Abstract

Bortezomib (Btz) is an active agent used to treat multiple myeloma (MM). Not all patients who receive Btz-containing therapy show a favorable response. Interaction of cellular adhesion molecules with MM and bone marrow stromal cells is crucial for the survival of MM cells. However, little is known about the role of these molecules in the sensitivity of MM to Btz-containing therapy. Thus, we evaluated the correlation between the level of cellular adhesion molecules in MM cells and the efficacy of Btz plus dexamethasone (Bd) therapy. The expression of the neural cell adhesion molecule gene (NCAM, also known as CD56), ITGA4, CXCR4, and other genes were analyzed in 74 samples of primary MM cells collected from patients before they received Bd therapy. Of the eight genes tested, expression of NCAM was lower among patients who responded poorly to Bd therapy. In vitro expression of NCAM induced by transfection of MM cells enhanced their sensitivity to Btz treatment by causing accumulation of polyubiquitinated proteins. Our results indicate that expression of NCAM is associated with better response to Btz treatment and is a promising candidate biomarker for predicting response to therapies involving Btz.

Highlights

  • Treatment of multiple myeloma (MM) has changed markedly with clinical use of proteasome inhibitors (PIs) and immunomodulatory drugs

  • We identified the influence of Neural cell adhesion molecule (NCAM) (CD56) on Btz plus dexamethasone (Bd) therapy for MM

  • Enhanced expression of NCAM contributed to the improved anti-myeloma effect of Bd therapy by promoting endoplasmic reticulum (ER) stress upon Btz treatment

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Summary

Introduction

Treatment of multiple myeloma (MM) has changed markedly with clinical use of proteasome inhibitors (PIs) and immunomodulatory drugs. Bortezomib (Btz), a PI that targets the beta 5 subunit of the 20S proteasome in MM cells, has significant anti-MM activity when combined with other agents, such as dexamethasone, alkylating agents, and immunomodulatory drugs. Adding dexamethasone to Btz therapy has been reported to be associated with improved responses to treatment by patients with progressive disease or disease that is refractory upon initial Btz monotherapy, including 13 of 74 evaluable patients (18%) in the SUMMIT study and 9 of 27 (33%) patients in the CREST study [1]. Association of NCAM expression with the efficacy of bortezomib treatment. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

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