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  • 1
    Online Resource
    Online Resource
    American Society of Hematology ; 2018
    In:  Blood Vol. 132, No. Supplement 1 ( 2018-11-29), p. 1672-1672
    In: Blood, American Society of Hematology, Vol. 132, No. Supplement 1 ( 2018-11-29), p. 1672-1672
    Abstract: Introduction: Role of angiogenesis in growth, spread and survival of malignant lymphomas remains largely unexplored. Bevacizumab, a monoclonal antibody against vascular endothelial growth factor (VEGF), has been approved for treatment of several types of solid tumors including colorectal carcinoma or breast carcinoma, in all cases in combination with chemotherapy. Mantle cell lymphoma (MCL) is a type of B-cell non-Hodgkin lymphoma characterized by frequent extranodal involvement. Two agents approved for the therapy of MCL including lenalidomide and temsirolimus exert their anti-lymphoma activity at least partially by inhibition of angiogenesis. Our aim was to investigate role of VEGF-dependent angiogenesis on growth and spread of MCL in vivo using different murine models of MCL including patient-derived xenografts (PDXs). We also analyzed a potential anti-lymphoma synergy of a multi-level inhibition of angiogenesis achieved by bevacizumab and temsirolimus. Methods: Experimental therapies were implemented using NOD.Cg-Prkdcscid Il2rgtm1Wjl/SzJ mice purchased from Jackson Laboratory (Bar Harbor, Maine, USA). Therapies were initiated three to five days after subcutaneous (SC) or intravenous (IV) injection of MCL cells (= day 1, D1). Therapies were terminated when SC tumor reached 2 cm, or when mice developed signs of terminal disease. Mice were xenografted either with MCL cell lines (JEKO-1, HBL2) or with PDX cells (VFN-M1, VFN-M2) derived in our laboratory from patients with relapsed MCL. Both PDXs were confirmed by NGS to keep majority of somatic mutations with the primary MCL cells. Growth curves of calculated tumor volumes and overall survivals were compared in case of SC and IV-xenografted animals, respectiverly, in the treated mice compared to untreated controls. VEGF levels were analyzed in different tissues (blood, tumor lysate, spleen lysate) by commercially available ELISA kit. TaqMan Angiogenesis Array was used to compare gene expression changes associated with bevacizumab failure. Results: Bevacizumab significantly inhibited growth of SC MCL tumors all tested models (Figure 1) (JEKO-1: 0.71g ±0.24g vs 3.22g ±0.65g, p=0.0061; HBL-2: 0.95g ±0.11g vs 4.2g ±0.28g, p 〈 0.0001; VFN-M1: 0.49g ±0.04g vs 2.18g ±0.13g, p 〈 0.0001; VFN-M2: 0.77g ±0.07g vs 1.15g ±0.18g, p=0.0012). Unexpectedly, bevacizumab failed to prolong overall survival of IV-xenografted mice in three out of four murine models (HBL-2, JEKO-1, VFN-M1) compared to controls (p=0.89, 0.87 and 0.09, respectively), and only prolonged survival of bevacizumab-treated mice in VFN-M2-xenografted mice by as few as 3 days (Figure 2). Analysis of VEGF levels in lysates of SC tumors revealed a positive correlation between the tumor size and the VEGF level. In contrast, analysis of murine blood and spleen did not detect measureable amounts of VEGF in any case. We hypothesize that SC growth of MCL cells (in form of a lymphoma mass) is associated with hypoxia, which induces secretion of VEGF that stimulates angiogenesis and functions as a paracrine growth factor for MCL cells. SC tumor growth is therefore VEGF-stimulated and sensitive to inhibition by bevacizumab. Indeed, murine (but not human) vessels were detected by immunohistochemistry in SC tumors in all MCL models including both PDX models. In sharp contrast, systemic engraftment and spread of MCL cells (e.g. infiltration of the bone marrow or involvement of the spleen) are not associated with hypoxia, which would explain why bevacizumab failed to prolong overall survival of IV-xenografted mice. Combination of temsirolimus and bevacizumab did not lead to anti-lymphoma synergy, but was associated