Phenotype-based drug screening reveals association between venetoclax response and differentiation stage in acute myeloid leukemia

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Kuusanmäki , H , Leppä , A-M , Pölönen , P , Kontro , M , Dufva , O , Deb , D , Yadav , B , Bruck , O , Kumar , A , Everaus , H , Gjertsen , B T , Heinäniemi , M , Porkka , K , Mustjoki , S & Heckman , C A 2020 , ' Phenotype-based drug screening reveals association between venetoclax response and differentiation stage in acute myeloid leukemia ' , Haematologica , vol. 105 , no. 3 , pp. 708-720 . https://doi.org/10.3324/haematol.2018.214882

Title: Phenotype-based drug screening reveals association between venetoclax response and differentiation stage in acute myeloid leukemia
Author: Kuusanmäki, Heikki; Leppä, Aino-Maija; Pölönen, Petri; Kontro, Mika; Dufva, Olli; Deb, Debashish; Yadav, Bhagwan; Bruck, Oscar; Kumar, Ashwini; Everaus, Hele; Gjertsen, Bjorn Tore; Heinäniemi, Merja; Porkka, Kimmo; Mustjoki, Satu; Heckman, Caroline A.
Contributor: University of Helsinki, Institute for Molecular Medicine Finland
University of Helsinki, Institute for Molecular Medicine Finland
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, Institute for Molecular Medicine Finland
University of Helsinki, Hematologian yksikkö
University of Helsinki, Immunobiology Research Program
University of Helsinki, Institute for Molecular Medicine Finland
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, HUS Comprehensive Cancer Center
University of Helsinki, Institute for Molecular Medicine Finland
Date: 2020-03-01
Number of pages: 13
Belongs to series: Haematologica
ISSN: 0390-6078
URI: http://hdl.handle.net/10138/313615
Abstract: Ex vivo drug testing is a promising approach to identify novel treatment strategies for acute myeloid leukemia (AML). However, accurate blast- specific drug responses cannot be measured with homogeneous "add-mix-measure" cell viability assays. In this study, we implemented a flow cytometry-based approach to simultaneously evaluate the ex vivo sensitivity of different cell populations in 34 primary AML samples to seven drugs and 27 rational drug combinations. Our data demonstrate that different cell populations present in AML samples have distinct sensitivity to targeted therapies. Particularly, blast cells of FAB M0/1 AML showed high sensitivity to venetoclax. In contrast, differentiated monocytic cells abundantly present in M4/5 subtypes showed resistance to Bcl-2 inhibition, whereas immature blasts in the same samples were sensitive, highlighting the importance of blast-specific readouts. Accordingly, in the total mononuclear cell fraction the highest BCL2/MCL1 gene expression ratio was observed in M0/1 and the lowest in M4/5 AML. Of the seven tested drugs, venetoclax had the highest blast-specific toxicity, and combining venetoclax with either MEK inhibitor trametinib or JAK inhibitor ruxolitinib effectively targeted all venetoclax-resistant blasts. In conclusion, we show that ex vivo efficacy of targeted agents and particularly Bcl-2 inhibitor venetoclax is influenced by the cell type, and accurate blast-specific drug responses can be assessed with a flow cytometry-based approach.
Subject: 3122 Cancers
BCL-2 INHIBITION
MCL-1
CELLS
INTERLEUKIN-1
SENSITIVITY
EXPRESSION
PATHWAY
BCL-2 INHIBITION
MCL-1
CELLS
INTERLEUKIN-1
SENSITIVITY
EXPRESSION
PATHWAY
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