The peripheral benzodiazepine receptor ligand PK11195 overcomes different resistance mechanisms to sensitize AML cells to gemtuzumab ozogamicin

Blood. 2004 Jun 1;103(11):4276-84. doi: 10.1182/blood-2003-11-3825. Epub 2004 Feb 12.

Abstract

The antibody-targeted therapeutic, gemtuzumab ozogamicin (GO, Mylotarg), is approved for treatment of relapsed acute myeloid leukemia (AML). We previously showed that AML blasts from GO refractory patients frequently express the drug transporters P-glycoprotein (Pgp) and/or multidrug resistance protein (MRP). We also previously reported that inhibition of drug transport by the Pgp modulator, cyclosporine A (CSA), can increase GO sensitivity in Pgp(+) AML cells and that the peripheral benzodiazepine receptor ligand, PK11195, sensitizes AML cells to standard chemotherapeutics both by inhibiting Pgp-mediated efflux and by promoting mitochondrial apoptosis. We now show that PK11195 also can overcome multiple resistance mechanisms to increase GO sensitivity in AML cells, including resistance associated with expression of drug transporters and/or antiapoptotic proteins. PK11195 substantially increases GO cytotoxicity in AML cells from many different cell lines and primary patient samples, often more effectively than CSA. We also show that PK11195 is nontoxic in NOD/SCID mice and can sensitize xenografted human AML cells to GO. Since PK11195 is well tolerated in humans as a single agent, its further study as a multifunctional chemosensitizer for anti-AML therapies, including GO-based therapies, is warranted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Acute Disease
  • Aminoglycosides / pharmacology*
  • Animals
  • Antibodies, Monoclonal / pharmacology*
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents / pharmacology*
  • Cyclosporine / pharmacology
  • Drug Resistance, Neoplasm
  • Gemtuzumab
  • Gene Expression Regulation, Leukemic / drug effects
  • HL-60 Cells
  • Humans
  • Immunosuppressive Agents / pharmacology
  • Isoquinolines / pharmacology*
  • Leukemia, Myeloid / drug therapy*
  • Leukemia, Myeloid / metabolism
  • Leukotriene Antagonists / pharmacology
  • Ligands
  • Mice
  • Mice, Inbred NOD
  • Mice, SCID
  • Propionates / pharmacology
  • Proto-Oncogene Proteins c-bcl-2 / genetics
  • Quinolines / pharmacology
  • Receptors, GABA-A / metabolism*
  • Xenograft Model Antitumor Assays
  • bcl-X Protein

Substances

  • Aminoglycosides
  • Antibodies, Monoclonal
  • Antibodies, Monoclonal, Humanized
  • Antineoplastic Agents
  • BCL2L1 protein, human
  • Bcl2l1 protein, mouse
  • Immunosuppressive Agents
  • Isoquinolines
  • Leukotriene Antagonists
  • Ligands
  • Propionates
  • Proto-Oncogene Proteins c-bcl-2
  • Quinolines
  • Receptors, GABA-A
  • bcl-X Protein
  • verlukast
  • Cyclosporine
  • Gemtuzumab
  • PK 11195