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2015 ; 21
(11
): 2538-45
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Targeting the Spleen Tyrosine Kinase with Fostamatinib as a Strategy against
Waldenström Macroglobulinemia
#MMPMID25748087
Kuiatse I
; Baladandayuthapani V
; Lin HY
; Thomas SK
; Bjorklund CC
; Weber DM
; Wang M
; Shah JJ
; Zhang XD
; Jones RJ
; Ansell SM
; Yang G
; Treon SP
; Orlowski RZ
Clin Cancer Res
2015[Jun]; 21
(11
): 2538-45
PMID25748087
show ga
PURPOSE: Waldenström macroglobulinemia (WMG) is a lymphoproliferative disorder
characterized by good initial responses to standard therapeutics, but only a
minority of patients achieve complete remissions, and most inevitably relapse,
indicating a need for novel agents. B-cell receptor signaling has been linked to
clonal evolution in WMG, and Spleen tyrosine kinase (Syk) is overexpressed in
primary cells, suggesting that it could be a novel and rational target.
EXPERIMENTAL DESIGN: We studied the impact of the Syk inhibitor fostamatinib on
BCWM.1 and MWCL-1 WMG-derived cell lines both in vitro and in vivo, as well as on
primary patient cells. RESULTS: In WMG-derived cell lines, fostamatinib induced a
time- and dose-dependent reduction in viability, associated with activation of
apoptosis. At the molecular level, fostamatinib reduced activation of Syk and
Bruton's tyrosine kinase, and also downstream signaling through MAPK kinase
(MEK), p44/42 MAPK, and protein kinase B/Akt. As a single agent, fostamatinib
induced tumor growth delay in an in vivo model of WMG, and reduced viability of
primary WMG cells, along with inhibition of p44/42 MAPK signaling. Finally,
fostamatinib in combination with other agents, including dexamethasone,
bortezomib, and rituximab, showed enhanced activity. CONCLUSIONS: Taken together,
these data support the translation of approaches targeting Syk with fostamatinib
to the clinic for patients with relapsed and possibly even newly diagnosed WMG.