Targeting Bcl-2 family members with the BH3 mimetic AT-101 markedly enhances the therapeutic effects of chemotherapeutic agents in in vitro and in vivo models of B …

L Paoluzzi, M Gonen, JR Gardner… - Blood, The Journal …, 2008 - ashpublications.org
L Paoluzzi, M Gonen, JR Gardner, J Mastrella, D Yang, J Holmlund, M Sorensen, L Leopold…
Blood, The Journal of the American Society of Hematology, 2008ashpublications.org
Overexpression of antiapoptotic members of the Bcl-2 family are observed in approximately
80% of B-cell lymphomas, contributing to intrinsic and acquired drug resistance. Nullifying
antiapoptotic function can potentially overcome this in-trinsic and acquired drug resistance.
AT-101 is a BH3 mimetic known to be a potent inhibitor of antiapoptotic Bcl-2 family
members including Bcl-2, Bcl-XL, and Mcl-1. In vitro, AT-101 exhibits concentration-and time-
dependent cytotoxicity against lymphoma and multiple myeloma cell lines, enhancing the …
Abstract
Overexpression of antiapoptotic members of the Bcl-2 family are observed in approximately 80% of B-cell lymphomas, contributing to intrinsic and acquired drug resistance. Nullifying antiapoptotic function can potentially overcome this in-trinsic and acquired drug resistance. AT-101 is a BH3 mimetic known to be a potent inhibitor of antiapoptotic Bcl-2 family members including Bcl-2, Bcl-XL, and Mcl-1. In vitro, AT-101 exhibits concentration- and time-dependent cytotoxicity against lymphoma and multiple myeloma cell lines, enhancing the activity of cytotoxic agents. The IC50 for AT-101 is between 1 and 10 μM for a diverse panel of B-cell lymphomas. AT-101 was synergistic with carfilzomib (C), etoposide (E), doxorubicin (D), and 4-hydroxycyclophosphamide (4-HC) in mantle cell lymphoma (MCL) lines. In a transformed large B-cell lymphoma line (RL), AT-101 was synergistic when sequentially combined with 4-HC, but not when both drugs were added simultaneously. AT-101 also induced potent mitochondrial membrane depolarization (ΔΨm) and apoptosis when combined with carfilzomib, but not with bortezomib in MCL. In severe combined immunodeficient (SCID) beige mouse models of drug-resistant B-cell lymphoma, 35 mg/kg per day of AT-101 was safe and efficacious. The addition of AT-101 to cyclophosphamide (Cy) and rituximab (R) in a schedule-dependent manner enhanced the efficacy of the conventional therapy.
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