1. Bortezomib is significantly beneficial for de novo pediatric AML patients with low phosphorylation of the NF-κB subunit RelA.
- Author
-
van Dijk AD, Hoff FW, Qiu Y, Gerbing RB, Gamis AS, Aplenc R, Kolb EA, Alonzo TA, Meshinchi S, Jenkins GN, de Bont ESJM, Kornblau SM, and Horton TM
- Subjects
- Antineoplastic Combined Chemotherapy Protocols therapeutic use, Bortezomib pharmacology, Bortezomib therapeutic use, Child, Cytarabine adverse effects, Humans, Neoplasm Recurrence, Local chemically induced, Neoplasm Recurrence, Local drug therapy, Phosphorylation, Transcription Factor RelA therapeutic use, Leukemia, Myeloid, Acute drug therapy, NF-kappa B
- Abstract
Purpose: The addition of the proteasome inhibitor (PI) bortezomib to standard chemotherapy (ADE: cytarabine [Ara-C], daunorubicin, and etoposide) did not improve overall outcome of pediatric AML patients in the Children's Oncology Group AAML1031 phase 3 randomized clinical trial (AAML1031) . Bortezomib prevents protein degradation, including RelA via the intracellular NF-kB pathway. In this study, we hypothesized that subgroups of pediatric AML patients benefitting from standard therapy plus bortezomib (ADEB) could be identified based on pre-treatment RelA expression and phosphorylation status., Experimental Design: RelA-total and phosphorylation at serine 536 (RelA-pSer
536 ) were measured in 483 patient samples using reverse phase protein array technology., Results: In ADEB-treated patients, low-RelA-pSer536 was favorably prognostic when compared to high-RelA-pSer536 (3-yr overall survival (OS): 81% vs. 68%, p = 0.032; relapse risk (RR): 30% vs. 49%, p = 0.004). Among low-RelA-pSer536 patients, RR significantly decreased with ADEB compared to ADE (RR: 30% vs. 44%, p = 0.035). Correlation between RelA-pSer536 and 295 other assayed proteins identified a strong correlation with HSF1-pSer326 , another protein previously identified as modifying ADEB response. The combination of low-RelA-pSer536 and low-HSF1-pSer326 was a significant predictor of ADEB response (3-yr OS: 86% vs. 67%, p = 0.013)., Conclusion and Clinical Relevance: Bortezomib may improve clinical outcome in a subgroup of AML patients identified by low-RelA-pSer536 and low-HSF1-pSer326 ., (© 2021 Wiley-VCH GmbH.)- Published
- 2022
- Full Text
- View/download PDF