骨肉瘤是儿童和青少年常见的原发性恶性骨肿瘤,其治疗手段有限。激酶在肿瘤进展中具有关键作用,因此激酶抑制剂成为了潜在的重要治疗药物。然而,由于骨肉瘤的高度异质性和低发病率,与其它肿瘤相比,激酶抑制剂的疗效研究进展相对缓慢。此外,使用激酶抑制剂的重要挑战在于,当单一激酶被抑制时,癌细胞可能通过启动其它激酶相关致癌通路以形成治疗抵抗,从而继续维持其生存和增殖。联合治疗策略可有效弥补单一药物治疗的不足,提供更具潜力的治疗方案。
近日,中南大学湘雅二医院的 黎志宏 教授团队在 Oncogene 上发表题为 Cooperative blockade of FLT3 and ALK synergistically suppresses growth of osteosarcoma 的文章, 通过对FDA批准的激酶抑制剂进行联合筛选,发现ALK抑制剂和FLT3抑制剂的组合是一种有效的基于激酶的骨肉瘤治疗策略 。
研究人员首先在骨肉瘤细胞系中筛选FDA批准的激酶抑制剂,确定了17种对骨肉瘤细胞有杀伤作用的激酶抑制剂。通过进一步的组合药物筛选确定了几个具有显著协同效应的药物组合,其中Crenolanib + Ceritinib组合在多种浓度下均表现出更强的协同作用。该组合在细胞系、患者来源的类器官和异种移植模型中均能协同抑制骨肉瘤生长,且在小鼠模型中未表现出明显的不良反应,为其在临床上的应用提供了初步的安全性和有效性证据。
机制研究表明,抑制FLT3会显著促进ALK的激活,进而增强其下游PI3K/Akt和MAPK信号通路,而ALK抑制剂的联合使用可有效逆转这一过程。此外,CRISPR/Cas9敲除实验进一步证实,ALK和FLT3的双重敲除显著降低了细胞活力,抑制了肿瘤生长,表明二者在骨肉瘤生长中具有协同作用。
总的来说, 该研究发现了一种新的治疗骨肉瘤的潜在策略,即联合使用ALK抑制剂和FLT3抑制剂,为骨肉瘤的治疗提供了新的思路和方向。 同时,该研究也强调了在靶向癌症治疗中考虑通路串扰的重要性,为未来开发更有效的抗癌疗法提供了理论依据和实践指导。
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Osteosarcoma is a common primary malignant bone tumor in children and young adults, with limited progress in improving survival rates for metastatic or recurrent cases. Kinase inhibitors have emerged as potential treatments for osteosarcoma due to the critical role kinases play in regulating cellular networks. However, single-agent kinase inhibitors often face challenges due to the activation of compensatory oncogenic signaling pathways, which can undermine treatment efficacy. In this study, a combination screening of FDA-approved kinase inhibitors was conducted in osteosarcoma cells. We identified the combination of ALK inhibitor and FLT3 inhibitor as a potent kinase-based therapeutic strategy for osteosarcoma. Our results showed that the combinatorial treatment synergistically suppressed osteosarcoma in cell lines, patient-derived organoids, and xenograft models. Mechanistically, the inhibition of FLT3 significantly promoted the activation of ALK, which subsequently enhanced its downstream PI3K/Akt and MAPK signaling pathways. The combinatorial use of an ALK inhibitor could reverse this process. Thus, our study demonstrates that the cooperative blockade of FLT3 and ALK synergistically suppresses osteosarcoma, providing a potential alternative for its treatment.
DOI: 10.1038/s41388-024-03205-y
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链接:http://www.lewenyixue.com/2024/12/26/Oncogene%E4%B8%A8%E9%BB%8E%E5%BF%97%E5%AE%8F%E5%9B%A2%E9%98%9F%E5%8F%91%E7%8E%B0%E8%81%94%E5%90%88%E9%98%BB%E6%96%AD/