Department of Pharmacology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
University of Malaya Cancer Research Institute, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
J Cell Mol Med. 2021 Sep;25(17):8187-8200. doi: 10.1111/jcmm.16684. Epub 2021 Jul 28.
Prostate cancer (PCa) is the second most common malignancy and is the fifth leading cause of cancer mortality among men globally. Docetaxel-based therapy remains the first-line treatment for metastatic castration-resistant prostate cancer. However, dose-limiting toxicity including neutropenia, myelosuppression and neurotoxicity is the major reason for docetaxel dose reductions and fewer cycles administered, despite a recent study showing a clear survival benefit with increased total number of docetaxel cycles in PCa patients. Although previous studies have attempted to improve the efficacy and reduce docetaxel toxicity through drug combination, no drug has yet demonstrated improved overall survival in clinical trial, highlighting the challenges of improving the activity of docetaxel monotherapy in PCa. Herein, we identified 15 lethality hits for which inhibition could enhance docetaxel sensitivity in PCa cells via a high-throughput kinome-wide loss-of-function screen. Further drug-gene interactions analyses identified Janus kinase 1 (JAK1) as a viable druggable target with existing experimental inhibitors and FDA-approved drugs. We demonstrated that depletion of endogenous JAK1 enhanced docetaxel-induced apoptosis in PCa cells. Furthermore, inhibition of JAK1/2 by baricitinib and ruxolitinib synergizes docetaxel sensitivity in both androgen receptor (AR)-negative DU145 and PC3 cells, but not in the AR-positive LNCaP cells. In contrast, no synergistic effects were observed in cells treated with JAK2-specific inhibitor, fedratinib, suggesting that the synergistic effects are mainly mediated through JAK1 inhibition. In conclusion, the combination therapy with JAK1 inhibitors and docetaxel could be a useful therapeutic strategy in the treatment of prostate cancers.
前列腺癌(PCa)是第二大常见恶性肿瘤,也是全球男性癌症死亡的第五大主要原因。基于多西紫杉醇的治疗仍然是转移性去势抵抗性前列腺癌的一线治疗方法。然而,包括中性粒细胞减少症、骨髓抑制和神经毒性在内的剂量限制毒性是减少多西紫杉醇剂量和减少给药周期的主要原因,尽管最近的一项研究表明,增加前列腺癌患者多西紫杉醇周期总数可明显提高生存率。尽管以前的研究试图通过药物联合提高疗效并降低多西紫杉醇毒性,但没有一种药物在临床试验中显示出改善总生存的效果,这突出了提高多西紫杉醇单药在前列腺癌中活性的挑战。在此,我们通过高通量激酶组全基因组缺失功能筛选确定了 15 个致死性靶点,抑制这些靶点可以增强前列腺癌细胞中多西紫杉醇的敏感性。进一步的药物-基因相互作用分析确定了 Janus 激酶 1(JAK1)作为一个可行的药物靶点,具有现有的实验抑制剂和 FDA 批准的药物。我们证明,耗尽内源性 JAK1 可增强前列腺癌细胞中多西紫杉醇诱导的细胞凋亡。此外,巴瑞替尼和鲁索利替尼抑制 JAK1/2 与多西紫杉醇在雄激素受体(AR)阴性的 DU145 和 PC3 细胞中协同作用,但在 AR 阳性的 LNCaP 细胞中则没有协同作用。相比之下,用 JAK2 特异性抑制剂 fedratinib 处理的细胞没有观察到协同作用,这表明协同作用主要是通过 JAK1 抑制介导的。总之,JAK1 抑制剂与多西紫杉醇联合治疗可能是治疗前列腺癌的一种有用的治疗策略。