基于咪吡酮的联合疗法对组蛋白H3K27M突变型弥漫性内生型脑桥胶质瘤具有强大的临床前敏感性,这与整合应激反应的诱导、肿瘤坏死因子相关凋亡诱导配体(TRAIL)死亡受体DR5、ClpX减少和细胞凋亡有关。

Potent preclinical sensitivity to imipridone-based combination therapies in oncohistone H3K27M-mutant diffuse intrinsic pontine glioma is associated with induction of the integrated stress response, TRAIL death receptor DR5, reduced ClpX and apoptosis.

作者信息

Borsuk Robyn, Zhou Lanlan, Chang Wen-I, Zhang Yiqun, Sharma Aditi, Prabhu Varun V, Tapinos Nikos, Lulla Rishi R, El-Deiry Wafik S

机构信息

Division of Pediatric Hematology/Oncology, Department of Pediatrics, Brown University Providence, RI, USA.

Warren Alpert Medical School of Brown University Providence, RI, USA.

出版信息

Am J Cancer Res. 2021 Sep 15;11(9):4607-4623. eCollection 2021.

DOI:
Abstract

The H3K27M oncohistone mutation, identified in approximately 80% of diffuse intrinsic pontine gliomas (DIPG), is a potential target for therapy. Imipridone ONC201/TIC10 (TRAIL-Inducing Compound #10) induces apoptosis of cancer cells, and has clinical efficacy against H3K27M-mutant DIPG. We demonstrate synergy between ONC201, ONC206 and ONC212, and targeted therapies with known preclinical activity against DIPG. We hypothesized that imipridone combinations with HDAC or proteasome inhibitors may be superior to single agent ONC201 treatment in H3K27M mutant DIPG. Six patient-derived DIPG cell lines (SU-DIPG-IV, SU-DIPG-13, SU-DIPG-25, SU-DIPG-27, SU-DIPG-29, SU-DIPG-36) were exposed to imipridones alone or combinations with histone de-acetylase inhibitors [HDACi], marizomib, etoposide, and temozolomide. Dose-dependent response to imipridones was observed in DIPG cells with half-maximal inhibitory concentration (IC) of 1.46 µM, 0.11 µM, and 0.03 µM, for ONC201, ONC206, and ONC212, respectively. Upon treatment with the imipridones, DIPG cell lines engaged CLpP/CLPX, the integrated stress response with ATF4 activation, and TRAIL death receptor 5 (DR5) induction. Strong synergy was identified between ONC201 and HDACi panobinostat (combination index [CI] 0.01), romidepsin (CI 0.08) and proteasome inhibitor marizomib (CI 0.19). Synergy was demonstrated between ONC201 and etoposide (CI 0.54), although to a lesser degree than with panobinostat, romidepsin, and marizomib. ONC206 and ONC212 showed similar synergistic effects with panobinostat, romidepsin, and marizomib. Induction of apoptosis was demonstrated with imipridones and panobinostat or romidepsin combinations. Our results suggest increased sensitivity of H3K27M-mutant DIPG cell lines to second generation imipridone therapies, as compared to ONC201. Additionally, there is synergistic cell death with combination of imipridones and panobinostat, romidepsin, or marizomib, which may be further tested and in clinical trials.

摘要

在大约80%的弥漫性脑桥内在胶质瘤(DIPG)中发现的H3K27M致癌组蛋白突变是一个潜在的治疗靶点。咪哌立酮ONC201/TIC10(诱导肿瘤坏死因子相关凋亡诱导配体的化合物#10)可诱导癌细胞凋亡,并且对H3K27M突变的DIPG具有临床疗效。我们证明了ONC201、ONC206和ONC212之间的协同作用,以及与已知对DIPG具有临床前活性的靶向治疗之间的协同作用。我们假设,在H3K27M突变的DIPG中,咪哌立酮与组蛋白去乙酰化酶(HDAC)抑制剂或蛋白酶体抑制剂联合使用可能优于单药ONC201治疗。将6种患者来源的DIPG细胞系(SU-DIPG-IV、SU-DIPG-13、SU-DIPG-25、SU-DIPG-27、SU-DIPG-29、SU-DIPG-36)单独暴露于咪哌立酮或与组蛋白脱乙酰酶抑制剂[HDACi]、马立佐米、依托泊苷和替莫唑胺联合使用。在DIPG细胞中观察到对咪哌立酮的剂量依赖性反应,ONC201、ONC206和ONC212的半数最大抑制浓度(IC)分别为1.46 μM、0.11 μM和0.03 μM。在用咪哌立酮治疗后,DIPG细胞系激活了CLpP/CLPX、伴有激活转录因子4(ATF4)激活的综合应激反应以及肿瘤坏死因子相关凋亡诱导配体死亡受体5(DR5)的诱导。在ONC201与HDACi帕比司他(联合指数[CI] 0.01)、罗米地辛(CI 0.08)和蛋白酶体抑制剂马立佐米(CI 0.19)之间发现了强烈的协同作用。ONC201与依托泊苷之间也表现出协同作用(CI 0.54),尽管程度低于与帕比司他、罗米地辛和马立佐米的协同作用。ONC206和ONC212与帕比司他、罗米地辛和马立佐米表现出相似的协同效应。咪哌立酮与帕比司他或罗米地辛联合使用可诱导细胞凋亡。我们的结果表明,与ONC201相比,H3K27M突变的DIPG细胞系对第二代咪哌立酮疗法的敏感性增加。此外, 咪哌立酮与帕比司他、罗米地辛或马立佐米联合使用可导致协同性细胞死亡,这可能需要在临床试验中进一步测试。

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