Systems-pharmacology dissection of a drug synergy in imatinib-resistant CML

GE Winter, U Rix, SM Carlson, KV Gleixner… - Nature chemical …, 2012 - nature.com
GE Winter, U Rix, SM Carlson, KV Gleixner, F Grebien, M Gridling, AC Müller, FP Breitwieser
Nature chemical biology, 2012nature.com
Occurrence of the BCR-ABLT315I gatekeeper mutation is among the most pressing
challenges in the therapy of chronic myeloid leukemia (CML). Several BCR-ABL inhibitors
have multiple targets and pleiotropic effects that could be exploited for their synergistic
potential. Testing combinations of such kinase inhibitors identified a strong synergy between
danusertib and bosutinib that exclusively affected CML cells harboring BCR-ABLT315I. To
elucidate the underlying mechanisms, we applied a systems-level approach comprising …
Abstract
Occurrence of the BCR-ABLT315I gatekeeper mutation is among the most pressing challenges in the therapy of chronic myeloid leukemia (CML). Several BCR-ABL inhibitors have multiple targets and pleiotropic effects that could be exploited for their synergistic potential. Testing combinations of such kinase inhibitors identified a strong synergy between danusertib and bosutinib that exclusively affected CML cells harboring BCR-ABLT315I. To elucidate the underlying mechanisms, we applied a systems-level approach comprising phosphoproteomics, transcriptomics and chemical proteomics. Data integration revealed that both compounds targeted Mapk pathways downstream of BCR-ABL, resulting in impaired activity of c-Myc. Using pharmacological validation, we assessed that the relative contributions of danusertib and bosutinib could be mimicked individually by Mapk inhibitors and collectively by downregulation of c-Myc through Brd4 inhibition. Thus, integration of genome- and proteome-wide technologies enabled the elucidation of the mechanism by which a new drug synergy targets the dependency of BCR-ABLT315I CML cells on c-Myc through nonobvious off targets.
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