Phosphatidylinositol 3-kinase-δ inhibitor CAL-101 shows promising preclinical activity in chronic lymphocytic leukemia by antagonizing intrinsic and extrinsic cellular …

SEM Herman, AL Gordon, AJ Wagner… - Blood, The Journal …, 2010 - ashpublications.org
SEM Herman, AL Gordon, AJ Wagner, NA Heerema, W Zhao, JM Flynn, J Jones, L Andritsos…
Blood, The Journal of the American Society of Hematology, 2010ashpublications.org
Targeted therapy with imatinib in chronic myeloid leukemia (CML) prompted a new
treatment paradigm. Unlike CML, chronic lymphocytic leukemia (CLL) lacks an aberrant
fusion protein kinase but instead displays increased phosphatidylinositol 3-kinase (PI3K)
activity. To date, PI3K inhibitor development has been limited because of the requirement of
this pathway for many essential cellular functions. Identification of the hematopoietic-
selective isoform PI3K-δ unlocks a new therapeutic potential for B-cell malignancies. Herein …
Abstract
Targeted therapy with imatinib in chronic myeloid leukemia (CML) prompted a new treatment paradigm. Unlike CML, chronic lymphocytic leukemia (CLL) lacks an aberrant fusion protein kinase but instead displays increased phosphatidylinositol 3-kinase (PI3K) activity. To date, PI3K inhibitor development has been limited because of the requirement of this pathway for many essential cellular functions. Identification of the hematopoietic-selective isoform PI3K-δ unlocks a new therapeutic potential for B-cell malignancies. Herein, we demonstrate that PI3K has increased enzymatic activity and that PI3K-δ is expressed in CLL cells. A PI3K-δ selective inhibitor CAL-101 promoted apoptosis in primary CLL cells ex vivo in a dose- and time-dependent fashion that was independent of common prognostic markers. CAL-101–mediated cytotoxicity was caspase dependent and was not diminished by coculture on stromal cells. In addition, CAL-101 abrogated protection from spontaneous apoptosis induced by B cell–activating factors CD40L, TNF-α, and fibronectin. In contrast to malignant cells, CAL-101 does not promote apoptosis in normal T cells or natural killer cells, nor does it diminish antibody-dependent cellular cytotoxicity. However, CAL-101 did decrease activated T-cell production of various inflammatory and antiapoptotic cytokines. Collectively, these studies provide rationale for the clinical development of CAL-101 as a first-in-class targeted therapy for CLL and related B-cell lymphoproliferative disorders.
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