1
|
Jayappa KD, Tran B, Gordon VL, Morris CG, Saha S, Farrington CC, O'Connor CM, Zawacki KP, Isaac KM, Kester M, Bender TP, Williams ME, Portell CA, Weber MJ, Narla G. PP2A modulation overcomes multidrug resistance in chronic lymphocytic leukemia via mPTP-dependent apoptosis. J Clin Invest 2023:155938. [PMID: 37166997 DOI: 10.1172/jci155938] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023] Open
Abstract
Targeted therapies such as venetoclax (Bcl-2 inhibitor) have revolutionized the treatment of chronic lymphocytic leukemia (CLL). We previously reported that persister CLL cells in treated patients overexpress multiple anti-apoptotic proteins and display resistance to pro-apoptotic agents. Here, we demonstrated that multidrug resistant CLL cells in vivo exhibit apoptosis restriction at a premitochondrial level due to insufficient activation of the Bax and Bak proteins. Co-immunoprecipitation analyses with selective BH-domain antagonists revealed that the pleotropic pro-apoptotic protein (Bim) is prevented from activating Bax/Bak by "switching" interactions to other upregulated anti-apoptotic proteins (Mcl-1/Bcl-xL/Bcl-2). Hence, treatments that bypass Bax/Bak restriction are required to deplete these resistant cells in patients. Protein Phosphatase 2A (PP2A) contributes to oncogenesis and treatment resistance. We observed that a small molecule activator of PP2A (SMAP) induced cytotoxicity in multiple cancer cell lines and CLL samples, including multidrug resistant leukemia/lymphoma cells. The SMAP (DT-061) activated apoptosis in multidrug resistant CLL cells through induction of mitochondrial permeability transition pores (mPTP), independent of Bax/Bak. DT-061 inhibited the growth of wild type and Bax/Bak double knockout multidrug resistant CLL cells in a xenograft mouse model. Collectively, we discovered multidrug resistant CLL cells in patients, and validated a pharmacologically tractable pathway to deplete this reservoir.
Collapse
Affiliation(s)
- Kallesh D Jayappa
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Brian Tran
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Vicki L Gordon
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Christopher G Morris
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Shekhar Saha
- Department of Biochemistry and Molecular Genetics, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Caroline C Farrington
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Caitlin M O'Connor
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Kaitin P Zawacki
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| | - Krista M Isaac
- Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Mark Kester
- Department of Pharmacology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Timothy P Bender
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Michael E Williams
- Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Craig A Portell
- Division of Hematology/Oncology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Michael J Weber
- Department of Microbiology, Immunology, and Cancer Biology, University of Virginia School of Medicine, Charlottesville, United States of America
| | - Goutham Narla
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, United States of America
| |
Collapse
|
2
|
Peris I, Romero-Murillo S, Martínez-Balsalobre E, Farrington CC, Arriazu E, Marcotegui N, Jiménez-Muñoz M, Alburquerque-Prieto C, Torres-López A, Fresquet V, Martínez-Climent JA, Mateos MC, Cayuela ML, Narla G, Odero MD, Vicente C. Activation of the PP2A-B56α heterocomplex synergizes with venetoclax therapies in AML through BCL2 and MCL1 modulation. Blood 2023; 141:1047-1059. [PMID: 36455198 PMCID: PMC10023731 DOI: 10.1182/blood.2022016466] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 11/18/2022] [Accepted: 11/18/2022] [Indexed: 12/02/2022] Open
Abstract
Venetoclax combination therapies are becoming the standard of care in acute myeloid leukemia (AML). However, the therapeutic benefit of these drugs in older/unfit patients is limited to only a few months, highlighting the need for more effective therapies. Protein phosphatase 2A (PP2A) is a tumor suppressor phosphatase with pleiotropic functions that becomes inactivated in ∼70% of AML cases. PP2A promotes cancer cell death by modulating the phosphorylation state in a variety of proteins along the mitochondrial apoptotic pathway. We therefore hypothesized that pharmacological PP2A reactivation could increase BCL2 dependency in AML cells and, thus, potentiate venetoclax-induced cell death. Here, by using 3 structurally distinct PP2A-activating drugs, we show that PP2A reactivation synergistically enhances venetoclax activity in AML cell lines, primary cells, and xenograft models. Through the use of gene editing tools and pharmacological approaches, we demonstrate that the observed therapeutic synergy relies on PP2A complexes containing the B56α regulatory subunit, of which expression dictates response to the combination therapy. Mechanistically, PP2A reactivation enhances venetoclax-driven apoptosis through simultaneous inhibition of antiapoptotic BCL2 and extracellular signal-regulated kinase signaling, with the latter decreasing MCL1 protein stability. Finally, PP2A targeting increases the efficacy of the clinically approved venetoclax and azacitidine combination in vitro, in primary cells, and in an AML patient-derived xenograft model. These preclinical results provide a scientific rationale for testing PP2A-activating drugs with venetoclax combinations in AML.
