BTK inhibition sensitizes acute lymphoblastic leukemia to asparaginase by suppressing the amino acid response pathway

Asparaginase (ASNase) therapy has been a mainstay of acute lymphoblastic leukemia (ALL) protocols for decades and shows promise in the treatment of a variety of other cancers. To improve the efficacy of ASNase treatment, we used a CRISPR/Cas9-based screen to identify actionable signaling intermediat...

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Veröffentlicht in:Blood 2021-12, Vol.138 (23), p.2383-2395
Hauptverfasser: Butler, Miriam, van Ingen Schenau, Dorette S., Yu, Jiangyan, Jenni, Silvia, Dobay, Maria P., Hagelaar, Rico, Vervoort, Britt M.T., Tee, Trisha M., Hoff, Fieke W., Meijerink, Jules P., Kornblau, Steven M., Bornhauser, Beat, Bourquin, Jean-Pierre, Kuiper, Roland P., van der Meer, Laurens T., van Leeuwen, Frank N.
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container_end_page 2395
container_issue 23
container_start_page 2383
container_title Blood
container_volume 138
creator Butler, Miriam
van Ingen Schenau, Dorette S.
Yu, Jiangyan
Jenni, Silvia
Dobay, Maria P.
Hagelaar, Rico
Vervoort, Britt M.T.
Tee, Trisha M.
Hoff, Fieke W.
Meijerink, Jules P.
Kornblau, Steven M.
Bornhauser, Beat
Bourquin, Jean-Pierre
Kuiper, Roland P.
van der Meer, Laurens T.
van Leeuwen, Frank N.
description Asparaginase (ASNase) therapy has been a mainstay of acute lymphoblastic leukemia (ALL) protocols for decades and shows promise in the treatment of a variety of other cancers. To improve the efficacy of ASNase treatment, we used a CRISPR/Cas9-based screen to identify actionable signaling intermediates that improve the response to ASNase. Both genetic inactivation of Bruton's tyrosine kinase (BTK) and pharmacological inhibition by the BTK inhibitor ibrutinib strongly synergize with ASNase by inhibiting the amino acid response pathway, a mechanism involving c-Myc–mediated suppression of GCN2 activity. This synthetic lethal interaction was observed in 90% of patient-derived xenografts, regardless of the genomic subtype. Moreover, ibrutinib substantially improved ASNase treatment response in a murine PDX model. Hence, ibrutinib may be used to enhance the clinical efficacy of ASNase in ALL. This trial was registered at www.clinicaltrials.gov as # NCT02884453. •CRISPR/Cas9 kinome screen identifies genes involved in ASNase sensitivity.•Ibrutinib synergizes with ASNase by inhibiting the amino acid response pathway via c-Myc– mediated regulation of GCN2. [Display omitted]
doi_str_mv 10.1182/blood.2021011787
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subjects Adenine - analogs & derivatives
Adenine - pharmacology
Adenine - therapeutic use
Agammaglobulinaemia Tyrosine Kinase - antagonists & inhibitors
Agammaglobulinaemia Tyrosine Kinase - metabolism
Amino Acids - metabolism
Animals
Antineoplastic Agents - pharmacology
Antineoplastic Agents - therapeutic use
Apoptosis - drug effects
Asparaginase - pharmacology
Asparaginase - therapeutic use
Cell Line, Tumor
Humans
Lymphoid Neoplasia
Mice
Piperidines - pharmacology
Piperidines - therapeutic use
Precursor Cell Lymphoblastic Leukemia-Lymphoma - drug therapy
Precursor Cell Lymphoblastic Leukemia-Lymphoma - metabolism
Signal Transduction - drug effects
title BTK inhibition sensitizes acute lymphoblastic leukemia to asparaginase by suppressing the amino acid response pathway
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