with additive effect only. Failure of bevacizumab monotherapy was associated with higher expression of several proangiogenic genes including angiogenin, transcription factor FOXC2 or interferon-beta I suggesting activation of alternate pro-angiogenic pathways after blockage of VEGF. Conclusions: Our data clearly indicate that all anti-angiogenic treatment approaches in malignant lymphomas have to be validated in vivo not only using SC xenografts, but also using systemic (IV) models. Our data also indicate that anti-angiogenic therapies might have auxiliary role (in combination with chemotherapy or targeted agents) in the treatment of malignant lymphomas. The gene expression data after failure of bevacizumab suggest activation of alternate pro-angiogenic pathways. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2018
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  • 2
    In: Laboratory Investigation, Elsevier BV, Vol. 94, No. 7 ( 2014-07), p. 806-817
    Type of Medium: Online Resource
    ISSN: 0023-6837
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    Language: English
    Publisher: Elsevier BV
    Publication Date: 2014
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  • 3
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 4307-4307
    Abstract: Mature B-cell lymphomas represent a heteregenous group of malignancies, which are considered to arise along different steps of B-cell development, particularly from germinal or post-germinal center B-cells. Recent studies, however, indicate that hematopoietic stem and progenitor cells (HSPC) could be involved in the pathogenesis of these diseases. We analyzed HSPC populations from 131 patients with mature B-cell malignancies, including chronic lymphocytic leukemia (CLL, n=20), mantle cell lymphoma (MCL, n=26), diffuse large B-cell lymphoma (DLBCL, n=35), follicular lymphoma (FL, n=25), and multiple myeloma (MM, n=25). For comparison, HSPC populations obtained from 22 healthy donors were used. Hematopoietic stem cells (HSC, Lin-CD34+CD38-CD90+CD45RA-), multipotent progenitors (MPP, Lin-CD34+CD38-CD90-CD45RA-), multi-lymphoid progenitors (MLP, Lin-CD34+CD38-CD90-CD45RA+), and pro-B cells (CD34+CD38+CD10+CD19+) were analyzed by flow cytometry. Proportions of HSPC and pro-B cells were related to CD34+CD38- and CD34+CD38+ cells, respectively. HSC and pro-B cell populations were sorted directly into tubes containing lysis solution for subsequent gene expression analyses. Preamplified cDNA was used for quantitative PCR of selected gene targets (n=28 in HSC, and n=27 in pro-B). The expression of targets was normalized to GAPDH expression. Corresponding cell populations isolated from healthy donors were used as controls. The aforementioned flow cytometry analyses revealed significantly decreased MLP population in all 5 tested diagnoses: CLL (p 〈 0.0001), MCL (p=0.0004), DLBCL (p=0.002), FL (p=0.004), and MM (p=0.004) compared to CTRL (Figure 1). Pro-B cell populations were also decreased in all tested diagnoses, but statistical significance was reached only in MCL (p 〈 0.0001), DLBCL (p=0.0003), and MM (p=0.0025), but not in CLL (p=0.078) or FL (p=0.308). HSC populations were significantly increased in DLBCL (p=0.0023), FL (p=0.015), and MCL (p=0.036), but not in MM (p=0.207) or CLL (p=0.875). The only significant change in MPP population was an increase in CLL (p=0.031). To gain more insight into biology of the stem and progenitor cell populations we analyzed gene expression changes of the key transcriptional regulators, HSC and pro-B cell specific surface markers, or genes that are overexpressed in particular lymphoma subtypes. We observed: 1) Significant upregulation of BCL11A, RUNX1, IKAROS, GATA2, PROM1, and CD44 mRNA within HSC populations obtained from all tested diagnoses compared to CTRL-HSC. 2) None of the targets in pro-B cells were significantly deregulated across all 5 diagnoses, the only significantly upregulated genes were IKAROS and EBF1 in CLL compared to CTRL pro-B cells. 