Collapse
Affiliation(s)
- Irene Peris
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Silvia Romero-Murillo
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
| | - Elena Martínez-Balsalobre
- Cancer and Aging Group, Hospital Universitario Virgen de la Arrixaca, and Instituto Murciano de Investigación Biosanitaria, Murcia, Spain
| | - Caroline C. Farrington
- Division of Genetic Medicine, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI
| | - Elena Arriazu
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Oncología, Instituto de Salud Carlos III, Madrid, Spain
| | - Nerea Marcotegui
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
| | - Marta Jiménez-Muñoz
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
| | | | | | - Vicente Fresquet
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Oncología, Instituto de Salud Carlos III, Madrid, Spain
| | - Jose A. Martínez-Climent
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Oncología, Instituto de Salud Carlos III, Madrid, Spain
| | - Maria C. Mateos
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Hematology Service, Hospital Universitario de Navarra, Pamplona, Spain
| | - Maria L. Cayuela
- Cancer and Aging Group, Hospital Universitario Virgen de la Arrixaca, and Instituto Murciano de Investigación Biosanitaria, Murcia, Spain
| | - Goutham Narla
- Division of Genetic Medicine, Department of Internal Medicine, The University of Michigan Medical School, Ann Arbor, MI
| | - Maria D. Odero
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
- Centro de Investigación Biomédica en Red de Oncología, Instituto de Salud Carlos III, Madrid, Spain
| | - Carmen Vicente
- Centro de Investigación Médica Aplicada, University of Navarra, Pamplona, Spain
- Department of Biochemistry and Genetics, University of Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| |
Collapse
|
3
|
Farrington CC, Yuan E, Mazhar S, Izadmehr S, Hurst L, Allen-Petersen BL, Janghorban M, Chung E, Wolczanski G, Galsky M, Sears R, Sangodkar J, Narla G. Protein phosphatase 2A activation as a therapeutic strategy for managing MYC-driven cancers. J Biol Chem 2020. [DOI: 10.1016/s0021-9258(17)49933-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
|
4
|
Farrington CC, Yuan E, Mazhar S, Izadmehr S, Hurst L, Allen-Petersen BL, Janghorban M, Chung E, Wolczanski G, Galsky M, Sears R, Sangodkar J, Narla G. Protein phosphatase 2A activation as a therapeutic strategy for managing MYC-driven cancers. J Biol Chem 2019; 295:757-770. [PMID: 31822503 DOI: 10.1074/jbc.ra119.011443] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 12/04/2019] [Indexed: 12/14/2022] Open
Abstract
The tumor suppressor protein phosphatase 2A (PP2A) is a serine/threonine phosphatase whose activity is inhibited in most human cancers. One of the best-characterized PP2A substrates is MYC proto-oncogene basic helix-loop-helix transcription factor (MYC), whose overexpression is commonly associated with aggressive forms of this disease. PP2A directly dephosphorylates MYC, resulting in its degradation. To explore the therapeutic potential of direct PP2A activation in a diverse set of MYC-driven cancers, here we used biochemical assays, recombinant cell lines, gene expression analyses, and immunohistochemistry to evaluate a series of first-in-class small-molecule activators of PP2A (SMAPs) in Burkitt lymphoma, KRAS-driven non-small cell lung cancer, and triple-negative breast cancer. In all tested models of MYC-driven cancer, the SMAP treatment rapidly and persistently inhibited MYC expression through proteasome-mediated degradation, inhibition of MYC transcriptional activity, decreased cancer cell proliferation, and tumor growth inhibition. Importantly, we generated a series of cell lines expressing PP2A-dependent phosphodegron variants of MYC and demonstrated that the antitumorigenic activity of SMAPs depends on MYC degradation. Collectively, the findings presented here indicate a pharmacologically tractable approach to drive MYC degradation by using SMAPs for the management of a broad range of MYC-driven cancers.
