Exploiting Protein Translation Dependence in Multiple Myeloma with Omacetaxine-Based Therapy
- 27 October 2020
- journal article
- research article
- Published by American Association for Cancer Research (AACR) in Clinical Cancer Research
- Vol. 27 (3), 819-830
- https://doi.org/10.1158/1078-0432.ccr-20-2246
Abstract
Purpose: The prognosis of patients with multiple myeloma (MM) who are resistant to proteasome inhibitors, immunomodulatory drugs (IMiDs), and daratumumab is extremely poor. Even B-cell maturation antigen (BCMA)-specific chimeric antigen receptor (CAR) T cell therapies provide only a temporary benefit before patients succumb to their disease. In this report, we interrogate the unique sensitivity of MM cells to the alternative strategy of blocking protein translation with omacetaxine. Experimental Design: We determined protein translation levels (n = 17) and sensitivity to omacetaxine (n = 51) of primary MM patient samples. Synergy was evaluated between omacetaxine and IMiDs in vitro, ex vivo, and in vivo. Underlying mechanism was investigated via proteomic analysis. Results: Almost universally, primary patient MM cells exhibit >2.5-fold increased rates of protein translation compared to normal marrow cells. Ex vivo treatment with omacetaxine resulted in >50% reduction in viable MM cells. In this cohort, high levels of translation serve as a biomarker for patient MM cell sensitivity to omacetaxine. Unexpectedly, omacetaxine demonstrated synergy with IMiDs in MM cell lines in vitro. In addition, in an IMiD-resistant relapsed patient sample, omacetaxine/IMiD combination treatment re-sensitized the MM cells to the IMiD. Proteomic analysis found that the omacetaxine/IMiD combination treatment produced a double-hit on the IRF4/c-MYC pathway, which is critical to MM survival. Conclusion: Overall, protein translation inhibitors represent a potential new drug class for myeloma treatment and provide a rationale for conducting clinical trials with omacetaxine alone and in combination with IMiDs for patients with relapsed/refractory MM.Keywords
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Funding Information
- NCI (K08CA222704)
This publication has 47 references indexed in Scilit:
- BH3 profiling – Measuring integrated function of the mitochondrial apoptotic pathway to predict cell fate decisionsCancer Letters, 2013
- Pharmacokinetic study of omacetaxine mepesuccinate administered subcutaneously to patients with advanced solid and hematologic tumorsCancer Chemotherapy and Pharmacology, 2012
- Cereblon is a direct protein target for immunomodulatory and antiproliferative activities of lenalidomide and pomalidomideLeukemia, 2012
- BET Bromodomain Inhibition as a Therapeutic Strategy to Target c-MycCell, 2011
- Clinical and biological implications of MYC activation: a common difference between MGUS and newly diagnosed multiple myelomaLeukemia, 2011
- Homoharringtonine reduced Mcl-1 expression and induced apoptosis in chronic lymphocytic leukemiaBlood, 2011
- International Myeloma Working Group molecular classification of multiple myeloma: spotlight reviewLeukemia, 2009
- U2504 Determines the Species Specificity of the A-Site Cleft Antibiotics:: The Structures of Tiamulin, Homoharringtonine, and Bruceantin Bound to the RibosomeJournal of Molecular Biology, 2009
- IRF4 addiction in multiple myelomaNature, 2008
- Frequent gain of chromosome band 1q21 in plasma-cell dyscrasias detected by fluorescence in situ hybridization: incidence increases from MGUS to relapsed myeloma and is related to prognosis and disease progression following tandem stem-cell transplantationBlood, 2006