3) NOTCH1 and CCND1 mRNA were not detected in CTRL-HSC, but NOTCH1 was detectable in more than 50% of DLBCL and MM-HSC samples, while CCND1 was detectable in more than 50% of CLL-HSC samples. 4) More than 50% difference in gene expression frequency between CTRL and patient HSC samples was observed in the case of BMI1 (CLL, DLBCL, FL and MM), FOXO1 (MM), FOXP1 (DLBCL), and IRF4 (CLL). 5) Pro-B cells obtained from CTRL samples did not express BCL2, BMI1, MYC, PAX5, or ZAP70, but these genes were detected in more than 50% of patient pro-B cell samples as follows: BCL2 in FL, BMI1 and ZAP70 in CLL and DLBCL, MYC in CLL, DLBCL and FL, PAX5 in CLL. 6) More than 50% difference in gene expression frequency between CTRL and patient pro-B cells was observed in case of BCL11A (CLL, DLBCL, FL, MM, and MCL), BCL2L1 (CLL, DLBCL, FL, MM), CD38 (CLL, DLBCL, FL), CD44 (in CLL, DLBCL), IRF4 (CLL, DLBCL, FL), IRF8 and LEF1 (CLL), PU.1 (CLL, FL), and RUNX1 (CLL, DLBCL). In this study, we showed that bone marrow HSPC in patients with mature B-cell malignancies are quantitatively and qualitatively different compared to HSPC obtained from healthy controls. We currently study whether this deregulation is caused by the influence of malignant cells on HSPC or reflects HSPC intrinsic changes that are involved in the pathogenesis of these malignancies. Grant support: IGA-MZ NT13201-4/2012, GACR14-19590S, UNCE 204021, SVV-2013-266509, GA-UK 595912, PRVOUK-27/LF1/1 Figure 1: Percentage of HSPC in patients with diverse mature B-cell malignancies and healthy donors (controls). Symbols are plotted at means and standard deviations are omitted for clarity. Asterisk denotes statistically significant changes. Figure 1:. Percentage of HSPC in patients with diverse mature B-cell malignancies and healthy donors (controls). Symbols are plotted at means and standard deviations are omitted for clarity. Asterisk denotes statistically significant changes. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
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  • 4
    In: Clinical Cancer Research, American Association for Cancer Research (AACR), Vol. 22, No. 5 ( 2016-03-01), p. 1138-1149
    Abstract: Purpose: To investigate the roles of BCL2, MCL1, and BCL-XL in the survival of diffuse large B-cell lymphoma (DLBCL). Experimental designs: Immunohistochemical analysis of 105 primary DLBCL samples, and Western blot analysis of 18 DLBCL cell lines for the expression of BCL2, MCL1, and BCL-XL. Pharmacologic targeting of BCL2, MCL1, and BCL-XL with ABT-199, homoharringtonine (HHT), and ABT-737. Analysis of DLBCL clones with manipulated expressions of BCL2, MCL1, and BCL-XL. Immunoprecipitation of MCL1 complexes in selected DLBCL cell lines. Experimental therapy aimed at inhibition of BCL2 and MCL1 using ABT-199 and HHT, single agent, or in combination, in vitro and in vivo on primary cell-based murine xenograft models of DLBCL. Results: By the pharmacologic targeting of BCL2, MCL1, and BCL-XL, we demonstrated that DLBCL can be divided into BCL2-dependent and MCL1-dependent subgroups with a less pronounced role left for BCL-XL. Derived DLBCL clones with manipulated expressions of BCL2, MCL1, and BCL-XL, as well as the immunoprecipitation experiments, which analyzed MCL1 protein complexes, confirmed these findings at the molecular level. We demonstrated that concurrent inhibition of BCL2 and MCL1 with ABT-199 and HHT induced significant synthetic lethality in most BCL2-expressing DLBCL cell lines. The marked cytotoxic synergy between ABT-199 and HHT was also confirmed in vivo using primary cell-based murine xenograft models of DLBCL. Conclusions: As homoharringtonine is a clinically approved antileukemia drug, and ABT-199 is in advanced phases of diverse clinical trials, our data might have direct implications for novel concepts of early clinical trials in patients with aggressive DLBCL. Clin Cancer Res; 22(5); 1138–49. ©2015 AACR.
