1 5849 114 SUBEROYLANILIDE HYDROXAMIC ACID (SAHA) AND CLADRIBINE SYNERGISTICALLY INDUCE APOPTOSIS IN NK-LGL LEUKAEMIA. NATURAL KILLER (NK) LARGE GRANULAR LYMPHOCYTE (LGL) LEUKAEMIA FEATURES A CLONAL PROLIFERATION OF CD3(-) NK CELLS THAT CAN BE CLASSIFIED INTO EITHER AGGRESSIVE OR CHRONIC CATEGORIES. THE NKL CELL LINE, DERIVED FROM AN AGGRESSIVE ASIAN NK CELL LEUKAEMIA, AND PATIENT SAMPLES FROM CHRONIC NK-LGL LEUKAEMIA WERE USED IN OUR STUDY TO PROBE FOR SYNERGISTIC EFFICACY OF THE EPIGENETIC DRUGS VORINOSTAT (SAHA) AND CLADRIBINE IN THIS DISEASE. WE DEMONSTRATE THAT HISTONE DEACETYLASES (HDACS) ARE OVER-EXPRESSED IN BOTH AGGRESSIVE AND CHRONIC NK LEUKAEMIA. ADMINISTRATION OF THE HDAC INHIBITOR SAHA REDUCES CLASS I AND II HDAC EXPRESSION AND ENHANCES HISTONE ACETYLATION IN LEUKAEMIC NK CELLS. IN VITRO COMBINATION TREATMENT WITH SAHA AND CLADRIBINE DOSE-DEPENDENTLY EXERTS SYNERGISTIC CYTOTOXIC AND APOPTOTIC EFFECTS ON LEUKAEMIC NK CELLS. EXPRESSION PROFILING OF APOPTOTIC REGULATORY GENES SUGGESTS THAT BOTH COMPOUNDS LED TO CASPASE-DEPENDENT APOPTOSIS THROUGH ACTIVATION OF INTRINSIC MITOCHONDRIAL AND EXTRINSIC DEATH RECEPTOR PATHWAYS. COLLECTIVELY, THESE DATA SHOW THAT COMBINED EPIGENETIC THERAPY, USING HDAC AND DNA METHYLTRANSFERASE INHIBITORS, MAY BE A PROMISING THERAPEUTIC APPROACH FOR NK-LGL LEUKAEMIA. 2015 2 6688 36 VALPROATE SYNERGIZES WITH PURINE NUCLEOSIDE ANALOGUES TO INDUCE APOPTOSIS OF B-CHRONIC LYMPHOCYTIC LEUKAEMIA CELLS. RESISTANCE TO CHEMOTHERAPY AND DRUG TOXICITY ARE TWO MAJOR CONCERNS OF CHRONIC LYMPHOCYTIC LEUKAEMIA (B-CLL) TREATMENT BY PURINE NUCLEOSIDE ANALOGUES (PNA, I.E. FLUDARABINE AND CLADRIBINE). WE HYPOTHESIZED THAT TARGETING EPIGENETIC CHANGES MIGHT ADDRESS THESE ISSUES AND EVALUATED THE EFFECT OF THE HISTONE DEACETYLASE INHIBITOR VALPROATE (VPA) AT A CLINICALLY RELEVANT CONCENTRATION. VPA ACTED IN A HIGHLY SYNERGISTIC/ADDITIVE MANNER WITH FLUDARABINE AND CLADRIBINE TO INDUCE APOPTOSIS OF B-CLL CELLS. IMPORTANTLY, VPA ALSO RESTORED SENSITIVITY TO FLUDARABINE IN B CELLS FROM POOR PROGNOSIS CLL PATIENTS WHO BECAME RESISTANT TO CHEMOTHERAPY. MECHANISM OF APOPTOSIS INDUCED BY VPA ALONE OR COMBINED WITH FLUDARABINE OR TO CLADRIBINE WAS CASPASE-DEPENDENT AND INVOLVED THE EXTRINSIC PATHWAY. VPA, BUT NEITHER FLUDARABINE NOR CLADRIBINE, ENHANCED THE PRODUCTION OF REACTIVE OXYGEN SPECIES (ROS) AND INHIBITION OF ROS WITH N-ACETYLCYSTEINE DECREASES APOPTOSIS OF CLL CELLS. VPA STIMULATES HYPERPHOSPHORYLATION OF P42/P44 ERK, CYTOCHROME C RELEASE AND OVEREXPRESSION OF BAX AND FAS. TOGETHER, OUR DATA INDICATE THAT VPA MAY AMELIORATE THE OUTCOME OF PNA-BASED THERAPEUTIC PROTOCOLS AND PROVIDE A POTENTIAL ALTERNATIVE TREATMENT IN BOTH THE RELAPSED AND FRONT-LINE RESISTANT PATIENTS AND IN PATIENTS WITH HIGH RISK FEATURES. 2009 3 2782 29 EZH2 INHIBITION CONFERS PIK3CA-DRIVEN LUNG TUMORS ENHANCED SENSITIVITY TO PI3K INHIBITION. MEMBERS OF THE PI3K SIGNALING PATHWAY, ESPECIALLY PIK3CA, THE GENE ENCODING THE CATALYTIC SUBUNIT OF THE PI3K COMPLEX, ARE HIGHLY MUTATED AND AMPLIFIED IN VARIOUS CANCER TYPES, INCLUDING NON-SMALL CELL LUNG CANCER. ALTHOUGH PI3K INHIBITORS HAVE BEEN USED IN CLINICS FOR FOLLICULAR LYMPHOMA AND CHRONIC LYMPHOCYTIC LEUKEMIA, NO AGENTS TARGETING PI3K ABERRATIONS IN LUNG CANCER HAVE BEEN APPROVED BY THE FDA SO FAR. IN THIS STUDY, WE OBSERVED THAT PIK3CA-E545K, THE MOST COMMON MUTATION IN LUNG CANCER, HARBORED A MODEST INDUCTION OF STEM-LIKE PROPERTIES IN LUNG EPITHELIAL CELLS, AND DROVE DEVELOPMENT OF ADENOCARCINOMA AUTOCHTHONOUSLY WHEN PAIRED WITH P53 LOSS IN A MURINE MOUSE MODEL. WE ALSO FOUND THAT PIK3CA-MUTANT OF AMPLIFIED LUNG CANCER CELLS WERE SENSITIVE TO EZH2 INHIBITION. EZH2 INHIBITION SYNERGIZED WITH PI3K INHIBITION IN HUMAN CANCER CELLS IN VITRO AND WORKED TOGETHER EFFICIENTLY IN VIVO. MECHANISTICALLY, EZH2 INHIBITION COOPERATED WITH PI3K INHIBITION TO PRODUCE A MORE POTENT SUPPRESSION OF PHOSPHO-AKT DOWNSTREAM OF PI3K. THIS STUDY SUGGESTS A PROMISING COMBINATION THERAPY TO COMBAT LUNG CANCERS WITH PIK3CA MUTATION OR AMPLIFICATION. BOTH COPANLISIB, THE PI3K INHIBITOR, AND TAZEMETOSTAT, THE EZH2 INHIBITOR, ARE FDA-APPROVED, WHICH SHOULD ENHANCE THE CLINICAL TRANSLATION OF THIS WORK. 2022 4 1287 41 DECITABINE-INDUCED APOPTOSIS IS