首个小分子伊马替尼 ONC201 在血液系统恶性肿瘤中的单药及协同组合疗效。
Single agent and synergistic combinatorial efficacy of first-in-class small molecule imipridone ONC201 in hematological malignancies.
机构信息
a Oncoceutics, Inc. , Philadelphia , PA.
b The Children's Hospital of Philadelphia , Philadelphia , PA.
出版信息
Cell Cycle. 2018;17(4):468-478. doi: 10.1080/15384101.2017.1403689. Epub 2018 Feb 19.
ONC201, founding member of the imipridone class of small molecules, is currently being evaluated in advancer cancer clinical trials. We explored single agent and combinatorial efficacy of ONC201 in preclinical models of hematological malignancies. ONC201 demonstrated (GI50 1-8 µM) dose- and time-dependent efficacy in acute myeloid leukemia (AML), acute lymphoblastic leukemia (ALL), chronic myelogenous leukemia (CML), chronic lymphocytic leukemia (CLL), diffuse large B-cell lymphoma (DLBCL), mantle cell lymphoma (MCL), Burkitt's lymphoma, anaplastic large cell lymphoma (ALCL), cutaneous T-cell lymphoma (CTCL), Hodgkin's lymphoma (nodular sclerosis) and multiple myeloma (MM) cell lines including cells resistant to standard of care (dexamethasone in MM) and primary samples. ONC201 induced caspase-dependent apoptosis that involved activation of the integrated stress response (ATF4/CHOP) pathway, inhibition of Akt phosphorylation, Foxo3a activation, downregulation of cyclin D1, IAP and Bcl-2 family members. ONC201 synergistically reduced cell viability in combination with cytarabine and 5-azacytidine in AML cells. ONC201 combined with cytarabine in a Burkitt's lymphoma xenograft model induced tumor growth inhibition that was superior to either agent alone. ONC201 synergistically combined with bortezomib in MM, MCL and ALCL cells and with ixazomib or dexamethasone in MM cells. ONC201 combined with bortezomib in a Burkitt's lymphoma xenograft model reduced tumor cell density and improved CHOP induction compared to either agent alone. These results serve as a rationale for ONC201 single-agent trials in relapsed/refractory acute leukemia, non-Hodgkin's lymphoma, MM and combination trial with dexamethasone in MM, provide pharmacodynamic biomarkers and identify further synergistic combinatorial regimens that can be explored in the clinic.
ONC201 是 imipridone 类小分子的创始成员之一,目前正在进行晚期癌症临床试验。我们在血液系统恶性肿瘤的临床前模型中探索了 ONC201 的单一药物和联合疗效。ONC201 在急性髓性白血病 (AML)、急性淋巴细胞白血病 (ALL)、慢性髓性白血病 (CML)、慢性淋巴细胞白血病 (CLL)、弥漫性大 B 细胞淋巴瘤 (DLBCL)、套细胞淋巴瘤 (MCL)、伯基特淋巴瘤、间变性大细胞淋巴瘤 (ALCL)、皮肤 T 细胞淋巴瘤 (CTCL)、霍奇金淋巴瘤 (结节性硬化症) 和多发性骨髓瘤 (MM) 细胞系中表现出剂量和时间依赖性疗效(GI50 为 1-8µM),包括对标准治疗(MM 中的地塞米松)和原代样本耐药的细胞。ONC201 诱导了 caspase 依赖性凋亡,涉及整合应激反应 (ATF4/CHOP) 途径的激活、Akt 磷酸化的抑制、Foxo3a 的激活、细胞周期蛋白 D1、IAP 和 Bcl-2 家族成员的下调。ONC201 与阿糖胞苷和 5-氮杂胞苷联合使用可协同降低 AML 细胞的活力。ONC201 与阿糖胞苷联合用于伯基特淋巴瘤异种移植模型中可诱导肿瘤生长抑制,优于单独使用任何一种药物。ONC201 与硼替佐米联合使用可在 MM、MCL 和 ALCL 细胞中以及与 ixazomib 或地塞米松联合使用可在 MM 细胞中产生协同作用。ONC201 与硼替佐米联合使用可在伯基特淋巴瘤异种移植模型中降低肿瘤细胞密度并改善 CHOP 诱导,优于单独使用任何一种药物。这些结果为 ONC201 在复发性/难治性急性白血病、非霍奇金淋巴瘤、MM 中的单一药物试验以及与地塞米松联合用于 MM 的联合试验提供了依据,并提供了药效学生物标志物,并确定了可在临床上进一步探索的协同组合方案。