[PDF][PDF] Combined targeting of JAK2 and Bcl-2/Bcl-xL to cure mutant JAK2-driven malignancies and overcome acquired resistance to JAK2 inhibitors

M Waibel, VS Solomon, DA Knight, RA Ralli, SK Kim… - Cell reports, 2013 - cell.com
M Waibel, VS Solomon, DA Knight, RA Ralli, SK Kim, KM Banks, E Vidacs, C Virely, KCS Sia…
Cell reports, 2013cell.com
To design rational therapies for JAK2-driven hematological malignancies, we functionally
dissected the key survival pathways downstream of hyperactive JAK2. In tumors driven by
mutant JAK2, Stat1, Stat3, Stat5, and the Pi3k and Mek/Erk pathways were constitutively
active, and gene expression profiling of TEL-JAK2 T-ALL cells revealed the upregulation of
prosurvival Bcl-2 family genes. Combining the Bcl-2/Bcl-xL inhibitor ABT-737 with JAK2
inhibitors mediated prolonged disease regressions and cures in mice bearing primary …
Summary
To design rational therapies for JAK2-driven hematological malignancies, we functionally dissected the key survival pathways downstream of hyperactive JAK2. In tumors driven by mutant JAK2, Stat1, Stat3, Stat5, and the Pi3k and Mek/Erk pathways were constitutively active, and gene expression profiling of TEL-JAK2 T-ALL cells revealed the upregulation of prosurvival Bcl-2 family genes. Combining the Bcl-2/Bcl-xL inhibitor ABT-737 with JAK2 inhibitors mediated prolonged disease regressions and cures in mice bearing primary human and mouse JAK2 mutant tumors. Moreover, combined targeting of JAK2 and Bcl-2/Bcl-xL was able to circumvent and overcome acquired resistance to single-agent JAK2 inhibitor treatment. Thus, inhibiting the oncogenic JAK2 signaling network at two nodal points, at the initiating stage (JAK2) and the effector stage (Bcl-2/Bcl-xL), is highly effective and provides a clearly superior therapeutic benefit than targeting just one node. Therefore, we have defined a potentially curative treatment for hematological malignancies expressing constitutively active JAK2.
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