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ESMO Open. 2018 Sep 26;3(6):e000387. doi: 10.1136/esmoopen-2018-000387. eCollection 2018.

BET bromodomain inhibitor birabresib in mantle cell lymphoma: in vivo activity and identification of novel combinations to overcome adaptive resistance.

ESMO open

Chiara Tarantelli, Elena Bernasconi, Eugenio Gaudio, Luciano Cascione, Valentina Restelli, Alberto Jesus Arribas, Filippo Spriano, Andrea Rinaldi, Afua Adjeiwaa Mensah, Ivo Kwee, Maurilio Ponzoni, Emanuele Zucca, Laura Carrassa, Maria E Riveiro, Keyvan Rezai, Anastasios Stathis, Esteban Cvitkovic, Francesco Bertoni

Affiliations

  1. Università della Svizzera italiana (USI), Institute of Oncology Research (IOR), Bellinzona, Switzerland.
  2. Swiss Institute of Bioinformatics (SIB), Lausanne, Switzerland.
  3. IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy.
  4. Dalle Molle Institute for Artificial Intelligence (IDSIA), Manno, Switzerland.
  5. Department of Onco-Haematology, Unit of Lymphoid Malignancies, San Raffaele Scientific Institute, Milan, Italy.
  6. IOSI Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
  7. OTD Oncology, Therapeutic Development, Clichy, France.
  8. Institut Curie, Hôpital René Huguenin, Saint-Cloud, France.
  9. OncoEthix GmbH, a wholly owned subsidiary of Merck Sharp & Dohme Corp, and Merck & Co., Inc, Kenilworth, New Jersey, USA.

PMID: 30305939 PMCID: PMC6173228 DOI: 10.1136/esmoopen-2018-000387

Abstract

BACKGROUND: The outcome of patients affected by mantle cell lymphoma (MCL) has improved in recent years, but there is still a need for novel treatment strategies for these patients. Human cancers, including MCL, present recurrent alterations in genes that encode transcription machinery proteins and of proteins involved in regulating chromatin structure, providing the rationale to pharmacologically target epigenetic proteins. The Bromodomain and Extra Terminal domain (BET) family proteins act as transcriptional regulators of key signalling pathways including those sustaining cell viability. Birabresib (MK-8628/OTX015) has shown antitumour activity in different preclinical models and has been the first BET inhibitor to successfully undergo early clinical trials.

MATERIALS AND METHODS: The activity of birabresib as a single agent and in combination, as well as its mechanism of action was studied in MCL cell lines.

RESULTS: Birabresib showed in vitro and in vivo activities, which appeared mediated via downregulation of MYC targets, cell cycle and NFKB pathway genes and were independent of direct downregulation of CCND1. Additionally, the combination of birabresib with other targeted agents (especially pomalidomide, or inhibitors of BTK, mTOR and ATR) was beneficial in MCL cell lines.

CONCLUSION: Our data provide the rationale to evaluate birabresib in patients affected by MCL.

Keywords: BET bromodomain; MYC; epigenetics; lymphoma

Conflict of interest statement

Competing interests: Francesco Bertoni and Anastasios Stathis have received institutional research funds from Oncology Therapeutic Development. Maria E. Riveiro was an employee of Oncology Therapeutic

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