DERIVED BY PUMA AND NOXA INDUCTION IN CHRONIC MYELOID LEUKEMIA CELL LINE AS WELL AS IN PBL AND IS POTENTIATED BY SAHA. RESTORATION OF CELLULAR APOPTOTIC PATHWAYS PLAYS A CRUCIAL ROLE IN CANCER THERAPY STRATEGIES. IN A BROAD SPECTRUM OF ANTICANCER DRUGS, EPIGENETIC EFFECTORS ARE IN THE CENTER OF INTEREST MOSTLY BECAUSE OF POTENTIAL REVERSIBILITY OF THEIR ACTION. METHYLATION STATUS OF THE CELLS IS INFLUENCED BY METHYLTRANSFERASE INHIBITOR 2-DEOXY-5'-AZACYTIDINE (DECITABINE, DAC), BUT HIGHER CONCENTRATIONS OF THIS AGENT CAUSE A DNA-DAMAGE. IN OUR STUDY, TUMOR SUPRESSOR P53-APOPTOTIC PATHWAY WAS ACTIVATED IN DECITABINE-INDUCED CELL DEATH. EXPRESSION OF P53-INDUCIBLE BH3-ONLY APOPTOTIC PROTEINS PUMA AND NOXA WAS ELEVATED AND LARGE ACTIVATION OF EXECUTIVE CASPASES WAS OBSERVED. THE EXTENT OF ACETYLATION IN THE CELL IS AFFECTED BY HISTONEDEACETYLASE INHIBITOR SUBEROYLANILIDE HYDROXAMIC ACID (SAHA). COMBINATION OF SAHA WITH DECITABINE BROUGHT SYNERGISTIC EFFECT ON APOPTOSIS TRIGGERING IN CML-T1 CELL LINE, BUT APOPTOSIS AS WELL AS NECROSIS OCCURRED ALSO IN NORMAL PERIPHERAL BLOOD LYMPHOCYTES. THEREFORE, PROMISING POTENTIAL OF SUCH COMBINED THERAPY CALLS FOR MORE DETAILED INVESTIGATION OF UNWANTED EFFECTS IN NORMAL CELLS. 2011 5 171 42 ABROGATION OF HISTONE DEACETYLASES (HDACS) DECREASES SURVIVAL OF CHRONIC MYELOID LEUKEMIA CELLS: NEW INSIGHT INTO ATTENUATING EFFECTS OF THE PI3K/C-MYC AXIS ON PANOBINOSTAT CYTOTOXICITY. ALTHOUGH THE IDENTIFICATION OF TYROSINE KINASE INHIBITORS (TKIS) HAS CHANGED THE TREATMENT PARADIGM OF MANY CANCER TYPES INCLUDING CHRONIC MYELOID LEUKEMIA (CML), STILL ADJUSTMENT OF NEOPLASTIC CELLS TO CYTOTOXIC EFFECTS OF ANTICANCER DRUGS IS A SERIOUS CHALLENGE. IN THE AREA OF DRUG RESISTANCE, EPIGENETIC ALTERATIONS ARE AT THE CENTER OF ATTENTION AND THE PRESENT STUDY AIMED TO EVALUATE WHETHER BLOCKAGE OF EPIGENETICS MECHANISMS USING A PAN-HISTONE DEACETYLASE (HDAC) INHIBITOR INDUCES CELL DEATH IN CML-DERIVED K562 CELLS. WE FOUND THAT THE ABROGATION OF HDACS USING PANOBINOSTAT RESULTED IN A REDUCTION IN SURVIVAL OF THE K562 CELL LINE THROUGH P27-MEDIATED CELL CYCLE ARREST. NOTEWORTHY, THE RESULTS OF THE SYNERGISTIC EXPERIMENTS REVEALED THAT HDAC SUPPRESSION COULD BE RECRUITED AS A WAY TO POTENTIATE CYTOTOXICITY OF IMATINIB AND TO ENHANCE THE THERAPEUTIC EFFICACY OF CML. HERE, WE PROPOSED FOR THE FIRST TIME THAT THE INHIBITORY EFFECT OF PANOBINOSTAT WAS OVERSHADOWED, AT LEAST PARTIALLY, THROUGH THE ABERRANT ACTIVATION OF THE PHOSPHOINOSITIDE 3-KINASE (PI3K)/C-MYC AXIS. MEANWHILE, WE FOUND THAT UPON BLOCKAGE OF AUTOPHAGY AND THE PROTEASOME PATHWAY, AS THE MAIN AXIS INVOLVED IN THE ACTIVATION OF AUTOPHAGY, THE ANTI-LEUKEMIC PROPERTY OF THE HDAC INHIBITOR WAS POTENTIATED. TAKEN TOGETHER, OUR STUDY SUGGESTS THE BENEFICIAL APPLICATION OF HDAC INHIBITION IN THE TREATMENT STRATEGIES OF CML; HOWEVER, FURTHER IN VIVO STUDIES ARE NEEDED TO DETERMINE THE EFFICACY OF THIS INHIBITOR, EITHER AS A SINGLE AGENT OR IN COMBINATION WITH SMALL MOLECULE INHIBITORS OF PI3K AND/OR C-MYC IN THIS MALIGNANCY. 2021 6 3217 30 HEDGEHOG/GLI AND PI3K SIGNALING IN THE INITIATION AND MAINTENANCE OF CHRONIC LYMPHOCYTIC LEUKEMIA. THE INITIATION AND MAINTENANCE OF A MALIGNANT PHENOTYPE REQUIRES COMPLEX AND SYNERGISTIC INTERACTIONS OF MULTIPLE ONCOGENIC SIGNALS. THE HEDGEHOG (HH)/GLI PATHWAY HAS BEEN IMPLICATED IN A VARIETY OF CANCER ENTITIES AND TARGETED PATHWAY INHIBITION IS OF THERAPEUTIC RELEVANCE. SIGNAL CROSS-TALK WITH OTHER CANCER PATHWAYS INCLUDING PI3K/AKT MODULATES HH/GLI SIGNAL STRENGTH AND ITS ONCOGENICITY. IN THIS STUDY, WE ADDRESSED THE ROLE OF HH/GLI AND ITS PUTATIVE INTERACTION WITH THE PI3K/AKT CASCADE IN THE INITIATION AND MAINTENANCE OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). USING TRANSGENIC MOUSE MODELS, WE SHOW THAT B-CELL-SPECIFIC CONSTITUTIVE ACTIVATION OF HH/GLI SIGNALING EITHER AT THE LEVEL OF THE HH EFFECTOR AND DRUG TARGET SMOOTHENED OR AT THE LEVEL OF THE GLI TRANSCRIPTION FACTORS DOES NOT SUFFICE TO INITIATE A CLL-LIKE PHENOTYPE CHARACTERIZED BY THE ACCUMULATION OF CD5(+) B CELLS IN THE LYMPHATIC SYSTEM AND PERIPHERAL BLOOD. FURTHERMORE, HH/GLI ACTIVATION IN PTEN-DEFICIENT B CELLS WITH ACTIVATED PI3K/AKT SIGNALING FAILED TO ENHANCE THE EXPANSION OF LEUKEMIC CD5(+) B CELLS, SUGGESTING THAT GENETIC OR EPIGENETIC ALTERATIONS LEADING TO ABERRANT HH/GLI SIGNALING IN B CELLS DO NOT SUFFICE TO ELICIT A CLL-LIKE PHENOTYPE IN MICE. BY CONTRAST, WE IDENTIFY A CRITICAL ROLE OF GLI AND PI3K SIGNALING FOR THE SURVIVAL OF HUMAN PRIMARY CLL CELLS. WE SHOW THAT COMBINED TARGETING OF GLI AND PI3K/AKT/MTOR SIGNALING CAN HAVE A SYNERGISTIC THERAPEUTIC EFFECT IN CELLS FROM A SUBGROUP OF CLL PATIENTS, THEREBY PROVIDING A BASIS FOR THE EVALUATION OF FUTURE COMBINATION THERAPIES TARGETING HH/GLI AND PI3K SIGNALING IN THIS COMMON HEMATOPOIETIC MALIGNANCY. 