MALT1反馈机制的鉴定有助于合理设计针对ABC-DLBCL的有效抗淋巴瘤方案。

Identification of MALT1 feedback mechanisms enables rational design of potent antilymphoma regimens for ABC-DLBCL.

作者信息

Fontan Lorena, Goldstein Rebecca, Casalena Gabriella, Durant Matthew, Teater Matthew R, Wilson Jimmy, Phillip Jude, Xia Min, Shah Shivem, Us Ilkay, Shinglot Himaly, Singh Ankur, Inghirami Giorgio, Melnick Ari

机构信息

Division of Hematology/Oncology, Department of Medicine, Weill Cornell Medicine, New York, NY.

Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY; and.

出版信息

Blood. 2021 Feb 11;137(6):788-800. doi: 10.1182/blood.2019004713.

Abstract

MALT1 inhibitors are promising therapeutic agents for B-cell lymphomas that are dependent on constitutive or aberrant signaling pathways. However, a potential limitation for signal transduction-targeted therapies is the occurrence of feedback mechanisms that enable escape from the full impact of such drugs. Here, we used a functional genomics screen in activated B-cell-like (ABC) diffuse large B-cell lymphoma (DLBCL) cells treated with a small molecule irreversible inhibitor of MALT1 to identify genes that might confer resistance or enhance the activity of MALT1 inhibition (MALT1i). We find that loss of B-cell receptor (BCR)- and phosphatidylinositol 3-kinase (PI3K)-activating proteins enhanced sensitivity, whereas loss of negative regulators of these pathways (eg, TRAF2, TNFAIP3) promoted resistance. These findings were validated by knockdown of individual genes and a combinatorial drug screen focused on BCR and PI3K pathway-targeting drugs. Among these, the most potent combinatorial effect was observed with PI3Kδ inhibitors against ABC-DLBCLs in vitro and in vivo, but that led to an adaptive increase in phosphorylated S6 and eventual disease progression. Along these lines, MALT1i promoted increased MTORC1 activity and phosphorylation of S6K1-T389 and S6-S235/6, an effect that was only partially blocked by PI3Kδ inhibition in vitro and in vivo. In contrast, simultaneous inhibition of MALT1 and MTORC1 prevented S6 phosphorylation, yielded potent activity against DLBCL cell lines and primary patient specimens, and resulted in more profound tumor regression and significantly improved survival of ABC-DLBCLs in vivo compared with PI3K inhibitors. These findings provide a basis for maximal therapeutic impact of MALT1 inhibitors in the clinic, by disrupting feedback mechanisms that might otherwise limit their efficacy.

摘要

MALT1抑制剂对于依赖组成型或异常信号通路的B细胞淋巴瘤而言是很有前景的治疗药物。然而,信号转导靶向治疗的一个潜在局限是出现反馈机制,使得肿瘤细胞能够逃避此类药物的全面影响。在此,我们在经小分子不可逆MALT1抑制剂处理的活化B细胞样(ABC)弥漫性大B细胞淋巴瘤(DLBCL)细胞中进行了功能基因组筛选,以鉴定可能赋予耐药性或增强MALT1抑制(MALT1i)活性的基因。我们发现,B细胞受体(BCR)和磷脂酰肌醇3激酶(PI3K)激活蛋白的缺失增强了敏感性,而这些信号通路负调节因子(如TRAF2、TNFAIP3)的缺失则促进了耐药性。通过单个基因敲低以及聚焦于BCR和PI3K通路靶向药物的联合药物筛选验证了这些发现。其中,在体外和体内观察到PI3Kδ抑制剂对ABC-DLBCL具有最有效的联合作用,但这导致磷酸化S6适应性增加并最终导致疾病进展。同样,MALT1i促进了MTORC1活性增加以及S6K1-T389和S6-S235/6的磷酸化,这一效应在体外和体内仅被PI3Kδ抑制部分阻断。相比之下,同时抑制MALT1和MTORC1可防止S6磷酸化,对DLBCL细胞系和原发性患者标本产生强效活性,与PI3K抑制剂相比,在体内导致更显著的肿瘤消退并显著提高ABC-DLBCL的生存率。这些发现为MALT1抑制剂在临床上实现最大治疗效果提供了依据,即通过破坏可能限制其疗效的反馈机制来实现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4352/7885826/87e9711643ef/bloodBLD2019004713absf1.jpg

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