1. PI3K/mTOR dual-inhibition with VS-5584 enhances anti-leukemic efficacy of ponatinib in blasts and Ph-negative LSCs of chronic myeloid leukemia
- Author
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Roya Gasimli, Sunde Yilmaz Susluer, Güray Saydam, Fatma Sogutlu, Tugce Balci Okcanoglu, Cagla Kayabasi, Cigir Biray Avci, Aycan Asik, Cumhur Gündüz, and Besra Ozmen Yelken
- Subjects
mTOR inhibitor ,Stem-Cells ,Resistance ,Apoptosis ,PI3K ,chemistry.chemical_compound ,Phosphatidylinositol 3-Kinases ,Antineoplastic Combined Chemotherapy Protocols ,Kinase Inhibitor ,Phosphoinositide-3 Kinase Inhibitors ,Stem Cells ,TOR Serine-Threonine Kinases ,Ponatinib ,Chronic myeloid leukemia ,Imidazoles ,NF-kappa B ,Myeloid leukemia ,Drug Synergism ,Pyridazines ,Leukemia ,STAT Transcription Factors ,Differentiation ,Combination ,Stem cell ,Mitogen-Activated Protein Kinases ,Bcr-Abl ,Signal Transduction ,Cell Survival ,Mtor ,Morpholines ,Leukemia stem cell ,Antineoplastic Agents ,Inhibitory Concentration 50 ,Leukemia, Myelogenous, Chronic, BCR-ABL Positive ,medicine ,Humans ,Viability assay ,Protein kinase B ,Biology ,PI3K/AKT/mTOR pathway ,Janus Kinases ,Pharmacology ,medicine.disease ,G1 Phase Cell Cycle Checkpoints ,chemistry ,C/Ebp-Alpha ,Purines ,Imatinib ,Cancer research ,K562 Cells ,Proto-Oncogene Proteins c-akt ,Transcription Factors - Abstract
Ponatinib is used for advanced treatment of chronic myeloid leukemia (CML), although low doses to prevent side effects do not suppress survival pathways and eradicate leukemia stem cells (LSCs). We evaluated the potential of ponatinib and PI3K/mTOR dual-inhibitor VS-5584 combination (PoVS) therapy to increase the anti-leukemic effects of ponatinib and investigated the underlying mechanisms at the molecular level. We measured the cytotoxicities of ponatinib, VS-5584, and PoVS (CCK-8 assay), and used the median-effect equation for combination analyses. We investigated the effects of inhibitory concentrations on apoptosis, cell viability and cell-cycle regulation (flow cytometry), protein levels (ELISA, Western blot), transcriptional activities (dual-luciferase reporter assay), gene expressions (qRT-PCR). VS-5584 exerted selective cytotoxic effects against CML and LSC cell lines. VS-5584 inhibited the PI3K/Akt/mTOR pathway, resulting in reduced cell viability, slightly induced caspase-independent apoptosis, prominent G0/G1 cell-cycle blockade that is not a consequence of quiescence. Normal hematopoietic stem cell line was the least affected. Moreover, ponatinib and VS-5584 mediated synergistic anti-leukemic effects on leukemic cells. VS-5584 reduced the ponatinib dose required to target leukemic cells. PoVS treatment inhibited PI3K/Akt/mTOR pathway more consistently than either of the two agents alone through reducing p-Akt, p-mTOR, p-S6K, p-PRAS40, p-S6. The subsequent downstream effects were an increase in C/EBP transcriptional activity and decreases in activities of E2F/DP1, Myc/Max, CREB, STAT3, NF kappa B, AP-1, Elk-1/SRF. Transcriptional regulation resulted in alterations in the expression levels of target mRNAs. Our results highlight PoVS can be a promising treatment strategy for eliminating CML cells and LSCs selectively, with the reduced ponatinib doses., Ege University Scientific Research Projects (BAP) Department [15-TIP-019, 2015-TIP-063], This work was supported by Ege University Scientific Research Projects (BAP) Department (Grand no. 15-TIP-019, 2015-TIP-063).
- Published
- 2021