2015 7 306 30 AKT TARGETING AS A STRATEGY TO BOOST CHEMOTHERAPY EFFICACY IN NON-SMALL CELL LUNG CANCER THROUGH METABOLISM SUPPRESSION. METABOLIC REPROGRAMMING IS A HALLMARK OF CANCER DEVELOPMENT, MEDIATED BY GENETIC AND EPIGENETIC ALTERATIONS THAT MAY BE PHARMACOLOGICALLY TARGETED. AMONG ONCOGENES, THE KINASE AKT IS COMMONLY OVEREXPRESSED IN TUMORS AND FAVORS GLYCOLYSIS, PROVIDING A RATIONALE FOR USING AKT INHIBITORS. HERE, WE ADDRESSED THE QUESTION OF WHETHER AND HOW INHIBITING AKT ACTIVITY COULD IMPROVE THERAPY OF NON-SMALL CELL LUNG CANCER (NSCLC) THAT REPRESENTS MORE THAN 80% OF ALL LUNG CANCER CASES. FIRST, WE DEMONSTRATED THAT AKT INHIBITORS INTERACTED SYNERGISTICALLY WITH MICROTUBULE-TARGETING AGENTS (MTAS) AND SPECIFICALLY IN CANCER CELL LINES, INCLUDING THOSE RESISTANT TO CHEMOTHERAPY AGENTS AND ANTI-EGFR TARGETED THERAPIES. IN VIVO, WE FURTHER REVEALED THAT THE CHRONIC ADMINISTRATION OF LOW-DOSES OF PACLITAXEL - I.E. METRONOMIC SCHEDULING - AND THE ANTI-AKT PERIFOSINE WAS THE MOST EFFICIENT AND THE BEST TOLERATED TREATMENT AGAINST NSCLC. REGARDING DRUG MECHANISM OF ACTION, PERIFOSINE POTENTIATED THE PRO-APOPTOTIC EFFECTS OF PACLITAXEL, INDEPENDENTLY OF CELL CYCLE ARREST, AND COMBINING PACLITAXEL/PERIFOSINE RESULTED IN A SUSTAINED SUPPRESSION OF GLYCOLYTIC AND MITOCHONDRIAL METABOLISM. THIS STUDY POINTS OUT THAT TARGETING CANCER CELL BIOENERGETICS MAY REPRESENT A NOVEL THERAPEUTIC AVENUE IN NSCLC, AND PROVIDES A STRONG FOUNDATION FOR FUTURE CLINICAL TRIALS OF METRONOMIC MTAS COMBINED WITH AKT INHIBITORS. 2017 8 4741 43 NOVEL HDAC INHIBITOR MAKV-8 AND IMATINIB SYNERGISTICALLY KILL CHRONIC MYELOID LEUKEMIA CELLS VIA INHIBITION OF BCR-ABL/MYC-SIGNALING: EFFECT ON IMATINIB RESISTANCE AND STEM CELLS. BACKGROUND: CHRONIC MYELOID LEUKEMIA (CML) PATHOGENESIS IS MAINLY DRIVEN BY THE ONCOGENIC BREAKPOINT CLUSTER REGION-ABELSON MURINE LEUKEMIA VIRAL ONCOGENE HOMOLOG 1 (BCR-ABL) FUSION PROTEIN. SINCE BCR-ABL DISPLAYS ABNORMAL CONSTITUTIVE TYROSINE KINASE ACTIVITY, THERAPIES USING TYROSINE KINASE INHIBITORS (TKIS) SUCH AS IMATINIB REPRESENT A MAJOR BREAKTHROUGH FOR THE OUTCOME OF CML PATIENTS. NEVERTHELESS, THE DEVELOPMENT OF TKI RESISTANCE AND THE PERSISTENCE OF LEUKEMIA STEM CELLS (LSCS) REMAIN BARRIERS TO CURE THE DISEASE, JUSTIFYING THE DEVELOPMENT OF NOVEL THERAPEUTIC APPROACHES. SINCE THE ACTIVITY OF HISTONE DEACETYLASE (HDAC) IS DEREGULATED IN NUMEROUS CANCERS INCLUDING CML, PAN-HDAC INHIBITORS MAY REPRESENT PROMISING THERAPEUTIC REGIMENS FOR THE TREATMENT OF CML CELLS IN COMBINATION WITH TKI. RESULTS: WE ASSESSED THE ANTI-LEUKEMIC ACTIVITY OF A NOVEL HYDROXAMATE-BASED PAN-HDAC INHIBITOR MAKV-8, WHICH COMPLIED WITH THE LIPINSKI'S "RULE OF FIVE," IN VARIOUS CML CELLS ALONE OR IN COMBINATION WITH IMATINIB. WE VALIDATED THE IN VITRO HDAC-INHIBITORY POTENTIAL OF MAKV-8 AND DEMONSTRATED EFFICIENT BINDING TO THE LIGAND-BINDING POCKET OF HDAC ISOENZYMES. IN CELLULO, MAKV-8 SIGNIFICANTLY INDUCED TARGET PROTEIN ACETYLATION, DISPLAYED CYTOSTATIC AND CYTOTOXIC PROPERTIES, AND TRIGGERED CONCOMITANT ER STRESS/PROTECTIVE AUTOPHAGY LEADING TO CANONICAL CASPASE-DEPENDENT APOPTOSIS. CONSIDERING THE SPECIFIC UPREGULATION OF SELECTED HDACS IN LSCS FROM CML PATIENTS, WE INVESTIGATED THE DIFFERENTIAL TOXICITY OF A CO-TREATMENT WITH MAKV-8 AND IMATINIB IN CML VERSUS HEALTHY CELLS. WE ALSO SHOWED THAT BECLIN-1 KNOCKDOWN PREVENTED MAKV-8-IMATINIB COMBINATION-INDUCED APOPTOSIS. MOREOVER, MAKV-8 AND IMATINIB CO-TREATMENT SYNERGISTICALLY REDUCED BCR-ABL-RELATED SIGNALING PATHWAYS INVOLVED IN CML CELL GROWTH AND SURVIVAL. SINCE OUR RESULTS SHOWED THAT LSCS FROM CML PATIENTS OVEREXPRESSED C-MYC, IMPORTANTLY MAKV-8-IMATINIB CO-TREATMENT REDUCED C-MYC LEVELS AND THE LSC POPULATION. IN VIVO, TUMOR GROWTH OF XENOGRAFTED K-562 CELLS IN ZEBRAFISH WAS COMPLETELY ABROGATED UPON COMBINED TREATMENT WITH MAKV-8 AND IMATINIB. CONCLUSIONS: COLLECTIVELY, THE PRESENT FINDINGS SHOW THAT COMBINATIONS HDAC INHIBITOR-IMATINIB ARE LIKELY TO OVERCOME DRUG RESISTANCE IN CML PATHOLOGY. 