University of Bologna, Institute of Hematology and Medical Oncology L.A. Seragnoli, Via Massarenti 9, 40138 Bologna, Italy.
Expert Opin Investig Drugs. 2013 Jun;22(6):775-85. doi: 10.1517/13543784.2013.775244. Epub 2013 Feb 26.
The Janus kinase (JAK)/signal transducer and activator of transcription (STAT) pathway mediates signaling by cytokine, chemokine and growth factor receptors on cell surface to the nucleus. JAK/STAT pathway is aberrantly activated in a variety of lymphomas, with a dual role of promoting cell survival/proliferation and immune evasion.
This review describes the preclinical rationale behind the development of JAK inhibitors in lymphoma, some of which are being evaluated in Phase I/II studies, and summarizes the characteristics and clinical results of different JAK inhibitors in clinical development. Available preclinical and clinical data about JAK inhibition in lymphoid malignancies were reviewed using a PubMed access. To date, pacritinib (SB1518), a selective JAK2/FLT3 inhibitor is the first and only JAK inhibitor that has been evaluated in patients with relapsed lymphoma.
The preclinical rationale behind the development of pacritinib in lymphoproliferative neoplasms is strong, as the deregulation of the JAK/STAT pathway is involved in the pathogenesis of multiple lymphoma subtypes, although with different mechanisms. Pacritinib demonstrated safety and early clinical efficacy in a variety of lymphoma histologic types, providing the first proof of principle of the potential clinical value of targeting JAK/STAT pathway in lymphoma.
Janus 激酶(JAK)/信号转导子和转录激活子(STAT)通路介导细胞表面的细胞因子、趋化因子和生长因子受体向细胞核的信号转导。JAK/STAT 通路在多种淋巴瘤中异常激活,具有促进细胞存活/增殖和免疫逃逸的双重作用。
本文描述了 JAK 抑制剂在淋巴瘤中的临床前作用机制,其中一些正在进行 I/II 期研究,并总结了不同 JAK 抑制剂在临床开发中的特点和临床结果。使用 PubMed 检索,回顾了关于淋巴恶性肿瘤中 JAK 抑制的可用的临床前和临床数据。迄今为止,pacritinib(SB1518),一种选择性 JAK2/FLT3 抑制剂,是第一个也是唯一一个在复发性淋巴瘤患者中评估的 JAK 抑制剂。
pacritinib 在淋巴增生性肿瘤中的开发具有强大的临床前作用机制,因为 JAK/STAT 通路的失调涉及多种淋巴瘤亚型的发病机制,尽管机制不同。pacritinib 在多种淋巴瘤组织学类型中表现出安全性和早期临床疗效,为靶向 JAK/STAT 通路在淋巴瘤中的潜在临床价值提供了第一个原理证明。