Collapse
Affiliation(s)
| | - Eric Yuan
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106
| | - Sahar Mazhar
- Department of Pathology, Case Western Reserve University, Cleveland, Ohio 44106
| | - Sudeh Izadmehr
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Lauren Hurst
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48105
| | - Brittany L Allen-Petersen
- Department of Molecular and Medical Genetics, Oregon Health and Sciences University, Portland, Oregon 97239
| | - Mahnaz Janghorban
- Department of Molecular and Medical Genetics, Oregon Health and Sciences University, Portland, Oregon 97239
| | - Eric Chung
- Case Comprehensive Cancer Center, Case Western Reserve University, Cleveland, Ohio 44106
| | - Grace Wolczanski
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48105
| | - Matthew Galsky
- Department of Medicine, Division of Hematology and Medical Oncology, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York 10029
| | - Rosalie Sears
- Department of Molecular and Medical Genetics, Oregon Health and Sciences University, Portland, Oregon 97239
| | - Jaya Sangodkar
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48105
| | - Goutham Narla
- Division of Genetic Medicine, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan 48105
| |
Collapse
|
5
|
Farrington CC, Narla G. Lulling the Cancer Cell into an Eternal Sleep. Cancer Res 2019; 79:1756-1757. [PMID: 30987978 DOI: 10.1158/0008-5472.can-19-0853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 03/13/2019] [Accepted: 03/14/2019] [Indexed: 11/16/2022]
Abstract
A hallmark of metastasis is the ability of cancer cells to undergo the epithelial-to-mesenchymal transition to invade and disseminate to distal sites. More recently, the case has been made that the critical last step in metastasis is dependent on the ability to undergo reversion to an epithelial phenotype in a process known as the mesenchymal-to-epithelial transition (MET). It is this transition in the metastatic cascade that researchers are focusing on clinically to treat disseminated disease. Shinde and colleagues identified spleen tyrosine kinase (SYK) as a critical mediator of MET that facilitated the removal of P-bodies during autophagy. Remarkably, pharmacologic inhibition of SYK inhibited the clearance of P-bodies and autophagy in preclinical models of metastasis, arresting cancer cells in an indefinite dormant state and preventing tumor cell colonization and thus the establishment of aggressive metastatic disease.See related article by Shinde et al., p. 1831.
Collapse
Affiliation(s)
| | - Goutham Narla
- Division of Genetic Medicine, Department of Medicine, University of Michigan, Ann Arbor, Michigan.
