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2018 ; 103
(7
): 1218-1228
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Repurposing tofacitinib as an anti-myeloma therapeutic to reverse
growth-promoting effects of the bone marrow microenvironment
#MMPMID29622655
Lam C
; Ferguson ID
; Mariano MC
; Lin YT
; Murnane M
; Liu H
; Smith GA
; Wong SW
; Taunton J
; Liu JO
; Mitsiades CS
; Hann BC
; Aftab BT
; Wiita AP
Haematologica
2018[Jul]; 103
(7
): 1218-1228
PMID29622655
show ga
The myeloma bone marrow microenvironment promotes proliferation of malignant
plasma cells and resistance to therapy. Activation of JAK/STAT signaling is
thought to be a central component of these microenvironment-induced phenotypes.
In a prior drug repurposing screen, we identified tofacitinib, a pan-JAK
inhibitor Food and Drug Administration (FDA) approved for rheumatoid arthritis,
as an agent that may reverse the tumor-stimulating effects of bone marrow
mesenchymal stromal cells. Herein, we validated in vitro, in stromal-responsive
human myeloma cell lines, and in vivo, in orthotopic disseminated xenograft
models of myeloma, that tofacitinib showed efficacy in myeloma models.
Furthermore, tofacitinib strongly synergized with venetoclax in coculture with
bone marrow stromal cells but not in monoculture. Surprisingly, we found that
ruxolitinib, an FDA approved agent targeting JAK1 and JAK2, did not lead to the
same anti-myeloma effects. Combination with a novel irreversible JAK3-selective
inhibitor also did not enhance ruxolitinib effects. Transcriptome analysis and
unbiased phosphoproteomics revealed that bone marrow stromal cells stimulate a
JAK/STAT-mediated proliferative program in myeloma cells, and tofacitinib
reversed the large majority of these pro-growth signals. Taken together, our
results suggest that tofacitinib reverses the growth-promoting effects of the
tumor microenvironment. As tofacitinib is already FDA approved, these results can
be rapidly translated into potential clinical benefits for myeloma patients.