Obatoclax interacts synergistically with the irreversible proteasome inhibitor carfilzomib in GC- and ABC- DLBCL cells in vitro and in vivo

摘要

Interactions between the the irreversible proteasome inhibitor carfilzomib (CFZ) and the pan-BH3 mimetic obatoclax (Obato) were examined in GC- and ABC-DLBCL cells. Co-treatment with minimally toxic concentrations of CFZ (i.e., 2–6 nM) and sub-toxic concentrations of obato (0.05–2.0μM) synergistically increased apoptosis in multiple DLBCL cell lines and increased lethality toward primary human DLBCL but not normal CD34⁺ cells. Synergistic interactions were associated with sharp increases in caspase-3 activation, PARP cleavage, phospho-JNK induction, up-regulation of Noxa, and AKT dephosphorylation. Combined treatment also diminished CFZ-mediated Mcl-1 up-regulation while immunoprecipitation analysis revealed reduced associations between Bak and Mcl-1/Bcl-xL, and Bim and Mcl-1. The CFZ/Obato regimen triggered translocation, conformational change and dimerization of Bax and activation of Bak. Genetic interruption of JNK and Noxa by shRNA knockdown, ectopic Mcl-1 expression, or enforced activation of AKT significantly attenuated CFZ/Obato-mediated apoptosis. Notably, co-administration of CFZ/Obato sharply increased apoptosis in multiple bortezomib-resistant DLBCL models. Finally, in vivo administration of CFZ and Obato to mice inoculated with SUDHL4 cells substantially suppressed tumor growth, activated JNK, inactivated AKT, and increased survival compared to the effects of single agent treatment. Together, these findings argue that a strategy combining CFZ and Obato warrants attention in DLBCL.