2020 9 5691 38 SILENCING OF HDAC6 AS A THERAPEUTIC TARGET IN CHRONIC LYMPHOCYTIC LEUKEMIA. ALTHOUGH THE TREATMENT PARADIGM FOR CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS RAPIDLY CHANGING, THE DISEASE REMAINS INCURABLE, EXCEPT WITH ALLOGENEIC BONE MARROW TRANSPLANTATION, AND RESISTANCE, RELAPSED DISEASE, AND PARTIAL RESPONSES PERSIST AS SIGNIFICANT CHALLENGES. RECENT STUDIES HAVE UNCOVERED ROLES FOR EPIGENETIC MODIFICATION IN THE REGULATION OF MECHANISMS CONTRIBUTING TO MALIGNANT PROGRESSION OF CLL B CELLS. HOWEVER, THE EXTENT TO WHICH EPIGENETIC MODIFIERS CAN BE TARGETED FOR THERAPEUTIC BENEFIT IN CLL PATIENTS REMAINS POORLY EXPLORED. WE REPORT FOR THE FIRST TIME THAT EXPRESSION OF EPIGENETIC MODIFIER HISTONE DEACETYLASE 6 (HDAC6) IS UPREGULATED IN CLL PATIENT SAMPLES, CELL LINES, AND EUTCL1 TRANSGENIC MOUSE MODELS COMPARED WITH HDAC6 IN NORMAL CONTROLS. GENETIC SILENCING OF HDAC6 CONFERRED SURVIVAL BENEFIT IN EUTCL1 MICE. ADMINISTRATION OF ISOFORM-SPECIFIC HDAC6 INHIBITOR ACY738 IN THE EUTCL1 AGING AND ADOPTIVE TRANSFER MODELS DETERRED PROLIFERATION OF CLL B CELLS, DELAYED DISEASE ONSET VIA DISRUPTION OF B-CELL RECEPTOR SIGNALING, AND SENSITIZED CLL B CELLS TO APOPTOSIS. FURTHERMORE, COADMINISTRATION OF ACY738 AND IBRUTINIB DISPLAYED SYNERGISTIC CELL KILL AGAINST CLL CELL LINES AND IMPROVED OVERALL SURVIVAL COMPARED WITH EITHER SINGLE AGENT IN VIVO. THESE RESULTS DEMONSTRATE FOR THE FIRST TIME THE THERAPEUTIC EFFICACY OF SELECTIVE HDAC6 INHIBITION IN PRECLINICAL CLL MODELS AND SUGGEST A RATIONALE FOR THE CLINICAL DEVELOPMENT OF HDAC6 INHIBITORS FOR CLL TREATMENT, EITHER ALONE OR IN COMBINATION WITH BRUTON TYROSINE KINASE INHIBITION. 2018 10 5917 36 TARGETING BCL-2 IN B-CELL MALIGNANCIES AND OVERCOMING THERAPEUTIC RESISTANCE. DEFECTS IN APOPTOSIS CAN PROMOTE TUMORIGENESIS AND IMPAIR RESPONSES OF MALIGNANT B CELLS TO CHEMOTHERAPEUTICS. MEMBERS OF THE B-CELL LEUKEMIA/LYMPHOMA-2 (BCL-2) FAMILY OF PROTEINS ARE KEY REGULATORS OF THE INTRINSIC, MITOCHONDRIAL APOPTOTIC PATHWAY. OVEREXPRESSION OF ANTIAPOPTOTIC BCL-2 FAMILY PROTEINS IS ASSOCIATED WITH TREATMENT RESISTANCE AND POOR PROGNOSIS. THUS, INHIBITION OF BCL-2 FAMILY PROTEINS IS A RATIONAL THERAPEUTIC OPTION FOR MALIGNANCIES THAT ARE DEPENDENT ON ANTIAPOPTOTIC BCL-2 FAMILY PROTEINS. VENETOCLAX (ABT-199, GDC-0199) IS A HIGHLY SELECTIVE BCL-2 INHIBITOR THAT REPRESENTS THE FIRST APPROVED AGENT OF THIS CLASS AND IS CURRENTLY WIDELY USED IN THE TREATMENT OF CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) AS WELL AS ACUTE MYELOID LEUKEMIA (AML). DESPITE IMPRESSIVE CLINICAL ACTIVITY, VENETOCLAX MONOTHERAPY FOR A PROLONGED DURATION CAN LEAD TO DRUG RESISTANCE OR LOSS OF DEPENDENCE ON THE TARGETED PROTEIN. IN THIS REVIEW, WE PROVIDE AN OVERVIEW OF THE MECHANISM OF ACTION OF BCL-2 INHIBITION AND THE ROLE OF THIS APPROACH IN THE CURRENT TREATMENT PARADIGM OF B-CELL MALIGNANCIES. WE SUMMARIZE THE DRIVERS OF DE NOVO AND ACQUIRED RESISTANCE TO VENETOCLAX THAT ARE CLOSELY ASSOCIATED WITH COMPLEX CLONAL SHIFTS, INTERPLAY OF EXPRESSION AND INTERACTIONS OF BCL-2 FAMILY MEMBERS, TRANSCRIPTIONAL REGULATORS, AND METABOLIC MODULATORS. WE ALSO EXAMINE HOW TUMORS INITIALLY RESISTANT TO VENETOCLAX BECOME RESPONSIVE TO IT FOLLOWING PRIOR THERAPIES. HERE, WE SUMMARIZE PRECLINICAL DATA PROVIDING A RATIONALE FOR EFFICACIOUS COMBINATION STRATEGIES OF VENETOCLAX TO OVERCOME THERAPEUTIC RESISTANCE BY A TARGETED APPROACH DIRECTED AGAINST ALTERNATIVE ANTIAPOPTOTIC BCL-2 FAMILY PROTEINS (MCL-1, BCL-XL), COMPENSATORY PROSURVIVAL PATHWAYS, EPIGENETIC MODIFIERS, AND DYSREGULATED CELLULAR METABOLISM/ENERGETICS FOR DURABLE CLINICAL REMISSIONS. 