Targeting CCR7-PI3Kγ overcomes resistance to tyrosine kinase inhibitors in ALK-rearranged lymphoma
Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) show potent efficacy in several ALK-driven tumors, but the development of resistance limits their long-term clinical impact. Although resistance mechanisms have been studied extensively in ALK-driven non-small cell lung cancer, they...
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Published in | Science translational medicine Vol. 15; no. 702; p. eabo3826 |
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Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Format | Journal Article |
Language | English |
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United States
28.06.2023
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Abstract | Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) show potent efficacy in several ALK-driven tumors, but the development of resistance limits their long-term clinical impact. Although resistance mechanisms have been studied extensively in ALK-driven non-small cell lung cancer, they are poorly understood in ALK-driven anaplastic large cell lymphoma (ALCL). Here, we identify a survival pathway supported by the tumor microenvironment that activates phosphatidylinositol 3-kinase γ (PI3K-γ) signaling through the C-C motif chemokine receptor 7 (CCR7). We found increased PI3K signaling in patients and ALCL cell lines resistant to ALK TKIs. PI3Kγ expression was predictive of a lack of response to ALK TKI in patients with ALCL. Expression of CCR7, PI3Kγ, and PI3Kδ were up-regulated during ALK or STAT3 inhibition or degradation and a constitutively active PI3Kγ isoform cooperated with oncogenic ALK to accelerate lymphomagenesis in mice. In a three-dimensional microfluidic chip, endothelial cells that produce the CCR7 ligands CCL19/CCL21 protected ALCL cells from apoptosis induced by crizotinib. The PI3Kγ/δ inhibitor duvelisib potentiated crizotinib activity against ALCL lines and patient-derived xenografts. Furthermore, genetic deletion of CCR7 blocked the central nervous system dissemination and perivascular growth of ALCL in mice treated with crizotinib. Thus, blockade of PI3Kγ or CCR7 signaling together with ALK TKI treatment reduces primary resistance and the survival of persister lymphoma cells in ALCL. |
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AbstractList | Anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors (TKIs) show potent efficacy in several ALK-driven tumors, but the development of resistance limits their long-term clinical impact. Although resistance mechanisms have been studied extensively in ALK-driven non-small cell lung cancer, they are poorly understood in ALK-driven anaplastic large cell lymphoma (ALCL). Here, we identify a survival pathway supported by the tumor microenvironment that activates phosphatidylinositol 3-kinase γ (PI3K-γ) signaling through the C-C motif chemokine receptor 7 (CCR7). We found increased PI3K signaling in patients and ALCL cell lines resistant to ALK TKIs. PI3Kγ expression was predictive of a lack of response to ALK TKI in patients with ALCL. Expression of CCR7, PI3Kγ, and PI3Kδ were up-regulated during ALK or STAT3 inhibition or degradation and a constitutively active PI3Kγ isoform cooperated with oncogenic ALK to accelerate lymphomagenesis in mice. In a three-dimensional microfluidic chip, endothelial cells that produce the CCR7 ligands CCL19/CCL21 protected ALCL cells from apoptosis induced by crizotinib. The PI3Kγ/δ inhibitor duvelisib potentiated crizotinib activity against ALCL lines and patient-derived xenografts. Furthermore, genetic deletion of CCR7 blocked the central nervous system dissemination and perivascular growth of ALCL in mice treated with crizotinib. Thus, blockade of PI3Kγ or CCR7 signaling together with ALK TKI treatment reduces primary resistance and the survival of persister lymphoma cells in ALCL. |
Author | Shoji, Brent Martinengo, Cinzia Peola, Silvia Arigoni, Maddalena Campisi, Marco Turner, Suzanne D Mologni, Luca Piazza, Rocco Chiarle, Roberto Germena, Giulia Mota, Ines Olivero, Martina Hirsch, Emilio Gambacorti-Passerini, Carlo Ambrogio, Chiara Koch, Raphael Mastini, Cristina Mura, Giulia Tabbò, Fabrizio Patrucco, Enrico Cuesta-Mateos, Carlos Weinstock, David M Voena, Claudia Aster, Jon C Costa, Carlotta Calogero, Raffaele Brugieres, Laurence D'Aliberti, Deborah Prokoph, Nina Kamm, Roger D Chiono, Valeria Inghirami, Giorgio G Ferreira, Antonio Molinaro, Luca Geoerger, Birgit Vissio, Elena |
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SubjectTerms | Anaplastic Lymphoma Kinase Animals Carcinoma, Non-Small-Cell Lung - drug therapy Cell Line, Tumor Crizotinib - pharmacology Crizotinib - therapeutic use Endothelial Cells - metabolism Humans Lung Neoplasms - drug therapy Lymphoma, Large-Cell, Anaplastic - drug therapy Lymphoma, Large-Cell, Anaplastic - genetics Lymphoma, Large-Cell, Anaplastic - pathology Mice Phosphatidylinositol 3-Kinases Protein Kinase Inhibitors - pharmacology Protein Kinase Inhibitors - therapeutic use Protein-Tyrosine Kinases Receptor Protein-Tyrosine Kinases - metabolism Receptors, CCR7 - genetics Tumor Microenvironment Tyrosine Kinase Inhibitors |
Title | Targeting CCR7-PI3Kγ overcomes resistance to tyrosine kinase inhibitors in ALK-rearranged lymphoma |
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