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Supplementary Tables 1 and 2 and Supplementary Figures 1 through 5 from The Dual MEK/FLT3 Inhibitor E6201 Exerts Cytotoxic Activity against Acute Myeloid Leukemia Cells Harboring Resistance-Conferring FLT3 Mutations

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posted on 2023-03-30, 23:43 authored by Weiguo Zhang, Gautam Borthakur, Chen Gao, Ye Chen, Hong Mu, Vivian R. Ruvolo, Kenichi Nomoto, Nanding Zhao, Marina Konopleva, Michael Andreeff
<p>Supplementary Table 1. Gene alterations and cytogenic information of AML patients. Supplementary Table 2. Comparison of IC50s of E6201 and AC220 in murine ITD mutant and TKDs mutant cell lines. Fig. S1. Molecular structures of drugs used in this study. Fig. S2. Normal bone marrow samples (three cases) were treated with indicated concentration of E6201 for 72 hours and apoptosis induction was measured by stained with annexin V-Fluo and counting annexin V positivity using flow cytometry. Fig. S3. Body weight of mice was measured at Day 4, in which the mice started E6201 (n = 11) or vehicle (n = 10) treatment, and Day 18 after MOLM13-Luci-GFP cells injection. Fig. S4. Baf3-ITD+691 cells were treated with E6201 for 1 hour and protein profiling of correlated signaling pathways was determined using immunoblotting. Fig. S5. OCI/AML3 and MOLM13 p53 knock down (KD) cells and their respective controls were treated with E6201 for E6201 for 72 hour and apoptosis induction were assessed as the percentage of annexin V-positive cells by flow cytometry.</p>

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ARTICLE ABSTRACT

Fms-like tyrosine kinase 3 (FLT3) inhibition has elicited encouraging responses in acute myeloid leukemia (AML) therapy. Unfortunately, unless combined with a bone marrow transplant, disease relapse is frequent. In addition to the acquired point mutations in the FLT3 kinase domain that contribute to FLT3 inhibitor resistance, MEK/ERK signaling is persistently activated in AML cells even when FLT3 phosphorylation is continually suppressed. Thus, concomitant targeting of FLT3 and MAPK may potentially exert synergistic activity to counteract the resistance of AML cells to FLT3-targeted therapy. In this study, we investigated the antileukemia activity of a MEK1 and FLT3 dual inhibitor, E6201, in AML cells resistant to FLT3 inhibition. We found that E6201 exerted profound apoptogenic effects on AML cells harboring resistance-conferring FLT3 mutations. This activity appeared to be p53 dependent, and E6201-induced cytotoxicity was retained under hypoxic culture conditions and during coculture with mesenchymal stem cells that mimic the AML microenvironment. Furthermore, E6201 markedly reduced leukemia burden and improved the survival of mice in a human FLT3–mutated AML model. Collectively, our data provide a preclinical basis for the clinical evaluation of E6201 in AML patients harboring FLT3 mutations, including those who relapse following FLT3-targeted monotherapy. Cancer Res; 76(6); 1528–37. ©2016 AACR.

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