2020 11 2189 29 EPIGENETIC MECHANISMS UNDERLYING THE THERAPEUTIC EFFECTS OF HDAC INHIBITORS IN CHRONIC MYELOID LEUKEMIA. CHRONIC MYELOID LEUKEMIA (CML) IS A HEMATOLOGICAL DISORDER CAUSED BY THE ONCOGENIC BCR-ABL FUSION PROTEIN IN MORE THAN 90% OF PATIENTS. DESPITE THE STRIKING IMPROVEMENTS IN THE MANAGEMENT OF CML PATIENTS SINCE THE INTRODUCTION OF TYROSINE KINASE INHIBITORS (TKIS), THE APPEARANCE OF TKI RESISTANCE AND SIDE EFFECTS LEAD TO TREATMENT FAILURE, JUSTIFYING THE NEED OF NOVEL THERAPEUTIC APPROACHES. HISTONE DEACETYLASE INHIBITORS (HDACIS), ABLE TO MODULATE GENE EXPRESSION PATTERNS AND IMPORTANT CELLULAR SIGNALING PATHWAYS THROUGH THE REGULATION OF THE ACETYLATION STATUS OF BOTH HISTONE AND NON-HISTONE PROTEIN TARGETS, HAVE BEEN REPORTED TO DISPLAY PROMISING ANTI-LEUKEMIC PROPERTIES ALONE OR IN COMBINATION WITH TKIS. THIS REVIEW SUMMARIZES PRE-CLINICAL AND CLINICAL STUDIES THAT INVESTIGATED THE MECHANISMS UNDERLYING THE ANTICANCER POTENTIAL OF HDACIS AND DISCUSSES THE RATIONALE FOR A COMBINATION OF HDACIS WITH TKIS AS A THERAPEUTIC OPTION IN CML. 2020 12 926 35 CHRONIC INFLAMMATION PATHWAY NF-KAPPAB COOPERATES WITH EPIGENETIC REPROGRAMMING TO DRIVE THE MALIGNANT PROGRESSION OF GLIOBLASTOMA. WITHOUT AN EFFECTIVE STRATEGY FOR TARGETED THERAPY, GLIOBLASTOMA IS STILL INCURABLE WITH A MEDIAN SURVIVAL OF ONLY 15 MONTHS. BOTH CHRONIC INFLAMMATION AND EPIGENETIC REPROGRAMMING ARE HALLMARKS OF CANCER. HOWEVER, THE MECHANISMS AND CONSEQUENCES OF THEIR COOPERATION IN GLIOBLASTOMA REMAIN UNKNOWN. HERE, WE DISCOVER THAT CHRONIC INFLAMMATION GOVERNS H3K27ME3 REPROGRAMMING IN GLIOBLASTOMA THROUGH THE CANONICAL NF-KAPPAB PATHWAY TO TARGET EZH2. BEING A CRUCIAL MEDIATOR OF CHRONIC INFLAMMATION, THE CANONICAL NF-KAPPAB SIGNALLING SPECIFICALLY DIRECTS THE EXPRESSION AND REDISTRIBUTION OF H3K27ME3 BUT NOT H3K4ME3, H3K9ME3 AND H3K36ME3. USING RNA-SEQ SCREENING TO FOCUS ON GENES ENCODING METHYLTRANSFERASES AND DEMETHYLASES OF HISTONE, WE IDENTIFY EZH2 AS A KEY METHYLTRANSFERASE TO CONTROL INFLAMMATION-TRIGGERED EPIGENETIC REPROGRAMMING IN GLIOMAGENESIS. MECHANISTICALLY, NF-KAPPAB SELECTIVELY DRIVES THE EXPRESSION OF EZH2 BY ACTIVATING ITS TRANSCRIPTION, CONSEQUENTLY RESULTING IN A GLOBAL CHANGE IN H3K27ME3 EXPRESSION AND DISTRIBUTION. FURTHERMORE, WE FIND THAT CO-ACTIVATION OF NF-KAPPAB AND EZH2 CONFERS THE POOREST CLINICAL OUTCOME, AND THAT THE RISK FOR GLIOBLASTOMA CAN BE ACCURATELY MOLECULARLY STRATIFIED BY NF-KAPPAB AND EZH2. IT IS NOTABLE THAT NF-KAPPAB CAN POTENTIALLY COOPERATE WITH EZH2 IN MORE THAN ONE WAY, AND MOST IMPORTANTLY, WE DEMONSTRATE A SYNERGISTIC EFFECT OF CANCER CELLS INDUCED BY COMBINATORY INHIBITION OF NF-KAPPAB AND EZH2, WHICH BOTH ARE FREQUENTLY OVER-ACTIVATED IN GLIOBLASTOMA. IN SUMMARY, WE UNCOVER A FUNCTIONAL COOPERATION BETWEEN CHRONIC INFLAMMATION AND EPIGENETIC REPROGRAMMING IN GLIOBLASTOMA, COMBINED TARGETING OF WHICH BY INHIBITORS GUARANTEED IN SAFETY AND AVAILABILITY FURNISHES A POTENT STRATEGY FOR EFFECTIVE TREATMENT OF THIS FATAL DISEASE. 2022 13 1036 34 CLASS I HISTONE DEACETYLASES REGULATE P53/NF-KAPPAB CROSSTALK IN CANCER CELLS. THE TRANSCRIPTION FACTORS NF-KAPPAB AND P53 AS WELL AS THEIR CROSSTALK DETERMINE THE FATE OF TUMOR CELLS UPON THERAPEUTIC INTERVENTIONS. REPLICATIVE STRESS AND CYTOKINES PROMOTE SIGNALING CASCADES THAT LEAD TO THE CO-REGULATION OF P53 AND NF-KAPPAB. CONSEQUENTLY, NUCLEAR P53/NF-KAPPAB SIGNALING COMPLEXES ACTIVATE NF-KAPPAB-DEPENDENT SURVIVAL GENES. THE 18 HISTONE DEACETYLASES (HDACS) ARE EPIGENETIC MODULATORS THAT FALL INTO FOUR CLASSES (I-IV). INHIBITORS OF HISTONE DEACETYLASES (HDACI) BECOME INCREASINGLY APPRECIATED AS ANTI-CANCER AGENTS. BASED ON THEIR EFFECTS ON P53 AND NF-KAPPAB, WE ADDRESSED WHETHER CLINICALLY RELEVANT HDACI AFFECT THE NF-KAPPAB/P53 CROSSTALK. THE CHEMOTHERAPEUTICS HYDROXYUREA, ETOPOSIDE, AND FLUDARABINE HALT CELL CYCLE PROGRESSION, INDUCE DNA DAMAGE, AND LEAD TO DNA FRAGMENTATION. THESE AGENTS CO-INDUCE P53 AND NF-KAPPAB-DEPENDENT GENE EXPRESSION IN CELL LINES FROM BREAST AND COLON CANCER AND IN PRIMARY CHRONIC LYMPHATIC LEUKEMIA (CLL) CELLS. USING SPECIFIC HDACI, WE FIND THAT THE CLASS I SUBGROUP OF HDACS, BUT NOT THE CLASS IIB DEACETYLASE HDAC6, ARE REQUIRED FOR THE HYDROXYUREA-INDUCED CROSSTALK BETWEEN P53 AND NF-KAPPAB. HDACI DECREASE THE BASAL AND STRESS-INDUCED EXPRESSION OF P53 AND BLOCK NF-KAPPAB-REGULATED GENE EXPRESSION. WE FURTHER SHOW THAT CLASS I HDACI INDUCE SENESCENCE IN PANCREATIC CANCER CELLS WITH MUTANT P53. 