[PDF][PDF] GAPDH expression predicts the response to R-CHOP, the tumor metabolic status, and the response of DLBCL patients to metabolic inhibitors

J Chiche, J Reverso-Meinietti, A Mouchotte… - Cell metabolism, 2019 - cell.com
J Chiche, J Reverso-Meinietti, A Mouchotte, C Rubio-Patiño, R Mhaidly, E Villa
Cell metabolism, 2019cell.com
Diffuse large B cell lymphoma (DLBCL) is a heterogeneous disease treated with anti-CD20-
based immuno-chemotherapy (R-CHOP). We identified that low levels of GAPDH predict a
poor response to R-CHOP treatment. Importantly, we demonstrated that GAPDH low
lymphomas use OxPhos metabolism and rely on mTORC1 signaling and glutaminolysis.
Consistently, disruptors of OxPhos metabolism (phenformin) or glutaminolysis (L-
asparaginase) induce cytotoxic responses in GAPDH low B cells and improve GAPDH low B …
Summary
Diffuse large B cell lymphoma (DLBCL) is a heterogeneous disease treated with anti-CD20-based immuno-chemotherapy (R-CHOP). We identified that low levels of GAPDH predict a poor response to R-CHOP treatment. Importantly, we demonstrated that GAPDHlow lymphomas use OxPhos metabolism and rely on mTORC1 signaling and glutaminolysis. Consistently, disruptors of OxPhos metabolism (phenformin) or glutaminolysis (L-asparaginase) induce cytotoxic responses in GAPDHlow B cells and improve GAPDHlow B cell-lymphoma-bearing mice survival, while they are low or not efficient on GAPDHhigh B cell lymphomas. Ultimately, we selected four GAPDHlow DLBCL patients, who were refractory to all anti-CD20-based therapies, and targeted DLBCL metabolism using L-asparaginase (K), mTOR inhibitor (T), and metformin (M) (called KTM therapy). Three out of the four patients presented a complete response upon one cycle of KTM. These findings establish that the GAPDH expression level predicts DLBCL patients' response to R-CHOP treatment and their sensitivity to specific metabolic inhibitors.
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