Seipel Katja, Mandhair Harpreet, Bacher Ulrike, Pabst Thomas
Department for Biomedical Research, University of Bern, 3008 Bern, Switzerland.
Department of Hematology, University Hospital Bern, 3010 Bern, Switzerland.
Curr Issues Mol Biol. 2024 Mar 29;46(4):2946-2960. doi: 10.3390/cimb46040184.
Targeting the FLT3 receptor and the IL-1R associated kinase 4 as well as the anti-apoptotic proteins MCL1 and BCL2 may be a promising novel approach in the treatment of acute myeloid leukemia (AML). The FLT3 and IRAK4 inhibitor emavusertib (CA4948), the MCL1 inhibitor S63845, the BCL2 inhibitor venetoclax, and the HSP90 inhibitor PU-H71 were assessed as single agents and in combination for their ability to induce apoptosis and cell death in leukemic cells in vitro. AML cells represented all major morphologic and molecular subtypes, including and mutant AML cell lines and a variety of patient-derived AML cells. Emavusertib in combination with MCL1 inhibitor S63845 or BCL2 inhibitor venetoclax induced cell cycle arrest and apoptosis in MOLM-13 cells. In primary AML cells, the response to emavusertib was associated with the presence of the gene mutation with an allelic ratio >0.5 and the presence of gene mutations. S63845 was effective in all tested AML cell lines and primary AML samples. Blast cell percentage was positively associated with the response to CA4948, S63845, and venetoclax, with elevated susceptibility of primary AML with blast cell fraction >80%. Biomarkers of the response to venetoclax included the blast cell percentage and bone marrow infiltration rate, as well as the expression levels of CD11b, CD64, and CD117. Elevated susceptibility to CA4948 combination treatments with S63845 or PU-H71 was associated with -mutated AML and CD34 < 30%. The combination of CA4948 and BH3-mimetics may be effective in the treatment in -mutated AML with differential target specificity for MCL1 and BCL2 inhibitors. Moreover, the combination of CA4948 and PU-H71 may be a candidate combination treatment in -mutated AML.
靶向FLT3受体、白细胞介素-1受体相关激酶4以及抗凋亡蛋白MCL1和BCL2可能是治疗急性髓系白血病(AML)的一种有前景的新方法。对FLT3和IRAK4抑制剂emavusertib(CA4948)、MCL1抑制剂S63845、BCL2抑制剂维奈克拉以及热休克蛋白90抑制剂PU-H71进行了单药及联合用药评估,以检测它们在体外诱导白血病细胞凋亡和细胞死亡的能力。AML细胞代表了所有主要的形态学和分子亚型,包括 和 突变的AML细胞系以及多种患者来源的AML细胞。Emavusertib与MCL1抑制剂S63845或BCL2抑制剂维奈克拉联合使用可诱导MOLM-13细胞的细胞周期停滞和凋亡。在原发性AML细胞中,对emavusertib的反应与等位基因比例>0.5的 基因突变的存在以及 基因突变的存在相关。S63845在所有测试的AML细胞系和原发性AML样本中均有效。原始细胞百分比与对CA4948、S63845和维奈克拉的反应呈正相关,原始细胞比例>80%的原发性AML易感性升高。对维奈克拉反应的生物标志物包括原始细胞百分比和骨髓浸润率,以及CD11b、CD64和CD117的表达水平。对CA4948与S63845或PU-H71联合治疗的易感性升高与 突变的AML和CD34<30%相关。CA4948与BH3模拟物的联合使用可能对 突变的AML有效,对MCL1和BCL2抑制剂具有不同的靶向特异性。此外,CA4948与PU-H71的联合使用可能是 突变的AML的候选联合治疗方案。