型中显示出疗效。JAK2 与 HSP90 和 PU-H71 都有物理结合,并且在体外和体内的 PU-H71 处理中被降解,这表明 JAK2 是 HSP90 的伴侣客户。PU-H71 处理导致 JAK2 突变细胞系和原发性 MPN 患者样本中的细胞生长和信号传导受到强烈、剂量依赖性抑制。PU-H71 处理小鼠导致 JAK2 降解、JAK-STAT 信号抑制、外周血计数正常化,并在不使正常组织中的 JAK2 降解或引起实质性毒性的剂量下改善 MPN 模型中的存活。重要的是,PU-H71 处理还降低了小鼠中的突变等位基因负担。这些数据确立了我们认为 HSP90 抑制在治疗 JAK2 依赖性 MPN 中的一种新的治疗原理。