2017 14 3195 37 HDAC INHIBITORS AUGMENTED CELL MIGRATION AND METASTASIS THROUGH INDUCTION OF PKCS LEADING TO IDENTIFICATION OF LOW TOXICITY MODALITIES FOR COMBINATION CANCER THERAPY. PURPOSE: HISTONE DEACETYLASE INHIBITORS (HDACI) ARE ACTIVELY EXPLORED AS NEW-GENERATION EPIGENETIC DRUGS BUT HAVE LOW EFFICACY IN CANCER MONOTHERAPY. TO REVEAL NEW MECHANISM FOR COMBINATION THERAPY, WE SHOW THAT HDACI INDUCE CELL DEATH BUT SIMULTANEOUSLY ACTIVATE TUMOR-PROGRESSIVE GENES TO RUIN THERAPEUTIC EFFICACY. COMBINED TREATMENTS TO TARGET TUMORIGENESIS AND HDACI-ACTIVATED METASTASIS WITH LOW TOXIC MODALITIES COULD DEVELOP NEW STRATEGIES FOR LONG-TERM CANCER THERAPY. EXPERIMENTAL DESIGN: BECAUSE METASTASIS IS THE MAJOR CAUSE OF CANCER MORTALITY, WE MEASURED CELL MIGRATION ACTIVITY AND PROFILED METASTASIS-RELATED GENE EXPRESSIONS IN HDACI-TREATED CANCER CELLS. WE DEVELOPED LOW TOXIC COMBINATION MODALITIES TARGETING TUMORIGENESIS AND HDACI-ACTIVATED METASTASIS FOR PRECLINICAL THERAPIES IN MICE. RESULTS: WE SHOWED THAT CELL MIGRATION ACTIVITY WAS DRAMATICALLY AND DOSE DEPENDENTLY ENHANCED BY VARIOUS CLASSES OF HDACI TREATMENTS IN 13 OF 30 EXAMINED HUMAN BREAST, GASTRIC, LIVER, AND LUNG CANCER CELL LINES. TUMOR METASTASIS WAS ALSO ENHANCED IN HDACI-TREATED MICE. HDACI TREATMENTS ACTIVATED MULTIPLE PKCS AND DOWNSTREAM SUBSTRATES ALONG WITH UPREGULATED PROAPOPTOTIC P21. FOR TARGETING TUMORIGENESIS AND METASTASIS WITH IMMEDIATE CLINICAL IMPACT, WE SHOWED THAT NEW MODALITIES OF HDACI COMBINED DRUGS WITH PKC INHIBITORY AGENT, CURCUMIN OR TAMOXIFEN, NOT ONLY SUPPRESSED HDACI-ACTIVATED TUMOR PROGRESSIVE PROTEINS AND CELL MIGRATION IN VITRO BUT ALSO INHIBITED TUMOR GROWTH AND METASTASIS IN VIVO. CONCLUSION: TREATMENTS OF DIFFERENT STRUCTURAL CLASSES OF HDACI SIMULTANEOUSLY INDUCED CELL DEATH AND PROMOTED CELL MIGRATION AND METASTASIS IN MULTIPLE CANCER CELL TYPES. SUPPRESSION OF HDACI-INDUCED PKCS LEADS TO DEVELOPMENT OF LOW TOXIC AND LONG-TERM THERAPEUTIC STRATEGIES TO POTENTIALLY TREAT CANCER AS A CHRONIC DISEASE. 2012 15 5475 33 RESTORING MLL REACTIVATES LATENT TUMOR SUPPRESSION-MEDIATED VULNERABILITY TO PROTEASOME INHIBITORS. MLL UNDERGOES MULTIPLE DISTINCT CHROMOSOMAL TRANSLOCATIONS TO YIELD AGGRESSIVE LEUKEMIA WITH DISMAL OUTCOMES. BESIDES THEIR WELL-ESTABLISHED ROLE IN LEUKEMOGENESIS, MLL FUSIONS ALSO POSSESS LATENT TUMOR-SUPPRESSIVE ACTIVITY, WHICH CAN BE EXPLOITED AS EFFECTIVE CANCER TREATMENT STRATEGIES USING PHARMACOLOGICAL MEANS SUCH AS PROTEASOME INHIBITORS (PIS). HERE, USING MLL-REARRANGED XENOGRAFTS AND MLL LEUKEMIC CELLS AS MODELS, WE SHOW THAT WILD-TYPE MLL IS INDISPENSABLE FOR THE LATENT TUMOR-SUPPRESSIVE ACTIVITY OF MLL FUSIONS. MLL DYSFUNCTION, SHOWN AS LOSS OF THE CHROMATIN ACCUMULATION AND SUBSEQUENT DEGRADATION OF MLL, COMPROMISES THE LATENT TUMOR SUPPRESSION OF MLL-AF4 AND IS INSTRUMENTAL FOR THE ACQUIRED PI RESISTANCE. MECHANISTICALLY, MLL DYSFUNCTION IS CAUSED BY CHRONIC PI TREATMENT-INDUCED EPIGENETIC REPROGRAMMING THROUGH THE H2BUB-ASH2L-MLL AXIS AND CAN BE SPECIFICALLY RESTORED BY HISTONE DEACETYLASE (HDAC) INHIBITORS, WHICH INDUCE HISTONE ACETYLATION AND RECRUITS MLL ON CHROMATIN TO PROMOTE CELL CYCLE GENE EXPRESSION. OUR FINDINGS NOT ONLY DEMONSTRATE THE MECHANISM UNDERLYING THE INEVITABLE ACQUISITION OF PI RESISTANCE IN MLL LEUKEMIC CELLS, BUT ALSO ILLUSTRATE THAT PREVENTING THE EMERGENCE OF PI-RESISTANT CELLS CONSTITUTES A NOVEL RATIONALE FOR COMBINATION THERAPY WITH PIS AND HDAC INHIBITORS IN MLL LEUKEMIAS. 2020 16 4839 35 ONCOGENIC ROLE AND TARGET PROPERTIES OF THE LYSINE-SPECIFIC DEMETHYLASE KDM1A IN CHRONIC LYMPHOCYTIC LEUKEMIA. IN CHRONIC LYMPHOCYTIC LEUKEMIA (CLL), EPIGENETIC ALTERATIONS ARE CONSIDERED TO CENTRALLY SHAPE THE TRANSCRIPTIONAL SIGNATURES THAT DRIVE DISEASE EVOLUTION AND UNDERLIE ITS BIOLOGICAL AND CLINICAL SUBSETS. CHARACTERIZATIONS OF EPIGENETIC REGULATORS, PARTICULARLY HISTONE-MODIFYING ENZYMES, ARE VERY RUDIMENTARY IN CLL. IN EFFORTS TO ESTABLISH EFFECTORS OF THE CLL-ASSOCIATED ONCOGENE T-CELL LEUKEMIA 1A (TCL1A), WE IDENTIFIED HERE THE LYSINE-SPECIFIC HISTONE DEMETHYLASE KDM1A TO INTERACT WITH THE TCL1A PROTEIN IN B CELLS IN CONJUNCTION WITH AN INCREASED CATALYTIC ACTIVITY OF KDM1A. WE DEMONSTRATE THAT KDM1A IS UPREGULATED IN