| |
Collapse
|
6
|
Sangodkar J, Perl A, Tohme R, Kiselar J, Kastrinsky DB, Zaware N, Izadmehr S, Mazhar S, Wiredja DD, O'Connor CM, Hoon D, Dhawan NS, Schlatzer D, Yao S, Leonard D, Borczuk AC, Gokulrangan G, Wang L, Svenson E, Farrington CC, Yuan E, Avelar RA, Stachnik A, Smith B, Gidwani V, Giannini HM, McQuaid D, McClinch K, Wang Z, Levine AC, Sears RC, Chen EY, Duan Q, Datt M, Haider S, Ma'ayan A, DiFeo A, Sharma N, Galsky MD, Brautigan DL, Ioannou YA, Xu W, Chance MR, Ohlmeyer M, Narla G. Activation of tumor suppressor protein PP2A inhibits KRAS-driven tumor growth. J Clin Invest 2017; 127:2081-2090. [PMID: 28504649 DOI: 10.1172/jci89548] [Citation(s) in RCA: 136] [Impact Index Per Article: 19.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2016] [Accepted: 03/07/2017] [Indexed: 12/20/2022] Open
Abstract
Targeted cancer therapies, which act on specific cancer-associated molecular targets, are predominantly inhibitors of oncogenic kinases. While these drugs have achieved some clinical success, the inactivation of kinase signaling via stimulation of endogenous phosphatases has received minimal attention as an alternative targeted approach. Here, we have demonstrated that activation of the tumor suppressor protein phosphatase 2A (PP2A), a negative regulator of multiple oncogenic signaling proteins, is a promising therapeutic approach for the treatment of cancers. Our group previously developed a series of orally bioavailable small molecule activators of PP2A, termed SMAPs. We now report that SMAP treatment inhibited the growth of KRAS-mutant lung cancers in mouse xenografts and transgenic models. Mechanistically, we found that SMAPs act by binding to the PP2A Aα scaffold subunit to drive conformational changes in PP2A. These results show that PP2A can be activated in cancer cells to inhibit proliferation. Our strategy of reactivating endogenous PP2A may be applicable to the treatment of other diseases and represents an advancement toward the development of small molecule activators of tumor suppressor proteins.
Collapse
Affiliation(s)
- Jaya Sangodkar
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Abbey Perl
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Rita Tohme
- Case Western Reserve University, Cleveland, Ohio, USA.,Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
| | - Janna Kiselar
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Nilesh Zaware
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sudeh Izadmehr
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sahar Mazhar
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | | | - Divya Hoon
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Neil S Dhawan
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Shen Yao
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | | | - Lifu Wang
- University of Virginia, Charlottesville, Virginia, USA
| | - Elena Svenson
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Eric Yuan
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Rita A Avelar
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Agnes Stachnik
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Blake Smith
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Vickram Gidwani
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Daniel McQuaid
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Zhizhi Wang
- University of Washington, Seattle, Washington, USA
| | - Alice C Levine
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Edward Y Chen
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Qiaonan Duan
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Manish Datt
- International Centre for Genetic Engineering and Biotechnology (ICGEB), New Delhi, India
| | - Shozeb Haider
- School of Pharmacy, University College London, London, United Kingdom.,University of Washington, Seattle, Washington, USA
| | - Avi Ma'ayan
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Analisa DiFeo
- Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Matthew D Galsky
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | | | - Wenqing Xu
- University of Washington, Seattle, Washington, USA
| | - Mark R Chance
- Case Western Reserve University, Cleveland, Ohio, USA
| | - Michael Ohlmeyer
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Goutham Narla
- Case Western Reserve University, Cleveland, Ohio, USA
| |
Collapse
|
7
|
Kastrinsky DB, Sangodkar J, Zaware N, McClinch K, Farrington CC, Giannini HM, Izadmehr S, Dhawan NS, Narla G, Ohlmeyer M. Corrigendum to "Reengineered tricyclic anti-cancer agents" [Bioorg. Med. Chem. 23 (2015) 6528-6534]. Bioorg Med Chem 2015; 23:7487. [PMID: 28290285 DOI: 10.1016/j.bmc.2015.11.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- David B Kastrinsky
- Department of Structural and Chemical Biology, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Jaya Sangodkar
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Nilesh Zaware
- Department of Structural and Chemical Biology, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Kimberly McClinch
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Caroline C Farrington
- Department of Medicine, Institute for Transformative Molecular Medicine, Case Western Reserve University, 2103 Cornell Road, Cleveland, OH 44106, United States
| | - Heather M Giannini
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Sudeh Izadmehr
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Neil S Dhawan
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States
| | - Goutham Narla
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States; Department of Medicine, Institute for Transformative Molecular Medicine, Case Western Reserve University, 2103 Cornell Road, Cleveland, OH 44106, United States
| | - Michael Ohlmeyer
- Department of Structural and Chemical Biology, Icahn School of Medicine at Mt. Sinai, 1425 Madison Avenue, New York, NY 10029, United States.
| |
Collapse
|