    Type of Medium: Online Resource
    ISSN: 1078-0432 , 1557-3265
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    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2016
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  • 5
    In: Molecular Cancer, Springer Science and Business Media LLC, Vol. 13, No. 1 ( 2014-12)
    Type of Medium: Online Resource
    ISSN: 1476-4598
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2014
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  • 6
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 805-805
    Abstract: Tumor immunotherapy based on the use of Chimeric Receptor Modified T cells (CAR T cells) is a promising approach for the treatment of a refractory hematological cancer. However, a robust response mediated by CAR T cells is observed only in a minority of patients and the expansion and persistence of CAR T cells in vivo is mostly unpredictable. In order to enhance the effectiveness of CAR-based immunotherapy we tested the immunoadjuvant properities of lenalidomide in combination with CAR19 T cells in a mouse model of B cell lymphoma. CAR19 construct which was used is composed of anti-CD19scFv joined with signaling domain of 4-1BB and TCR zeta and was delivered into T cell via lentiviral transduction. Lenalidomide is an immunomodulatory drug used for the treatment of multiple myeloma and selected B-cell malignancies, e.g. mantle cell lymphoma (MCL) or activated B-cell subtype of diffuse large B-cell lymphoma (ABC-DLBCL). However, the precise mechanism of action is not very well understood and it is believed that is mediated by a modulation of activity of E3 ubiquitin ligase cereblon which leads to increased ubiquitinylation of Ikaros and Aiolos transcription factors resulting in changes of expression of various receptors on the surface of tumor cells. To test our hypothesis, immunodeficient NSG mice (NOD-SCID-gamma chain null mice) were s.c. transplanted with various human B cells lymphoma cells (MCL or ABC-DLBCL) followed by i.v treatment with CAR19 T cells with or without daily i.p. lenalidomide. First, when we measured the growth of tumors following treatment with CAR19 T cells plus lenalidomide we found that this combination more effectively suppressed growth of s.c. B-NHL tumors than treatment with only CAR19 T cells or only lenalidomide (Figure 1, 1x10e7 Nemo tumor cell s.c., followed with 2 doses of 1x10(7) CAR19 T cells + Lenalidomide daily, tumor weight was measured 14 days after treatment). Additionally, in this experiment lenalidomide significantly enhanced infiltration of residual tumors by CD8+CAR19 T cells (not shown). Next, we tested the response of CAR19 T cells in vitro to B-NHL cells in the presence or, absence of lenalidomide to determine the costimulatory effect of lenalidomide on signaling via CAR, our data show that lenalidomide significantly enhanced functional response of CAR19 T cells following recognition of B cells in vitro which is demonstrated by enhanced production of IFN-gamma and by increased expression of CD69 by CAR19 T cells, interestingly, this effect was seen only if CAR19 T cells but not B-NHL cells were pre-treated with lenalidomide or, when we activated CAR19 T cell with antibody to CAR but not with antibody to CD3. Thus, our data indicate that lenalidomide might work through direct effects on T cells and specifically enhance signaling via CAR. The biochemical events underlying this costimulatory effect of lenalidomide on signaling by CAR are currently being investigated. In summary, our data support the use of lenalidomide for augmentation CAR-based immunotherapy in clinical settings. Figure 1 Figure 1. Disclosures Klener: Cellgene: Research Funding.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
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  • 7
    In: Blood, American Society of Hematology, Vol. 124, No. 21 ( 2014-12-06), p. 3645-3645
