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Targeting the Spleen Tyrosine Kinase with Fostamatinib as a Strategy Against Waldenström?s 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 PMID25748087show ga
Purpose: Waldenström?s macroglobulinemia (WM) 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 WM, and Spleen tyrosine kinase (Syk) is over-expressed 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 Waldenstrom?s-derived cell lines both in vitro and in vivo, as well as on primary patient cells. Results: In WM-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 mitogen activated protein kinase (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 WM, and reduced viability of primary WM 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 Waldenstrom?s.