Combination therapy of BCR-ABL-positive B cell acute lymphoblastic leukemia by tyrosine kinase inhibitor dasatinib and c-JUN N-terminal kinase inhibition

J Hematol Oncol. 2020 Jun 18;13(1):80. doi: 10.1186/s13045-020-00912-3.

Abstract

Background: The Philadelphia chromosome (Ph), which leads to the creation and expression of the fusion gene product BCR-ABL, underlines the pathogenesis of chronic myelogenous leukemia (CML) and a fraction of adult and pediatric acute B-lymphoblastic leukemia (B-ALL). The BCR-ABL tyrosine kinase inhibitors (TKIs) have shown a remarkable clinical activity in patients with CML, but their efficacy in treating Ph+ B-ALL is limited. Identifying additional therapeutic targets is important for the effective treatment of Ph+ B-ALL.

Methods: Activation of the JNK signaling pathway in human and mouse BCR-ABL+ B-ALL cells with or without dasatinib treatment was analyzed by Western blotting. JNK was inhibited either by RNA interference or chemical inhibitors, such as JNK-IN-8. The effect of JNK inhibition with or without BCR-ABL TKI dasatinib on BCR-ABL+ B-ALL cells was analyzed by the CellTiter-Glo® Luminescent Cell Viability Assay. The in vivo effects of JNK-IN-8 and dasatinib alone or in combination were tested using a BCR-ABL induced B-ALL mouse model.

Results: We found that the c-JUN N-terminal kinase (JNK) signaling pathway is abnormally activated in both human and mouse BCR-ABL+ B-ALL cells, but the BCR-ABL TKI does not inhibit JNK activation in these cells. Inhibition of JNK, either by RNAi-mediated downregulation or by JNK inhibitors, could significantly reduce viability of Ph+ B-ALL cells. JNK inhibition by RNAi-mediated downregulation or JNK inhibitors also showed a synergistic effect with the BCR-ABL TKI, dasatinib, in killing Ph+ B-ALL cells in vitro. Furthermore, a potent JNK inhibitor, JNK-IN-8, in combination with dasatinib markedly improved the survival of mice with BCR-ABL induced B-ALL, as compared to the treatment with dasatinib alone.

Conclusions: Our findings indicate that simultaneously targeting both BCR-ABL and JNK kinase might serve as a promising therapeutic strategy for Ph+ B-ALL.

Keywords: Combination target therapy; Dasatinib; JNK; Ph+ B-ALL.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Animals
  • Anthracenes / administration & dosage
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
  • Azepines / administration & dosage
  • Benzamides / administration & dosage
  • Cell Line, Tumor
  • Dasatinib / administration & dosage
  • Drug Screening Assays, Antitumor
  • Female
  • Fusion Proteins, bcr-abl / antagonists & inhibitors*
  • Humans
  • Imatinib Mesylate / administration & dosage
  • JNK Mitogen-Activated Protein Kinases / antagonists & inhibitors*
  • Male
  • Mice
  • Mice, Inbred BALB C
  • Molecular Targeted Therapy*
  • Neoplasm Proteins / antagonists & inhibitors*
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma
  • Protein Kinase Inhibitors / administration & dosage
  • Proto-Oncogene Proteins c-myc / biosynthesis
  • Pyridines / administration & dosage
  • Pyrimidines / administration & dosage
  • RNA Interference
  • RNA, Small Interfering / genetics
  • RNA, Small Interfering / pharmacology
  • Radiation Chimera
  • Random Allocation
  • Signal Transduction / drug effects
  • Triazoles / administration & dosage

Substances

  • (+)-JQ1 compound
  • Anthracenes
  • Azepines
  • BCR-ABL1 fusion protein, human
  • Benzamides
  • JNK-IN-8
  • MYC protein, human
  • Neoplasm Proteins
  • Protein Kinase Inhibitors
  • Proto-Oncogene Proteins c-myc
  • Pyridines
  • Pyrimidines
  • RNA, Small Interfering
  • Triazoles
  • pyrazolanthrone
  • Imatinib Mesylate
  • Fusion Proteins, bcr-abl
  • JNK Mitogen-Activated Protein Kinases
  • Dasatinib