Newcastle Cancer Centre, Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom.
Vertex Pharmaceuticals (Europe) Ltd, Abingdon, Oxfordshire, United Kingdom.
Blood Adv. 2018 May 22;2(10):1157-1169. doi: 10.1182/bloodadvances.2017015214.
The ataxia telangiectasia and Rad3-related (ATR) protein kinase promotes cancer cell survival by signaling stalled replication forks generated by replication stress, a common feature of many cancers including acute myeloid leukemia (AML). Here we show that the antileukemic activity of the chemotherapeutic nucleoside analogs hydroxyurea and gemcitabine was significantly potentiated by ATR inhibition via a mechanism involving ribonucleotide reductase (RNR) abrogation and inhibition of replication fork progression. When administered in combination with gemcitabine, an inhibitor of the M1 RNR subunit, the ATR inhibitor VX-970, eradicated disseminated leukemia in an orthotopic mouse model, eliciting long-term survival and effective cure. These data identify a synergistic interaction between ATR inhibition and RNR loss that will inform the deployment of small molecule inhibitors for the treatment of AML and other hematologic malignancies.
共济失调毛细血管扩张症和 Rad3 相关蛋白激酶(ATR)通过信号转导停滞的复制叉促进癌细胞存活,复制叉停滞是许多癌症(包括急性髓细胞白血病 (AML))的共同特征。在这里,我们表明通过涉及核糖核苷酸还原酶 (RNR) 阻断和复制叉推进抑制的机制,通过 ATR 抑制,化疗核苷类似物羟基脲和吉西他滨的抗白血病活性显著增强。当与吉西他滨(M1 RNR 亚基的抑制剂)联合使用时,ATR 抑制剂 VX-970 在原位小鼠模型中根除了播散性白血病,引起长期存活和有效治愈。这些数据确定了 ATR 抑制和 RNR 缺失之间的协同相互作用,这将为小分子抑制剂治疗 AML 和其他血液系统恶性肿瘤提供信息。