J 2024

Blockage of BCL-XL overcomes venetoclax resistance across BCL2-positive lymphoid malignancies irrespective of BIM status

DOLNIKOVA, Alexandra, Dmitry KAZANTSEV, Magdalena KLANOVA, Eva POKORNA, Dana SOVILJ et. al.

Basic information

Original name

Blockage of BCL-XL overcomes venetoclax resistance across BCL2-positive lymphoid malignancies irrespective of BIM status

Authors

DOLNIKOVA, Alexandra (203 Czech Republic), Dmitry KAZANTSEV (203 Czech Republic), Magdalena KLANOVA (203 Czech Republic), Eva POKORNA (203 Czech Republic), Dana SOVILJ (203 Czech Republic), Cristina Daniela KELEMEN (203 Czech Republic), Liliana TUSKOVA (203 Czech Republic), Eva HOFERKOVÁ (203 Czech Republic, belonging to the institution), Marek MRÁZ (203 Czech Republic, belonging to the institution), Karel HELMAN (203 Czech Republic), Nikola CURIK (203 Czech Republic), Katerina MACHOVA POLAKOVA (203 Czech Republic), Ladislav ANDĚRA (203 Czech Republic), Marek TRNĚNÝ (203 Czech Republic) and Pavel KLENER (203 Czech Republic)

Edition

Blood advances, AMSTERDAM, ELSEVIER, 2024, 2473-9529

Other information

Language

English

Type of outcome

Article in a journal

Country of publisher

Netherlands

Confidentiality degree

is not subject to a state or trade secret

References:

RIV identification code

RIV/00216224:14740/24:00136285

Organization

Středoevropský technologický institut – Repository – Repository

UT WoS

001294402000001

EID Scopus

2-s2.0-85195879602

Keywords in English

CHRONIC LYMPHOCYTIC-LEUKEMIA; MANTLE CELL LYMPHOMA; HOMOZYGOUS DELETIONS; SUSCEPTIBILITY; SENSITIVITY; IBRUTINIB; MCL-1

Links

LX22NPO5102, research and development project. NU23-08-00448, research and development project.
Changed: 3/6/2025 00:50, RNDr. Daniel Jakubík

Abstract

V originále

Venetoclax, a BCL2 inhibitor, has a promising single-agent activity in mantle cell lymphoma (MCL), acute lymphoblastic leukemia (ALL), and large B-cell lymphomas (LBCL), but remissions were generally short, which calls for rational drug combinations. Using a panel of 21 lymphoma and leukemia cell lines and 28 primary samples we demonstrated strong synergy between venetoclax and A1155463, a BCL-XL inhibitor. Immunoprecipitation experiments, and studies on clones with knockout of expression, or transgenic expression of BCL-XL confirmed its key role in mediating inherent and acquired venetoclax resistance. Of note, the venetoclax and A1155463 combination was synthetically lethal even in the cell lines with lack of expression of the pro-apoptotic BCL2L11/BIM, and in the derived clones with genetic knockout of BCL2L11/BIM. This is clinically important because BCL2L11/BIM deletion, downregulation, or sequestration results in venetoclax resistance. Immunoprecipitation experiments further suggested that the pro-apoptotic effector BAX belongs to principal mediators of the venetoclax and A1155463 mode of action in the BIM-deficient cells. Lastly, the efficacy of the new pro-apoptotic combination was confirmed in vivo on a panel of 9 PDX models including MCL (n = 3), B-ALL (n = 2), T-ALL (n = 1), and DLBCL (n = 3). Because continuous inhibition of BCL-XL causes thrombocytopenia, we proposed and tested an interrupted 4 days ON / 3 days OFF treatment regimen, which retained the desired anti-tumor synergy with manageable platelet toxicity. The proposed VEN and A1155463 combination represents an innovative chemotherapy-free regimen with significant preclinical activity across diverse BCL2-positive hematologic malignancies irrespective of the BCL1L11/BIM status.

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