MALIGNANT B CELLS. ELEVATED KDM1A AND ASSOCIATED GENE EXPRESSION SIGNATURES CORRELATED WITH AGGRESSIVE DISEASE FEATURES AND ADVERSE CLINICAL OUTCOMES IN A LARGE PROSPECTIVE CLL TRIAL COHORT. GENETIC KDM1A KNOCKDOWN IN EMU-TCL1A MICE REDUCED LEUKEMIC BURDEN AND PROLONGED ANIMAL SURVIVAL, ACCOMPANIED BY UPREGULATED P53 AND PROAPOPTOTIC PATHWAYS. GENETIC KDM1A DEPLETION ALSO AFFECTED MILIEU COMPONENTS (T, STROMAL, AND MONOCYTIC CELLS), RESULTING IN SIGNIFICANT REDUCTIONS IN THEIR CAPACITY TO SUPPORT CLL-CELL SURVIVAL AND PROLIFERATION. INTEGRATED ANALYSES OF DIFFERENTIAL GLOBAL TRANSCRIPTOMES (RNA SEQUENCING) AND H3K4ME3 MARKS (CHROMATIN IMMUNOPRECIPITATION SEQUENCING) IN EMU-TCL1A VS IKDM1AKD;EMU-TCL1A MICE (CONFIRMED IN HUMAN CLL) IMPLICATE KDM1A AS AN ONCOGENIC TRANSCRIPTIONAL REPRESSOR IN CLL WHICH ALTERS HISTONE METHYLATION PATTERNS WITH PRONOUNCED EFFECTS ON DEFINED CELL DEATH AND MOTILITY PATHWAYS. FINALLY, PHARMACOLOGIC KDM1A INHIBITION ALTERED H3K4/9 TARGET METHYLATION AND REVEALED MARKED ANTI-B-CELL LEUKEMIC SYNERGISMS. OVERALL, WE ESTABLISHED THE PATHOGENIC ROLE AND EFFECTOR NETWORKS OF KDM1A IN CLL VIA TUMOR-CELL INTRINSIC MECHANISMS AND ITS IMPACTS IN CELLS OF THE MICROENVIRONMENT. OUR DATA ALSO PROVIDE RATIONALES TO FURTHER INVESTIGATE THERAPEUTIC KDM1A TARGETING IN CLL. 2023 17 590 30 BET BROMODOMAIN PROTEIN INHIBITION REVERSES CHIMERIC ANTIGEN RECEPTOR EXTINCTION AND REINVIGORATES EXHAUSTED T CELLS IN CHRONIC LYMPHOCYTIC LEUKEMIA. CHIMERIC ANTIGEN RECEPTOR (CAR) T CELLS HAVE INDUCED REMARKABLE ANTITUMOR RESPONSES IN B CELL MALIGNANCIES. SOME PATIENTS DO NOT RESPOND BECAUSE OF T CELL DEFICIENCIES THAT HAMPER THE EXPANSION, PERSISTENCE, AND EFFECTOR FUNCTION OF THESE CELLS. WE USED LONGITUDINAL IMMUNE PROFILING TO IDENTIFY PHENOTYPIC AND PHARMACODYNAMIC CHANGES IN CD19-DIRECTED CAR T CELLS IN PATIENTS WITH CHRONIC LYMPHOCYTIC LEUKEMIA (CLL). CAR EXPRESSION MAINTENANCE WAS ALSO INVESTIGATED BECAUSE THIS CAN AFFECT RESPONSE DURABILITY. CAR T CELL FAILURE WAS ACCOMPANIED BY PREEXISTING T CELL-INTRINSIC DEFECTS OR DYSFUNCTION ACQUIRED AFTER INFUSION. IN A SMALL SUBSET OF PATIENTS, CAR SILENCING WAS OBSERVED COINCIDENT WITH LEUKEMIA RELAPSE. USING A SMALL MOLECULE INHIBITOR, WE DEMONSTRATED THAT THE BROMODOMAIN AND EXTRA-TERMINAL (BET) FAMILY OF CHROMATIN ADAPTERS PLAYS A ROLE IN DOWNREGULATING CAR EXPRESSION. BET PROTEIN BLOCKADE ALSO AMELIORATED CAR T CELL EXHAUSTION AS MANIFESTED BY INHIBITORY RECEPTOR REDUCTION, ENHANCED METABOLIC FITNESS, INCREASED PROLIFERATIVE CAPACITY, AND ENRICHED TRANSCRIPTOMIC SIGNATURES OF T CELL REINVIGORATION. BET INHIBITION DECREASED LEVELS OF THE TET2 METHYLCYTOSINE DIOXYGENASE, AND FORCED EXPRESSION OF THE TET2 CATALYTIC DOMAIN ELIMINATED THE POTENCY-ENHANCING EFFECTS OF BET PROTEIN TARGETING IN CAR T CELLS, PROVIDING A MECHANISM LINKING BET PROTEINS AND T CELL DYSFUNCTION. THUS, MODULATING BET EPIGENETIC READERS MAY IMPROVE THE EFFICACY OF CELL-BASED IMMUNOTHERAPIES. 2021 18 3725 31 INHIBITION OF GLYCOGEN SYNTHASE KINASE-3 ACTIVITY LEADS TO EPIGENETIC SILENCING OF NUCLEAR FACTOR KAPPAB TARGET GENES AND INDUCTION OF APOPTOSIS IN CHRONIC LYMPHOCYTIC LEUKEMIA B CELLS. CHRONIC LYMPHOCYTIC LEUKEMIA (CLL) IS COMMONLY DEFINED AS A DISEASE OF FAILED APOPTOSIS OF B CELLS AND REMAINS AN INCURABLE DISEASE. THE MECHANISM OF RESISTANCE TO APOPTOSIS IN CLL IS COMPLEX AND INFLUENCED BY NUMEROUS FACTORS, INCLUDING NUCLEAR FACTOR KAPPAB (NFKAPPAB)-MEDIATED EXPRESSION OF ANTIAPOPTOTIC MOLECULES. RECENT EVIDENCE INDICATES THAT GLYCOGEN SYNTHASE KINASE-3BETA (GSK-3BETA) POSITIVELY REGULATES NFKAPPAB-MEDIATED GENE TRANSCRIPTION AND CELL SURVIVAL. USING MALIGNANT B CELLS COLLECTED FROM PATIENTS WITH CLL, WE FIND THAT BOTH GSK-3BETA AND NFKAPPAB ACCUMULATE IN THE NUCLEUS OF CLL B CELLS, AND PHARMACOLOGIC INHIBITION OF GSK-3 RESULTS IN DECREASED EXPRESSION OF TWO NFKAPPAB TARGET GENES BCL-2 AND XIAP AND A SUBSEQUENT INCREASE IN CLL B-CELL APOPTOSIS EX VIVO. FURTHERMORE, WE OBSERVED THAT INHIBITION OF GSK-3 LEADS TO A DECREASE IN NFKAPPAB-MEDIATED GENE TRANSCRIPTION BUT DOES NOT AFFECT THE NUCLEAR ACCUMULATION OF NFKAPPAB IN CLL B CELLS. LAST, USING CHROMATIN IMMUNOPRECIPITATION, WE SHOW THAT GSK-3 INHIBITION ABROGATES NFKAPPAB BINDING TO ITS TARGET