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CS2164与维奈托克在伴有 和 重排的高级别B细胞淋巴瘤中显示出协同抗肿瘤活性。

CS2164 and Venetoclax Show Synergistic Antitumoral Activities in High Grade B-Cell Lymphomas With and Rearrangements.

作者信息

Yuan Delin, Li Genhong, Yu Lian, Jiang Yuelong, Shi Yuanfei, Chen Qiulin, Ma Xiaomei, Pham Lan V, Young Ken H, Deng Manman, Fang Zhihong, Xu Bing

机构信息

Department of Hematology, The First Affiliated Hospital of Xiamen University and Institute of Hematology, School of Medicine, Xiamen University, Xiamen, China.

Department of Hematology, Key Laboratory of Xiamen for Diagnosis and Treatment of Hematological Malignancy, Xiamen, China.

出版信息

Front Oncol. 2021 Mar 10;11:618908. doi: 10.3389/fonc.2021.618908. eCollection 2021.

Abstract

High-grade B-cell lymphoma with concurrent and rearrangements (HGBL-DHL) is a rare, aggressive mature B-cell malignancy with a high likelihood of treatment failure following front-line immunochemotherapies. Patients with HGBL-DHL who develop a relapsed or refractory disease have little effective therapeutic strategies and show very poor clinical outcomes, thus calling for development of novel therapies for this specific patient population. In this study, we investigated the preclinical anti-lymphoma efficacies and potential mechanism of action of a novel treatment approach, combining the BCL2 inhibitor venetoclax with CS2164, a new orally active multitarget inhibitor, in HGBL-DHL models. This combination therapy exhibited a robust synergistic cytotoxicity against HGBL-DHL cells, evidenced by cooperatively inducing loss of cell viability and promoting cell apoptosis. Moreover, coadministration of CS2164 and venetoclax resulted in significant superior suppression of HGBL-DHL cell growth and remarkably abrogated tumor burden in a HGBL-DHL-xenografted mouse model. The synergistic lethality of CS2164 and venetoclax in HGBL-DHL cells was associated with induction of DNA damage and impairment of DNA repair ability. Of importance, the combined treatment almost abolished the expression of both BCL2 and MYC, two hallmark proteins of HGBL-DHL, and substantially blunted the activity of PI3K/AKT/mTOR signaling cascade. In addition, MCL1 and BCL-XL, two well-characterized contributors for venetoclax resistance, were significantly lessened in the presence of CS2164 and venetoclax, thus leading to the accumulation of proapoptotic proteins BAX and PUMA and then initiating the intrinsic apoptosis pathway. Taken together, these findings suggest that the regimen of CS2164 and venetoclax is highly effective to eliminate HGBL-DHL cells in the preclinical setting, warranting further clinical investigations of this regimen for the treatment of unfavorable HGBL-DHL patients.

摘要

伴有同时性 和 重排的高级别B细胞淋巴瘤(HGBL-DHL)是一种罕见的侵袭性成熟B细胞恶性肿瘤,一线免疫化疗后治疗失败的可能性很高。发生复发或难治性疾病的HGBL-DHL患者几乎没有有效的治疗策略,临床结局非常差,因此需要为这一特定患者群体开发新的疗法。在本研究中,我们在HGBL-DHL模型中研究了一种新的治疗方法的临床前抗淋巴瘤疗效和潜在作用机制,该方法将BCL2抑制剂维奈克拉与新型口服活性多靶点抑制剂CS2164联合使用。这种联合疗法对HGBL-DHL细胞表现出强大的协同细胞毒性,表现为协同诱导细胞活力丧失和促进细胞凋亡。此外,在HGBL-DHL异种移植小鼠模型中,CS2164和维奈克拉的共同给药导致对HGBL-DHL细胞生长的显著抑制,并显著减轻肿瘤负担。CS2164和维奈克拉在HGBL-DHL细胞中的协同致死作用与DNA损伤的诱导和DNA修复能力的损害有关。重要的是,联合治疗几乎消除了HGBL-DHL的两个标志性蛋白BCL2和MYC的表达,并显著减弱了PI3K/AKT/mTOR信号级联的活性。此外,在存在CS2164和维奈克拉的情况下,维奈克拉耐药的两个特征性因素MCL1和BCL-XL显著减少,从而导致促凋亡蛋白BAX和PUMA的积累,进而启动内源性凋亡途径。综上所述,这些发现表明CS2164和维奈克拉方案在临床前环境中对消除HGBL-DHL细胞非常有效,值得对该方案进行进一步的临床研究,以治疗预后不良的HGBL-DHL患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22e9/7988232/0b3681cb40b8/fonc-11-618908-g001.jpg

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