ABT199/venetoclax synergism with thiotepa enhances the cytotoxicity of fludarabine, cladribine and busulfan in AML cells

ABT199/venetoclax, an inhibitor of the pro-survival BCL-2 protein, has improved AML treatment. Its efficacy in hematopoietic stem cell transplantation (HSCT), when combined with other chemotherapeutic drugs, has not been thoroughly investigated. The present study demonstrates the synergistic cytotoxicity of ABT199/venetoclax with the DNA alkylator thiotepa (Thio) in AML cells. Cleavage of Caspase 3, PARP1 and HSP90, as well as increased Annexin V positivity, suggest potent activation of apoptosis by this two-drug combination; increased levels of γ-H2AX, P-CHK1 (S317), P-CHK2 (S19) and P-SMC1 (S957) indicate an enhanced DNA damage response. Likewise, the increased level of P-SAPK/JNK (T183/Y185) and decreased P-PI3Kp85 (Y458) suggest enhanced activation of stress signaling pathways. These molecular readouts were synergistically enhanced when ABT199/venetoclax and Thio were combined with fludarabine, cladribine and busulfan. The five-drug combination decreased the levels of BCL-2, BCL-xL and MCL-1, suggesting its potential clinical relevance in overcoming ABT199/venetoclax resistance. Moreover, this combination is active against P53-negative and FLT3-ITD-positive cell lines. Enhanced activation of apoptosis was observed in leukemia patient-derived cell samples exposed to the five-drug combination, suggesting a clinical relevance. The results provide a rationale for clinical trials using these two- and five-drug combinations as part of a conditioning regimen for AML patients undergoing HSCT.

Medienart:

E-Artikel

Erscheinungsjahr:

2024

Erschienen:

2024

Enthalten in:

Zur Gesamtaufnahme - volume:15

Enthalten in:

Oncotarget - 15(2024) vom: 14. März, Seite 220-231

Sprache:

Englisch

Beteiligte Personen:

Valdez, Benigno C [VerfasserIn]
Yuan, Bin [VerfasserIn]
Murray, David [VerfasserIn]
Ramdial, Jeremy L [VerfasserIn]
Popat, Uday [VerfasserIn]
Nieto, Yago [VerfasserIn]
Andersson, Borje S [VerfasserIn]

Links:

Volltext

Themen:

47M74X9YT5
905Z5W3GKH
Acute myeloid leukemia
Bridged Bicyclo Compounds, Heterocyclic
Busulfan
Cladribine
Drug Combinations
FA2DM6879K
Fludarabine
G1LN9045DK
Journal Article
N54AIC43PW
P2K93U8740
Pre-transplant regimens
Proto-Oncogene Proteins c-bcl-2
Sulfonamides
Thiotepa
Venetoclax
Vidarabine

Anmerkungen:

Date Completed 18.03.2024

Date Revised 18.03.2024

published: Electronic

Citation Status MEDLINE

doi:

10.18632/oncotarget.28563

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM369738454