PDI inhibitor LTI6426 enhances panobinostat efficacy in preclinical models of multiple myeloma.

PDI inhibitor LTI6426 enhances panobinostat efficacy in preclinical models of multiple myeloma.
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DOI:
10.1007/s00280-022-04425-3
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发表时间:
2022-05
影响因子:
3
通讯作者:
Dolloff, Nathan G.
Dolloff, Nathan G.
中科院分区:
医学3区
文献类型:
--
作者:
Robinson, Reeder M.;Basar, Ashton P.;Reyes, Leticia;Duncan, Ravyn M.;Li, Hong;Dolloff, Nathan G.

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组蛋白去乙酰化酶抑制剂(HDACi)帕比司他(Panobinostat)(Pano)已被美国食品药品监督管理局(FDA)和欧洲药品管理局(EMA)批准用于治疗复发性/难治性多发性骨髓瘤(MM)。尽管获得了监管机构的批准,但Pano在MM中的使用有限,主要是由于其不良的毒性特征。MM治疗前景继续发展,Pano要在该范例中保持一席之地,就必须确定优化其有效性的治疗方案,特别是那些允许减少剂量以消除不必要毒性的治疗方案。在这里,我们提出了这样一个方案相结合的Pano与LTI 6426,一流的口服生物利用蛋白质二硫键异构酶(PDI)抑制剂。我们使用MM的蛋白酶体抑制剂抗性小鼠模型和未显示毒性迹象的低剂量Pano显示,LTI 6426显著增强Pano的体外和体内抗MM活性。我们继续表征由LTI 6426/Pano组合诱导的转录程序,证明了两种药物对内质网(ER)应激途径效应物ATF 3(激活转录因子3)、DDIT 3/CHOP(DNA损伤诱导转录物3,又称为DIT 3)的会聚。C/EBP同源蛋白)和DNAJB 1(DNAJ同源物亚家族B成员1,也称为HSP 40)。我们得出结论,LTI 6426可以安全地增强低剂量Pano方案,并且ATF 3、DDIT 3/CHOP和DNAJB 1是对这种新型治疗方案的响应的候选药效学生物标志物。
The histone deacetylase inhibitor (HDACi), panobinostat (Pano), is approved by the United States Food and Drug Administration (FDA) and European Medicines Agency (EMA) for treatment of relapsed/refractory multiple myeloma (MM). Despite regulatory approvals, Pano is used on a limited basis in MM due largely to an unfavorable toxicity profile. The MM treatment landscape continues to evolve, and for Pano to maintain a place in that paradigm it will be necessary to identify treatment regimens that optimize its effectiveness, particularly those that permit dose reductions to eliminate unwanted toxicity. Here, we propose such a regimen by combining Pano with LTI6426, a first-in-class orally bioavailable protein disulfide isomerase (PDI) inhibitor. We show that LTI6426 dramatically enhances the anti-MM activity of Pano in vitro and in vivo using a proteasome inhibitor resistant mouse model of MM and a low dose of Pano that exhibited no signs of toxicity. We go on to characterize a transcriptional program that is induced by the LTI6426/Pano combination, demonstrating a convergence of the two drugs on endoplasmic reticulum (ER) stress pathway effectors ATF3 (Activating Transcription Factor 3), DDIT3/CHOP (DNA Damage Inducible Transcript 3, a.k.a. C/EBP Homologous Protein), and DNAJB1 (DnaJ homolog subfamily B member 1, a.k.a. HSP40). We conclude that LTI6426 may safely enhance low-dose Pano regimens and that ATF3, DDIT3/CHOP, and DNAJB1 are candidate pharmacodynamic biomarkers of response to this novel treatment regimen.
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