GENE PROMOTERS (XIAP, BCL-2), IN PART THROUGH EPIGENETIC MODIFICATION OF HISTONES. OUR RESULTS ESTABLISH THAT INHIBITION OF GSK-3 ABROGATES NFKAPPAB BINDING TO ITS TARGET GENE PROMOTERS THROUGH AN EPIGENETIC MECHANISM, ENHANCES APOPTOSIS IN CLL B CELLS EX VIVO AND IDENTIFIES GSK-3 AS A POTENTIAL THERAPEUTIC TARGET IN THE TREATMENT OF CLL. 2007 19 6444 39 THERAPEUTIC ASPECTS OF C-MYC SIGNALING IN INFLAMMATORY AND CANCEROUS COLONIC DISEASES. COLONIC INFLAMMATION IS REQUIRED TO HEAL INFECTIONS, WOUNDS, AND MAINTAIN TISSUE HOMEOSTASIS. AS THE SEVENTH HALLMARK OF CANCER, HOWEVER, IT MAY AFFECT ALL PHASES OF TUMOR DEVELOPMENT, INCLUDING TUMOR INITIATION, PROMOTION, INVASION AND METASTATIC DISSEMINATION, AND ALSO EVASION IMMUNE SURVEILLANCE. INFLAMMATION ACTS AS A CELLULAR STRESSOR AND MAY TRIGGER DNA DAMAGE OR GENETIC INSTABILITY, AND, FURTHER, CHRONIC INFLAMMATION CAN PROVOKE GENETIC MUTATIONS AND EPIGENETIC MECHANISMS THAT PROMOTE MALIGNANT CELL TRANSFORMATION. BOTH SPORADICAL AND COLITIS-ASSOCIATED COLORECTAL CARCINOGENESIS ARE MULTI-STEP, COMPLEX PROCESSES ARISING FROM THE UNCONTROLLED PROLIFERATION AND SPREADING OF MALIGNANTLY TRANSFORMED CELL CLONES WITH THE OBVIOUS ABILITY TO EVADE THE HOST'S PROTECTIVE IMMUNITY. IN CELLS UPON DNA DAMAGE SEVERAL PROTO-ONCOGENES, INCLUDING C-MYC ARE ACTIVATED IN PARELELL WITH THE INACTIVATION OF TUMOR SUPPRESSOR GENES. THE TARGET GENES OF THE C-MYC PROTEIN PARTICIPATE IN DIFFERENT CELLULAR FUNCTIONS, INCLUDING CELL CYCLE, SURVIVAL, PROTEIN SYNTHESIS, CELL ADHESION, AND MICRO-RNA EXPRESSION. THE TRANSCRIPTIONAL PROGRAM REGULATED BY C-MYC IS CONTEXT DEPENDENT, THEREFORE THE FINAL CELLULAR RESPONSE TO ELEVATED C-MYC LEVELS MAY RANGE FROM INCREASED PROLIFERATION TO AUGMENTED APOPTOSIS. CONSIDERING PHYSIOLOGICAL INTESTINAL HOMEOSTASIS, C-MYC DISPLAYS A FUNDAMENTAL ROLE IN THE REGULATION OF CELL PROLIFERATION AND CRYPT CELL NUMBER. HOWEVER, C-MYC GENE IS FREQUENTLY DEREGULATED IN INFLAMMATION, AND OVEREXPRESSED IN BOTH SPORADIC AND COLITIS-ASSOCIATED COLON ADENOCARCINOMAS. RECENT RESULTS DEMONSTRATED THAT ENDOGENOUS C-MYC IS ESSENTIAL FOR EFFICIENT INDUCTION OF P53-DEPENDENT APOPTOSIS FOLLOWING DNA DAMAGE, BUT C-MYC FUNCTION IS ALSO INVOLVED IN AND REGULATED BY AUTOPHAGY-RELATED MECHANISMS, WHILE ITS EXPRESSION IS AFFECTED BY DNA-METHYLATION, OR HISTONE ACETYLATION. MOLECULES DIRECTLY TARGETING C-MYC, OR AGENTS ACTING ON OTHER GENES INVOLVED IN THE C-MYC PATHWAY COULD BE SELECTED FOR COMBINED REGIMENTS. HOWEVER, DUE TO ITS CONTEXT-DEPENDENT CELLULAR FUNCTION, IT IS CLINICALLY ESSENTIAL TO CONSIDER WHICH CYTOTOXIC DRUGS ARE USED IN COMBINATION WITH C-MYC TARGETED AGENTS IN VARIOUS TISSUES. INCREASING OUR KNOWLEDGE ABOUT MYC-DEPENDENT PATHWAYS MIGHT PROVIDE DIRECTION TO NOVEL ANTI-INFLAMMATORY AND COLORECTAL CANCER THERAPIES. 2016 20 4386 27 MITOCHONDRIAL STRESS INDUCED BY CONTINUOUS STIMULATION UNDER HYPOXIA RAPIDLY DRIVES T CELL EXHAUSTION. CANCER AND CHRONIC INFECTIONS INDUCE T CELL EXHAUSTION, A HYPOFUNCTIONAL FATE CARRYING DISTINCT EPIGENETIC, TRANSCRIPTOMIC AND METABOLIC CHARACTERISTICS. HOWEVER, DRIVERS OF EXHAUSTION REMAIN POORLY UNDERSTOOD. AS INTRATUMORAL EXHAUSTED T CELLS EXPERIENCE SEVERE HYPOXIA, WE HYPOTHESIZED THAT METABOLIC STRESS ALTERS THEIR RESPONSES TO OTHER SIGNALS, SPECIFICALLY, PERSISTENT ANTIGENIC STIMULATION. IN VITRO, ALTHOUGH CD8(+) T CELLS EXPERIENCING CONTINUOUS STIMULATION OR HYPOXIA ALONE DIFFERENTIATED INTO FUNCTIONAL EFFECTORS, THE COMBINATION RAPIDLY DROVE T CELL DYSFUNCTION CONSISTENT WITH EXHAUSTION. CONTINUOUS STIMULATION PROMOTED BLIMP-1-MEDIATED REPRESSION OF PGC-1ALPHA-DEPENDENT MITOCHONDRIAL REPROGRAMMING, RENDERING CELLS POORLY RESPONSIVE TO HYPOXIA. LOSS OF MITOCHONDRIAL FUNCTION GENERATED INTOLERABLE LEVELS OF REACTIVE OXYGEN SPECIES (ROS), SUFFICIENT TO PROMOTE EXHAUSTED-LIKE STATES, IN PART THROUGH PHOSPHATASE INHIBITION AND THE CONSEQUENT ACTIVITY OF NUCLEAR FACTOR OF ACTIVATED T CELLS. REDUCING T CELL-INTRINSIC ROS AND LOWERING TUMOR HYPOXIA LIMITED T CELL EXHAUSTION, SYNERGIZING WITH IMMUNOTHERAPY. THUS, IMMUNOLOGIC AND METABOLIC SIGNALING ARE INTRINSICALLY LINKED: THROUGH MITIGATION OF METABOLIC STRESS, T CELL DIFFERENTIATION CAN BE ALTERED TO PROMOTE MORE FUNCTIONAL CELLULAR FATES. 2021