Mechanisms Responsible for the Synergistic Antileukemic Interactions Between ATR Inhibition and Cytarabine in Acute Myeloid Leukemia Cells

Overview

Journal Sci Rep

Specialty Science

Date 2017 Feb 9

PMID 28176818

Citations 29

Authors

Jun Ma

Xinyu Li

Yongwei Su

Jianyun Zhao

Daniel A Luedtke

Valeria Epshteyn

Holly Edwards

Guan Wang

Zhihong Wang

Roland Chu

Jeffrey W Taub

Hai Lin

Yue Wang

Yubin Ge

Affiliations

Soon will be listed here.

Abstract

Acute myeloid leukemia (AML) continues to be a challenging disease to treat, thus new treatment strategies are needed. In this study, we investigated the antileukemic effects of ATR inhibition alone or combined with cytarabine in AML cells. Treatment with the ATR-selective inhibitor AZ20 caused proliferation inhibition in AML cell lines and primary patient samples. It partially abolished the G2 cell cycle checkpoint and caused DNA replication stress and damage, accompanied by CDK1-independent apoptosis and downregulation of RRM1 and RRM2. AZ20 synergistically enhanced cytarabine-induced proliferation inhibition and apoptosis, abolished cytarabine-induced S and G2/M cell cycle arrest, and cooperated with cytarabine in inducing DNA replication stress and damage in AML cell lines. These key findings were confirmed with another ATR-selective inhibitor AZD6738. Therefore, the cooperative induction of DNA replication stress and damage by ATR inhibition and cytarabine, and the ability of ATR inhibition to abrogate the G2 cell cycle checkpoint both contributed to the synergistic induction of apoptosis and proliferation inhibition in AML cell lines. Synergistic antileukemic interactions between AZ20 and cytarabine were confirmed in primary AML patient samples. Our findings provide insight into the mechanism of action underlying the synergistic antileukemic activity of ATR inhibition in combination with cytarabine in AML.

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