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BGB324 抑制 Axl 阻断可抑制 BCR-ABL 酪氨酸激酶抑制剂敏感和耐药的慢性髓性白血病。

Axl Blockade by BGB324 Inhibits BCR-ABL Tyrosine Kinase Inhibitor-Sensitive and -Resistant Chronic Myeloid Leukemia.

机构信息

Department of Hematology and Oncology with Sections BMT and Pneumology, Hubertus Wald Tumorzentrum, University Comprehensive Cancer Center Hamburg, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

Department of Tumor Biology, Center of Experimental Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

出版信息

Clin Cancer Res. 2017 May 1;23(9):2289-2300. doi: 10.1158/1078-0432.CCR-16-1930. Epub 2016 Nov 17.

Abstract

BCR-ABL kinase inhibitors are employed successfully for chronic myeloid leukemia (CML) treatment. However, resistant disease and persistence of BCR-ABL1-independent leukemia stem and progenitor cells (LSPC) remain clinical challenges. The receptor tyrosine kinase Axl can mediate survival and therapy resistance of different cancer cells. We investigated the therapeutic potential of Axl inhibition in CML. We used primary cells from patients with CML and TKI-sensitive and -resistant BCR-ABL1 CML cell lines and a novel ponatinib-resistant cell line KCL-22 PonR. We analyzed the effects of genetic and pharmacologic Axl blockade by the small-molecule Axl inhibitor BGB324 and In BCR-ABL1-unmutated cells, we also investigated BGB324 in combination with imatinib. We demonstrate overexpression of Axl receptor tyrosine kinase in primary cells of patients with CML compared with healthy individuals and a further increase of Axl expression in BCR-ABL TKI-resistant patients. We show that Axl blockage decreased growth of BCR-ABL TKI-sensitive CML cells including CD34 cells and exerts additive effects with imatinib via inhibition of Stat5 activation. BGB324 also inhibits BCR-ABL TKI-resistant cells, including T315I-mutated and ponatinib-resistant primary cells. BGB324 exerted therapeutic effects in BCR-ABL1 T315I-mutated and ponatinib-resistant preclinical mouse models. Notably, BGB324 does not inhibit BCR-ABL1 and consequently inhibits CML independent of BCR-ABL1 mutational status. Our data show that Axl inhibition has therapeutic potential in BCR-ABL TKI-sensitive as well as -resistant CML and support the need for clinical trials. .

摘要

BCR-ABL 激酶抑制剂被成功用于治疗慢性髓性白血病 (CML)。然而,耐药疾病和 BCR-ABL1 非依赖性白血病干细胞和祖细胞 (LSPC) 的持续存在仍然是临床挑战。受体酪氨酸激酶 Axl 可以介导不同癌细胞的存活和治疗耐药性。我们研究了 Axl 抑制在 CML 中的治疗潜力。我们使用来自 CML 患者的原代细胞以及 TKI 敏感和耐药的 BCR-ABL1 CML 细胞系和一种新的 ponatinib 耐药细胞系 KCL-22 PonR。我们分析了小分子 Axl 抑制剂 BGB324 和遗传和药理学 Axl 阻断的效果。在未突变的 BCR-ABL1 细胞中,我们还研究了 BGB324 与伊马替尼的联合作用。我们证明与健康个体相比,CML 患者的原代细胞中 Axl 受体酪氨酸激酶过度表达,并且在 BCR-ABL TKI 耐药患者中 Axl 表达进一步增加。我们表明 Axl 阻断可降低 BCR-ABL TKI 敏感的 CML 细胞(包括 CD34 细胞)的生长,并通过抑制 Stat5 激活与伊马替尼产生相加作用。BGB324 还抑制 BCR-ABL TKI 耐药细胞,包括 T315I 突变和 ponatinib 耐药的原代细胞。BGB324 在 BCR-ABL1 T315I 突变和 ponatinib 耐药的临床前小鼠模型中发挥了治疗作用。值得注意的是,BGB324 不抑制 BCR-ABL1,因此抑制 CML 不依赖于 BCR-ABL1 突变状态。我们的数据表明,Axl 抑制在 BCR-ABL TKI 敏感和耐药的 CML 中具有治疗潜力,并支持进行临床试验的必要性。

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