Abstract

The "gate-keeper" mutations T674I platelet-derived growth factor receptor α (PDGFRα) in hypereosinophilic syndrome (HES) and T315I Bcr-Abl in chronic myeloid leukemia (CML) are resistant to imatinib and the second-generation small-molecule tyrosine kinase inhibitors (TKI). However, to combat acquired resistance to imatinib, an alternative approach is to decrease the expression of the addicted gene to efficiently kill resistant malignant hematologic cells. The purpose of this study was to evaluate the strategy of shutting down the transcription and expression of FIP1-like-1 (FIP1L1)-PDGFRα and Bcr-Abl with SNS-032, an inhibitor of cyclin-dependent kinase 7 (CDK7) and CDK9 in phase I clinical trials. The effects of SNS-032 on PDGFRα and Bcr-Abl signaling pathways, apoptosis, and cell cycling were analyzed in TKI-resistant cells of HES and CML. The in vivo antitumor activity of SNS-032 was assessed with xenografted BaF3-T674I FIP1L1-PDGFRα and KBM5-T315I Bcr-Abl cells in nude mouse models. SNS-032 inhibited the phosphorylation on Ser5 and Ser2 of RNA polymerase II. SNS-032 decreased both the mRNA and protein levels of FIP1L1-PDGFRα and Bcr-Abl and inhibited the proliferation of malignant cells expressing FIP1L1-PDGFRα or Bcr-Abl. It also decreased the phosphorylation of downstream molecules. It induced apoptosis by triggering both the mitochondrial pathway and the death receptor pathway. This CDK7/9 inhibitor potently inhibits FIP1L1-PDGFRα-positive HES cells and Bcr-Abl-positive CML cells regardless of their sensitivity to imatinib. SNS-032 may have potential in treating hematologic malignancy by abrogating oncogene addiction.

Highlights

  • In "oncogene addiction", malignant cells depend highly on the continual activation of intracellular signaling by a specific oncogene despite a multitude of additional carcinogenic genetic changes [1,2,3]

  • The "gatekeeper" mutations T674I platelet—derived growth factor receptor a (PDGFRa) in hypereosinophilic syndrome (HES) and T315I BcrAbl in chronic myeloid leukemia (CML), which are analogous to T670I KIT in gastrointestinal stromal tumors (GIST), are resistant to the second-generation tyrosine kinase inhibitors (TKI)

  • SNS-032 downregulates mRNA of PDGFRa and Bcr-Abl Because SNS-032 is a selective inhibitor of cyclin-dependent kinase 7 (CDK7) and 9, disabling RNA polymerase II (pol II) and gene transcription [35, 36], we first examined its effect on the expression of the addicted genes FIP1L1-PDGFRa (HES) and Bcr-Abl (CML)

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Summary

Introduction

In "oncogene addiction", malignant cells depend highly on the continual activation of intracellular signaling by a specific oncogene despite a multitude of additional carcinogenic genetic changes [1,2,3]. Targeted therapy to inhibit "addicted" oncoproteins has shown some success: smallmolecule tyrosine kinase inhibitors (TKI) have been used to block Bcr-Abl, KIT, and PDGFRa in chronic myeloid leukemia (CML), gastrointestinal stromal tumors (GIST), and hypereosinophilic syndrome (HES), respectively [2, 4,5,6]. The importance of platelet-derived growth factor receptor a (PDGFRa) in HES and Bcr-Abl in CML are good examples of oncogene addiction [7, 8], but the malignant cells can adapt to the challenge of TKIs, and acquired resistance to imatinib is an emergent problem [9, 10]. The "gatekeeper" mutations T674I PDGFRa in HES and T315I BcrAbl in CML, which are analogous to T670I KIT in GISTs, are resistant to the second-generation TKIs

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