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Title: Dual TORK/DNA-PK inhibition blocks critical signaling pathways in chronic lymphocytic leukemia.
Authors: Thijssen, Rachel
Ter Burg, Johanna
Garrick, Brett
van Bochove, Gregor G W
Brown, Jennifer R
Fernandes, Stacey M
Rodríguez, María Solé
Michot, Jean-Marie
Hallek, Michael
Eichhorst, Barbara
Reinhardt, Hans Christian
Bendell, Johanna
Derks, Ingrid A M
van Kampen, Roel J W
Hege, Kristen
Kersten, Marie José
Trowe, Torsten
Filvaroff, Ellen H
Eldering, Eric
Kater, Arnon P
metadata.dc.subject.mesh: Bridged Bicyclo Compounds, Heterocyclic
DNA-Activated Protein Kinase
Drug Resistance, Neoplasm
Leukemia, Lymphocytic, Chronic, B-Cell
Neoplasm Proteins
Nuclear Proteins
TOR Serine-Threonine Kinases
Tumor Cells, Cultured
Issue Date: 27-May-2016
Abstract: Inhibition of B-cell receptor (BCR) signaling pathways in chronic lymphocytic leukemia (CLL) provides significant clinical benefit to patients, mainly by blocking adhesion of CLL cells in the lymph node microenvironment. The currently applied inhibitors ibrutinib and idelalisib have limited capacity however to induce cell death as monotherapy and are unlikely to eradicate the disease. Acquired resistance to therapy in CLL is often caused by mutations in the response network being targeted, both for DNA damage or BCR signaling pathways. Thus, drugs with dual targeting capacity could offer improved therapeutic value. Here, the potency of CC-115, a novel inhibitor of mammalian target of rapamycin kinase (TORK) and DNA-dependent protein kinase (DNA-PK), was evaluated in primary CLL cells in vitro and in CLL patients. Combined TORK and DNA-PK inhibition in vitro resulted in caspase-dependent cell killing irrespective of p53, ATM, NOTCH1, or SF3B1 status. Proliferation induced by CD40(+) interleukin-21 stimulation was completely blocked by CC-115, and CD40-mediated resistance to fludarabine and venetoclax could be reverted by CC-115. BCR-mediated signaling was inhibited by CC-115 and also in CLL samples obtained from patients with acquired resistance to idelalisib treatment. Clinical efficacy of CC-115 was demonstrated in 8 patients with relapsed/refractory CLL/small lymphocytic lymphoma harboring ATM deletions/mutations; all but 1 patient had a decrease in lymphadenopathy, resulting in 1 IWCLL partial response (PR) and 3 PRs with lymphocytosis. In conclusion, these preclinical results, along with early promising clinical activity, suggest that CC-115 may be developed further for treatment of CLL. The trial was registered at as #NCT01353625.
metadata.dc.identifier.doi: 10.1182/blood-2016-02-700328
Appears in Collections:Producción 2020

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