Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy

Despite advancements in cancer therapeutics, acute myeloid leukemia patients over 60 years old have a 5-year survival rate of less than 8%. In an attempt to improve this, epigenetic modifying agents have been combined as therapies in clinical studies. In particular combinations with Decitabine and V...

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Main Authors: Young, Christine S., Clarke, Kathryn M., Kettyle, Laura M., Thompson, Alexander, Mills, Ken I.
Format: Article
Published: Impact Journals 2017
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Online Access:https://eprints.nottingham.ac.uk/49749/
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author Young, Christine S.
Clarke, Kathryn M.
Kettyle, Laura M.
Thompson, Alexander
Mills, Ken I.
author_facet Young, Christine S.
Clarke, Kathryn M.
Kettyle, Laura M.
Thompson, Alexander
Mills, Ken I.
author_sort Young, Christine S.
building Nottingham Research Data Repository
collection Online Access
description Despite advancements in cancer therapeutics, acute myeloid leukemia patients over 60 years old have a 5-year survival rate of less than 8%. In an attempt to improve this, epigenetic modifying agents have been combined as therapies in clinical studies. In particular combinations with Decitabine and Vorinostat have had varying degrees of efficacy. This study therefore aimed to understand the underlying molecular mechanisms of these agents to identify potential rational epi-sensitized combinations. Combined Decitabine-Vorinostat treatment synergistically decreased cell proliferation, induced apoptosis, enhanced acetylation of histones and further decreased DNMT1 protein with HL-60 cells showing a greater sensitivity to the combined treatment than OCI-AML3. Combination therapy led to reprogramming of unique target genes including AXL, a receptor tyrosine kinase associated with cell survival and a poor prognosis in AML, which was significantly upregulated following treatment. Therefore targeting AXL following epi-sensitization with Decitabine and Vorinostat may be a suitable triple combination. To test this, cells were treated with a novel triple combination therapy including BGB324, an AXL specific inhibitor. Triple combination increased the sensitivity of OCI-AML3 cells to Decitabine and Vorinostat as shown through viability assays and significantly extended the survival of mice transplanted with pretreated OCI-AML3 cells, while bioluminescence imaging showed the decrease in disease burden following triple combination treatment. Further investigation is required to optimize this triple combination, however, these results suggest that AXL is a potential marker of response to Decitabine-Vorinostat combination treatment and offers a new avenue of epigenetic combination therapies for acute myeloid leukemia.
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spelling nottingham-497492020-05-04T18:46:25Z https://eprints.nottingham.ac.uk/49749/ Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy Young, Christine S. Clarke, Kathryn M. Kettyle, Laura M. Thompson, Alexander Mills, Ken I. Despite advancements in cancer therapeutics, acute myeloid leukemia patients over 60 years old have a 5-year survival rate of less than 8%. In an attempt to improve this, epigenetic modifying agents have been combined as therapies in clinical studies. In particular combinations with Decitabine and Vorinostat have had varying degrees of efficacy. This study therefore aimed to understand the underlying molecular mechanisms of these agents to identify potential rational epi-sensitized combinations. Combined Decitabine-Vorinostat treatment synergistically decreased cell proliferation, induced apoptosis, enhanced acetylation of histones and further decreased DNMT1 protein with HL-60 cells showing a greater sensitivity to the combined treatment than OCI-AML3. Combination therapy led to reprogramming of unique target genes including AXL, a receptor tyrosine kinase associated with cell survival and a poor prognosis in AML, which was significantly upregulated following treatment. Therefore targeting AXL following epi-sensitization with Decitabine and Vorinostat may be a suitable triple combination. To test this, cells were treated with a novel triple combination therapy including BGB324, an AXL specific inhibitor. Triple combination increased the sensitivity of OCI-AML3 cells to Decitabine and Vorinostat as shown through viability assays and significantly extended the survival of mice transplanted with pretreated OCI-AML3 cells, while bioluminescence imaging showed the decrease in disease burden following triple combination treatment. Further investigation is required to optimize this triple combination, however, these results suggest that AXL is a potential marker of response to Decitabine-Vorinostat combination treatment and offers a new avenue of epigenetic combination therapies for acute myeloid leukemia. Impact Journals 2017-05-19 Article PeerReviewed Young, Christine S., Clarke, Kathryn M., Kettyle, Laura M., Thompson, Alexander and Mills, Ken I. (2017) Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy. Oncotarget, 8 (31). pp. 51429-51446. ISSN 1949-2553 epigenetic combination therapies AXL receptor tyrosine kinase acute myeloid leukemia HDAC inhibitors DNMT inhibitors https://doi.org/10.18632/oncotarget.18009 doi:10.18632/oncotarget.18009 doi:10.18632/oncotarget.18009
spellingShingle epigenetic combination therapies
AXL receptor tyrosine kinase
acute myeloid leukemia
HDAC inhibitors
DNMT inhibitors
Young, Christine S.
Clarke, Kathryn M.
Kettyle, Laura M.
Thompson, Alexander
Mills, Ken I.
Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
title Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
title_full Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
title_fullStr Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
title_full_unstemmed Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
title_short Decitabine-Vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
title_sort decitabine-vorinostat combination treatment in acute myeloid leukemia activates pathways with potential for novel triple therapy
topic epigenetic combination therapies
AXL receptor tyrosine kinase
acute myeloid leukemia
HDAC inhibitors
DNMT inhibitors
url https://eprints.nottingham.ac.uk/49749/
https://eprints.nottingham.ac.uk/49749/
https://eprints.nottingham.ac.uk/49749/