Department of Medicine III, University Hospital, LMU Munich, Munich, Germany.
German Cancer Consortium (DKTK), partner site Munich, Munich, Germany.
Leukemia. 2018 Feb;32(2):313-322. doi: 10.1038/leu.2017.257. Epub 2017 Aug 14.
The fms-related tyrosine kinase 3 (FLT3) receptor has been extensively studied over the past two decades with regard to oncogenic alterations that do not only serve as prognostic markers but also as therapeutic targets in acute myeloid leukemia (AML). Internal tandem duplications (ITDs) became of special interest in this setting as they are associated with unfavorable prognosis. Because of sequence-dependent protein conformational changes FLT3-ITD tends to autophosphorylate and displays a constitutive intracellular localization. Here, we analyzed the effect of tyrosine kinase inhibitors (TKIs) on the localization of the FLT3 receptor and its mutants. TKI treatment increased the surface expression through upregulation of FLT3 and glycosylation of FLT3-ITD and FLT3-D835Y mutants. In T cell-mediated cytotoxicity (TCMC) assays, using a bispecific FLT3 × CD3 antibody construct, the combination with TKI treatment increased TCMC in the FLT3-ITD-positive AML cell lines MOLM-13 and MV4-11, patient-derived xenograft cells and primary patient samples. Our findings provide the basis for rational combination of TKI and FLT3-directed immunotherapy with potential benefit for FLT3-ITD-positive AML patients.
在过去的二十年中,人们对 fms 相关酪氨酸激酶 3(FLT3)受体进行了广泛的研究,涉及到致癌改变,这些改变不仅可以作为预后标志物,还可以作为急性髓系白血病(AML)的治疗靶点。在这种情况下,内部串联重复(ITD)引起了特别的关注,因为它们与不良预后相关。由于序列依赖性蛋白质构象变化,FLT3-ITD 倾向于自身磷酸化,并表现出组成型细胞内定位。在这里,我们分析了酪氨酸激酶抑制剂(TKI)对 FLT3 受体及其突变体定位的影响。TKI 治疗通过上调 FLT3 和 FLT3-ITD 和 FLT3-D835Y 突变体的糖基化,增加了表面表达。在 T 细胞介导的细胞毒性(TCMC)测定中,使用双特异性 FLT3×CD3 抗体构建体,与 TKI 治疗联合使用增加了 FLT3-ITD 阳性 AML 细胞系 MOLM-13 和 MV4-11、患者来源的异种移植物细胞和原发性患者样本中的 TCMC。我们的发现为 TKI 和 FLT3 导向免疫疗法的合理联合提供了基础,可能对 FLT3-ITD 阳性 AML 患者有益。