TY - JOUR
T1 - Tyrosine kinase inhibitor–induced defects in DNA repair sensitize FLT3(ITD)-positive leukemia cells to PARP1 inhibitors
AU - Maifrede, Silvia
AU - Nieborowska-Skorska, Margaret
AU - Sullivan-Reed, Katherine
AU - Dasgupta, Yashodhara
AU - Podszywalow-Bartnicka, Paulina
AU - Le, Bac Viet
AU - Solecka, Martyna
AU - Lian, Zhaorui
AU - Belyaeva, Elizaveta A.
AU - Nersesyan, Alina
AU - Machnicki, Marcin M.
AU - Toma, Monika M.
AU - Chatain, Nicolas
AU - Rydzanicz, Malgorzata
AU - Zhao, Huaqing
AU - Jelinek, Jaroslav
AU - Piwocka, Katarzyna
AU - Sliwinski, Tomasz
AU - Stoklosa, Tomasz
AU - Ploski, Rafal
AU - Fischer, Thomas
AU - Sykes, Stephen M.
AU - Koschmieder, Steffen
AU - Bullinger, Lars
AU - Valent, Peter
AU - Wasik, Mariusz A.
AU - Huang, Jian
AU - Skorski, Tomasz
N1 - Publisher Copyright:
© 2018 by The American Society of Hematology
PY - 2018/7/5
Y1 - 2018/7/5
N2 - Mutations in FMS-like tyrosine kinase 3 (FLT3), such as internal tandem duplications (ITDs), can be found in up to 23% of patients with acute myeloid leukemia (AML) and confer a poor prognosis. Current treatment options for FLT3(ITD)-positive AMLs include genotoxic therapy and FLT3 inhibitors (FLT3i’s), which are rarely curative. PARP1 inhibitors (PARP1i’s) have been successfully applied to induce synthetic lethality in tumors harboring BRCA1/2 mutations and displaying homologous recombination (HR) deficiency. We show here that inhibition of FLT3(ITD) activity by the FLT3i AC220 caused downregulation of DNA repair proteins BRCA1, BRCA2, PALB2, RAD51, and LIG4, resulting in inhibition of 2 major DNA double-strand break (DSB) repair pathways, HR, and nonhomologous end-joining. PARP1i, olaparib, and BMN673 caused accumulation of lethal DSBs and cell death in AC220-treated FLT3(ITD)-positive leukemia cells, thus mimicking synthetic lethality. Moreover, the combination of FLT3i and PARP1i eliminated FLT3(ITD)-positive quiescent and proliferating leukemia stem cells, as well as leukemic progenitors, from human and mouse leukemia samples. Notably, the combination of AC220 and BMN673 significantly delayed disease onset and effectively reduced leukemia-initiating cells in an FLT3(ITD)-positive primary AML xenograft mouse model. In conclusion, we postulate that FLT3i-induced deficiencies in DSB repair pathways sensitize FLT3(ITD)-positive AML cells to synthetic lethality triggered by PARP1i’s. Therefore, FLT3(ITD) could be used as a precision medicine marker for identifying AML patients that may benefit from a therapeutic regimen combining FLT3 and PARP1i’s.
AB - Mutations in FMS-like tyrosine kinase 3 (FLT3), such as internal tandem duplications (ITDs), can be found in up to 23% of patients with acute myeloid leukemia (AML) and confer a poor prognosis. Current treatment options for FLT3(ITD)-positive AMLs include genotoxic therapy and FLT3 inhibitors (FLT3i’s), which are rarely curative. PARP1 inhibitors (PARP1i’s) have been successfully applied to induce synthetic lethality in tumors harboring BRCA1/2 mutations and displaying homologous recombination (HR) deficiency. We show here that inhibition of FLT3(ITD) activity by the FLT3i AC220 caused downregulation of DNA repair proteins BRCA1, BRCA2, PALB2, RAD51, and LIG4, resulting in inhibition of 2 major DNA double-strand break (DSB) repair pathways, HR, and nonhomologous end-joining. PARP1i, olaparib, and BMN673 caused accumulation of lethal DSBs and cell death in AC220-treated FLT3(ITD)-positive leukemia cells, thus mimicking synthetic lethality. Moreover, the combination of FLT3i and PARP1i eliminated FLT3(ITD)-positive quiescent and proliferating leukemia stem cells, as well as leukemic progenitors, from human and mouse leukemia samples. Notably, the combination of AC220 and BMN673 significantly delayed disease onset and effectively reduced leukemia-initiating cells in an FLT3(ITD)-positive primary AML xenograft mouse model. In conclusion, we postulate that FLT3i-induced deficiencies in DSB repair pathways sensitize FLT3(ITD)-positive AML cells to synthetic lethality triggered by PARP1i’s. Therefore, FLT3(ITD) could be used as a precision medicine marker for identifying AML patients that may benefit from a therapeutic regimen combining FLT3 and PARP1i’s.
UR - http://www.scopus.com/inward/record.url?scp=85049595648&partnerID=8YFLogxK
U2 - 10.1182/blood-2018-02-834895
DO - 10.1182/blood-2018-02-834895
M3 - Article
C2 - 29784639
SN - 0006-4971
VL - 132
SP - 67
EP - 77
JO - Blood
JF - Blood
IS - 1
ER -