    Abstract: Introduction: Diffuse large B-cell lymphoma (DLBCL) represents the most prevalent type of B-cell non-Hodgkin lymphomas (B-NHL) in the Western hemisphere. While BCL2 gene deregulation was repeatedly associated with poor prognosis, the role of MCL1 in the biology of DLBCL remains largely unknown. ABT199 is a highly-selective inhibitor of BCL2 protein currently evaluated in clinical trials. Homoharringtonine (HHT) is a plant alkaloid and as a semisynthetic compound (omacetaxine) it was approved for the treatment of relapsed chronic myelogenous leukemia (CML). Anti-tumor activity of HHT includes downregulation of the anti-apoptotic protein MCL1. Aim: The aim of the project was to evaluate the preclinical anti-lymphoma efficacy of BCL2 and MCL1-targeting agents ABT199 and HHT in DLBCL. Methods: Immunophenotype of primary DLBCL samples was determined by immunohistochemistry (IHC) using the Hans algorithm. Sensitivity of DLBCL cell lines to ABT199 and HHT was determined by Annexin V-based apoptotic assay and WST8-based cell proliferation assay. DLBCL clones with downregulation of selected anti-apoptotic proteins were derived using pLKO1-based lentiviral particles containing shRNAs against BCL2, BCL-XL and MCL1. For upregulation, BCL2, BCL-XL and MCL1 were cloned in the lentiviral expression vector pCDHNeo and the prepared lentiviral particles were used for the transduction of DLBCL cell lines. Results: We analyzed molecular mechanisms of cytotoxic activity of HHT in 7 DLBCL cell lines, and confirmed decreased expression of MCL1 protein in all cases. By semi-quantitative protein expression analysis (western blot or IHC) we demonstrated that BCL-XL and MCL1 were detectable in all DLBCL cell lines (n=18) and primary samples (n=114, GCB=51, ABC=63), while BCL2 was not detectable in 6 out of 18 DLBCL cell lines and 32 out of 114 primary DLBCL samples. 8 out of 12 BCL2-positive DLBCL cell lines were sensitive to 1 microM ABT199 (i.e. did not survive 1 microM ABT199 by standard proliferation assay). In contrary, 6 out of 6 BCL2-negative DLBCL cell lines were resistant to 1 microM ABT199. 11 out of 12 BCL2-positive DLBCL cell lines were sensitive to 30 nM HHT (considered a steady-state plasma level in CML patients treated with HHT). 5 out of 6 BCL2-negative DLBCL cell lines were sensitive to 30 nM HHT. Significant drug synergism between ≤1 microM ABT199 and ≤ 30 nM HHT was observed in 8 out of 12 BCL2-positive, but only in 1 out of 6 BCL2-negative DLBCL cell lines. We demonstrated that high expression of BCL2 positively correlated with sensitivity to ABT-199, irrespective of expression levels of BCL-XL and MCL1. Expression levels of BCL2 and BCL-XL negatively correlated with sensitivity to HHT. Expression level of MCL1 did not correlate with sensitivity to HHT. Both targeted downregulation and transgenic overexpression of BCL-XL in selected DLBCL cell lines confirmed that the expression of BCL-XL negatively correlates with sensitivity to HHT (but not to ABT199). While increase in sensitivity to HHT was observed in 3 out of 3 DLBCL cell lines with targeted knock-down of BCL2, increase in sensitivity to ABT199 was observed only in 1 out of these 3 DLBCL cell lines. Targeted knockdown of MCL1 was associated with increased sensitivity to HHT in 1 out of 2 DLBCL cell lines, but with no change of sensitivity to ABT199. Conclusions: HHT is a promising anti-DLBCL agent in both BCL2-positive and BCL2-negative cases. ABT199, as a single-agent or in combination with HHT, effectively eliminates BCL2-positive DLBCL cells. Based on the observed data two biological categories of DLBCL might be assumed: BCL2-dependent (ABT199-sensitive, HHT-sensitive) and MCL1-dependent (ABT199-resistant, HHT-sensitive) DLBCL. Grant support: IGA-MZ: NT13201-4/2012, GACR14-19590S, UNCE 204021, SVV-2013-266509, PRVOUK P24/LF1/3, GA-UK 1270214 Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2014
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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